Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four hundred and nine cases of acute brain syndrome, encountered in psychiatric consultations among 54,942 general hospital patients over a 5 year period, fell into 4 groups according to symptom picture: lethargic, bewildered, agitated and psychotic. Treatment included reality orientation, protection and pharamacologic measures.
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PMID:Acute brain syndromes. 42 20

In 7 children aged from 6 to 13 years with hysterical psychoses relatively rare psychopathological phenomena were found which were named by the author as short-time lethargy, prolonged somnabulism, hysterical automatism, the phenomenon of "personality split" and special fantasies. The paper contains a psychopathological analysis related to the age traits and clinical aspects of these conditions. A special place occupied by these symptoms in the psychotic structure is due, in the opinion of the author, to the appearance of "hypnoid-hypobulic" disturbances.
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PMID:[Clinico-psychopathologic features of hysterical disorders with altered consciousness in children]. 49 16

The article describes the versions of meningeal tuberculosis in 300 patients observed by the author from 1975 to 1990. In the majority of the patients, the onset of the disease was gradual and its course, typical. For an acute onset of the disease, certain types of serous meningitis (6.7%), influenza (2.3%), acute psychosis (3%), purulent meningitis (1.3%), craniocerebral injury (1%), seriously disturbed cerebral circulation (4%) and lethargic encephalitis (0.66%) were identified. Chronic forms were mainly characterized by fibroplastic processes, local focal neurologic symptoms and congestive changes in the eye ground. The full-scale picture of the disease was sometimes observed at the terminal stage only. In 5% of the patients, such neurologic symptoms, as aphasias and paralyses, were prevalent in the clinical picture. The final diagnosis of a follow-up and repeated examination of the cerebrospinal fluid.
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PMID:[Variants of meningeal tuberculosis in adults]. 208 86

Delirium, an acute confusional state, is an organic brain syndrome that manifests deficits in attention, irrelevant or rambling speech, and other cognitive deficits. Its symptoms often fluctuate over the course of the day, and patients may be hyperactive--for example, restless and screaming--or hypoactive--for example, quiet, inactive, and stuporous. Occurring in approximately 20% of hospitalized elderly patients, delirium is the most common psychiatric syndrome in acutely ill general medical and surgical patients. Fifteen to 30% of delirious patients expire, and others are prone to a variety of complications: falls, pressure ulcers, oversedation, dehydration, and others. Almost any acute illness can cause delirium in the elderly, but the most common offenders are acute infections and drugs. Many patients have a pre-existing dementia. The first step in arriving at a correct diagnosis is to distinguish delirium from other psychiatric syndromes that can cause confusion, such as dementia, depression, schizophrenia, and mania. Once delirium is established, a comprehensive general examination and a mental status examination is required. Routine laboratory and radiologic tests are directed at the common metabolic and infectious disorders that precipitate delirium. Treatment is directed at the underlying acute illness. In all patients, it is important (1) to treat the underlying acute illness, (2) to provide appropriate fluid and electrolytes, (3) to discontinue any unnecessary drugs, and (4) to allay the patient's fear and agitation through the use of simple, repetitive instructions, orientation cues, and by limiting the use of physical restraints. If psychotropic medications are needed to treat psychotic symptoms, to prevent patients from harming themselves or others, or to facilitate necessary diagnostic and therapeutic interventions, then haloperidol is the drug of choice in most instances. Drugs with anticholinergic properties should be avoided.
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PMID:Delirium in the elderly. 218 81

Many psychiatric patients have polydipsia and polyuria without identifiable underlying medical causes. Hyponatremia develops in some polydipsic patients and can progress to water intoxication with such symptoms as confusion, lethargy, psychosis, and seizures or death. This syndrome is sometimes called "compulsive water drinking," "psychogenic polydipsia," and "self-induced water intoxication." Although the underlying pathophysiology of the syndrome is unclear, several factors have been implicated in producing polydipsia and symptomatic hyponatremia. These include a possible hypothalamic defect, the syndrome of inappropriate secretion of ADH (SIADH), and neuroleptic medication. Evaluation of psychiatric patients with polydipsia includes a search for other medical causes of polydipsia, polyuria, hyponatremia, and SIADH. Treatment modalities currently available include fluid restriction and medications.
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PMID:Polydipsia and hyponatremia in psychiatric patients. 328 1

