Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have described three patients who illustrate the broad clinical spectrum of quinacrine-associated neuropsychiatric disturbances. The toxic manifestations range from subtle changes of restlessness, insomnia, hyperirritability to frank psychosis and seizures. These symptoms may follow only a few doses of the drug, or they may occur well after the drug has been discontinued. Our patients reemphasize the importance of recognizing the variability of quinacrine-induced toxic reactions.
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PMID:Quinacrine-induced psychiatric disturbances. 706 14

Diclofensine inhibits uptake of serotonin, norepinephrine, and dopamine. In this pilot trial, 169 mostly hospitalized patients with various subtypes of depression were treated over a period of 30 days. From the data collected we were able to document a response rate of 75%. The response was characterized by psychoenergizing, mood alleviating effects. Symptoms such as depressed mood, psychomotor retardation, anxiety, ideas of suicide, phobic thoughts, and agitation contributed most to the overall improvement, whereas insomnia and delusions were little affected. Patients with non-psychotic depressions reacted more rapidly and impressively than patients with psychotic features. Also their dose requirements were less. Drop-outs due to adverse reactions were very low. Only a very few severely depressed patients showed a clinical deterioration after 1 week of initially good response. A number of patients continued on maintenance medication with diclofensine over a period of 2-4 months without showing any signs of abrupt dissipation. It can be hypothesized that diclofensine can be an effective drug for the relief of depressions, in particular for those patients who require psychic energization. Its nonsedative profile, good tolerance, and broad margin of safety make this drug particularly interesting for the general practice.
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PMID:Pilot trials with diclofensine, a new psychoactive drug in depressed patients. 710 85

Psychiatric manifestations were studied in 72 amputees in the post-operative period. All were right handed. Besides phantom limb phenomena, which were observed in nearly four-fifths of the cases and are described in another paper, nearly two-thirds had psychiatric symptoms inthe form of depression (45 patients), anxiety (38), crying spells (38), insomnia (34), loss of appetite (23), suicidal ideas (21) and psychotic behaviour (2). Right arm amputees had phantom phenomena and insomnia significantly more often than left. Nearly one-fifth of the cases were diagnosed as having psychotic depressive reactions, two-fifths as having depressive neurosis and two, both with right upper limb amputations, as schizophrenic.
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PMID:A psychiatric study of amputees. 711 72

Twenty-four children treated wih flupenthixol for behavioural disorders were studied in the out-patient clinic. The drug was given in small doses (0.4 to 2.0 mg per day) for periods ranging from 6 months to 2 years as an alternative to psychotherapy in cases where the latter was not possible. All patients were diagnosed clinically and psychologically as suffering from progressive symptoms of aggression or psychosis. Both the clinical and the psychological assessments showed improvement, particularly in insomnia and aggression. There was also improvement in social contact and concentration leading to improvement in performance at school. Although the health of the children remained very delicate, the results achieved with flupenthixol appeared to be stable even after treatment was stopped.
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PMID:The use of flupenthixol ('Fluanxol') in the management of behavioural disorders in disturbed and psychotic children. 713 29

The diazepam withdrawal syndrome was studied in 10 patients who had abused the drug for 3 to 14 years. In the previous 6 months their consumption of diazepam had ranged from 60 to 120 mg daily; none had used other drugs during this period. The withdrawal period lasted about 6 weeks. The intensity of the symptoms and signs was high initially, fell during the first 2 weeks, then rose again in the third week, before finally declining. Three groups of symptoms and signs were identified. Group A symptoms occurred throughout withdrawal and included tremor, anorexia, insomnia and myoclonus. Group B symptoms and signs were largely confined to the first 10 days and were those of a toxic psychosis. Group C symptoms reached a peak in the third and fourth weeks of withdrawal and were characterized by sense perceptions that were either heightened or lowered. The symptom groups, the presence of tremor and myoclonus, and the relief of symptoms by a test dose permit diazepam withdrawal to be distinguished from anxiety. The biphasic course of the symptoms is probably related to the pharmacokinetics of diazepam.
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PMID:Diazepam withdrawal syndrome: its prolonged and changing nature. 713 56

Sleeplessness and resting pulse rate were studied in relation to behavioral treatment of 34 chronic psychotics using an 18-week ABAB research design. These arousal measures, unrelated in the base line, showed significant opposing changes during four of the first ten treatment weeks. Sleeplessness improved proportionately with clinical response, gauged by social participation, whereas pulse rates were significantly exacerbated early in treatment. When treatment was withdrawn and reinstated, pulse rates correspondingly decreased and increased significantly. These results suggested that arousal changes transcend specific drug action and are a consequence of treatment -- possibly a hindrance -- rather than its source. The systematic differences supported a distinction between two arousal processes, on responsive and one resistant to treatment. It was proposed that the elevation of autonomic arousal with treatment may reflect dysphoria from threat to psychotic homeostasis and consequent therapeutic resistance. Implications were drawn regarding clinical intervention with poor prognosis psychotics, a two-factor model of arousal disorder, and a nonunitary approach to arousal research.
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PMID:Disjunctive arousal changes as a consequence of nondrug clinical intervention. 722 74

