Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Several developments in serotonin neuropharmacology have implications for psychiatric disorders and have already begun to impact their treatment. Selective inhibitors of serotonin uptake, which enhance serotonergic function by preventing the removal of serotonin from the synaptic cleft via the membrane transporter, have been introduced for the treatment of depression and may be effective in other disorders. Precursor loading can increase serotonin concentrations in the synaptic cleft, and tryptophan--which has been available in health food stores and drug stores--had become increasingly used for self-medication of depression, insomnia, and premenstrual syndrome. Conversion to serotonin is not the major metabolic pathway for tryptophan, and large increases in other tryptophan metabolites (such as quinolinic acid, a substance that is excitotoxic at high concentrations) accompany small increases in extracellular serotonin. The recent epidemic of the eosinophilia-myalgia syndrome associated with tryptophan now appears due to a trace contaminant in the product from a single manufacturer. A major advance in serotonin pharmacology has been the elucidation of serotonin receptor heterogeneity. At least seven receptor subtypes (5-HT1A, 5-HT1B, 5-HT1C, 5-HT1D, 5-HT2, 5-HT3, 5-HT4) have been identified in brain. Direct-acting agonists and antagonists can have selective affinity for specific receptor subtypes. Selective activation of 5-HT1A receptors seems to cause anxiolytic and possibly antidepressive effects. Selective antagonists of 5-HT2 or 5-HT3 receptors may be useful in treating anxiety and schizophrenia. Drugs that enhance serotonergic function suppress aggression in animals, but the specific receptor subtypes involved are not known. The advances being made in serotonin pharmacology will help define the role of this brain neurotransmitter in psychiatric and other disorders and can be expected to lead to further therapeutic advances.
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PMID:Role of serotonin in therapy of depression and related disorders. 167 51

Alprazolam is the product of the incorporation of the triazolo ring into the benzodiazepine structure. More than 90% of alprazolam is absorbed after an oral dose; the absorption rate is dose independent. After a single oral dose of 0.5 to 3 mg of alprazolam, peak plasma concentrations of 7 to 40 ng/ml are reached at 0.7 to 2.1 hours after administration. Factors such as liver and kidney disease, smoking, age, sex, and obesity have minimal effects on alprazolam pharmacokinetics. A review of alprazolam-drug interactions revealed few that were clinically significant, except that cimetidine and oral contraceptives reduce alprazolam clearance and increase its half-life. The mechanisms of action of alprazolam are reviewed. Its anxiolytic effect is similar to that of other benzodiazepines, but the basis of its other effects is less clear. Like other benzodiazepines, it has a good ratio of efficacy to side effects; its most common side effect, mild sedation, occurs early in treatment. The potential of dependence to and abuse of alprazolam and its toxicity are similar to that of other benzodiazepines. Finally, alprazolam's therapeutic role as an anxiolytic and anti-depressant and its use in the management of panic attacks, agoraphobia, schizophrenia, cancer, the premenstrual syndrome, and anxiety and as a cardioprotective agent are assessed.
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PMID:The pharmacology of alprazolam: a review. 202 16

Patients with primary affective disorders, such as melancholic depression and anorexia nervosa, frequently have a hyperactive hypothalamic-pituitary-adrenal (HPA) axis, characterized by hypersecretion of CRH and a blunted ACTH response to exogenous CRH. Premenstrual syndrome (PMS) is a luteal phase dysphoric disorder characterized by primarily affective and behavioral disturbances. HPA axis function was compared in PMS patients and control women, respectively, diagnosed by DSM3-R criteria or found to have no current psychiatric disorders, determined by the Schedule for Affective Disorders and Schizophrenia-Lifetime Interview. Urinary free cortisol excretion was the same in PMS and normal women, and no differences in urinary free cortisol excretion between the follicular and luteal phases occurred in either group. Two HPA axis abnormalities, however, were noted when PMS patients were compared to normal women. First, basal evening cortisol concentrations in plasma were significantly decreased, while the time-integrated response of plasma cortisol to ovine (o) CRH was significantly increased. Second, the negative correlation between time-integrated plasma ACTH and cortisol responses to oCRH and basal luteal progesterone concentrations present in normal control women was not seen in the PMS patients. These changes in basal and oCRH-stimulated plasma cortisol levels in association with normal urinary free cortisol excretion suggest that women with PMS might have transient or episodic disturbances of their HPA axis, which appear adequately corrected by this system's servomechanisms. This probably explains the maintenance of regular menstrual cycles in PMS patients, which contrasts with the irregular menses observed in patients with depression, anorexia nervosa, or women who participate in chronic strenuous exercise.
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PMID:Hypothalamic-pituitary-adrenal function in patients with the premenstrual syndrome. 217 72

