Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Animal data indicate that serotonin (5-HT) is a major neurotransmitter involved in the control of numerous central nervous system functions including mood, aggression, pain, anxiety, sleep, memory, eating behavior, addictive behavior, temperature control, endocrine regulation, and motor behavior. Moreover, there is evidence that abnormalities of 5-HT functions are related to the pathophysiology of diverse neurological conditions including Parkinson's disease, tardive dyskinesia, akathisia, dystonia, Huntington's disease, familial tremor, restless legs syndrome, myoclonus, Gilles de la Tourette's syndrome, multiple sclerosis, sleep disorders, and dementia. The psychiatric disorders of schizophrenia, mania, depression, aggressive and self-injurious behavior, obsessive compulsive disorder, seasonal affective disorder, substance abuse, hypersexuality, anxiety disorders, bulimia, childhood hyperactivity, and behavioral disorders in geriatric patients have been linked to impaired central 5-HT functions. Tryptophan, the natural amino acid precursor in 5-HT biosynthesis, increases 5-HT synthesis in the brain and, therefore, may stimulate 5-HT release and function. Since it is a natural constituent of the diet, tryptophan should have low toxicity and produce few side effects. Based on these advantages, dietary tryptophan supplementation has been used in the management of neuropsychiatric disorders with variable success. This review summarizes current clinical use of tryptophan supplementation in neuropsychiatric disorders.
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PMID:L-tryptophan in neuropsychiatric disorders: a review. 130 30

In a 4-week double-blind study comparing alprazolam with diazepam treatments, 48 outpatients suffering from mild to moderate generalized anxiety were evaluated after a 5-day placebo washout, and then after 1, 2, and 4 weeks of treatment. The optimal therapeutic doses without excessive sedation averaged 2 mg for alprazolam and 15.8 mg for diazepam. Results from the Hamilton Anxiety Rating Scale, the Clinical Global Impression Scale, a behavior checklist questionnaire, and a symptomatic patients' self-rating scale indicated that patients improved in both treatment groups. Results from the comparative phase suggest that diazepam is more efficient than alprazolam in the reduction of several symptoms of anxiety and depression in particular. Assuming that the first 2-week ratings depend on accuracy of dose adjustment and that week 4 ratings are an important evaluation of long-term efficacy, results from this study suggest that adequate control of anxiety is obtained more readily with diazepam and that symptoms of depression might benefit more from that drug. Few side effects were reported: mainly, drowsiness, tremor, light- headedness , and dry mouth. A toxic reaction to alprazolam, possibly allergic, was observed. Either alprazolam or diazepam appeared to be effective in the treatment of generalized anxiety disorder, and the statistically significant differences between the two drugs were not clinically striking.
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PMID:Alprazolam and diazepam in the treatment of generalized anxiety. 614 26

Two cases of basal ganglia calcification involving the globus pallidus are presented. Both patients had cognitive dysfunction, temporal lobe-like symptoms (including amnestic state, perceptual distortions, or complex visual hallucinations), and myoclonus. Patient 1 manifested depression, auditory hallucinations, anxiety, paranoia, and postural tremor; patient 2 manifested multifocal dystonia with dystonic tremor. These cases supplement other reports of psychotic features and dementia associated with pallidal pathology. Additionally, the phenomena encountered in these cases are considered in light of recent advances in our understanding of basal ganglia functional pathways. These cases afford a potential pathophysiological window to the possible role of the globus pallidus in these neuropsychiatric conditions. In concert with other recent findings, these cases suggest specific pathway involvement in hallucinations, paranoia, depression, myoclonus, and dystonia. Further research will indicate if these pathways play a role in schizophrenia, mood disorders, and anxiety disorders.
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PMID:Neuropsychiatric disorders, myoclonus, and dystonia in calcification of basal ganglia pathways. 801 2

Anxiety is one of the common yet underdiagnosed mental health problems of Americans; as many as 20% of people seeking primary care have symptoms of treatable anxiety disorders. Untreated anxiety increases costly visits to urgent care. Clinicians need to screen for anxiety among patients at risk who have physical symptoms such as shortness of breath, nervousness, gastrointestinal upset, palpitations, muscle aches, tension, and insomnia. Other diagnostic clues include restlessness, nervousness, phobias, trembling, fatigue, and shaking. Onset typically occurs in the 20s but may occur at any age. Symptoms of two anxiety disorders, generalized anxiety disorder (GAD) and panic disorder, are discussed. A combination of treatments including antidepressant and anxiolytic medications, behavioral treatments, education (e.g., self-management, relaxation), and counseling (e.g., coping strategies) have high success rates; psychiatric consultations or referrals are useful.
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PMID:Diagnosis and treatment of panic disorder and generalized anxiety in primary care. 887 88

In 1962 propranolol, the first beta adrenoceptor antagonist (beta blocker), was brought on to the market. There is now a host of different beta blockers available, and these compounds are among the most commonly prescribed groups of drugs. The efficacy of beta blockers has been proven predominantly for the treatment of cardiovascular diseases. Beta blockers are also used for certain types of CNS disorders, such as anxiety disorders, essential tremor and migraine. While low toxicity means that they have a favorable risk-benefit ratio, given the high intensity of use, it is essential to have a comprehensive knowledge of adverse events. Adverse events of beta blockers that can be related to the CNS are quite often neglected, even in textbooks of clinical pharmacology or review articles, and thus often misdiagnosed. The following article, therefore, after summarizing the use of beta blockers for CNS indications, critically reviews the literature on centrally mediated adverse events. General pharmacological features of beta blockers and their molecular basis of action will briefly be addressed to the extent that they are or may become relevant for central nervous pharmacotherapy and side-effects.
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PMID:Adverse CNS-effects of beta-adrenoceptor blockers. 895 49

Associations between self-report symptom profiles for nicotine withdrawal, personality (TPQ, EPQ-R), life-time history of psychopathology and smoking history were examined in data obtained from 553 female adult Australian twins (246 regular smokers), aged 32-48 years, who had participated in a telephone interview survey that included life-time assessments of smoking history, nicotine dependence and symptoms of withdrawal. Two hundred and two respondents were from high-risk pairs where either the respondent or the respondent's co-twin had reported a life-time history of alcohol dependence; 351 were from control pairs. Latent class analysis was used to identify subtypes ('classes') of smokers reporting similar withdrawal symptom profiles. Three major classes were identified which appeared to represent a continuum from mild to severe nicotine withdrawal. Smokers from the severe withdrawal class were best characterized by hands shaking and by the prominence of depressive features. There were marked increases in life-time alcohol dependence rates as a function of severity class. In contrast, significantly elevated rates of major depression, conduct disorder and anxiety disorder were observed only among smokers from the most severe withdrawal class. Neuroticism was the only personality factor strongly associated with the development of withdrawal symptoms.
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PMID:Nicotine withdrawal in women. 929 47

Beta-adrenoceptors are members of a large family of hormone and neurotransmitter receptors that initiate their biological function by coupling to GTP-binding regulatory proteins. beta-Adrenoceptors can be subdivided into two main subgroups, designated beta1 and beta2. Atypical beta-adrenoceptors or beta3-adrenoceptors, which are present on adipocytes, have been demonstrated pharmacologically. Their function in adipose tissue is currently being investigated. Beta2-adrenoceptor agonists have played a key role in the treatment of asthma for some 30 years, being used for the relief and prophylaxis of symptoms. There is, however, no evidence that tolerance to the bronchodilator or anti-bronchoconstrictor effects of these drugs is responsible for the deleterious effects reported with the regular use of bronchodilators. In neuropsychiatry, beta-adrenoceptor antagonists have been used for the treatment of acute stress reactions and generalised anxiety, essential tremor and prophylaxis of migraine. In general, they are effective in anxiety disorders if the somatic symptoms are not extreme. For prophylactic treatment of migraine, beta-adrenoceptor antagonists such as propranolol, metoprolol, nadolol and atenolol are the drugs of first choice. In cardiology, beta-adrenoceptor antagonists are an important class for the treatment of high blood pressure, arrhythmias and angina pectoris, and for prevention of myocardial infarction. With chronic treatment, they reduce mortality in hypertension and prolong survival in patients with coronary heart disease.
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PMID:Current therapeutic uses and potential of beta-adrenoceptor agonists and antagonists. 955 98

The most common indication for the use of radiation therapy in the treatment of benign central nervous system disease is for the treatment of benign brain tumors, such as meningioma, pituitary adenoma, acoustic neuroma, arteriovenous malformation, and craniopharyngioma. Other less common benign intracranial tumors treated with radiation include chordoma, pilocytic astrocytoma, pineocytoma, choroid-plexus papilloma, hemangioblastoma, and temporal bone chemodectomas. Benign conditions, such as histiocytosis X, trigeminal neuralgia, and epilepsy, are also amenable to radiation treatment. There have also been reports of radiosurgery being used for the treatment of movement disorders and psychiatric disturbances, such as obsessive-compulsive and anxiety disorders. For benign brain tumors, radiation therapy as either primary or adjuvant therapy plays an integral role in improving local control. In the treatment of trigeminal neuralgia, epilepsy, tremor, and some psychiatric disturbances, radiosurgery may help ameliorate or eliminate some symptoms. Patients with benign central nervous system disease are expected to live a long time. As such, treatment should be highly conformal and based on three-dimensional planning using magnetic resonance imaging, computed tomography, or both. It is critical that damage to normal brain be minimized.
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PMID:Radiation therapy for benign central nervous system disease. 1009 4

The aim of this investigation was to establish the clinical and electromyographic pattern of tremor in patients with depression.Twenty-eight patients with depression and tremor and 30 patients with tremor and generalized anxiety disorder were investigated. Tremor was scored clinically by the Webster Tremor Scale. Electromyographic examination of tremor activity from antagonistic hand muscles was performed.Our results revealed in both groups of patients a postural and kinetic tremor with characteristics of an enhanced physiological tremor. Tremor involved only both upper limbs and no other body parts in all patients.In conclusion tremor in depression and generalized anxiety disorder is an enhanced physiological tremor.
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PMID:Clinical and electromyographic characteristics of tremor in patients with depression. 1069 91

Tremor is a well-known symptom of thyrotoxicosis, yet no detailed clinical and electromyographic (EMG) examination of it has been published. The aim of this investigation was to establish the clinical and EMG pattern of tremor in patients with thyrotoxicosis and to compare it with the well-known pattern of enhanced physiological tremor caused by anxiety. Twenty-six patients with thyrotoxicosis and tremor and 30 patients with tremor and generalised anxiety disorder were investigated. Tremor was scored clinically in all possible limb positions. EMG examination of tremor activity from antagonist hand muscles was performed. A postural and kinetic tremor with characteristics of an enhanced physiological tremor was found in patients with thyrotoxicosis and generalised anxiety disorder. Tremor involved only the upper limbs in all patients. In conclusion, tremor in thyrotoxicosis and generalised anxiety disorder is an enhanced physiological tremor which cannot be separated clinically or by EMG measurement. Both types of tremor have similar mechanisms and can be distinguished only by the circumstances responsible for their occurrence. Despite only a moderate correlation between tremor intensity and thyroid hormone levels, successful treatment of thyrotoxicosis results in a dramatic improvement of tremor.
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PMID:Clinical and electromyographic examination of tremor in patients with thyrotoxicosis. 1109 9


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