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)

A total of 61 patients with recurrent or persistent clinically measurable platin-resistant epithelial ovarian carcinoma were treated with 260 mg/m2 oral hexamethylmelamine daily for 14 days, repeated at 4-week intervals. Platin resistance was defined as progression or stable disease during cis- or carboplatin treatment (used alone or in combination with other drugs), or relapse within 6 months after the end of that therapy. Fifty patients were evaluable for response and 57 for toxicity. The objective response rate was 14% (3 complete and 4 partial responses). The response rate was higher in patients with relapse within 6 months than in patients with progression or stable disease on platin-based therapy. This observation underscores the importance of defining response and time to progression after first-line chemotherapy. The median duration of response was 8 months and the median survival in responding patients was 9+ months versus 5 months for patients with progression on hexamethylmelamine. Nausea and vomiting requiring antiemetic treatment occurred in 8 (14%) patients and reversible peripheral neuropathy in 3 patients. Two patients developed agitation, insomnia, and depression during hexamethylmelamine therapy. In conclusion, the 14% objective response rate and the occurrence of complete responses with oral hexamethylmelamine treatment in a group of ovarian cancer patients with true platin resistance are noteworthy.
Gynecol Oncol 1992 Dec
PMID:Hexamethylmelamine as second-line therapy in platin-resistant ovarian cancer. 147 37

We report the association between periodic leg movements (PLM) during sleep and congestive heart failure (CHF) in a patient who had a successful heart transplant. Pretransplant, the patient had chronic insomnia and CHF. Overnight polysomnography revealed severe PLM disorder and sleep disruption. Three months following transplantation his insomnia had resolved associated with a dramatic reduction in PLM.
Sleep 1992 Dec
PMID:Periodic leg movements during sleep before and after heart transplantation. 147 62

Delta sleep-inducing-peptide (DSIP) has been reported to increase sleep in subjects with insomnia. The authors studied cerebrospinal fluid (CSF) DSIP-like immunoreactivity (DSIP-LI) in 15 drug-free male subjects with a DSM-IIIR diagnosis of schizophrenia. The subjects underwent a lumbar puncture and three nights of polysomnography. CSF DSIP-LI was significantly correlated with polysomnography the night before the LP: with stage 3 sleep (p = 0.05), stage 3 and delta (stages 3 + 4) sleep during the first nonrapid eye movement NREM period (p = 0.02 and p = 0.05, respectively) and the ratio of the first and second NREM period (p < 0.05), and negatively with stage 2% sleep (p < 0.05). Whether this first report of a potential relationship between CSF DSIP-LI and slow-wave sleep in man might be generalized to sleep in nonpsychiatric subjects awaits further study.
Sleep 1992 Dec
PMID:Delta sleep-inducing-peptide-like immunoreactivity (DSIP-LI) and delta sleep in schizophrenic volunteers. 147 66

It was hypothesized that the metabolic effects of caffeine, which can be objectively measured (i.e. physiological, "arousal"), could be used to develop a physiological arousal model of chronic insomnia in a group of normal young adults. Twelve normal young adult males participated for 11 nights after laboratory adaptation. Subjects received 400 mg of caffeine three times a day for 7 nights and days. As predicted, the use of caffeine resulted in increased metabolic rate. Sleep efficiency was significantly reduced by caffeine and multiple sleep latency tests (MSLTs) were significantly increased. Some adaptation to the metabolic, sleep efficiency, and MSLT effects of caffeine was seen over the week of administration. Withdrawal effects (i.e. rebound sleep or sleepiness) were not seen for metabolic, MSLT or sleep variables. The data indicated that caffeine was effective in producing significant metabolic and sleep effects and that those effects were related. The results were consistent with the interpretation that a chronic decrease in sleep efficiency associated with increased physiological arousal, although producing subjective dysphoria, does not produce a physiological sleep debt.
Sleep 1992 Dec
PMID:Caffeine use as a model of acute and chronic insomnia. 147 67

Data from the National Disease and Therapeutic Index for the time period 1987-1991 (IMS, America) were examined for recent trends in the pharmacologic treatment of insomnia. All medications given with the desired action of promoting sleep or sedation at night were categorized as benzodiazepine hypnotics, benzodiazepine nonhypnotics, antidepressants, or other. From 1987 to 1991, the following trends were found: (1) overall pharmacologic treatment for insomnia decreased by approximately 10%, (2) use of benzodiazepine hypnotics fell about 30% during this time period, (3) use of antidepressants for insomnia increased by 100%, and (4) the noted changes were somewhat stronger for institutionalized patients than for ambulatory patients. These changes in the pharmacologic treatment of insomnia may be related to widespread media attention and are not supported by scientific data.
J Clin Psychiatry 1992 Dec
PMID:Trends in the pharmacologic treatment of insomnia. 807 Dec 64

