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)

Anabolic-androgenic steroid (AAS) withdrawal is established to be an important, though poorly known medical problem, because of AAS potency to cause physical and psychological dependence. Thus discontinuation of high-dose, long-term anabolic steroid use, apart from endocrine dysfunction (hypogonadotropic hypogonadism), may lead to development of withdrawal symptoms. They include mood disorders (with suicidal depression as the most life-threatening complication), insomnia, anorexia, decreased libido, fatigue, headache, muscle and joint pain, and desire to take more steroids. The withdrawal from anabolic steroids usually requires treatment. Clinical management, as with other drugs of abuse, consists of supportive therapy and pharmacotherapy. The goals of treatment are to restore endocrine (hypothalamic-pituitary-gonadal, HPG) function and to alleviate withdrawal symptoms. The endocrine medications that are targeted specifically to ameliorate HPG function include testosterone esters, human chorionic gonadotropin, synthetic analogues of gonadotropin-releasing hormone and antiestrogens. They are indicated in the presence of persistent clinical symptoms or/and laboratory evidence of HPG dysfunction. Other medications, that are targeted to provide symptomatic relief include antidepressants (especially serotonin selective re-uptake inhibitors), nonsteroidal anti-inflammatory drugs and clonidine. Notwithstanding, it should be remembered that many of the above mentioned drugs have their own potential for abuse or side-effects, so their use must be carefully weighted and optimal treatment strategies for AAS withdrawal must await further clinical research.
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PMID:[Treatment strategies of withdrawal from long-term use of anabolic-androgenic steroids]. 1189 57

Suggestions are offered for treatment of postabortal amenorrhea. In the absence of bleeding immediately after the procedure, a careful gynecological examination should be conducted to determine the size, consistency, and sensitivity of the uterus and the suppleness and vacuity of the lateral cul-de-sacs. A sonogram should be obtained if the results are abnormal, and a plasma dose of human chorionic gonadotropin should be administered after 12 days in case of doubt. If the sonogram suggests retained uterine contents a 2nd uterine evacuation should be carried out and appropriate antibiotic treatment should be initiated. The possibility of unsuccessful abortion must be considered, as must that of placental retention, hematoma, or ectopic pregnancy. A 2nd intervention should be carried out without hesitation if necessary. In the case of secondary amenorrhea more than 4 weeks after the intervention, a complete gynecological examination should be conducted, a serum human chorionic gonadotropin pregnancy test should be administered, incipient adhesions should be sought through X-ray or laparoscopy and perhaps removed, and symptoms appearing after the abortion, such as insomnia, irritability, weight loss, or consumption of drugs should be investigated. The possibility of another pregnancy should be investigated, adhesions should not be allowed to develop, and the possibility of psychogenic amenorrhea resulting from ambivalence about the abortion should be considered.
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PMID:[Do's and don'ts concerning an amenorrheic patient after pregnancy termination]. 1226 2