Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0043352 (xerostomia)
 4,250 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Imipramine and similarly acting compounds provoke a number of undesired reactions usually classified as so-called anticholinergic effects. Instances of dry mouth, disturbance of micturition and tachycardia are regularly quoted in the literature. It is contended that these effects are not necessarily due to inhibition of the vagal system, but preferentially attributable to increased activity of the sympathetic system, predominantly mediated by the beta- or the alpha-adrenergic receptors, depending on the organ affected. This hypothesis is not only theoretically interesting, but also of practical clinical significance with regard to possible remedies.
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PMID:Prejudices in pharmacology and pharmacotherapy. The so-called anticholinergic effect of antidepressants. 59 14

Lofepramine is a tricyclic antidepressant that is structurally similar to imipramine and is extensively metabolised to desipramine. In the absence of other major pharmacological effects it appears that its antidepressant activity stems from the facilitation of noradrenergic neurotransmission by uptake inhibition, and possibly by the additional facilitation of serotoninergic neurotransmission. The overall therapeutic efficacy of lofepramine is comparable to that of imipramine, amitriptyline, clomipramine, maprotiline and mianserin in patients with depression of varying severity, and coexisting anxiety. Dry mouth is the most commonly reported side effect of usual therapeutic doses of lofepramine, but the incidence of this and other anticholinergic side effects is less among patients treated with lofepramine than with imipramine. Lofepramine has not been associated with adverse effects on cardiac function even in cases of attempted suicide by overdose. Thus, providing its apparent favourable side effect profile is confirmed in practice, lofepramine may be a valuable alternative for treatment of the depressed patient where a tricyclic is indicated.
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PMID:Lofepramine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in depressive illness. 264 53

Fluvoxamine was given in placebo-controlled trials to 33 severely depressed patients of between 60 and 71 years, 29 received imipramine and 14 placebo. At week 4 of treatment fluvoxamine and imipramine were superior to placebo on the HAMD and CGI scales (P less than 0.05). There was indication of an earlier onset of antidepressant activity in the fluvoxamine group. There was no evidence of systematic changes in laboratory variables in any treatment group. Fluvoxamine and placebo had similar effects on heart rate and blood pressure. Imipramine was associated with significant postural falls in mean systolic pressure. The most frequent unwanted symptom with fluvoxamine was mild nausea, with imipramine, dry mouth. Toxic confusion was the major reason for dropout in the imipramine (n = 4) and nausea (n = 3) in the fluvoxamine-treated group.
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PMID:Fluvoxamine in the treatment of the older depressed patient; double-blind, placebo-controlled data. 310 46

The therapeutic dose range of nefazodone for treatment of major depression was examined in a series of placebo-controlled efficacy studies carried out during phase 2 and 3 premarketing clinical evaluation. Nefazodone is a new antidepressant drug with pharmacologic effects on both serotonin and norepinephrine neurotransmitters. The usual starting dose of nefazodone for depressed patients, unless they are being switched from a serotonin selective reuptake inhibitor (SSRI), is 100 mg. b.i.d. A lower starting dose is recommended for elderly patients or patients being treated with an SSRI. Following assessment of the patient's clinical response after the first week of therapy, the daily dose should be adjusted upward for most patients. In the efficacy studies, the majority of patients were being maintained on a dose of 300 to 500 mg daily at the end of the acute treatment period. The side effects of nefazodone most often related to dosage were sedation, nausea, and visual symptoms. Imipramine-treated patients, on the other hand, had a high incidence of dry mouth, constipation, and asthenia. In these studies, nefazodone was found to be effective and well tolerated by patients, the majority of whom were being maintained at a 300- to 500-mg/day dose, following an initial starting dose of 100 mg b.i.d.
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PMID:Therapeutic dose range of nefazodone in the treatment of major depression. 862 65

Approximately 20 million patients suffer from major depressive disorder each year, indicating a need for antidepressant agents that are synonymous with effectiveness, tolerability and patient compliance. The authors examined the effects of fluvoxamine, a selective serotonin reuptake inhibitor, in the treatment of outpatients meeting DSM-III-R criteria for major depressive disorder. A randomized, double-blind, parallel group, placebo- and imipramine-controlled single center study was conducted in 150 outpatients. Patients were randomized to receive up to 150 mg/day of fluvoxamine as a single bedtime dose, 240 mg/day of imipramine on a twice-daily (BID) schedule, or placebo for six weeks. Efficacy measurements included HAM-D, MADRS, CGI, Raskin-Covi and SCL-56 scales. The HAM-D total score indicated that both active treatment groups showed significantly (p < or = 0.05) greater therapeutic benefit than did placebo. Severely depressed patients (HAM-D > or = 30) responded better to fluvoxamine in five of six measures. Side-effects from fluvoxamine were similar to those reported for other selective serotonin reuptake inhibitors (nausea, somnolence) and were well tolerated. Imipramine was associated with anticholinergic effects such as dry mouth and dizziness. The pharmacokinetic properties of fluvoxamine which allow the drug to be administered as a single daily dose should aid in the maintenance of patient compliance, while offering significant clinical benefit in the improvement of depressive symptoms.
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PMID:Fluvoxamine versus imipramine and placebo: a double-blind comparison in depressed patients. 880 49

Urinary urgency is the key symptom of overactive bladder (OAB) and often forces patients to modify their lifestyle or daily routine. The impact of OAB on quality of life is significant. Antimuscarinics, an established pharmaceutical treatment for OAB, were originally thought to affect parasympathetic efferents to the bladder; however, there is increasing evidence of an important effect on afferent pathways. Dry mouth and constipation are the most common undesirable events resulting from the use of these agents. Imipramine, a tricyclic antidepressant, is a useful drug for the treatment of OAB, especially when combined with antimuscarinic agents, although this has not been adequately assessed as yet. One result of research in this field is the upcoming introduction of beta-3 agonists in the treatment of OAB. Botulinum toxin, a minimally invasive medical treatment, represents a new era for the treatment of refractory OAB. Despite the fact that this is currently an off-label treatment, it actually represents a widespread alternative method of therapy when conventional medical treatment fails. Pharmacotherapy will continue to play a major role in the treatment of OAB in the future.
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PMID:The pharmacotherapy of overactive bladder. 2129 48