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

Depressive illness among the elderly is an important public health concern. However, treatment of the elderly may be complicated by age-related changes in physiology, general medical status, and susceptibility to side effects. There is therefore a need for improved treatment modalities for depressed elderly patients. Paroxetine is an antidepressant that acts through selective inhibition of serotonin reuptake. It lacks the anticholinergic and cardiovascular side effects of most first- and second-generation antidepressants. The authors present the combined data from two similarly designed comparisons of paroxetine and doxepin in outpatients over 60 years of age with major depression. The results show that paroxetine was an effective as doxepin in alleviating depression as measured on the Hamilton Rating Scale for Depression (HAM-D) total score, the Montgomery and Asberg Depression Rating Scale (MADRS), and the Hopkins Symptom Checklist (SCL) depression factor score. Paroxetine was significantly superior to doxepin on the Clinical Global Impressions (CGI) scale for severity of illness, the HAM-D retardation factor, and the HAM-D depressed mood item. Doxepin produced significantly more anticholinergic effects, sedation, and confusion. Paroxetine was associated with more reports of nausea and headache. These results suggest that paroxetine may be a valuable tool for the treatment of major depression in the elderly.
 ...
PMID:Two combined, multicenter double-blind studies of paroxetine and doxepin in geriatric patients with major depression. 153 27

A double-blind comparison of moclobemide and toloxatone was performed in adult out-patients diagnosed as suffering from a major depressive disorder. Parallel groups of patients received moclobemide, 450 mg/day (n = 135) or toloxatone, 1000 mg/day (n = 133) for 28 days. Both groups showed a significant clinical improvement while on therapy; the response was most marked and rapid in those receiving moclobemide treatment. Improvement was greatest in those patients with the most severe depression at the time of trial onset. A significantly higher number of patients returned to normal sleep patterns following moclobemide treatment than following toloxatone. Overall, tolerance was rated as good or very good in more than 80% of patients. The most frequent complaints in the moclobemide-treated group were hot flushes, dry mouth, constipation and headache, while an increase in anxiety was associated with toloxatone usage. Moclobemide was found to be as effective as toloxatone in the treatment of major depressive episodes, but with the advantages of improved sleep patterns and reduced anxiety.
 ...
PMID:A double-blind comparison of moclobemide and toloxatone in out-patients presenting a major depressive disorder. 154 24

We examined prospectively the risk for major depression (MDD) and panic disorder in persons with prior history of migraine. A random sample of 995 young adults was interviewed in 1989 and reinterviewed in 1990. A history of migraine at baseline increased fourfold the risk for MDD during the follow-up interval. A history of any anxiety disorder exacerbated the risk for MDD in persons with migraine. Persons with a history of migraine were twelve times more likely to become cases of panic disorder than those with no history of migraine. The risk for MDD and/or panic disorder was unrelated to whether or not migraine was active during the year preceding the baseline interview or in remission for more than one year. The findings suggest that migraine, major depression and anxiety disorders might share common predispositions.
Cephalalgia 1992 Apr
PMID:Migraine, major depression and panic disorder: a prospective epidemiologic study of young adults. 157 44

In most healthy individuals, dexamethasone suppresses adrenal cortisol production. However, in patients with major depression, non-suppression frequently occurs and thus may be a marker for depression. The purpose of the present study was to examine the relationship of dexamethasone suppression test (DST) non-suppression to clinical variables such as major depression, site and duration of pain, prior surgery, and medication use in 81 chronic pain patients beginning inpatient pain treatment (Inpt. Pain), and 33 medication-restricted outpatients with chronic back pain and depression (Outpt. Back). In the Inpt. Pain group, the specificity of DST non-suppression for depression was 82% and for sensitivity 24%. In the Outpt. Back group, its sensitivity was 18%. Within the diverse inpatient samples, there was 69% non-suppression in patients with headache pain only, compared to 15% in patients with other sites of pain (P less than 0.01), but there was no significant difference in depression rate between these two groups. In the Inpt. Pain group, non-suppressors also had significantly less prior surgery. In the Outpt. Back group, opioid use was significantly higher in non-suppressors (33%) than in suppressors (11%). In chronic pain populations, the DST appears not to be useful clinically for the detection of depression and may be significantly affected by clinical variables other than depression.
 ...
PMID:Chronic pain, depression, and the dexamethasone suppression test. 159 56

Frequently overlooked, depression is a very common complex disorder that causes significant morbidity and mortality. This article provides a review of three commonly encountered depressive disorders in primary care settings: adjustment disorder with depressed mood, dysthymia and major depression. Since many individuals minimize the affective symptoms of depression, clinicians must maintain a high index of suspicion when clients present with vague somatic complaints, such as fatigue, headache, constipation and difficulty sleeping. To reach an accurate diagnosis, a thorough history, physical examination and appropriate laboratory studies should be performed. Numerous rating scales are presented to aid assessment. Common intervention strategies for the treatment of depressive disorders include education, drug therapy, and supportive individual and family counseling.
 ...
PMID:Assessment and treatment strategies for depressive disorders commonly encountered in primary care settings. 160 68

