Effectiveness of hypnotherapeutic and pharmacological treatment in primary monosymptomatic enuresis / Efectividad del tratamiento hipnoterapéutico y farmacológico en la enuresis primaria monosintomática

Abstract: Background: In primary monosymptomatic enuresis, it is not clear what dynamic changes occur in the efficacy of hypnotherapeutic versus pharmacological treatment plan. Objective: Determine the changes over time in the effectiveness of hypnotherapy and a pharmacological treatment plan in primary monosymptomatic enuresis. Method: A prospective, longitudinal and analytical study (time series) was performed on a universe of 119 patients between 7 and 16 years old, with primary monosymptomatic enuresis. 40 patients treated with imipramine and 79 patients with 1 session/1 hour /week of hypnotherapy were evaluated on the frequency of temporal changes of enuretic episodes during 14 weeks of treatments at the Hypnosis Clinic. Results: A logarithmic scale of the distributions of temporal changes in the frequencies of enuretic episodes in hypnotherapeutic and pharmacological treatments is presented, with an enuretic plateau from week 3 to week 6 in hypnotherapy. Conclusions: The hypnotherapeutic treatment was more favorable, as it had an early and efficient response compared to treatment with imipramine.

Resumen: Antecedentes: En la enuresis monosintomática primaria, no está claro qué cambios dinámicos ocurren en la eficacia del plan de tratamiento hipnoterapéutico versus farmacológico. Objetivo: Determinar los cambios dinámicos a lo largo del tiempo en la efectividad de la hipnoterapia y un plan de tratamiento farmacológico en la enuresis infantil no orgánica. Método: Se realizó un estudio prospectivo, longitudinal y analítico (serie temporal) en un universo de 119 pacientes entre 7 y 16 años, con enuresis nocturna no orgánica. 40 pacientes tratados con imipramina y 79 pacientes con 1 sesión / 1 hora / semana de hipnoterapia fueron evaluados en la frecuencia de cambios temporales de episodios enuréticos durante 14 semanas de tratamientos en la Clínica de Hipnosis. Resultados: Se presenta un modelo logarítmico de las distribuciones de cambios temporales en las frecuencias de episodios enuréticos en tratamientos hipnoterapéuticos y farmacológicos, con una meseta enurética desde la semana 3 a la semana 6 en hipnoterapia. Conclusiones: El tratamiento hipnoterapéutico fue más favorable, ya que tuvo una respuesta temprana y eficaz en comparación con el tratamiento con imipramina.

Effect of vitamin D on depression: an experimental study

Background: There is a scarcity of studies regarding antidepressant activity of vitamin D in animals while there are some contradictory reports regarding the same in humans. Therefore the present study was planned to investigate the antidepressant effect of vitamin D and its interaction with standard antidepressant drugs in animals.Methods: Forced swim test (FST) in adult male Wistar rats and tail suspension test (TST) in adult male Swiss albino mice were used to investigate antidepressant activity of vitamin D administered in single dose and multiple doses. Imipramine, a tri-cyclic antidepressant and fluoxetine, a selective serotonin reuptake inhibitor were used as standard antidepressant drugs. For interaction studies, half the therapeutic equivalent dose of vitamin D was combined with sub-effective dose (SED) of imipramine or fluoxetine. Data was expressed as Mean±SD and analyzed by standard statistical tests. P<0.05= significant. Present study was ethically approved.Results: Single dose administration of vitamin D did not show significant antidepressant effect either in FST or TST. Multiple dose administration of vitamin D showed significant antidepressant activity in TST but not in FST. Combination of vitamin D (half dose) with SED of either standard antidepressant drugs did not show any significant antidepressant activity. None of the treatment groups showed any significant difference on locomotor activity.Conclusions: In the present study, multiple dose administration of vitamin D showed some antidepressant activity. Further studies are needed to confirm and elaborate the role of vitamin D in behavioral disorders like depression.

Evaluation of antidepressant activity of tramadol in albino mice using forced swim model

Background: The fact that tramadol can be used as an antidepressant, has been already proved by some animal studies. The objective of the present study was to evaluate antidepressant activity of tramadol in albino mice using forced swim model.Methods: Forced swimming test (FST) model was used to evaluate the antidepressant effect. Mice in the group "I" were given normal saline. Mice in the group II were given imipramine. Mice in the group III were given tramadol 10mg/kg. Mice in the group IV were given tramadol 20mg/kg. Mice in the group V were given tramadol 40mg/kg. All doses in all groups were given by intra peritoneum route.Results: The average values of immobility in group I were higher significantly compared to group III, IV and V. The values of group I and group II were found to be comparable. It was found that the baseline mean value was 196.33 which reduced to 5.16 with the effect of imipramine where imipramine was given to those mice. But in tramadol 10mg group, it was highest, and it came down to 40.66 and as the dose of tramadol was increased, the immobility time reduced from 40.66 at 10mg dose to 31.33 at 20mg dose and finally to 13.33mg at 40mg dose.Conclusions: Considering the results of two different animal models of depression it can be concluded that Tramadol has antidepressant activity at 10mg, 20mg, 40mg which was almost similar to Imipramine.

The protective effect of L. siceraria against depression using behavioural despair animal models

Background: In recent years, the search for novel pharmacotherapy from medicinal plants for psychiatric illness was significantly progressed. The present study was performed to evaluate the antidepressant activity of ethanolic extract of Lagenaria siceraria in animal models.Methods: The antidepressant activity of ethanolic extract of the fruit of L. siceraria in rats was assessed using forced swim test and tail suspension test. Imipramine at 15 mg/kg was used as standard antidepressant drug.Results: The ethanolic extract of L. siceraria fruit (EELS) was significantly and dose-dependently reduced the duration of immobility after repeated treatment for 7 days in Forced swim test and Tail suspension Test. But combination of L. siceraria (200mg/kg) with Imipramine gave a highly significant result (p<0.001) in reduction of immobility duration and the effect of high dose (400mg/kg) with imipramine (15mg/kg) did not decrease the duration of immobility period in both animal models at end of the study. In this work the dose of 400mg/kg afforded more protection than the imipramine.Conclusions: The results obtained from this study was indicate that the antidepressant activity of L. siseraria.

A clinical study to compare hyponatremia induced by the use of two different tricyclic antidepressants – Amitriptyline and imipramine

Aims & Objectives: To compare the occurrence of hyponatremia in the patients receiving two different Tricyclic Antidepressants (TCAs)–Amitriptyline and Imipramine Methodology: Fifty OPD patients attendingthe Psychiatry outpatient clinic of Mahatma Gandhi Institute of Medical Sciences, Sewagram having diagnosis of Depressive episode as per DSM-IV-TR criteria were included in the study. Patients with normalserum sodium levels before treatment with antidepressant were included in the study. Repeat serum Sodium levels were done after one month of being on treatment. EPI Info-6 software was used to analyze the data. Results: Average serum sodium concentrations of the patients receiving different TCAs before treatment were 139.4+2.45 (Mean+SD). Out of the 44% patients who developed hyponatremia, 45.45% were amongst the Imipramine group and 54.54% were amongst the Amitriptyline group. Although of mild severity only, hyponatremia was more in patients receiving Amitriptyline compared to those receiving Imipramine. Conclusion: Patients receiving Amitriptyline have fairly more chance of developing hyponatremiathan Imipramine receiving patients. Hence precaution should be observed while using TCA group of antidepressants.

Protective effects of imipramine on alveolar epithelial barrier function against acute lung injury in mice / 中华急诊医学杂志

Objective To investigate the protective effects of imipramine on alveolar epithelial barrier functiou in mice against LPS-induced acute lung injury (ALI),and explore the possible mechanisms.Methods Total of 32 SPF male Balb/c mice were randomly (random number) divided into four groups:control group,Imipramine group,LPS group,LPS + Imipramine group.To establish an animal model of ALI,mice were administered intraperitoneally with LPS in 20 mg/kg.Mice were treated with imipramine in 25 mg/kg 30 min prior to LPS administration.FITC-FD4 was administered in mice via the tail vein with FITC-FD4 10 min before mice sacrificed under anesthesia at 12 hours after LPS administration,then bronchoalveolar lavage fluid (BALF) and lung tissue were obtained.HE staining was used to observe histopathological changes,and pathology scores;lung tissue wet-to-dry weight ratio and BALF/serum FD4 ratio were used to assess pulmonary edema and alveolar epithelial permeability.Real-time PCR,western blot and immunochemistry were employed to detect the mRNA expressions and protein levels of Occludin,Claudin-4 and ZO-1.Data were analyzed with SPSS 16.0 software,one way analysis of variance (ANOVA) was used to compare multiple sets of variables,the intergroup comparisons were analyzed by the least-significant-difference (LSD) tests with P ＜ 0.05 for the statistically significant difference.Results Compared with LPS group,LPS + lmipramine group had a statistically significant decrease in pathological score [(9.22 ± 0.21) vs.(11.23 ± O.55),P ＜ O.05);the wet-to-dry weight ratio in LPS + Imipramine group was less than that in LPS group and the difference was statistically significant (P ＜ 0.05);compared with LPS group,the ratio of BALF/serum FD4 in LPS + Imipramine was less and the difference was statistically significant (P ＜ 0.05);compared with LPS group,the mRNA expressions and protein levels of Occludin,Claudin-4 and ZO-1 in LPS + Imipramine group were significantly increased (mRNA:Occludin:P ＜ 0.05;Claudin-4:P ＜ 0.05;ZO-1:P ＜ 0.05 . western blot:Occludin:P ＜ 0.05;Claudin-4:P ＜ 0.05;ZO-1:P ＜ 0.05).Immunochemistry showed that Occludin and Claudin-4 were present mainly in alveolar epithelial cell membrane,Z0-1 was found mainly in cytoplasm of alveolar epithelial cell.In control group and Imipramine group,tight junction proteins were obviously expressed.Compared with control group,protein levels in LPS group were significantly decreased (Occludin:P ＜ 0.05;Claudin-4:P ＜ 0.05;ZO-1:t =6.59,P ＜ 0.05);compared with LPS group,the tight junction proteins in LPS + Imipramine group were significantly increased (Occludin:P ＜ 0.05;Claudin-4:P ＜ 0.05;ZO-1:P ＜ 0.05).Conclusion The protective effects of imipramine on alveolar epithelial barrier function by up-regulating tight junction proteins expression in murine LPS-induced ALI.

