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

Among some 14 new antiepileptic drugs (AEDs), those most extensively tested in humans include felbamate (FBM), gabapentin (GBP), lamotrigine (LTG), oxcarbazepine (OCBZ), vigabatrin (VGB), and zonisamide (ZNS). All are currently marketed in some but not all countries. Although no large, comparative studies on efficacy have been conducted, all of these new AEDs are effective in adult localization-related epilepsies, and some have activity in specific syndromes. Although these drugs all have some CNS side effects, especially when administered in combination with other AEDs, they also all have low toxicity profiles. The availability of AEDs with different mechanisms of action may facilitate rational polytherapy. FBM is not teratogenic in animals. Half-life of FBM in humans is 11-28 h. Daily FBM dosages are 15-45 mg/kg in children and 2,400-4,800 mg in adults. Side effects include insomnia and anorexia, with weight loss. FBM increases phenytoin (PHT) and valproate (VPA) concentrations, and FBM concentration may be affected by other drugs. It is available in the United States for treatment of Lennox-Gastaut syndrome and partial seizures in adults. GBP is very water soluble. Half-life of GBP in humans is 5-7 h and daily dosages range from 900 to 2,400 mg in adults. Few side effects have been observed. GBP is not metabolized by the liver and has no drug interactions. It is available in the United Kingdom and the United States. LTG has no teratogenicity in animal models. Half-life of LTG in humans depends on co-medication: with enzyme inducers it is 15-24 h, and with VPA it is approximately 60 h. LTG dosages are 100-600 mg/day in adults. LTG is available in Europe. OCBZ is rapidly metabolized to 10,11-dihydro-10-hydroxy-carbazepine (MHD), the active compound. Animal studies have shown similar efficacy but superior toxicity to carbamazepine (CBZ) in animal models. For MHD, half-life ranges from 10 to 15 h in patients. OCBZ dosages range from 300 to 1,800 mg/day. VGB is a potent, irreversible inhibitor of GABA transaminase which elevates GABA levels in the CNS. Daily dosages of 2,000-4,000 mg of VGB are needed in adults. Although intramyelinic edema has developed in rats and dogs, it has not yet presented in other mammals or humans. ZNS is a sulfonamide effective in animal models of epilepsy. Half-life of ZNS is 27-36 h. ZNS daily dosage is 400-600 mg. ZNS has been effective in some cases of Baltic myoclonic epilepsy.
 ...
PMID:Antiepileptic drugs in development: prospects for the near future. 817 17

The efficacy of tropisetron, a new 5-HT3 receptor antagonist, was evaluated in a group of 15 children with a variety of malignant tumours. The majority of children (14/15) received fractionated chemotherapy and on day one complete control of acute nausea and vomiting was observed in 68.7% of all patients with a single, 15-minute, i.v. infusion of tropisetron. Partial control of vomiting was observed in 25% of patients and of nausea in 31.3% of patients on Day 1. Complete control of delayed nausea and vomiting was more variable, with an observed range between 50%-81% of patients over Days 2-6. There was no loss of appetite in 75% of patients treated with tropisetron on Day 1 and, more variably, in 62%-87% of patients on Days 2-6. Side effects were recorded in 18.8% of chemotherapy cycles, the most significant being insomnia in 12.5% of cycles and slight fever in 6.3% of cycles. It was concluded that tropisetron was well suited for children and could be recommended for those receiving a high burden of fractionated chemotherapy.
 ...
PMID:Tropisetron in the control of nausea and vomiting induced by combined cancer chemotherapy in children. 836 98

Recently, we have established that major depression is characterized by hyperhaptoglobinemia, which may be regarded as an index of an "acute" phase response in that illness. The present study investigates the psychopathological correlates of increased plasma concentrations of haptoglobin (Hp) in major depression. To this end, the authors studied the Hp levels in relation to depressive items of the Structured Clinical Interview for DSM-III (SCID) and the Hamilton Rating Scale for Depression (HRSD) in 90 depressed subjects. There was a significant positive relationship between the SCID symptoms anorexia/weight loss, sleep, and psychomotor disorders and Hp plasma concentrations. Hp plasma levels were significantly and positively correlated with overall severity of illness (HRSD). The HRSD symptom correlates of higher Hp levels were loss of interest, middle insomnia, and psychomotor retardation. Up to 31.4% of the variance in Hp plasma values could be explained by psychomotor disorders, anorexia, weight loss, middle insomnia, and less diurnal variation of mood. It is suggested that hyperhaptoglobinemia, as an index of an "acute" phase response in major depression, is related to the somatic dimension of depressive illness.
 ...
PMID:Psychomotor retardation, anorexia, weight loss, sleep disturbances, and loss of energy: psychopathological correlates of hyperhaptoglobinemia during major depression. 837 61