We have previously reported that the serotonin (5-HT) agonist meta-chlorophenylpiperazine (m-CPP) induced late occurring migraine-like headaches in a group of patients with eating disorders and controls (n = 52). In this report, we extend our analyses of these data and describe results indicating that headache responses following m-CPP are greater in patients with bulimia nervosa than controls, regardless of the presence of anorexia nervosa or major depression. Although patients with severe migraine-like headaches had higher peak m-CPP levels than patients without severe headaches, these levels are not higher than other groups studied who did not get headaches. These findings suggest that post-synaptic 5-HT receptor sensitivity is altered in the vascular tissues of bulimic patients. Additional disturbances in 5-HT function, perhaps presynaptic ones, may be associated with anorexia nervosa and major depression. Similar alterations in other 5-HT pathways at or above the level of the hypothalamus may contribute to binge eating and other behavioral symptoms of bulimia nervosa. Further studies exploring the functional integrity of 5-HT receptors and their subtypes are warranted in bulimic patients, as well as in patients with nonbulimic anorexia nervosa, minor and major depression without an eating disorder, and migraine and other headache patients.
Headache 1992 May
PMID:Headache responses following m-chlorophenylpiperazine in bulimics and controls. 162 57

This report describes treatment over a period of 6 years of Mien refugees from highland Laos in the Indochinese Psychiatric Program of the Oregon Health Sciences University (Portland, OR). The medical and psychiatric problems of 84 patients were presented through somatic symptoms such as headache, dizziness, or musculoskeletal pain. Primary care medical problems were identified and treated, with the major focus on the two most common psychiatric diagnoses: major depression and posttraumatic stress disorder. Cultural beliefs about illness and medication interfered with adherence to prescribed treatment. A marked sensitivity to side effects of certain antidepressants also resulted in subtherapeutic doses. Patients rarely volunteered their traumatic histories, psychiatric problems, or dissatisfaction with medications. However, the effective use of medication for somatic complaints, along with the continuing recognition of Mien health beliefs in psychosocial treatments, allowed for the development of a trusting doctor-patient relationship and continued psychiatric care.
 ...
PMID:Posttraumatic stress disorder, depression, and somatic symptoms in U.S. Mien patients. 174 30

Major depression disease is uncommon in children; it occurs mostly in children with a depressed parent or in children under major psychosocial stress such as physical or sexual abuse. Most depression in children is masked, i.e., the child presents with signs or symptoms such as headaches, abdominal pain, muscle weakness, vomiting, dizziness, hyperactivity, or school avoidance. Careful evaluation of the history is required to assist in the diagnosis. Some basic laboratory tests should be done to rule out organic disease. Psychiatric referral should be carried out after an appropriate evaluation.
 ...
PMID:Depression and chronic fatigue in children. A masquerade ball. 187 11

In a double blind study performed in psychiatric clinics the efficacy and tolerability of the new antidepressant Moclobemide was compared. Moclobemide belongs to a new class of substances called RIMA (Reversible Inhibitor of the monoamine oxidase type A). 61 patients with major depression (according to DSM-III) were either treated with Moclobemide or Fluvoxamine, a selective reuptake-inhibitor of 5-HT. The latter belongs to a class of antidepressants known for their better tolerability compared to tricyclic antidepressants. Moclobemide was as effective as Fluvoxamine but much better tolerated as shown by a lower incidence of side effects such as gastrointestinal problems or headache.
 ...
PMID:[Multicenter study comparing efficacy and tolerance of moclobemide and fluvoxamine in hospitalized and ambulatory patients with severe depressive episodes]. 190 20

In a double-blind, random-assignment, parallel-group trial, outpatients with major depression received either the new antidepressant clovoxamine, the tricyclic amitriptyline, or placebo for 6 weeks. By an "improvement" criterion of 50% or greater improvement in the Hamilton Depression Scale (HAM-D) total score, 88% of clovoxamine completers improved versus 75% with amitriptyline and 43% with placebo; however, due to small numbers, the differences failed to reach statistical significance. Diminished salivary flow was significantly greater with amitriptyline, as were complaints of dry mouth, somnolence, dizziness, and headache. Nausea and vomiting were more common in the clovoxamine-treated group. With amitriptyline, but not with clovoxamine, memory performance declined over a month. However, psychomotor performance was not affected.
 ...
PMID:Clovoxamine in the treatment of depressed outpatients: a double-blind, parallel-group comparison against amitriptyline and placebo. 220 81


1 2 3 4 5 6 7 8 9 10 Next >>