Antidepressant pharmacotherapy of depression associated with multiple sclerosis

Article Abstract:

Previous studies have associated the onset of physical symptoms of multiple sclerosis (MS) with symptoms of mood disorder. Depressive disorders have occurred in patients with MS more often than in patients with other neurological disorders such as amyotrophic lateral sclerosis or muscular dystrophy. The effects of drug therapy for depression were evaluated in 28 patients with MS who had also been diagnosed with major depressive disorder. Half of the subjects received psychotherapy and the drug desipramine for five weeks; the other half received psychotherapy and a placebo for the same time period (patients were randomly assigned to one of the two groups). After five weeks, clinical evaluations of the patients indicated that those who received the desipramine showed significantly more improvement than the group that received the placebo. These observations were confirmed using the Hamilton Rating Scale for Depression. However, scores from the Beck Depression Inventory did not confirm the clinical observations. In seven of the patients receiving desipramine, treatment was limited by drug side effects which included low blood pressure, dry mouth, constipation, jitteriness, dizziness, rash, and fluid retention. Only a weak correlation was detected between the severity of MS and the severity of depression. Although several questions remain unanswered, these results have some clinical relevance for treating MS patients with major depression. Desipramine produces side effects in these patients, possibly more than in other populations, but the drug may provide modest clinical benefits. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Complications and side effects, Drug therapy, Multiple sclerosis

---

Depression in dementia of the Alzheimer type and in multi-infarct dementia

Article Abstract:

Depression has been reported to be associated with both multi-infarct dementia and dementia of the Alzheimer's type, affecting from 19 to 27 percent and from 0 to 87 percent of patients, respectively. In combination with the other symptoms of dementia, untreated depression causes additional suffering and makes early institutionalization necessary for those who are affected. Depression in the elderly is usually identified by evidence of mood disorders, since cognitive impairment as a result of depression may overlap with dementia symptoms. To investigate the relationship between severity of dementia and depression, 55 patients with Alzheimer's disease, 37 patients with multi-infarct dementia, and 30 control subjects who were not considered demented were evaluated. The Mini-Mental State examination and the Hamilton Rating Scale for Depression, a standard measure of depression, were used to independently evaluate the subjects. The results of the Hamilton Rating Scale for Depression indicated a comparable degree of depression in patients with either type of dementia. However, when scores of the Mini-Mental State examination were assessed, patients with severe Alzheimer's disease were less depressed than patients with severe multi-infarct dementia. The results suggest that depression is more severe in mildly demented Alzheimer's disease patients, but decreases as the dementia progresses, and that depression takes the opposite course in multi-infarct dementia patients. Longitudinal studies are recommended to further investigate these patterns. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Alzheimer's disease, Depression in old age, Geriatric depression, Multi-infarct dementia

---

Apparent phase advance in diurnal MHPG rhythm in depression

Article Abstract:

Research evidence suggests that the circadian (24-hour) rhythms of depressed patients are abnormal. A classic symptom of depression is alteration of the daily sleep-wakefulness cycle. Studies have shown that depressed individuals have sleep patterns that are shifted several hours earlier than normal; this is called a phase advance. Other bodily functions that follow circadian rhythms include oral temperature, activity-rest, and neurotransmitter (substances that carry messages from the brain) physiology; a phase advance or phase delay may occur in depression. Norepinephrine, a hormone secreted by nerve cells that acts as a neurotransmitter, may be involved in the abnormalities of depression. Diurnal (daytime) rhythms of the norepinephrine metabolite MHPG (3-methoxy-4-hydroxyphenylglycol) may be altered in depression. The diurnal MHPG rhythms of 18 depressed men and 12 healthy male subjects were measured using blood tests. The results showed evidence of phase advances in MHPG circadian rhythm in the depressed individuals. Subsequent treatment with the drug desipramine caused a significant phase delay of three hours in some subjects. The most important conclusion was that norepinephrine metabolism, as indicated by blood MHPG level, appears to vary diurnally in both normal and depressed subjects.

Research, Circadian rhythms, Noradrenaline, Norepinephrine, Biological rhythms, Biorhythms

Similar abstracts:

• Abstracts: Children with symptoms of depression - what do the adults see?
• Abstracts: Early treatment time course of depressive symptoms in opiate addicts. A hierarchical model of opiate addiction: failures of self-regulation as a central aspect of substance abuse
• Abstracts: The role of depression in couples involved in murder-suicide and homicide. The presumptive role of fantasy in serial sexual homicide
• Abstracts: Seasonal and mood independence of low basal prolactin secretion in premenopausal women with seasonal affective disorder
• Abstracts: A developmental perspective on psychotherapy and psychoanalysis. Putting DSM-IV in perspective

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.