Pharmacological therapy of nocturnal enuresis

Nocturnal enuresis is a common problem of children during sleeping at preschool or school age. It may affect negatively the psychosocial development of children. Children with enuresis may have lower self-esteem and lower quality of life. There are three main factors of the pathophysiology of enuresis: high nocturnal urine production, nocturnal low bladder capacity or increased detrusor muscle activity, and arousal disorder. As pharmacological therapy for nocturnal enuresis, several medications including desmopressin, anticholinergics, imipramine have been used for a long time. As first-line therapy, desmopressin combined with anticholinergics has good response in primary monosymptomatic nocturnal enuresis. Because imipramine has serious and lethal cardiotoxic effect with overdosage, imipramine should be prescribed after EKG to rule out the conduction problem of heart.

Effect of ethanolic extract of Zingiber officinale Roscoe on Central Nervous System activity in mice.

Zingiber officinale Roscoe, commonly known as ginger, is a traditional herb used to treat various disorders. In this study, we evaluated potential pharmacological effects of ethanolic extracts of Z.Officinale with respect to central nervous system (CNS) activity in mice. Role of ethanolic extract of ginger on CNS activity in mice was studied using models of elevated plus maze test, barbiturate-induced sleeping time, tail suspension test, hot-plate and tail-flick test. Ginger extract was administered to mice at single doses of 50 and 200 mg/kg, perorally while diazepam (1 mg/kg), morphine (5 mg/kg) and imipramine (30 mg/kg) intraperitoneally were used as standard drugs. The results showed that the ginger extract at all dose levels significantly exhibited anxiolytic activity increased the sleeping latency but reduced the sleeping time. Tail suspension test showed that the extract at both the doses was able to induce a significant decrease in the immobility time, similar to imipramine, a recognized antidepressant drug. Tail-flick and hot-plate tests demonstrated antinociceptive property of ginger extract, similar to morphine, a recognized antinociceptive agent. Higher dose level (200 mg/kg) showed better protective effects. Phytochemical screening of ethanolic extract revealed the presence of various phytoconstituents such as phenolic compounds, flavonoids, tannins, anthocyanins, carbohydrates, glycosides, proteins, resins and volatile oils. The possible mechanism by which ginger exhibited the significant beneficial effects on various CNS models in mice could be attributed to its antioxidant potential.

Treatment effect on temperament and character in panic disorder: a prospective randomized double-blind study / Efeito de tratamento sobre temperamento e caráter no transtorno de pânico: estudo randomizado prospectivo duplo-cego

OBJECTIVE: The present study aims to analyze the effect of pharmacological treatment for panic disorder on temperament and character dimensions and to compare the effect of imipramine and fluoxetine on this outcome. METHOD: Temperament and character dimensions were evaluated in panic disorder patients before and after six months of pharmacological treatment with imipramine and fluoxetine, using the Temperament and Character Inventory-Revised. Patients were randomized between groups and both (patient and investigators) were blinded to the intervention drug. Furthermore, 34 non-panic controls answered the revised Temperament and Character Inventory through an Internet survey. RESULTS: Panic disorder patients showed higher scores for Harm Avoidance and lower scores for Persistence, Self-Directedness, and Cooperativeness than controls at baseline, but only the low Persistence value remained different from controls after treatment. Responder patients presented significant reduction in Harm Avoidance scores and a significant increase in Self-Directedness scores, whereas non-responders showed a significant increase of Harm Avoidance levels. Fluoxetine and Imipramine showed similar effects on the revised Temperament and Character Inventory dimensions. CONCLUSION: High Harm Avoidance and low Self-Directedness, Persistence, and Cooperativeness are associated with panic disorder. Treatment of acute panic disorder symptoms lead to the reduction of Harm Avoidance and to an increase in Self-Directedness scores. However, there was no difference between treatment with fluoxetine and imipramine for the effect on the revised Temperament and Character Inventory dimensions.

