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)

One of the most widespread aspects of psychosomatic pathology of gastrointestinal tract is irritable bowel syndrome (IBS). Over 70% of functional pathology of large intestine falls at IBS. The aim of the investigation was the assessment of depression rate in patients with IBS. Taking into consideration the age of individuals, 100 patients 50 men and 50 women aged 21 to 75 years were examined by using clinical, psychological and statistic (correlation) analysis to determine whether there were relations between clinical manifestations of the irritable bowel syndrome and personality. Diarrhea variant of IBS syndrome was detected in 17 (34%) men and in 21 (42%) females. Diarrhea and pain variant of IBS syndrome was detected in 12 (24%) men and 17 (34%) female. Pain variant of IBS syndrome was detected in 5 (10%) men and 12 (24%) females. Constipation variant was detected in 16 (32%) men and 3 (6%) female. In 84% of patients with IBS was found dysphoria; weight loss and bed appetite - in 44%, insomnia - in 40%, general lethargy and adynamia - in 80%; loss of interest - in 38%; asthenia - in 70%, devoured by guilt - 43%, uncertainty - 80%. Depression in patients with IBS was treated with serotonin selective antidepressants. Investigation revealed that the best result is achieved with serotonin-selective antidepressant therapy.
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PMID:[Psychological aspects of psychosomatic pathology of large intestine]. 1957 11

Venlafaxine is a serotonin-noradrenaline reuptake inhibitor (SNRI) that has no affinity for muscarinic, adrenergic or histaminergic receptors. In short-term trials, the adverse effects that occurred more often with venlafaxine than with placebo included nausea, somnolence, dizziness, dry mouth, and sweating. Rapid titration of the dose of venlafaxine to higher levels appeared, not unexpectedly, to be associated with an increased incidence of side effects. Side effects that appeared to be dose related included insomnia, nausea and sexual dysfunction. The incidence of nausea and dizziness was highest during the first 2 or 3 weeks of therapy and decreased rapidly thereafter. Somnolence also decreased over time. At high doses blood pressure increases were reported in a small percent of patients on venlafaxine and antidepressant drugs but were uncommon at the venlafaxine dose of 75-150 mg daily. Studies with venlafaxine in healthy volunteers indicate a low potential for drug-drug interactions. Overdoses have been reported in 14 of 3,082 patients administered venlafaxine in clinical trials, and no deaths were reported among these patients. Overdoses of venlafaxine induced mainly drowsiness and lethargy.
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PMID:Neurobiologic basis of antidepressant safety profiles. 1969 84

High altitude problems like hypoxia, acute mountain sickness, high altitude cerebral edema, pulmonary edema, insomnia, tiredness, lethargy, lack of appetite, body pain, dementia, and depression may occur when a person or a soldier residing in a lower altitude ascends to high-altitude areas. These problems arise due to low atmospheric pressure, severe cold, high intensity of solar radiation, high wind velocity, and very high fluctuation of day and night temperatures in these regions. These problems may escalate rapidly and may sometimes become life-threatening. Shilajit is a herbomineral drug which is pale-brown to blackish-brown, is composed of a gummy exudate that oozes from the rocks of the Himalayas in the summer months. It contains humus, organic plant materials, and fulvic acid as the main carrier molecules. It actively takes part in the transportation of nutrients into deep tissues and helps to overcome tiredness, lethargy, and chronic fatigue. Shilajit improves the ability to handle high altitudinal stresses and stimulates the immune system. Thus, Shilajit can be given as a supplement to people ascending to high-altitude areas so that it can act as a "health rejuvenator" and help to overcome high-altitude related problems.
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PMID:Shilajit: A panacea for high-altitude problems. 2053 96

Understanding the particular pharmacology of different antidepressant drugs can help explain their adverse effects when they are discontinued. For all antidepressant drugs, abruptly stopping them can sometimes result in "rebound" hypomania or mania. Antidepressant drugs having anticholinergic effects often are associated with a discontinuation syndrome characterized by cholinergic rebound, with symptoms of nausea, vomiting, abdominal cramping, sweating, headache, and muscle spasms. Discontinuation of monoamine oxidase inhibitor drugs sometimes results in flu-like symptoms, dysphoria, restlessness, tachycardia, hypertension, and a delirium-like state. Serotonergic antidepressant drugs are sometimes associated with a distinct discontinuation syndrome characterized by dizziness, weakness, nausea, headache, lethargy, insomnia, anxiety, poor concentration, and paresthesias. Adverse discontinuation effects can occur with all types of antidepressant drugs, but only rarely would they be considered serious. To minimize adverse discontinuation effects and to reduce the risk of relapse or recurrence of the underlying treated condition, tapering antidepressant medication is prudent for all patients.
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PMID:Potential adverse effects of discontinuing psychotropic drugs: part 2: antidepressant drugs. 2060 81

