Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Psychogenic dizziness is defined as recurring or persistent symptoms of balance dysfunction, inconsistent with organic vestibular disease as determined by history, clinical examination and pertinent investigations, and consistent with emotional origin. Of 1,335 patients seen in our dizziness clinic between January 1988 and August 1991, psychogenic dizziness was diagnosed in 180 (13.5%) patients. There were 67 men and 113 women aged from 12 to 77 years (mean age 40.2 years). The characteristics of psychogenic dizziness are: (1) continuous dizziness for long periods of time; (2) younger patients; (3) predominant female; (4) associated symptoms of panic attack, such as headache, breathlessness, nausea, sleep disturbance, paresthesias, anxiety and palpitation; (5) symptoms of aggravation due to stressful life events; (6) normal neurotological bedside examination; (7) hyperventilation reproduced accurately. The electronystagmographic results of 74 patients show normal bithermal caloric responses in 47 patients (63.5%), caloric hyperactivity in 21 patients (28.4%), canal paresis in four patients (5.4%), canal paresis with directional preponderance in two patients (2.7%), large random voluntary eye swings or severe blinking in 35 patients (47.3%), and spontaneous nystagmus (slow phase velocity < 6.5 degrees/s) in four patients (5.4%). There were 31 patients who consulted psychiatrists with diagnoses of anxiety (51.6%), depression (16.1%), insomnia (12.9%), psychosomatic disorder and adjustment disorder. Treatment of patients with psychogenic dizziness must be directed at the underlying anxiety. Psychiatric consultation is necessary.
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PMID:[Psychogenic dizziness]. 848 48

Panic Disorder (PD) is a common anxiety disorder, which has its onset relatively often during adolescence. Twenty-five percent of adult patients with PD have previously suffered from school phobia. In young patients it often represents a form of agoraphobia, although it may be present also in other psychiatric disorders which have their onset in young age. In this report we describe the results of 8 to 15-month citalopram treatment on three young patients with school phobia associated with PD. In our patients, low doses with citalopram were effective as in all patients the severity of school phobia decreased and the panic attacks disappeared. There were few drug-related side-effects as only one patient had mild headache at the beginning of the treatment. Our very preliminary results suggest that citalopram may be effective in school phobia related to PD. However, controlled studies are needed to demonstrate the safety, efficacy and appropriate length of citalopram treatment in childhood PD before it can be widely used in this disorder.
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PMID:Citalopram in the treatment of early-onset panic disorder and school phobia. 885 32

20 patients with vegetative crises (panic attacks) and 20 patients with tension-type headache were treated by Lerivon (tetracyclic antidepressant) administration. The following parameters were investigated: the degree of headache expression according to visual analogous scale, the vegetative crises frequency and depression gravity by means of Spilberg test, the depression intensity by means of Back scale. The areas of different components of contingent negative deviation (CND)-early, late, postimperative negative waves as well as total CND area-were examined either. Both high clinical effects of the preparation and normalisation of psychophysiological parameters were found. 30 mg was the common daily dose for the patients with psychophysiological disorders. The clinical effect was observed quickly (7-10 days). The patients tolerated drug administration well, the sleepiness was the only side-effect. Thus, Lerivon proved highly effective for the treatment of both psychovegetative and algesic disorders and had some advantages as compared with commonly used tricyclic antidepressants.
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PMID:[The treatment with the antidepressant Lerivon of tension headaches and autonomic crises]. 899 39

26 patients with psychovegetative disorders of neurotic origin (vegetative dystonia syndrome, hyperventilation syndrome, panic attacks, headache, insomnia, motivation disorders) were treated. Light therapy (LT) was carried out every day during 2 weeks. The light of 4500-5000 lux was applied during 1 hour (the distance-60 cm). As a result positive effect was revealed in 11 patients while there was no effect in 15 individuals. The positive effect was observed as a decrease of clinical manifestations. Patients with positive treatment results were characterised by short disease duration, weak hypothalamus dysfunction, astheno-depressive disorders prevalence. Negative effect of LT was observed in patients with longer duration of disease, more severe hypothalamic dysfunction together with anxious and astheno-hypochondriac syndrome. The conclusion a made that LT effect is associated with the character and the degree of psychovegetative disorders, but not with presence or absence of hypothalamic dysfunction.
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PMID:[The phototherapy of psycho-autonomic disorders]. 899 41