OBJETIVO: O presente estudo tem como objetivo analisar o efeito do tratamento farmacológico do transtorno do pânico nas dimensões de temperamento e caráter, comparando os efeitos das medicações imipramina e fluoxetina neste desfecho. METODOLOGIA: As dimensões de temperamento e caráter foram avaliadas em pacientes com transtorno do pânico antes e depois de seis meses de tratamento com imipramina ou fluoxetina, utilizando-se o "Temperament and Character Inventory- Revised" (TCI-R). O estudo foi randomizado e duplo-cego. Além disso, 34 controles sem transtorno do pânico responderam ao TCI-R via internet. RESULTADOS: Pacientes com transtorno do pânico apresentaram maior pontuação para "Harm Avoidance" e menor pontuação para "Persistence", "Self-Directedness" e "Cooperativeness" que os controles antes do tratamento, mas apenas "Persistence" manteve a diferença após o tratamento. Pacientes respondedores apresentaram redução significativa da pontuação para "Harm Avoidance" e aumento significativo para "Self-Directedness" após o tratamento, enquanto os não-respondedores mostraram aumento significativo na pontuação para "Harm Avoidance". A fluoxetina e a imipramina apresentaram efeitos semelhantes nas dimensões do TCI-R. CONCLUSÃO: Alta pontuação para "Harm Avoidance" e baixa para "Persistence", "Self-Directness" e "Cooperativeness" estão associados ao transtorno do pânico. O tratamento sintomático do transtorno do pânico leva a redução da pontuação para "Harm Avoidance" e aumento de pontuação para "Self-Directedness". No entanto, não há diferença entre os efeitos da imipramina e da fluoxetina nestas dimensões do TCI-R.

Evaluation of anti-depressant effect of lemon grass (Cymbopogon citratus) in albino mice.

Background: Depression is a common serious psychiatric disorder and the available anti-depressant treatments are associated with many unwanted side-effects. Thus, various herbal products have been tried. The advantages of herbal treatments would include its complementary nature to the conventional treatment, thus making the latter a safer and cheaper option for depressive disorders. The objective of the present study was to evaluate the anti-depressant activity of lemon grass (Cymbopogon citratus) in albino mice and compare it with Imipramine. Methods: A total of 60 Swiss albino mice weighing around 20-40 g of either sex were divided into 10 groups (n=6). They were orally administered with tween 80, as a control, 20 mg/kg imipramine (standard), 5 mg/kg and 10 mg/kg C. citratus (test drugs), and combination of imipramine (10 mg/kg) and C. citratus (10 mg/kg). Duration of immobility was observed for last 4 mins of total 6 mins period in groups 1-5 for forced swimming test (porsolt test) and groups 6-10 for tail suspension test each on 1st, 8th and 15th day and recorded as mean±standard error of the mean. Results were analyzed by one-way analysis of variance, followed by Tukey’s post-hoc test. Results: Lemon grass at the above doses significantly reduced the immobility time in both the tests compared with the control (<0.05). The reduction in the duration of immobility at the dose of 10 mg/kg was comparable to imipramine. Conclusions: The essential oil of lemon grass (C. citratus) has significant anti-depressant activity comparable to imipramine.

Antidepressant activity of spirulina platensis in experimentally induced dipression in mice.

The spray dried powder of Spirulina platensis was used to treatment of depression in different doses (100mg/kg, 200 mg/kg and 400 mg/kg) and Impramine (15mg/kg) as standard drug in experimental animal models like Forced swim test in mice, Tail suspension test in mice, Clonidine induced aggression behaviour in mice test, L-dopa induced hyper activity and aggressive behavior in mice, 5-HT induced head twitches in mice, From all the experimental model results were observed that the Spirulina platensis was possess the dose dependent anti depressant activity.

Enuresis infantil tratada con imipramina / Imipramine-treated infant enuresis

Introducción: la enuresis, que se define como la emisión involuntaria de orina después de la edad en que el control vesical debía haberse alcanzado, alrededor de los 5 años, es un trastorno conocido desde épocas remotas, que ha merecido la atención de numerosos investigadores, y sobre el cual se plantean aún en la actualidad criterios muy disímiles en relación con su etiología. Objetivo: identificar la efectividad de la imipramina en la enuresis nocturna. Métodos: se investigan 150 niños de ambos sexos procedentes del área de salud del Policlínico Docente Plaza de la Revolución que presentaban enuresis nocturna, previamente estudiados, sin encontrar lesión orgánica. Se les impuso tratamiento con imipramina durante un año. Se analizan en estos pacientes variables como la edad y el sexo, se estudió la escolaridad, la clasificación de la enuresis, la frecuencia de las micciones y el umbral de sueño recogido de forma muy subjetiva. Resultados: se obtuvo que el grupo mayor de niños osciló entre los 6 a 8 años de edad, con predominio del sexo femenino en todos los grupos de edades. La escolaridad fue normal en 145 niños, que representa la inmensa mayoría de la muestra. Predominó ampliamente la enuresis primaria, que se manifestó en 148 pacientes, y fueron más frecuentes las micciones diarias y más de una vez por semana en el grupo de 6 a 8 años de edad. Casi todos los pacientes (132) permanecían dormidos después de orinarse. El tratamiento con imipramina se realizó con dosis crecientes de acuerdo con la edad, hasta una dosis máxima de 75 mg, y resultó eficaz en el 48,6 por ciento de los pacientes, en los cuales desapareció totalmente la sintomatología, y en un 28 por ciento se produjo mejoría en la presentación del síntoma. Conclusiones: la imipramina fue eficaz en la mayoría de los pacientes, pues desapareció totalmente la sintomatología