This paper reviews the premenstrual syndrome (PMS) from a historical and psychological perspective. The physician must recognize that the premenstruum-the four days before the onset of the menses-is a `high risk' phase for women. They may demonstrate somatic and psychological complaints such as irritability, aggression, tension, anxiety, depression, lethargy, insomnia, poor coordination and concentration. Psychological disturbances can range from self-deprecation and the feeling that `everything is too much' to pronounced feelings of oppression and depression. Psychiatric patients may become even more disturbed at this time. Recent reviews on PMS have studied its etiology and its possible connection to hormone imbalance, but to date there is no complete explanation for the syndrome's psychological symptoms. The most promising treatments for the psychological symptoms of PMS are pyridoxine (although there are conflicting reports about it), antidepressants, benzodiazepines if anxiety and tension dominate, and ongoing psychotherapy for severe cases.
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PMID:Premenstrual syndrome: a psychological overview. 2128 30

Although the basic function of sleep remains a mystery, insufficient sleep is associated with mood disturbance, fatigue and daytime lethargy, cognitive impairments, daytime behavior problems, academic problems, use of stimulants, work absenteeism, lost work production and an increase in healthcare utilization. The International Classification of Sleep Disorders distinguishes 90 different disorders, many of which can be effectively treated, but when left untreated can be costly in terms of quality of life, health and healthcare cost. Over the past 50 years we have become more effective in measuring sleep and have honed our treatments to better address the sleep disorders that most impact us. This article will focus on the three sleep disorders for which patients most frequently seek care, including insomnia, obstructive sleep apnea syndrome and restless leg syndrome.
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PMID:Integrating sleep management into clinical practice. 2244 2

Aripiprazole is an atypical antipsychotic medication that is a partial dopamine D(2) and serotonin 5-hydroxytryptamine (1A) receptor agonist and 5-hydroxytryptamine (2A) receptor antagonist. It has a safer profile compared to other antipsychotic medications with regard to its effect on weight, glucose tolerance, prolactin level, and cardiac conduction. The common neurological adverse effects include headache, agitation, insomnia, sleepiness, and extrapyramidal symptoms. Seizures have not been reported in the pediatric population and only twice in adult patients. Here, we report a case of a healthy 3-year-old child who experienced prolonged lethargy, dystonia, and 2 witnessed seizures after incidental ingestion of 30 mg of aripiprazole. To our knowledge, this is the first reported case of aripiprazole-induced seizures in a child.
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PMID:Aripiprazole-induced seizure in a 3-year-old child: a case report and literature review. 2333 73