L-365,260 is a CCKB antagonist which has been shown to completely prevent CCK-4-induced symptoms of panic attack in single-dose (50 mg) placebo-controlled studies in patients with panic disorder. The present report is data from one site (n = 38) in a multicenter study (n = 88) designed to assess the preliminary efficacy and safety of L-365,260 in patients meeting DSM-III-R criteria for panic disorder, with or without agoraphobia. In order to participate, male and female patients were between 18-55 years of age and in good physical health. Following a one-week single-blind placebo lead-in, patients were randomized to 30 mg four times daily of L-365,260 (n = 18; 7 M, 11 F) or placebo (n = 20; 9 M, 11 F) for six weeks. At end of study, none of the efficacy measures, including the frequency of panic attacks, the Physician's Global Improvement Scale, and the Hamilton Rating Scale for Anxiety, were significantly improved over baseline values. L-365,260 was well-tolerated; the most common drug-related adverse events were headache and lightheadedness. Further testing of L-365,260 at higher dosages, or testing of other CCKB antagonists, is required to rule out the usefulness of this novel treatment approach.
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PMID:Pilot study of a CCKB antagonist in patients with panic disorder: preliminary findings. 916 May 64

Panic disorder, a psychiatric disorder characterised by frequent panic attacks, is the most common anxiety disorder, affecting 2 to 6% of the general population. No one line of treatment has been found to be superior, making a risk-benefit assessment of the treatments available useful for treating patients. Choice of treatment depends on a number of issues, including the adverse effect profile, efficacy and the presence of concomitant syndromes. Tricyclic antidepressants (TCAs) are beneficial in the treatment of panic disorder. They have a proven efficacy, are affordable and are conveniently administered. Adverse effects, including jitteriness syndrome, bodyweight gain, anticholinergic effects and orthostatic hypotension are commonly associated with TCAs, but can be managed successfully. Selective serotonin (5-hydroxytryptamine; 5HT) reuptake inhibitors are also potential first line agents and are well tolerated and effective, with a favourable adverse effects profile. There is little risk in overdose or of anticholinergic effects. Adverse effects include sedation, dyspepsia and headache early in treatment, and sexual dysfunction and increased anxiety, but these can be effectively managed with proper dosage escalation and management. Benzodiazepines are an effective treatment, providing short-term relief of panic-related symptoms. Patients respond to treatment quickly, providing rapid relief of symptoms. Adverse effects include ataxia and drowsiness, and cognitive and psycho-motor impairment. There are reservations over their first-line use because of concerns regarding abuse and dependence. Monoamine oxidase inhibitors, because of their adverse effects profile, potential drug interactions, dietary restrictions, gradual onset of effect and overdose risk, are not considered to be first-line agents. They are effective however, and should be considered for patients with refractory disease. Valproic acid (valproate sodium), while not intensively studied, shows potential for use in panic disorder. More studies are needed in this area before the available data can be confirmed. As a supplement to drug therapy, cognitive behavioural therapy is effective. It is well tolerated, and may be beneficial in certain clinical situations. Its main drawback is the time commitment and effort needed to be made by the patient.
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PMID:A risk-benefit assessment of pharmacological treatments for panic disorder. 963 87

