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Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tetrabenazine, a presynaptic monoamine depleting agent, has been reported to have an ameliorating effect in a variety of hyperkinetic movement disorders. In a double-blind crossover trial of tetrabenazine versus placebo, 19 patients with a variety of hyperkinetic movement disorders were evaluated. During the evaluation period, all but 4 patients were treated for three or more weeks at a maximum dosage of 200 mg per day. The patients were examined and rated using clinical assessment of hyperkinesia, and movies of their activities were randomized and rated by an independent group of neurologists. A good correlation was found between the clinical examination scale and the film analysis score. Improvement was seen in all 4 patients with tardive dyskinesia, 4 of 6 patients with Meige disease, and 5 of 6 patients with other dystonias. One patient with Huntington disease showed marked improvement and 2 patients with congenital choreoathetosis showed only mild improvement. The most frequent side effects included daytime drowsiness, drooling or sialorrhea, insomnia, restlessness and anxiety, parkinsonian features, and mild postural hypotension. The adverse effects resolved with continued administration or with reduction in dosage. Tetrabenazine is a useful and safe therapeutic agent in some patients with hyperkinetic movement disorders.
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PMID:Treatment of hyperkinetic movement disorders with tetrabenazine: a double-blind crossover study. 646 Apr 67

In this study, 31 patients with involutional-onset major depression had significantly more somatization and hypochondriasis and less loss of libido, guilt, suicidal intent, and family history of depression than 60 patients with an earlier onset. Regardless of age at onset, patients over age 50 had more agitation, initial insomnia, and hypochondriasis than those under 50. These findings suggest that clinical characteristics of patients with unipolar endogenous depression may be influenced by age at both onset and time of current episode. Although there is insufficient evidence to view involutional melancholia as a separate clinical entity, further research into the genetic and biochemical basis of late-onset depression is warranted.
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PMID:Involutional melancholia revisited. 669 57

A double-blind randomized study was performed in 86 depressed out-patients, in order to compare the efficacy and tolerance of mianserin (30 to 60 mg daily) with that of nortriptyline (75 to 150 mg daily). Both drugs were administered for 6 weeks after a wash-out period of 1 week. The Hamilton Rating Scale for Depression was used weekly and the Clinical Global Impression Scale at the end of treatment. Both preparations proved to be effective, with no significant differences in response. However, tolerance in the mianserin group was much better than in the nortriptyline group. Significant differences were found mainly in the incidence and severity of tachycardia, dry mouth, constipation, sweating, insomnia, agitation and oedema.
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PMID:The clinical efficacy and side-effects of mianserin and nortriptyline in depressed out-patients: a double-blind randomized trial. 675 61

In an open clinical trial, Ro 11-1163, a newly developed MAO inhibitor, was given to 11 depressed patients, in a flexible dose, for 6 weeks. The clinical effect was measured on the 3rd day and at weekly intervals using the Hamilton and the Beck rating scales for depression and an overall self-assessment. A marked antidepressant effect was observed in almost all cases, which became evident as early as the 2nd day and resulted in complete remission in most patients at the end of the treatment period, with doses ranging between 100 and 400 mg/day. No serious side effects were noted, except for a transient agitation and insomnia. A battery of clinical and laboratory tests also failed to reveal any marked change during treatment. The results suggest that Ro 11-1163 is an effective antidepressant that has to be further evaluated by double-blind clinical trials.
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PMID:Antidepressant effect of Ro 11-1163, a new MAO inhibitor. 704 18

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

The symptoms exhibited by 100 depressed patients from Western India were studied. A statistical comparison was made of these symptoms with the symptoms of British depressed patients, reported in two studies from Newcastle-upon-Tyne. The symptoms in this group are similar to what has been reported for the Indian population in general except for paranoid features, which were less common. Compared with depressed patients from North India, somatic symptoms were significantly more common, while late insomnia, reduction in work and activities, and retardation were significant less frequent. Compared to South Indian depressed patients, depressed mood and hypochondriasis were significantly greater, and suicidal tendency and diurnal variation significantly less. Amongst Indian depressed patients generally, somatic symptoms, hypochondriasis, anxiety and agitation are present in a significantly larger percentage of patients, but guilt feelings, obsessional and paranoid symptoms are significantly less frequent, compared with British depressed patients.
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PMID:A cross cultural study of symptomatology of depression--eastern versus western patients. 711 58

The presenting symptom complex, diagnostic features, and therapeutic alternatives for obstructive and central sleep apnea are discussed in relation to two illustrative patients. Heavy snoring and restlessness during sleep in an obese individual, usually a male, may indicate obstructive apnea. Daytime hypersomnolence, intellectual deterioration, mental depression, impotence, cardiac arrhythmias, cor pulmonale, systemic hypertension, and erythrocytosis are the most common complications. Tracheostomy, the classic form of therapy, can be replaced by pharmacologic intervention in most patients. The clinical presentation of central apnea is less dramatic, but neurological and cardiac complications can occur. Therapy is less well established for this entity. Knowledge of the increased incidence of these disorders and awareness of more subtle complications indicate that sleep apnea should be placed in the differential diagnosis of pulmonary and systemic hypertension, hypersomnolence states, mental deterioration, psychiatric illness, and even insomnia.
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PMID:Diagnosis and therapy of sleep apnea. 722 83

Clonidine hydrochloride was found to be effective in the treatment of methadone hydrochloride withdrawal. Under controlled inpatient conditions established to assess dosage guidelines and to examine specific signs and symptoms of withdrawal, 20 of 25 (80%) patients were able to withdraw completely from methadone by the end of a two-week period. In most patients, ten to 11 days of clonidine administration, with a peak mean dose of 16 micro g /kg/day, resulted in a perceived reduction in symptoms compared with previous attempts to become opiate free. At these doses clonidine significantly reduced standing blood pressure without producing clinical problems. The withdrawal symptoms of anxiety, restlessness, insomnia, and muscular aching were most resistant to clonidine treatment and were reported by the majority of patients.
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PMID:The clinical use of clonidine in abrupt withdrawal from methadone. Effects on blood pressure and specific signs and symptoms. 730 8

In an open study the cholinolytic biperiden was administered to 10 severely depressed inpatients in an average dose of 12 mg per day for 30 days. Patients were classified according to the International Classification of Diseases, the research Diagnostic Criteria and the Newcastle Scale. A significant improvement was demonstrated in the global score of the Hamilton Depression Scale (p less than 0.001). Especially the factors retardation (p less than 0.001) and agitation (p less than 0.001) and the items depressed mood (p less than 0.001), initial insomnia (p less than 0.05), work and interest (p less than 0.001) and gastrointestinal symptoms (p less than 0.001) could favorably be influenced. Nevertheless, biperiden treatment had to be discontinued after three weeks in two patients because of a paranoid syndrome in one case and symptoms of inner restlessness and disturbances of vital feelings in the other case. There was a positive correlation between the clinical response and the cortisol non-suppressability to dexamethasone prior to the study (p less than 0.03). These results taken together with other findings from the literature suggest that cholinergic mechanisms may have an important impact on the pathogenesis of certain forms of depression.
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PMID:The anticholinergic biperiden in depressive disorders. 732 39


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