Introduction: enuresis, which is said to be the involuntary discharge of urine after the age at which the urinary control should has been achieved, that is, around 5 years-old, is a well-known disorder since ancient times. It has deserved the attention of numerous researchers but there are still very different criteria about its etiology at the present time. Objective: to identify the effectiveness of imipramine to treat night enuresis. Methods: one hundred and fifty children of both sexes with no previous lesions and night enuresis, who were attended at Plaza de la Revolucion teaching polyclinics, were studied. They were treated with imipramine for a year. Several variables such as age, sex, schooling, classification of enuresis, frequency of urination and sleep threshold, the latter being determined in a very subjective way, were all analyzed. Results: the elder group of children aged 6 to 8 years, with females predominating in all the age groups. Schooling was normal in 145 children who accounted for the vast majority of the sample. Primary enuresis extensively prevailed and the most frequent forms were daily involuntary urination and once a week in the 6-8 years-old group. Almost all the patients (132) remained asleep after urination. The imipramine-based treatment was given at growing doses, according to the age, up to maximum dose of 75 mg, and proved to be effective in 48.6 percent of patients, whose symptoms completely disappeared and in 28 percent of them who experienced some improvement in the presentation of symptoms. Conclusions: imipramine was effective in most of patients since the symptoms disappeared completely

Psycho pharmacologic approach for chronic cylical vomiting syndrome: a case report

In this case report, a middle aged lady presenting with persistent vomiting of 12 years duration, not responding to conventional management and showing dramatic response to combinations of low dose Imipramine and Trifluperazine is discussed. Method: In our case, a middle aged lady presenting with chronic, recurrent episodes of severe vomiting for approximately 12 years with poor treatment outcome was evaluated and treated with low dose imipramine and Trifluperazine, which was found to be highly effective. Results: Low dose Trifluperazine and imipramine is effective in the treatment of cyclic vomiting syndrome. Conclusion: Cyclic Vomiting Syndrome is often missed and appropriate psychiatric intervention gives a better outcome.

Comparación de los efectos del D-004, imipramina y sertralina en el modelo de nado forzado en ratones / Comparative effects of D-004, Imipramine and Sertraline in the forced swimming test in mice

Introducción: La finasterida, inhibidor de la 5 a-reductasa, se emplea en el tratamiento de la hiperplasia prostática benigna, y ocasiona entre sus efectos adversos un aumento de cuadros de depresión. El D-004 es un extracto lipídico extraído a partir del fruto de la palma real (Roystonea regia), inhibe la 5 a-reductasa y previene la hiperplasia prostática benigna, y muestra un efecto antidepresivo moderado en el ensayo de nado forzado y suspensión por la cola. Objetivo: comparar el efecto del D-004 con la imipramina y la sertralina sobre la duración de las conductas de inmovilidad, nado y escalado en el ensayo de nado forzado. Métodos: se distribuyeron los ratones en ocho grupos: control (vehículo), tres tratados con D-004 (100, 250 y 500 mg/kg), dos con sertralina y dos con imipramina (30 y 50 mg/kg) respectivamente. Estos se colocaron en un cilindro de cristal que contenía agua a una altura de 6 cm y se cuantificaron las conductas. Resultados: la administración oral de D-004 (100, 250 y 500 mg/kg) durante 14 días redujo significativamente el tiempo de inmovilidad con respecto al grupo control (17, 22 y 25 porciento) y aumentó significativamente la conducta de nado en 1,58, 1,68 y 1,74 veces. Este efecto resulta moderado (25 porciento) comparado con las reducciones alcanzadas por la sertralina y la imipramina (³ 60 porciento). Las dosis mayores (250 y 500 mg/kg) ocasionaron incrementos de la conducta de escalado, 2,79 y 3,55 veces superiores a la del grupo control, lo que mostró semejanza con la imipramina, aunque con una menor eficacia. Conclusiones: el D-004 ejerce un moderado efecto antidepresivo, lo que pudiera contribuir al manejo de los pacientes con hiperplasia prostática benigna en los cuales se informa coincidencia de cuadros depresivos