Nineteen patients treated by continuous ambulatory peritoneal dialysis (CAPD) were studied according to clinical outcome parameters: insomnia, asthenia, pruritus, arterial hypertension, anorexia, nausea and/or vomiting, anemia, and rate of hospitalization. Using clinical scores, three groups were defined: poor clinical outcome (P), intermediate (I), and good (G). The quantity of treatment by PD was evaluated monthly with urea kinetic tests (weekly Kt/V, weekly urea clearance/1.73 m2 of body surface area (BSA), index of dialysis by Teehan), and with the weekly creatinine clearance/1.73 m2 of BSA. The metabolic index was analyzed: normalized protein catabolic rate (NPCR), serum albumin (Alb) and prealbumin, and reabsorption of glucose. There was good correlation between clinical scores and quantity of dialysis. The Alb was lower in group P. Group G was differentiated from group I and from group P by quantification tests and NPCR, with lower levels as follows: weekly Kt/V = 2.06, urea clearance 70 L/week/1.73 m2, index of dialysis = 0.87, and creatinine clearance = 60 L/week/1.73 m2. We conclude that the qualitative clinical approach is not sufficient to predict deleterious signs, and the quantitative approach is predictive of the good clinical outcome and good nutritional status. We think that levels proposed to now are insufficient, and we suggest the following: weekly urea clearance > 70 L, weekly Kt/V > 2, weekly creatinine clearance > 60 L, and index of dialysis > 0.85.
 ...
PMID:Quantification of adequacy of peritoneal dialysis. 839 69

Ten HTLV-I-associated myelopathy (HAM) patients (four men and six women aged 38 to 58 years) with Expanded Disability Status Scale (EDSS) scores ranging from 4.0 to 8.5 entered an open-label zidovudine study. A high-dosage induction (2 g/d for 4 weeks) was followed by 1 g/d for 20 weeks. Five patients were natives of the Caribbean island Hispaniola, and one each was from Colombia, Cuba, El Salvador, Jamaica, and the United States; all were positive by polymerase chain reaction, and nine had positive Western immunoblots for HTLV-I. Side effects included anxiety, insomnia, gastric upset, anorexia, and loss of taste. Preexisting leg cramps were increased in two and headaches in one. Hemoglobin decreased from a mean of 13.5 to 11.8 g/dl and the hematocrit from 40.7% to 34.9% at 8 weeks, and then stabilized. Neutropenia appeared regularly but did not necessitate drug withdrawal. Mean EDSS scores changed little for the group as a whole, but the seven ambulatory patients improved objectively, with their scores dropping from 5.5 to 4.0 and none worsening. Timed gait improved by at least 50%. Following withdrawal, four of the five who had improved regressed. Zidovudine appears to be safe in subjects with HAM who have no other major health problems and should be investigated further.
 ...
PMID:High-dose zidovudine induction in HTLV-I-associated myelopathy: safety and possible efficacy. 841 77

Acute mountain sickness (AMS) affects, to varying degrees, all travelers to high altitudes (elevations greater than 5280 feet). In a small percentage of patients, AMS can lead to high-altitude pulmonary edema (HAPE) or high-altitude cerebral edema (HACE). Symptoms of AMS range from a combination of headache, insomnia, anorexia, nausea, and dizziness, to more serious manifestations, such as vomiting, dyspnea, muscle weakness, oliguria, peripheral edema, and retinal hemorrhage. Although the primary cause of these symptoms is related to the reduced oxygen content and humidity of the ambient air at high altitudes, the physiologic pathway relating hypoxemia to AMS and its sequelae remains unclear. Tips on self-diagnosis and symptom recognition are critical elements to be included in educating patients who are contemplating a trip to high altitudes. Preventive strategies include allowing 2 days of acclimatization before engaging in strenuous exercise at high altitudes, avoiding alcohol, and increasing fluid intake. Conditioning exercise for patients older than 35 years is also recommended before departure. A high-carbohydrate, low-fat, low-salt diet can also aid in preventing the onset of AMS. Acetazolamide (125 mg two or three times daily, or once at bedtime) has also been shown to reduce susceptibility to AMS and the incidence of HAPE and HACE. Although effective in treating cerebral symptoms of AMS, dexamethasone is not routinely recommended as a prophylactic agent for AMS.
 ...
PMID:A trek to the top: a review of acute mountain sickness. 855 56

Health-related quality of life (HQL) was assessed before and after either moderately or highly emetogenic chemotherapy. When the pretreatment HQL in patients who did not vomit after chemotherapy (n = 203) was compared to those who vomited (n = 230), it was found that patients who did not vomit had better physical, role, and social function scores as well as a better global quality of life score than did patients who had one or more episodes of vomiting. Furthermore, in patients who did not vomit, the pretreatment fatigue and anorexia scores were better than in patients who did vomit. Thus, pretreatment HQL scores appear to have value in predicting which patients will experience chemotherapy-induced emesis. In the week following chemotherapy, HQL change scores from prechemotherapy values for cognitive function, global quality of life, fatigue, anorexia, insomnia and dyspnea were significantly worse in the group experiencing emesis than in the group who remained completely free of emesis. There were no differences in physical, role, emotional and social function attributable to chemotherapy-induced vomiting.
 ...
PMID:Quality of life studies in chemotherapy-induced emesis. 869 59

The objective of this study was to describe the prevalence and course of depressive symptoms before AIDS in HIV-infected homosexual men. A descriptive and comparative analysis of data from HIV-infected and -uninfected homosexual men in the Multicenter AIDS Cohort Study was performed. The Center for Epidemiologic Studies Depression Scale (CES-D) was the primary measure of depressive symptoms. The prevalence of depressive symptoms and CES-D caseness estimates in the AIDS-free HIV-infected homosexual men were stable over time. Small differences between HIV seropositive and seronegative men were detected on the CES-D and on three of its subscales. These were mostly accounted for by less hope, and by more fearfulness, insomnia, and anorexia in the seropositive cohort. We concluded that there does not appear to be an overall increase in depressive symptoms in HIV-infected homosexual men from the time of infection until prior to AIDS. However, this group of men consistently report specific depressive symptoms more often. Implications of these findings for the clinical care of HIV-infected patients is discussed.
 ...
PMID:Depressive symptoms over the course of HIV infection before AIDS. 876 69

Patients are presenting in increasing numbers with multiorgan symptoms allegedly resulting from exposure to environmental chemicals. Among the symptoms expressed by patients with alleged multiple chemical sensitivities (MCS) are profound fatigue, mental confusion, myalgia, depression, anxiety, dizziness, headache, insomnia, loss of appetite, and numbness of the extremities, all in the absence of objective physical signs. Diagnostic criteria to assess the effects of environmental agents on organ systems are sorely needed because patients with MCS often have no tissue pathology or physiological abnormalities, but often do have diagnosable psychiatric illnesses. In treating patients with MCS, the physician should first perform a complete history and physical examination, including a comprehensive evaluation of chemical exposure. If the findings strongly suggest the presence of disease related to particular organ systems, further diagnostic evaluation should be undertaken. If abnormal findings are absent, psychiatric advice may be useful. The physician should keep an open mind about MCS but must also remember that a cause-effect relationship between exposure to multiple chemicals and symptoms has not been established.
 ...
PMID:Multiple chemical sensitivity multiorgan dysesthesia, multiple symptom complex, and multiple confusion: problems in diagnosing the patient presenting with unexplained multisystemic symptoms. 895 67

The objective of this study was to assess the psychiatric effects of the antiepileptic drug (AED) felbamate (FBM) in patients with epilepsy. FBM is a new AED with a novel putative (antiglutaminergic) mechanism. Older AEDs such as carbamazepine and valproate have psychotropic properties, but the psychiatric effects of FBM and other new antiglutamatergic AEDs remain to be determined. Thirty inpatients with refractory epilepsy were openly tapered off all AEDs in conjunction with intensive presurgical monitoring prior to a two week randomized double-blind parallel trial of FBM monotherapy versus placebo, followed by open FBM therapy. Psychopathology was rated with weekly psychiatric rating scales. Anxiety, depression and seizures increased significantly with AED discontinuation. Acute blind FBM monotherapy yielded antiepileptic and stimulant-like effects (insomnia, anorexia, and anxiety), but failed to influence AED withdrawal-emergent psychopathology. Restarting original AEDs resolved such pathology in FBM drop outs. Chronic open FBM also had stimulant-like effects, with half of the patients displaying psychiatric deterioration and the other half modest improvement compared to baseline therapies. Baseline insomnia and anxiety may be markers for poorer psychiatric responses to chronic open FBM. FBM had stimulant-like effects, lacked anxiolytic effects, and failed to attenuate AED withdrawal-emergent psychopathology. Baseline insomnia or anxiety may predict poorer psychiatric responses to FBM. Further studies are required to assess whether the novel psychiatric effects observed with FBM also occur with other new antiglutamatergic AEDs.
 ...
PMID:Felbamate monotherapy has stimulant-like effects in patients with epilepsy. 896 74


<< Previous 1 2 3 4 5 6 7 8 9 10