The prevalence of attention-deficit hyperactivity disorder (ADHD) in the USA is estimated at approximately 4-9% in children and 4% in adults. It is estimated that prescriptions for ADHD medications are written for more than 2.7 million children per year. In 2010, US poison centers reported 17,000 human exposures to ADHD medications, with 80% occurring in children <19 years old and 20% in adults. The drugs used for the treatment of ADHD are diverse but can be roughly separated into two groups: the stimulants such as amphetamine, methylphenidate, and modafinil; and the non-stimulants such as atomoxetine, guanfacine, and clonidine. This review focuses on mechanisms of toxicity after overdose with ADHD medications, clinical effects from overdose, and management. Amphetamine, dextroamphetamine, and methylphenidate act as substrates for the cellular monoamine transporter, especially the dopamine transporter (DAT) and less so the norepinephrine (NET) and serotonin transporter. The mechanism of toxicity is primarily related to excessive extracellular dopamine, norepinephrine, and serotonin. The primary clinical syndrome involves prominent neurological and cardiovascular effects, but secondary complications can involve renal, muscle, pulmonary, and gastrointestinal (GI) effects. In overdose, the patient may present with mydriasis, tremor, agitation, hyperreflexia, combative behavior, confusion, hallucinations, delirium, anxiety, paranoia, movement disorders, and seizures. The management of amphetamine, dextroamphetamine, and methylphenidate overdose is largely supportive, with a focus on interruption of the sympathomimetic syndrome with judicious use of benzodiazepines. In cases where agitation, delirium, and movement disorders are unresponsive to benzodiazepines, second-line therapies include antipsychotics such as ziprasidone or haloperidol, central alpha-adrenoreceptor agonists such as dexmedetomidine, or propofol. Modafinil is not US FDA approved for treatment of ADHD; however, it has been shown to improve ADHD signs and symptoms and has been used as an off-label pharmaceutical for this diagnosis in both adults and children. The mechanism of action of modafinil is complex and not fully understood. It is known to cause an increase in extracellular concentrations of dopamine, norepinephrine, and serotonin in the neocortex. Overdose with modafinil is generally of moderate severity, with reported ingestions of doses up to 8 g. The most common neurological effects include increased anxiety, agitation, headache, dizziness, insomnia, tremors, and dystonia. The management of modafinil overdose is largely supportive, with a focus on sedation, and control of dyskinesias and blood pressure. Atomoxetine is a selective presynaptic norepinephrine transporter inhibitor. The clinical presentation after overdose with atomoxetine has generally been mild. The primary effects have been drowsiness, agitation, hyperactivity, GI upset, tremor, hyperreflexia, tachycardia hypertension, and seizure. The management of atomoxetine overdose is largely supportive, with a focus on sedation, and control of dyskinesias and seizures. Clonidine is a synthetic imidazole derivative with both central and peripheral alpha-adrenergic agonist actions. The primary clinical syndrome involves prominent neurological and cardiovascular effects, with the most commonly reported features of depressed sensorium, bradycardia, and hypotension. While clonidine is an anti-hypertensive medication, a paradoxical hypertension may occur early with overdose. The clinical syndrome after overdose of guanfacine may be mixed depending on central or peripheral alpha-adrenoreceptor effects. Initial clinical effects may be drowsiness, lethargy, dry mouth, and diaphoresis. Cardiovascular effects may depend on time post-ingestion and may present as hypotension or hypertension. The management of guanfacine overdose is largely supportive, with a focus on support of blood pressure. Overdose with ADHD medications can produce major morbidity, with many cases requiring intensive care medicine and prolonged hospital stays. However, fatalities are rare with appropriate care.
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PMID:Overdose of drugs for attention-deficit hyperactivity disorder: clinical presentation, mechanisms of toxicity, and management. 2375 86

Fatigue is a common, often debilitating, side effect of cancer chemotherapy. Pharmacologic vitamin C has been used as an alternative treatment for the disease itself but its effects on fatigue have not often been documented. Here we report on the case of a woman with recurrent breast cancer, undergoing weekly chemotherapy, with lethargy as a major symptom. Vitamin C (50 g/session) was administered twice weekly and quality of life and multidimensional fatigue symptomology questionnaires were undertaken. Dramatic decreases in fatigue and insomnia were observed, as well as increased cognitive functioning. There were no adverse side effects of i.v. vitamin C.
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PMID:Relief from cancer chemotherapy side effects with pharmacologic vitamin C. 2448 89

There is an interdependent relationship between insomnia and fatigue in the medical literature, but both remain distinct entities. Insomnia entails problematic sleep initiation, maintenance, or restoration with an accompanying decrease in perceived daytime function. Lethargy is a symptom that has a wide differential diagnosis that heavily overlaps with cancer-related fatigue; however, insomnia may contribute to worsened fatigue and lethargy in cancer patients. Insomnia is a major risk factor for mood disturbances such as depression, which may also contribute to lethargy in this at-risk population. The pathophysiology of fatigue and insomnia is discussed in this review, including their differential diagnoses as well as the emerging understanding of the roles of neurotransmitters, branched-chain amino acids, and inflammatory cytokines. Treatment approaches for insomnia and fatigue are also discussed and reviewed, including the role of hypnotics, psychotropics, hormonal agents, and alternative therapies.
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PMID:Fighting insomnia and battling lethargy: the yin and yang of palliative care. 2453 3


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