Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0085631 (agitation)
 12,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ten patients with severe dementia due to Alzheimer's disease (AD) or multi-infarct dementia (MID) or both, were treated with the precursor amino acids of the neurotransmitters serotonin and dopamine. The precursor amino acids (PAA) were given orally in a preparation that included tyrosine (4 gm daily) and 5-hydroxy-tryptophan (5-HTP) (800 mg daily), plus carbidopa (100 mg daily) as an aromatic amino-acid decarboxylase inhibitor. Diagnosis was established by an electroencephalogram, brain scan, computerized axial tomographic scan, and in one case by necropsy findings. Serial clinical evaluations and measurements of neuropsychologic function were performed. Levels of homovanillic acid (HVA) and 5-hydroxyindole-acetic acid (5-HIAA) were determined before and after administration of probenecid. Side effects of the PAA therapy were diarrhea, drowsiness, nausea, vomiting and agitation, all of which were controlled by reducing the dosage. One patient with MID and one with AD+MID showed clinical and psychologic improvement, but the others did not improve. Analysis of the cerebrospinal fluid for HVA and 5-HIAA before and after the probenecid test indicated some improvement in the metabolic turnover of these acid metabolites of serotonin and dopamine after administration of their precursor amino acids.
 ...
PMID:Neurotransmitter precursor amino acids in the treatment of multi-infarct dementia and Alzheimer's disease. 30 Nov 48

Thirty-eight in-patients with endogenous- and 20 in-patients with non-endogenous depression, took part in a multi-centre 3-week double-blind trial where patients were randomly allocated to treatment with either 6 g L-tryptophan or 150 mg imipramine daily. Item analysis of Hamilton ratings, before the investigation and weekly during the trial period demonstrated few statistically different mean scores on individual items between the two treatment groups. After 3 weeks' treatment a statistically significant item mean reduction on the 0.1% level was found in the item Agitation in favour of imipramine-treated, and in the item Work and Activities in favour of L-tryptophan-treated endogenously depressed patients. After 3 weeks' treatment a statistically significant item mean reduction on the 5% level was found in the item Suicide in favour of imipramine-treated non-endogenously depressed patients. The present study has shown that, after 3 weeks' treatment, imipramine and L-tryptophan has decreased the mean score on individual items of HRS in about the same degree.
 ...
PMID:Symptom reduction in depression after treatment with L-tryptophan or imipramine. Item analysis of Hamilton rating scale for depression. 38 15

The evidence for disturbances of tryptophan and 5-hydroxytryptamine in depression and for various mechanisms by which such disturbances could occur is discussed. Two recent relevant studies in the author's laboratory are described: a) non-esterified fatty acid and total and free tryptophan were determined in plasmas of psychiatric patients unselected with respect to psychiatric diagnosis before and after a stress situation. Retarded patients had significantly low total and free tryptophan values which correlated negatively with agitation. Total tryptophan fell significantly after stress in the non-retarded subjects. The only biochemical abnormality significantly associated with a diagnosis of primary depression was the rise of plasma non-esterified fatty acid after stress. Thus tryptophan abnormalities were associated more with psychiatric rating scores than with diagnoses. b) Determinations on plasma and lumbar and ventricular CSF from psychiatric patients undergoing psychosurgery indicate that low plasma free tryptophan concentrations are associated with decreased 5HT turnover in the central nervous system.
 ...
PMID:Study of disturbed tryptophan metabolism in depressive illness. 44 10

Non-esterified fatty acid and total and free tryptophan were determined in the plasma of psychiatric patients unselected with respect to psychiatric diagnosis and in the plasma of normal subjects before and after physiological and psychiatric tests. Retarded patients had significantly low total and free tryptophan values which correlated negatively with agitation. Total tryptophan fell significantly after testing in the non-retarded subjects. The only biochemical abnormality significantly associated with a diagnosis of primary depression was the rise of plasma non-esterified fatty acid after testing. Thus, tryptophan abnormalities were associated more with psychiatric rating scores than with diagnoses.
 ...
PMID:Tryptophan disposition in psychiatric patients before and after stress. 48 68

L-tryptophan (L-T) was added at a dose of 150-450 mg daily to eight Parkinsonian patients who developed visual hallucinations with paranoidal features under L-dopa (L-D) treatment (112.5-75 mg daily) in combination with alpha-methyldopa hydrazine (12.5-75 mg daily). In six patients L-T ameliorated the symptomatology by arresting the visual paranoidal hallucinations or diminishing their frequency and relieving the psychomotor agitation. As a 'side effect', L-T produced new 'pleasurable', 'LSD-like' visual images in three patients. In two patients, in whom L-T did not affect the mental disturbances, amelioration was obtained only by phenothiazines. Theoretical considerations on the role of dopamine in the genesis of visual hallucinations and mental disturbances emphasizes the benefit of L-T administration in this 'organomental' syndrome.
 ...
PMID:L-tryptophan administration in L-dopa-induced hallucinations in elderly Parkinsonian patients. 89 50