Neurotensin (NT) concentrations in cerebrospinal fluid (CSF) were measured by a sensitive and specific radioimmunoassay in psychiatric patients and age- and sex-matched normal controls. No increase in CSF NT concentrations was observed after antipsychotic drug treatment. CSF NT concentrations were significantly lower in one group of schizophrenic subjects. NT concentrations were unaltered in patients with depression, anorexia/bulimia, or premenstrual syndrome, and no rostral-caudal gradient for NT in CSF was evident. NT concentrations were not related to age or sex, and probenecid treatment did not alter CSF NT concentrations. Finally CSF NT concentrations were unaltered in paranoid schizophrenic subjects. These findings confirm and extend previous studies of CSF NT that showed certain patients with schizophrenia, nonparanoid type, have reduced CSF concentrations of this tridecapeptide.
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PMID:Neurotensin-like immunoreactivity in cerebrospinal fluid of patients with schizophrenia, depression, anorexia nervosa-bulimia, and premenstrual syndrome. 257 18

Lack of interest in sexual activity is one of the most prevalent psychosexual problems seen by clinicians. No consensus exists on etiology, symptomatology, appropriate therapeutic intervention, or prognosis. Desire disorders are believed to be highly refractory to treatment because of severe intrapsychic conflict, but no systematic data have been gathered about the histories of psychopathology in these individuals. Forty-six married subjects with a primary DSM-III diagnosis of global inhibited sexual desire (ISD) were compared with 36 matched controls on lifetime psychopathology, current psychological profiles, and premenstrual syndrome. A clinical interview, the Schedule for Affective Disorders and Schizophrenia-Lifetime Version and the SCL-90-R were administered to all subjects. Only ISD subjects free from any other axis I disorder, medical illness, medication use, or substance abuse were selected; controls met similar criteria but had no sexual dysfunction. Despite the fact that all ISD subjects had nearly normal psychological profiles at the time of assessment, more ISDs than controls had significantly elevated lifetime prevalence rates of affective disorder. The proportion of ISD individuals with histories of major and/or intermittent depression alone was almost twice as high as controls. Additionally, the initial episode of the depressive disorder almost always coincided with or preceded ISD onset. Significantly more ISD women than controls also had severe symptoms of premenstrual syndrome. The remarkable lifetime rate of affective illness in ISD patients suggests that there may be a common biological etiology or that affective psychopathology may be contributing to the pathogenesis of the ISD dysfunction.
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PMID:Lifetime psychopathology in individuals with low sexual desire. 377 53

Prolactin is a protein hormone synthesized and secreted by the anterior pituitary gland. Because the monoamines dopamine and serotonin are important in the control of its secretion, prolactin has been the subject of much psychoendocrine research in recent years. The authors review some of the implications of the main findings of such research as they relate to schizophrenia, affective disorders, premenstrual syndrome, and alcoholism and discuss its possible usefulness to clinicians. As a research strategy, prolactin studies have a good potential for identifying specific neurotransmitters involved in discrete psychopathologic entities.
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PMID:Prolactin in psychiatry. 702 53

1. Estrogen exerts profound effects on mood, mental state and memory by acting on both "classical" monoamine and neuropeptide transmitter mechanisms in brain. Here we review an example of each type of action. 2. With respect to the effect of estrogen on central monoamine neurotransmission, low levels of estrogen in women are associated with the premenstrual syndrome, postnatal depression and post-menopausal depression. Sex differences in schizophrenia have also been attributed to estrogen. Previous studies have shown that estrogen stimulates a significant increase in dopamine2 (D2) receptors in the striatum. Here we show for the first time that estrogen also stimulates a significant increase in the density of 5-hydroxytryptamine2A (5-HT2A) binding sites in anterior frontal, cingulate and primary olfactory cortex and in the nucleus accumbens, areas of the brain concerned with the control of mood, mental state, cognition, emotion and behavior. These findings explain, for example, the efficacy of estrogen therapy or 5-HT uptake blockers such as fluoxetine in treating the depressive symptoms of the premenstrual syndrome. and suggest that the sex differences in schizophrenia may also be due to an action of estrogen mediated by way of 5-HT2A receptors. 3. With respect to the effect of estrogen on central neuropeptide transmission, estrogen stimulates the expression of the arginine vasopressin (AVP) gene in the bed nucleus of the stria terminalis (BNST) in rodents. This results in a 100-fold increase in AVP mRNA in the BNST and a massive increase in AVP peptide in the BNST and its projections to the lateral septum and lateral habenula. The BNST-AVP system enhances and/or maintains "social" or "olfactory" memory, and thus provides a powerful model for correlating transcriptional control of neuropeptide gene expression with behavior. Whether similar mechanisms operate in the human remain to be determined. 4. These two examples of the action of estrogen on central neurotransmission are discussed in terms of their immediate clinical importance for the treatment of depressive symptoms, their use as powerful models for investigations on the steroid control of central neurotransmitter mechanisms, and the role of estrogen as "Nature's" psychoprotectant.
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PMID:Estrogen control of central neurotransmission: effect on mood, mental state, and memory. 881