This paper examines several clinical concerns about the shorter half-life benzodiazepine hypnotics from an epidemiologic perspective. It draws on data from (1) 1979 and 1990 comprehensive probability-based U.S. national household surveys of the medical use of psychotherapeutic medications; (2) a 1990 four-city community-based volunteer call-in survey of the beneficial and adverse effects of hypnotics; and (3) an analogous random-digit dialing telephone survey in the general population. The issues addressed are abuse liability, rebound, depersonalization/derealization, paranoid feelings, accidents/injuries, and the unexamined consequences of the target illness in assessments of benefit-risk. In populations representative of everyday outpatient practice, we found that (1) the abuse liability of benzodiazepine hypnotics with shorter and longer elimination half-lives was generally low and comparable; (2) prevalence rates for rebound were low and not differential for flurazepam, temazepam, triazolam, and OTC sleeping pills; (3) reports of a single or an occasional experience involving depersonalization/derealization or paranoid feelings were fairly frequent in normals, in insomnia patients prior to treatment, and in persons with untreated insomnia; (4) treatment-emergent rates of occurrence for these same symptoms were low and not drug-specific; (5) past-year prevalence rates for serious accidents/injuries were much higher for chronic untreated insomnia than for normal controls and most groups treated with psychotherapeutic medications. A high proportion of past-year users of hypnotics were satisfied with their medication and would take it again.
J Clin Psychiatry 1992 Dec
PMID:New epidemiologic findings about insomnia and its treatment. 148 78

Despite the fact that the prevalence rate for insomnia in the United States is high (35.2%), the number of patients with this condition do not represent a large percentage of patients evaluated and treated in sleep disorders clinics. On the other hand, the great majority of patients with insomnia do not seek treatment for their condition from their physicians. Several hypotheses have been created to explain this phenomenon: (1) lack of training for physicians in the area of sleep disorders, (2) pessimism in relation to treatment outcome shared by patients and physicians, and (3) time constraints and other reasons on the part of the physicians. Insomniacs, however, deserve accurate diagnosis and effective treatments for their condition. Insomnia is often the result of multiple factors converging rather than one single cause. For academic purposes, however, different disorders in difficulties with initiation and maintenance of sleep are discussed. Among them, adjustment sleep disorder, obstructive sleep apnea, periodic limb movements in sleep, circadian abnormalities, and psychiatric disturbances. Emphasis is placed on the treatment of each, along with the treatment of the other factors that are commonly found in patients with insomnia: poor sleep hygiene, use of medications that disrupt sleep, performance anxiety, deficient exposure to entrainers of circadian rhythms, diet, and exercise. A comprehensive treatment that includes a multifactorial approach is the ideal way to treat patients with insomnia. Research that will enhance our knowledge of the biological substrate of insomnia will provide clinicians with additional tools to improve the outcome of their treatments of patients with insomnia.
J Clin Psychiatry 1992 Dec
PMID:Diagnosis and treatment of insomnia and risks associated with lack of treatment. 148 80

Insomnia is a highly prevalent problem occurring in about 35% of the adult population. The complaint can be divided into temporary insomnia and persistent insomnia. A 1983 NIMH/OMAR Consensus Development Conference on drugs and insomnia issued guidelines for the use of sleep-promoting medications. There was a consensus that hypnotic medication is indicated for the treatment of temporary insomnia. Temporary insomnia, in response to external circumstances, is real and can have very serious consequences. This paper reviews the proper use of sleeping pills in the primary care setting in the context of current controversy involving benzodiazepines in general and benzodiazepine hypnotics in particular. It is concluded if the physician feels a patient's temporary insomnia warrants symptomatic relief with medication, it is appropriate to prescribe use of the lowest effective dose of a benzodiazepine hypnotic for several nights. Depending on the circumstances, the physician can specify either a short-acting or a long-acting hypnotic. The patient should be firmly instructed to call the clinic or office the next day to report results.
J Clin Psychiatry 1992 Dec
PMID:The proper use of sleeping pills in the primary care setting. 148 81

In the past 18 months, there has been considerable controversy regarding the benzodiazepine triazolam (Halcion). To review data supporting or not supporting the assertion that treatment with triazolam results in adverse reactions more frequently than with other benzodiazepines, the author used computerized literature searches (MEDLINE, English language articles from 1975 to the present) to identify reports of behavioral disinhibition, amnesia, delirium, rebound insomnia, and withdrawal reactions on benzodiazepines. Studies of disinhibitory reactions during benzodiazepine treatment do not substantiate the argument that they are more prevalent with triazolam than with other benzodiazepines. The behavioral disinhibition reactions during treatment with benzodiazepines are associated with higher dosages and pretreatment level of hostility. Anterograde amnesia occurs with many benzodiazepines, but usually without changes in a person's normal activities and behaviors. The reports of anterograde amnesia during benzodiazepine treatment describe people performing rather complex tasks during which outside observers could not detect any unusual behaviors. The prevalence of delirium during treatment with triazolam and other benzodiazepines is unclear, but delirium is more frequent at higher dosages and in the elderly. Controlled studies regarding the adverse effects of triazolam on sleep are lacking. The author concludes that despite the considerable adverse publicity in the lay press, there is little scientific evidence that triazolam is associated with disinhibitory or other adverse reactions at a greater frequency than other benzodiazepines.
J Clin Psychiatry 1992 Dec
PMID:Disinhibition, amnestic reactions, and other adverse reactions secondary to triazolam: a review of the literature. 148 83

In a postal questionnaire we examined three samples of persons seven and a half months after their migration to Berlin: 1. 512 people having left East Germany, 2. 90 Germans who had left Poland, and 3. 283 people who lived in western parts of Germany before. The present study was to investigate social integration and psychic complaints in these groups. In general, all groups reported increased frequencies of unspecific symptoms like inner restlessness, irritability, nervousness, rumination, and sleeplessness. In people from the GDR symptoms decreased significantly during the first seven months after migration. Symptoms of people who had come from western parts of Germany increased within this period. Generally the course of symptoms was more favorable, when people found a satisfactory job.
Psychother Psychosom Med Psychol 1992 Dec
PMID:[Psychological symptoms after immigration: a comparison of various groups of immigrants in Berlin]. 149 18


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