Introduction: Finasteride is a 5 a-reductase inhibitor to treat benign prostatic hyperplasia (BPH) and one of the adverse effects is the increase of depressive symptoms. D-004 is a lipid extract from the real palm fruit (Roystonea regia) that is effective to prevent prostatic hyperplasia by inhibiting 5 a-reductase and shows moderate antidepressant effects in the forced swimming test (FST) and tail suspension test. Objective: to compare the effects of D-004, Imipramine and Sertraline on the duration of behaviours under conditions of immobility, swimming and climbing in the forced swimming test. Methods: mice were randomly distributed in 8 groups: control (vehicle), 3 treated with D-004 (100, 250 and 500 mg/kg), 2 with Sertraline and 2 with Imipramine (30 and 50 mg/kg) respectively. Mice were placed in a glass cylinder containing 6 cm high column of water and their behaviours were quantified. Results: oral administration of D-004 (100, 250 and 500 mg/kg) during 14 days reduced the length of time of immobility with respect to the control group (17, 22 and 25 percent), and significantly increased the behaviours at swimming by 1.58, 1.68 and 1.74 times. This is a moderate effect (25 percento) if compared with Sertraline and Imipramine (³ 60 percent) The doses of 250 and 500 mg/kg showed that climbing behaviours were 2.79 and 3.55 times higher than the control group. The results were similar to those of Imipramine but less effective. Conclusions: D-004 showed moderate antidepressant effect. This fact could help in the treatment of patients with benign prostatic hyperplasia, who reported similar depressive status

Floppy iris syndrome with oral imipramine: A case series.

Intraoperative floppy iris syndrome (IFIS) has commonly been seen with long-term use of α1-adrenoceptor blocking agents. We observed IFIS in three patients during phacoemulsification due to oral imipramine therapy. The three patients took imipramine for 25 years, 10 months and 1 year, respectively. However, only the first patient was on oral therapy at the time of surgery, while the other two patients had stopped 4 months and 2 months prior to undergoing phacoemulsification. The first and third patients developed complete IFIS features, while the second had only partial IFIS characteristics. Phacoemulsification could be completed in all three patients without any complication. None of these patients had history of taking any of the α1-adrenoceptor blocking agents. This is the first anecdotal report of IFIS with the oral use of imipramine and hence further evidences are required to ascertain the association of oral imipramine therapy and IFIS. However, ophthalmologists undertaking phacoemulsification on patients on imipramine therapy should be alert for the occurrence of IFIS.

Antidepressant and skeletal muscle relaxant effects of the aqueous extract of the Prosopis cineraria

The aqueous leaves extract of Prosopis cineraria (AEPC) is used traditionally for the treatment of various CNS disorder. The purpose of this study was to evaluate the extract for antidepressant and skeletal muscle relaxant activity. The antidepressant effect of the extract was evaluated using Forced swim test (FST). The immobility periods of control and treated mice were recorded. The antidepressant-like effect of tested compound was compared to that of imipramine (15 mg/kg. p.o). Muscle relaxant property was studied using rotarod apparatus and total fall off time for standard and control group was recorded. Phytochemical screening revealed the presence of saponins, flavonoids, alkaloids, glycosides, tannins and phenolic compounds. The leaf extract at doses of 200 mg/kg significantly decreased the duration of immobility time in FST. The efficacy of tested extract was found to be comparable to that of imipramine. Our results suggested that the aqueous extract of Prosopis cineraria leaves exerts antidepressant-like effect.

O extrato aquoso de folhas de Prosopis cineraria (AEPC) é utilizado, tradicionalmente, para o tratamento de várias disfunções do SNC. O propósito desse estudo foi avaliar o extrato quanto às atividades antidepressiva e relaxante muscular esquelética. O efeito antidepressivo do extrato foi avaliado usando o teste do nado forçado (FST). Registraram-se os períodos de imobilidade dos camundongos controle e dos tratados. O efeito antidepressivo do composto testado foi comparado com a imipramina ((15 mg/kg. p.o). A propriedade relaxante muscular foi estudada usando o cilindro giratório e o tempo total de queda para os grupos padrão e controle foram registrados. A triagem fitoquímica revelou a presença de saponinas, flavonoides, alcaloides, glicosídeos, taninos e compostos fenólicos. O extrato da folha em doses de 200 mg/kg diminui significativamente a duração do tempo de imobilidade no FST. A eficácia do extrato testado foi comparável àquela da imipramina. Nossos resultados sugeriram que o extrato aquoso das folhas da Prosopis cineraria exerce efeito semelhante ao antidepressivo.