Therapy by bright white light was applied to 51 patients. 4 blocks of psychoautonomic syndromes of neurotic nature were analysed: 1) pronounced (14 cases) and mild (12) hypothalamic dysfunction; 2) moderate and pronounced depression (21) and the state without depression (9); 3) headache of different types--37 patients, including 21 ones with chronic headache of effort, combined with migraine--5 cases, or combined with vascular headache--11 patients; 4) paroxysmal disorders (43 individuals: 25--with typical panic attacks, 18--with atypical panic attacks). More pronounced positive effect was found in the group with atypic PA and in the group with slight hypothalamic dysfunction, accompanied by solitary neuro-endocrine symptoms with moderate or severe depression, with chronic headache of strain including a combination with migraine. Neuroendocrine, motivative, psychovegetative, algesic and psychopathologic symptomatology was decreased significantly in all the groups with positive effect together with the improvement of the objective psychophysiologic indices. Intrahemispheric interactions were also improved, exactly: the power of frequency EEG spectrum increased, in general, because of both the increase of the slow rhythms from both sides and the approach of the coefficient of asymmetry to the control. The least effect was observed in the patients with senesto-hypochondric syndrome, with prevalence of anxiety over depression, with rude hypothalamic dysfunction, with vascular headache, with typic PA.
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PMID:[The influence of phototherapy on psycho-autonomic syndromes]. 1035 13

The primary objectives of this multicenter study were to determine the efficacy and safety of moclobemide, a selective reversible inhibitor of monoamino oxidase A, as drug treatment in DSM-III-R panic disorder with and without agoraphobia. In a comparative double-blind, randomized parallel-group design with fixed-flexible dose moclobemide 450 mg per day was compared to clomipramine 150 mg per day, as that drug was considered standard treatment of panic disorder in Europe. 135 patients were randomized and treated for a period of eight weeks. No other treatment was given. By the end of week 8, 49% of the patients treated with moclobemide and 53% of those treated with clomipramine were seen as treatment responders since they were without panic attacks. 78% of the patients in the moclobemide and 88% in the clomipramine group were considered responders according to clinical global impression of change. No significant differences were found between the two treatments at week 8. Adverse events were observed with significantly higher frequency among patients treated with clomipramine, particularly due to anticholinergic side effects. Close to 20% of those treated with moclobemide experienced headache, dizziness, nausea, insomnia, or dry mouth, but other adverse effects were infrequent. In conclusion, moclobemide in a dose of 450 mg per day seems to be a good drug alternative for treatment of panic disorder with and without agoraphobia.
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PMID:The efficacy and safety of moclobemide compared to clomipramine in the treatment of panic disorder. 1036 62

Migraine headache and panic disorder are two conditions that have a number of underlying physiological and psychological abnormalities in common. The temporal relationship between the occurrence of migraine headache and panic attacks could be different, however. According to our observations, some migraine subjects develop panic attacks with the typical symptoms (palpitation, dyspnea, anxiety/fear, shiver, sweating, polyuria) on the "peak" of their attacks. This variant of migraine without aura was conditionally defined as "panic migraine". Here we describe two patients suffering from migraine without aura in whom migraine was associated with the typical panic attack. It is suggested that a pronounced autonomic dysregulation along with marked psychological abnormalities could be responsible for the constellation of migraine and panic symptoms during one episode. Taking into account the previously obtained results, it is concluded that compared to "pure" migraine, "migraine associated with panic attacks" is characterized by a severe course, marked autonomic and emotional disturbances during pain-free intervals, seriously impaired quality of life, and requires a specific therapeutic approach.
Cephalalgia 1999 Oct
PMID:Migraine associated with panic attacks. 1057 Jul 28

40 patients with panic attacks, chronic algesic syndromes (chronic headaches of tension, cardialgias) entered the study. They also had depression of mild or moderate degree. 65% of the patients denied actively disorders of the mood; 80% were sure that they had a severe disease that was difficult to diagnose; most of them doubted the efficiency of therapy with psychotropic preparations. An analysis of the polymorphism of clinical symptomatology of the masked depression revealed in more than half of the patients some combinations of clinical syndromes, such as autonomic dysfunction, algesic manifestations, motivation and insomniac disorders. A structure of panic attacks was characterized by the prevalence of the autonomic symptoms as compared with the anxious ones. All the patients were treated with tianeptine (37.5 mg/day) during six weeks. The therapy was effective in 67.5% of the patients. The study revealed an equal efficiency of the drug in comorbid depressive, anxious and autonomic disorders as well as a good tolerance.
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PMID:[Neurological masks of depression (effectiveness of tianeptine)]. 1090 Jun 83


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