We have attempted to clarify clinical differentiating features of psychotic depression. Forty-six depressed subjects meeting DSM-III-R criteria for major depression with psychotic features were compared with (i) DSM-defined melancholic, (ii) Newcastle-defined endogenous, and (iii) a residual DSM-defined major depressive episode group. Additionally, a 'bottom up' latent class analysis (LCA) suggested a larger sample of 82 'psychotic depressive' subjects, and multivariate analyses contrasted these subjects with both LCA-identified melancholic and all residual depressed subjects. Analyses suggested that, in addition to two features with absolute specificity (delusions and hallucinations), both the DSM-defined and LCA-defined 'psychotic depressive' subjects were significantly more likely to demonstrate marked psychomotor disturbance, to report two morbid cognitions (feeling sinful and guilty; feeling deserving of punishment), as well as be more likely to report constipation, terminal insomnia, appetite/weight loss and (variable across the defined 'psychotic depressive' groups) loss of interest and pleasure. The study identifies a wider set of potentially discriminating clinical variables than previous studies, as well as both indicating the existence and assisting identification of 'true' psychotic depression in the absence of formal psychotic features being acknowledged or elicited.
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PMID:Sub-typing depression, II. Clinical distinction of psychotic depression and non-psychotic melancholia. 748 Apr 60

The therapeutic efficacy, utility and safety of bifemelane hydrochloride were studied in 52 elderly depressive patients. The drug was administered as a tablet containing 50 mg orally three times daily for 8 consecutive weeks. The final global improvement rating and global utility rating were respectively 80.8 and 73.1 percent for all patients. The improvement rates on the Hamilton depression rating scale (HAM-D) were more than 60% for depressed mood, guilt, suicide, middle insomnia, delayed insomnia, psychotic anxiety, gastro-intestinal symptom, hypochondriasis, depersonalization and derealization. The rates regarding global symptoms evaluated by the Psychoneurotic rating scale for doctor's use were more than 60% for tension, agitation, irritability and excitement, phobia, depression, hypochondria and nocturnal delirium in psychotic symptoms, and insomnia in addition to palpitation in somatic symptoms. A significant decrease was also observed in the symptoms covered by the Self-rating depression scale of Zung after treatment with this drug. There were no instances of side-effects, nor any abnormalities in laboratory tests, encountered throughout the trial. Therefore, bifemelane hydrochloride is of value for the treatment of geriatric depression.
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PMID:The effects of bifemelane hydrochloride on depressive illness of the elderly. 749 Jan 69

Respiratory patients require psychotropic drug administration to treat pain, cough and respiratory distress or to treat insomnia, anxiety, depression or psychosis. Terminal patients require thoughtful and compassionate use of these drugs, even when there is an expectation that such therapy may lead to an earlier death. Most psychotropic agents can be used safely in patients with respiratory disease, and careful use of selected drugs should always be employed if indicated for treating distressful conditions that may be benefitted. Guidelines to appropriate choices and doses are provided.
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PMID:Psychotropic drugs in terminal care. 753 7

The development of new antiepileptic drugs in recent years has enlarged the number of anticonvulsant compounds for the treatment of intractable focal epilepsies. The anticonvulsant potency of these drugs is usually compared by the number of patients who achieve a reduction in seizure frequency of more than 50%. Such an effect can be observed in approximately 20-30% of patients with pharmacoresistant focal epilepsies and is about the same with all the new compounds. In addition to the influence on focal seizures some of the novel anticonvulsant drugs exhibit efficacy in generalized seizures or in Lennox-Gastaut syndrome. In general there are fewer side effects in newly developed drugs than in standard anticonvulsants. However, in some cases characteristic side effects may occur: weight gain, depression or psychosis from vigabatrin; lamotrigine may provoke allergic rashes and felbamate may cause gastrointestinal side effects and sleeplessness. Apart from felbamate, there are no interactions with an antiepileptic comedication or they are of little importance. The development of the new anticonvulsants follows a rational design based on pathophysiological aspects: the main aim is to influence synaptic transmission, resulting in an increase in inhibitory and a decrease in excitatory transmitters. Thus, vigabatrin and tiagabine enhance the endogenous GABA amount, whereas felbamate and remacemide interact with the NMDA-receptor complex. Because it is not possible to draw sufficient conclusions from add-on studies in clinical testing it is necessary to establish new forms of trial design. Monotherapy designs are favored because they lack possible interactions with comedication and make the anticonvulsant efficacy of the compound better comparable to those of established anticonvulsants.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Anticonvulsive drug therapy. Historical and current aspects]. 754 58


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