Patrones de prescripción de antidepresivos en pacientes afiliados al sistema general de seguridad social en salud de Colombia / Antidepressant prescription patterns in patients affiliated with the general social security health system of Colombia

OBJETIVO: Determinar los patrones de prescripción de medicamentos antidepresivos en un grupo de afiliados al Sistema General de Seguridad Social en Salud de Colombia. MÉTODOS: Estudio descriptivo observacional con 9 881 pacientes medicados con antidepresivos, de ambos sexos, mayores de 5 a±os, con tratamiento continuo de agosto a octubre de 2009 y residentes en 56 ciudades colombianas. Se dise±ó una base de datos sobre consumo de medicamentos, obtenidos por la empresa que distribuye los medicamentos a los pacientes. RESULTADOS: Edad promedio de 59,1 ± 16,1 a±os; 73,7 por ciento de los participantes fueron mujeres. Del total de pacientes, 83,3 por ciento recibían monoterapia y 16,7 por ciento dos o mßs antidepresivos. El orden de prescripción de los medicamentos fue: inhibidores selectivos de la recaptación de serotonina 47,0 por ciento, atípicos 37,8 por ciento, tricíclicos 31,8 por ciento, inhibidores selectivos de la recaptación de serotonina y norepinefrina 1,8 por ciento e inhibidores selectivos de la recaptación de norepinefrina 0,03 por ciento. Las combinaciones mßs empleadas fueron fluoxetina + trazodona (n = 1 029), amitriptilina + fluoxetina (n= 265), amitriptilina + trazodona (n = 122), fluoxetina + imipramina (n = 106) e imipramina + trazodona (n = 71). Las comedicaciones mßs prescritas fueron antihipertensivos (52,3 por ciento), hormona tiroidea (23,3 por ciento), antiinflamatorios (19,6 por ciento), antiepilépticos (15,4 por ciento), antidiabéticos (13,8 por ciento), ansiolíticos e hipnóticos (12,4 por ciento), antipsicóticos (7,4 por ciento), antiparkinsonianos (4,3 por ciento) y antineoplßsicos (2,2 por ciento). CONCLUSIONES: Predominan hßbitos de prescripción de medicamentos de alto valor terapéutico, principalmente en monoterapia antidepresiva. La mayoría de los antidepresivos se emplean en dosis menores que las recomendadas. Se plantea la necesidad de dise±ar estrategias educativas para corregir algunos hßbitos de prescripción...

OBJECTIVE: Determine patterns of antidepressive drug prescription in a group of patients affiliated with the General Social Security Health System in Colombia. METHODS: Observational descriptive study of 9 881 patients, of both sexes and older than 5 years of age, medicated with antidepressants and continuously treated from August to October 2009. The patients include residents from 56 Colombian cities. A database was designed based on the consumption of medicines obtained from the company that distributes them to the patients. RESULTS: The average age was 59.1 ± 16.1 years; 73.7 percent of the participants were women. Of the total number of patients, 83.3 percent were treated with monotherapy and 16.7 percent with two or more antidepressants. The order of the prescription of the medicines was: selective serotonin reuptake inhibitors, 47.0 percent; atypical, 37.8 percent; tricyclical, 31.8 percent; selective serotonin reuptake inhibitors and norepinephrine, 1.8 percent; and selective norepinephrine reuptake inhibitors, 0.03 percent. The combinations most used were fluoxetine + trazodone (n = 1 029); amitriptyline + fluoxetine (n = 265); amitriptyline + trazodone (n = 122); fluoxetine + imipramine (n = 106); and imipramine + trazodone (n = 71). The most prescribed co-medications were anti-hypertensives (52.3 percent); thyroid hormones (23.3 percent); anti-inflammatories (19.6 percent); anti-epileptics (15.4 percent); anti-diabetics (13.8 percent); anti-anxiety and hypnotics (12.4 percent); antipsychotics (7.4 percent); anti-Parkinsons (4.3 percent); and anti-neoplastics (2.2 percent). CONCLUSIONS: The practice of prescribing medicines with a high therapeutic value predominates, mainly for antidepressive monotherapy. Most of the antidepressants are prescribed at dosages lower than those recommended. There is a need to design educational strategies to correct some prescription practices and to conduct research.

Effects of chronic corticosterone and imipramine administration on panic and anxiety-related responses