Mental symptoms increased in frequency among 100 patients with parkinsonism treated with levodopa. Dementia was found in about one-third of patients throughout the 6-year treatment period. Thirteen patients became demented during the study, and dementia worsened severely in seven others. Agitated confusion became increasingly frequent and was observed in 60 percent of patients taking levodopa for 6 years. Withdrawal from levodopa decreased agitation, but not dementia. Ten patients received L-tryptophan along with levodopa, but no change in mentation was observed. In view of previous studies of mentation in Parkinson's disease and reports of widespread neuronal changes in the brain of autopsied patients with parkinsonism, our results suggest that the high incidence of dementia in patients with Parkinson's disease who take levodopa reflects prolongation of the course of the illness rather than a direct effect of the medication.
 ...
PMID:Mental symptoms in Parkinson's disease during chronic treatment with levodopa. 94 87

The behaviour of some urinary metabolites of tryptophan/nicotinic acid pathway was studied in 7 patients with Parkinson's disease during a 24-day period of levodopa treatment. Corresponding to the appearance of side-effects (agitation, anorexia, dysphagia, glossitis, abdominal pains) in 5 patients there was an increase in urinary Ky, AA, AAG, o-AHA, and 3-HK, while 3-HAA excretion fell. Since no other drugs were given, it was presumed that this effect was due to levodopa administration.
 ...
PMID:Tryptophan/nicotinic acid pathway during levodopa treatment of Parkinsonism. 124 93

Agitation is a difficult problem to manage when patients suffer from cognitive impairment of varied etiology. In this article, the author proposes a combination of trazodone and tryptophan as a therapeutic possibility. The author presents an illustrative case. The patient was a 67 year old woman with a left cerebrovascular accident and a global aphasia who presented behaviour problems: she was restless, agitated, noisy, aggressive, screaming, howling and crying. In spite of treatment with neuroleptic, anxiolytic and antidepressive medication, behaviour did not improve. The use of a combination of trazodone and tryptophan was successful.
 ...
PMID:[Pharmacotherapy to control agitation in patients with cognitive deficits]. 186 30

The hematologic and pathologic effects of orally administered L-tryptophan and indoleactic acid and of L-tryptophan administered IV were studied in ponies. Sixteen adult Shetland ponies were allotted into 4 experimental groups. Group 1 consisted of 5 ponies (1-5) given 0.6 g of tryptophan/kg of body weight in a water slurry via stomach tube. Group 2 included 4 ponies (6-9) given 0.35 g of tryptophan/kg orally. Group-3 ponies (10-13) were given 0.35 g of indoleacetic acid/kg orally. Group 4 consisted of 3 ponies (14-16) given a single 4-hour IV infusion of 0.1 g of tryptophan/kg. Restlessness, increased respiratory rate, hemolysis, and hemoglobinuria were detected in 4 of the 5 group-1 ponies. Only pony 7 in group 2 developed hemolysis, hemoglobinuria, and a significant increase in respiratory rate. Renal pathologic lesions, consistent with hemoglobinuric nephrosis, were seen in ponies 2, 4, 5, and 7. Bronchiolar degeneration was evident in 4 of 9 ponies given tryptophan orally. The importance of these respiratory lesions was unknown. Clinical or pathologic abnormalities were not noticed in the ponies of groups 3 and 4. Mean plasma tryptophan values increased significantly in groups 1 and 2 at 6 hours after dosing. A second peak of tryptophan was detected in both groups at 12 hours. Values returned to predose values by 48 hours. Plasma indole and 3-methylindole concentrations were detectable in only 2 ponies (4 and 7). In vitro incubations of cecal fluid from ponies 6, 8, and 9 yielded a percentage conversion of tryptophan to indole of 16.75%, 5.84%, and 7.96%, respectively. 3-Methylindole was not produced. These results suggested that indole was the major metabolite of orally administered tryptophan in these ponies.
 ...
PMID:Acute hemolytic anemia after oral administration of L-tryptophan in ponies. 185

Cerebrospinal fluid (CSF) 5-hydroxyindoleacetic acid (5HIAA), homovanillic acid (HVA) and tryptophan (TRY) were measured in 14 male alcohol-dependent patients with delirium tremens. Lumbar punctures were performed immediately after admission following a standardized psychiatric examination and symptom rating in a drug-free state. Results were compared with a control group consisting of 32 neurological patients with only peripheral disorders, excluding spinal processes and abnormal routine CSF findings. All three substances were significantly increased in delirium tremens; 5HIAA showed the most marked and TRY the least pronounced increase. The statistical correction for age, height and body weight did not decrease but somewhat increased the differences. Duration of alcohol abuse did not account for the observed metabolic changes; severity of delirium tremens, however, correlated significantly with the 5HIAA and to a lesser degree with the HVA level. The further analysis revealed a differential relationship of the amine metabolite concentrations to some prominent symptoms: agitation was significantly dependent only on the HVA level while disorientation and hallucination seemed to be determined mostly by the serotonin metabolite 5HIAA in the CSF. TRY concentration proved to be unrelated to either global severity or any of these symptoms.
 ...
PMID:Cerebrospinal fluid amine metabolites in delirium tremens. 617 95


1 2 3 4 Next >>