The paper describes the psychiatric status on the basis of 76 patients with acquired immune deficiency syndrome. There is considerable difference between the different stages of the disease. The disorders are divided into groups following the German and French psychopathological tradition, where the incidence is dependent on the underlying complaint. 50% of the patients suffered from chronic psychoorganic disorders (34% organic personality disorders, 16% dementia). 9% suffered from an acute psychosis caused by complications and founded on substantial physical illness. 3 patients showed symptoms of a (under given circumstances) hitherto unknown endoform psychosis. In 9% of the patients, psychoreactive disturbances (anxiety and reactive depression) were observed. Two infants had congenital development deficiencies. 25% of the patients were without any psychopathology. Patients showing organic personality disorders mostly resemble each other to such a degree as to form a separate group. We suggest to name this group according to the most prominent psychopathology as "AIDS-lethargy". This status is characterised by a specific apathy, tiredness and indolence of the patients combined with the lack of emotional participation related to their own destiny. AIDS-lethargy is the first manifestation in appearance of the HIV infection of the brain itself. Another sequel of the brain infection is AIDS dementia which can be classified as "subcortical dementia" and differs from the more current forms of dementia clinically. Affected are mainly neuropsychologic functions like arousal, attention, mood and motivation, whereas the hallmarks of cortical involvement-aphasia, agnosia and apraxia-are not present. Supplementary findings (EEG, CCT, CSF): The group of patients with chronic psychoorganic disorders differs significantly from the group with psychoreactive disorders and normals. Pathological EEG and CCT are more frequent in psychoorganic disorders. CSF-test-including the intrathecally synthesized antibodies against HIV-does not show traceable variation in either group. There are four problems which may be combined in a given acute psychopathological HIV-syndrome: 1. Being member of a risk group with its reactive, psychosocial and personality problems. 2. Individual mental and emotional reaction to the fact of infection 3. Chronic psychoorganic disturbances. 4. Acute organic psychoses as a result of complications and other physical illness.
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PMID:[Psychopathologic pictures in HIV infection: AIDS lethargy and AIDS dementia]. 340 94

Alzheimer's disease is a slowly progressive disorder involving deterioration of both intellect and personality. The neuropathological features of Alzheimer's disease include abundant neurocortical senile plaques and neurofibrillary tangles. Drug therapies of Alzheimer's disease have been based on empirical observations of the signs and symptoms of the disease and have included the use of hypnotics to reverse insomnia or inverse sleep rhythms; anxiolytics to relieve anxiety, tension and restlessness antipsychotics to "tranquilize" or control psychotic symptoms, such as delusions and hallucinations; stimulants to overcome withdrawn behavior or lethargy; and lastly, antidepressants to control depression. Our growing knowledge of neuropathological and neurochemical changes associated with normal aging and Alzheimer's disease has made it possible to explore and develop pharmacologically-based therapies in Alzheimer's disease. Recent research has revealed behavioral symptoms associated with underlying biochemical changes in either the cholinergic, dopaminergic/ GABAergic (gama-aminobutyric acid) noradrenergic, serotoninergic, neurochemical and/or neuropeptidergic systems. Pharmacological strategies involving manipulation of these systems as a means of relieving Alzheimer's disease symptoms will be reviewed from several perspectives, e.g., those involving transmitter substitution, enzyme inhibition and direct specific receptor stimulation.
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PMID:Pharmacotherapy in Alzheimer's disease: basis and rationale. 354 Oct 49

A case of anorexia, paranoid delusions, and lethargy associated with digoxin toxicity is presented here. The digitalis glycosides are among the most commonly used drugs in modern medicine, and as such, they frequently cause toxicity. Although cardiac side effects of digoxin are well recognized, less attention has been paid to potential CNS effects. Psychiatric manifestations, from calm disorientation to violent psychosis, tend to occur more often in elderly patients and may be the earliest or only sign of digitalis toxicity.
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PMID:Digitalis delirium in an elderly woman. 358 69

Five cases of poisoning by indigenous mushroom Hikageshibiretake (Psilocybe argentipes) are reported. As this mushroom contains psilocybin, in general, clinical features were similar to those seen by pure psilocybin. Acute toxic stuporous state with complete amnesia in the culminating period occurred in one case, psychedelic state with dreamy consciousness in one case and psychotic adverse reactions with vivid visual hallucinations with consciousness in three cases. There were accompanied with anxiety and panic reactions to subjective experiences. Though these toxic effects were usually short-lived, for management of such patients it is important to recognize that horrible emotional reactions and other harmful behavioral problems can also occur.
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PMID:Poisoning by hallucinogenic mushroom hikageshibiretake (Psilocybe argentipes K. Yokoyama) indigenous to Japan. 370 65

There are grounds to expect behavioral and emotional changes during use of oral contraceptives, in the known frequency of premenstrual, postpartum and menopausal psychoses. A review of 11 studies on the effect of the pill on psychiatric symptoms yielded a low but definite incidence of adverse reactions, notably depression and other mood and behavior changes, but generally an improvement, particularly for patients with premenstrual exacerbation of their psychosis. In case reports, 4 women have suffered psychotic episodes on withdrawal from the pill and 3 have become psychotic on starting oral contraception. The author interviewed and tested 50 women in one study: 28 reported adverse effects, usually depression, decreased libido, and decreased ability to cope with stress. Another interview study of 101 pill users and 90 pregnant controls produced 34% with depression, 29% with irritability, 23% with lethargy, 15% with decreased libido, 64% with adverse effects and 25% discontinued. 11% reported increased well-being in addition to reporting adverse symptoms, which the author interpreted as increased emotional lability. Other systems through which oral contraceptives may exert these effects include catecholamine metabolism, tryptophan metabolism, corticoid hormones, drug interactions, susceptibility of EEG to progesterones depressant effects, and unconsious and conscious attitudes of the patient.
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PMID:Psychiatric reactions to oral contraceptives. 572 94


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