It is known that chronic high levels of corticosterone (CORT) enhance aversive responses such as avoidance and contextual freezing. In contrast, chronic CORT does not alter defensive behavior induced by the exposure to a predator odor. Since different defense-related responses have been associated with specific anxiety disorders found in clinical settings, the observation that chronic CORT alters some defensive behaviors but not others might be relevant to the understanding of the neurobiology of anxiety. In the present study, we investigated the effects of chronic CORT administration (through surgical implantation of a 21-day release 200 mg pellet) on avoidance acquisition and escape expression by male Wistar rats (200 g in weight at the beginning of the experiments, N = 6-10/group) tested in the elevated T-maze (ETM). These defensive behaviors have been associated with generalized anxiety and panic disorder, respectively. Since the tricyclic antidepressant imipramine is successfully used to treat both conditions, the effects of combined treatment with chronic imipramine (15 mg, ip) and CORT were also investigated. Results showed that chronic CORT facilitated avoidance performance, an anxiogenic-like effect (P < 0.05), without changing escape responses. Imipramine significantly reversed the anxiogenic effect of CORT (P < 0.05), although the drug did not exhibit anxiolytic effects by itself. Confirming previous observations, imipramine inhibited escape responses, a panicolytic-like effect. Unlike chronic CORT, imipramine also decreased locomotor activity in an open field. These data suggest that chronic CORT specifically altered ETM avoidance, a fact that should be relevant to a better understanding of the physiopathology of generalized anxiety and panic disorder.

Antidepressant activity of amantidine in albino mice.

Background: The glutamate system has been implicated in depression recently. This is a departure from previous thinking, which had focused on serotonin and norepinephrine. The glutamate system may represent a new avenue for treatment and research. NMDA and AMPA are receptors for the neurotransmitter glutamate. Blocking NMDA increases the activity of another receptor, AMPA, and this boost in AMPA activity is crucial for rapid antidepressant actions. Amantidine being a noncompetitive antagonist at NMDA receptor is evaluated for its antidepressant activity in this study. Objectives: To evaluate the antidepressant activity of amantidine and compare it with Imipramine in albino mice. Methodology: Total of 18 swiss albino male mice were used. They were divided into three treatment groups and with normal saline (control) 10mg/kg, Imipramine (standard) 10mg/kg and amantidine 26 mg/kg (test drug) given orally. Each group contained 6 animals. Duration of immobility was observed for 6 minutes in tail suspension test and for 4 minutes in forced swimming test on separate set of animals. Results: Results were analyzed by ANOVA followed by Post hoc Tukey’s test. Amantidine at the dose of 26 mg/kg significantly reduced the immobility time in both the tests compared to control (p < 0.05). Conclusion: Non-competative antagonist, amantidine has significant antidepressant activity in acute models of depression.

Imipramine for vestibular dysfunction in panic disorder: a prospective case series / Imipramina para disfunção vestibular em transtorno do pânico: uma série de casos prospectiva

OBJECTIVE: The purpose of this study was to evaluate the efficacy and effectiveness of imipramine on the treatment of comorbid chronic dizziness and panic disorder. METHOD: Nine patients with panic disorder and agoraphobia associated with chronic dizziness underwent otoneurological screening and were treated with a 3-months course of imipramine. Anxiety levels were measured with the Hamilton Anxiety Scale (HAM-A), dizziness levels were evaluated using the Dizziness Handicap Inventory (DHI), and panic severity and treatment outcome were assessed with the Clinical Global Impression Scale (CGI). RESULTS: At the baseline 33.3 percent (n=3) had a bilateral peripheral deficit vestibulopathy, the mean scores for HAM-A were 27.2±10.4, for DHI were 51.7±22.7, and for CGI-S were 4.8±0.9. All patients had a significant reduction in their HAM-A (11.1±5.5, p=0.008), DHI (11.5±8.1, p=0.008) and CGI-I (1.8±0.7, p=0.011) levels after 3-months imipramine treatment (mean=72.2±23.2 mg/day). CONCLUSION: This study found a decrease in anxiety levels and in the impact of dizziness in the patients' quality of life after a 3-months treatment course with imipramine.

OBJETIVO: O objetivo deste estudo foi avaliar a eficácia e efetividade da imipramina no tratamento da tontura crônica e do transtorno de pânico comórbidos. MÉTODO: Nove pacientes com transtorno do pânico e agorafobia associada com tontura crônica foram submetidos à avaliação otoneurológica e tratados durante 3 meses com imipramina. Os níveis de ansiedade foram medidos através da Escala Hamilton de Ansiedade (HAM-A); os de tontura foram avaliados usando o Dizziness Handicap Inventory (DHI), e a gravidade do pânico e sua resposta pela Escala de Impressão Clínica Global (CGI). RESULTADOS: Na avaliação inicial, 33,3 por cento (n=3) da amostra apresentavam vestibulopatia periférica deficitária bilateral; as médias foram: da HAM-A 27,2±10,4, do DHI 51,7±22,7 e do CGI-S 4,8±0,9. Todos tiveram uma redução significativa nos escores de HAM-A (11,1±5,5, p=0,008), DHI (11,5±8,1, p=0,008) e CGI-I (1,8±0,7, p=0,011), após 3 meses de tratamento com imipramina (média=72,2±23,2 mg/dia). CONCLUSÃO: Este estudo encontrou uma diminuição dos níveis de ansiedade e do impacto da tontura na qualidade de vida dos pacientes após um curso de 3 meses de tratamento com imipramina.