The role of calcium in the etiology of anxiety has been proposed for several decades. Calcium channel blockers profoundly influence calcium metabolism and the transport of calcium. Even though the evidence for the role of calcium remains weak, drugs affecting calcium might be useful in the treatment of anxiety disorders. One of these compounds, verapamil, has been used to treat mood disorders. Calcium channel blockers have also been tried in other indications such as premenstrual syndrome, irritable bowel syndrome, schizophrenia, tardive dyskinesia, and Tourette's syndrome. However, the number of articles on the use of calcium channel blockers in the treatment of anxiety disorders is low. Three reports (two open, one double-blind) described some success in the treatment of panic disorder with verapamil, diltiazem, or nimodipine and one open-label study described unsuccessful treatment of anxiety and phobia with nifedipine in patients with various anxiety disorders. Further double-blind placebo-controlled studies of calcium channel blockers in the treatment of anxiety disorders are warranted to determine a possible role of these compounds in the armamentarium of antianxiety drugs.
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PMID:Calcium channel blockers for anxiety disorders? 898 18

This paper presents the state of the art of our current knowledge in the field of female psychiatry. This domain of mental health studies the particularities of psychological distress in women. It is a new concept, and its creation is subtended by some clinical and epidemiological realities. The creation of this very interesting field of research has been promoted on the one hand because of the existence of certain female-specific psychiatric disorders (premenstrual syndrome, post-partum psychopathologies, pseudocyesis, Ferjol's syndrome and menopause-related disorders) and on the other hand because the vast majority of mental diseases may be expressing major gender-related variations (prevalence, natural history of disease, symptomatology, prognosis and treatment outcome). Research in female psychiatry has numerous goals. First of all, the sex-based differences in the prevalence of mental disorders (e.g., depression, schizophrenia, anxiety, anorexia nervosa, personality disorders) has to be understood (are they artefacts, or the expression of hormonal or genetic influence, or a consequence of social factors, or even the result of brain development?). Second, the specific nature of some of these diseases is under investigation (e.g., is postnatal depression a classical major depressive disorder or a puerperal-specific disease?). And third, treatments must be adapted accordingly. Indeed, the study of female psychiatry attempts the integration of the gender-effect in order to improve the treatment modalities.
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PMID:[Psychiatry of women: an new field of research in mental health]. 1119 92

The aim of the present study was to examine the frequencies of premenstrual syndrome (PMS) and premenstrual exacerbation (PME) of a number of psychiatric disorders in Chinese subjects. Premenstrual syndrome was assessed using a symptom checklist based on International Classification of Diseases (10th revision; ICD-10) criteria. Premenstrual exacerbation was defined as premenstrual worsening of pre-existing generalized anxiety disorder (GAD), major depressive disorder or dysthymic disorder (depressive disorders, DD), panic disorder (PD), or schizophrenia (SCH). Fifty outpatients were randomly sampled for each diagnostic group. Diagnosis was performed by psychiatrists using the structured Mini-International Neuropsychiatric Interview (MINI), and the frequencies of PMS and PME were compared for the different diagnostic groups. The PMS symptoms were reported by 78%, 80%, 68%, and 52% of GAD, DD, PD, and SCH patients, respectively, with 52%, 52%, 36%, and 20% fulfilling the definition of PME. No significant statistical relationships between diagnostic entities and family history of PMS, years of education, or age were demonstrated, but number of PMS symptoms was associated with severity of PME. No significant relationships were demonstrated between PME and marital status, parity, years of education, age, or family history of PMS. The results showed that high PME rates were noted for a sample of Chinese women with mental disorders, especially those with depressive and anxiety disorders.
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PMID:Premenstrual symptoms and premenstrual exacerbation in patients with psychiatric disorders. 1500 25


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