ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveThis article provides the chemical basis for the molecular modification of H1antihistamines in the rational development of some antidepressant and antipsychotic drugs.MethodsA review of the literature and personal experiences have been compiled.ConclusionsThe contributions of many basic scientists, the crucial observations of clinicians, and the desire of the drug industry to make money have resulted in the currently available psychopharmacological treatments. The future development of psychopharmacology depends on better clinical research to generate new hypotheses of the chemical and behavioral pathology of mental disease. Psychosomatic medicine can make a unique contribution in its interdisciplinary role of stressing brain, body, and mind relationships.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveTo determine whether the currently available evidence supports the hypothesis that antidepressants and mood stabilizers may bring about some of their long-term therapeutic effects by regulating signal transduction pathways and gene expression in the central nervous system.MethodsTo address this question, we reviewed the evidence showing that chronic administration of antidepressants and mood stabilizers involves alterations in signaling pathways and gene expression in the central nervous system.ResultsA large body of data has shown that lithium and valproate exert effects on the protein kinase C signaling pathway and the activator protein 1 family of transcription factors; in contrast, antidepressants affect the cyclic adenosine monophospate pathway and may bring about their therapeutic effects by modulating cyclic adenosine monophosphate–regulated gene expression in the central nervous system.ConclusionsGiven the key roles of these signaling cascades in the amplification and integration of signals in the central nervous system, the findings have clear implications not only for research into the etiology and pathophysiology of the severe mood disorders but also for the development of novel and innovative treatment strategies.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The efficacy of psychotropic drugs varies depending on the time of administration. This phenomenon is observed with antipsychotics, antidepressants, mood stabilizers, benzodiazepines, barbiturates, and psychostimulants. The presence or absence of this phenomenon and the rhythm phase in the efficacy of each drug varies depending on the drug, dose, parameter measured, animal species, and strain. A recent study demonstrating circannual changes in the phases of circadian rhythm of drug efficacy suggests that discrepancies between studies may be considerably explained by the presence of a circannual rhythm. The rhythms in drug effects are suggested not to be due to rhythmic changes in the pharmacokinetics of the drugs but rather to an endogenous rhythm in drug susceptibility resulting from a circadian rhythm in the intracerebral neurotransmission system. The presence of this phenomenon and its law have been demonstrated to a considerable extent in animals, but corresponding clinical reports in humans remain insufficient despite its clinical importance. Further study in humans is certainly warranted.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Addictive drugs like cocaine, ethanol, and morphine activate signal transduction pathways that regulate brain gene expression. Such regulation is modulated by the presence of certain transcription factor proteins present in a given neuron. This article summarizes the effects of several addictive drugs on transcriptional processes contributing to the development of a drug-dependent state. The characterization of drug-induced changes in gene expression shows promise for improving our understanding of drug-addiction phenomena and cellular modes of cocaine, ethanol, and morphine action.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Autism is a neurobiological disorder. The core clinical features of autism include impairment in social interaction, impairments in verbal and nonverbal communication, and restricted, repetitive, and stereotyped patterns of behavior, interests, and activities. Autism often has coexisting neuropsychiatric disorders, including seizure disorders, attention deficit hyperactivity disorder, affective disorders, anxiety disorder, obsessive-compulsive disorder, and Tourette disorder. No etiology-based treatment modality has been developed to cure individuals with autism. However, comprehensive intervention, including parental counseling, behavior modification, special education in a highly structured environment, sensory integration training, speech therapy, social skill training, and medication, has demonstrated significant treatment effects in many individuals with autism. Findings from preliminary studies of major neurotransmitters and other neurochemical agents strongly suggest that neurochemical factors play a major role in autism. The findings also provide the rationale for psychopharmacotherapy in individuals with autism. This article reviews studies of neurochemical systems and related psychopharmacological research in autism and related neuropsychiatric disorders. Clinical indications for pharmacotherapy are described, and uses of various medications are suggested. This article also discusses new avenues of investigation that may lead to the development of more effective medication treatments in persons with autism.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Major depression affects about one in five patients in the weeks after an acute myocardial infarction and is associated with an increased risk of cardiac morbidity and mortality. Consequently, there is considerable interest in the question of whether treating depression will improve medical prognosis in these patients. Safe, effective treatments for depression are available, but unless they also improve the underlying pathophysiological or behavioral mechanisms that contribute to cardiac morbidity and mortality, they may not have beneficial effects on prognosis. Altered cardiac autonomic tone is one of the leading candidate mechanisms. Unfortunately, a review of the available research reveals that cardiac autonomic tone often fails to normalize in patients treated for depression, and the research suggests that currently available treatments for depression will not necessarily improve cardiac event–free survival in patients who have had an acute myocardial infarction. Until there is convincing evidence that treatment can reduce the risk of cardiac morbidity and mortality, the principal reason to treat depression should continue to be to improve the quality of life of the patient who has had an acute myocardial infarction.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Increased interest in the complex interplay between gonadal steroids and neurotransmitter systems involved in mood has led investigators to question the role of gonadal steroids in the treatment of affective disorders, especially in women.ObjectivesThe purpose of this article is to provide a rationale for using gonadal hormones in the treatment of depression in women.MethodsThe literature is reviewed regarding 1) sex-specific phenomenologic and epidemiologic differences in the manifestation of psychiatric illness, 2) sex-specific differences in the therapeutic and adverse effects of psychotropic medications, 3) the complex interplay between gonadal steroids and neurotransmitter systems implicated in psychiatric disorders, and 4) the growing literature regarding the use of estrogen and progesterone in the treatment of mood disorders in women and androgens in the treatment of depression and sexual dysfunction in both men and women.ResultsFindings from pharmacologic trials of estrogen and androgens are encouraging, albeit mixed, in the treatment of mood disorders and decreased libido in women, respectively. Controlled studies have failed to confirm early open-label reports of the effectiveness of progesterone in the treatment of premenstrual syndrome.ConclusionsPending replication, estrogen may become an important pharmacologic agent in the treatment of postnatal and perimenopausal depression, whereas androgens have been shown to improve libido in postmenopausal women and hypogonadal men. Progesterone cannot be recommended as a treatment for premenstrual sydrome or postnatal depression.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID