Effect of citalopram on depression and cognitive functions of stroke patients

Background: Post stroke depression is a common state after stroke causing disability and affects cognitive status in patients. Present study tried to show the effect of citalopram on post stroke depression as well as cognitive state

Method and Materials: in clinical trial study all patients with acute ischemic stroke who had been consecutively admitted to the Ghaem Hospital [from 1388-1389], in Mashhad were evaluated for inclusion in the study.[218 person].in first visit neurological tests and hamilton rating test for depression were taken. At last 89 patients admitted az sample of study. Cognitive impairment was assessed with the Dementia Rating Scale [DRS]. The severity of the depressive symptoms was measured by Hamilton Rating Scale for Depression [HAM-D].Then they were classified into those with severe depressive symptoms [HAM-D >20;N=18], with mild depressive symptoms [HAM-D scores 12-19; N=39] and non-depressed patients [HAM-D scores < 12; N=32]. Patients with severe depressive symptoms were treated with citalopram. Statistical analysis was performed using spss version 11

Results: HRDS, MMSE and DRS scores had significant change at the baseline and the end of study in group treated by citalopram. There were significant differences between DRS scores in attention domain at the baseline and the end of study in both citalopram group and without depression

Conclusion: These data suggest that treatment of depressive symptoms in the acute phase of stroke improves both mood and cognition and would be a reasonable treatment for patients suffering post stroke depression and cognitive change after stroke

[ double-blind, randomized comparison of efficacy and side effects of bupropion versus methylphenidate in children with ADHD]

ADHD is one of the most common neuropsychiatric disorders in children. Methylphenidate is the most frequent medication prescribed for this disorder, while bupropion is suggested as an alternative for treatment. This research aims to compare the efficacy and safety of bupropion and methylphenidate [Ritalin] in children with ADHD. Forty children with ADHD, aged 6 to 12 years, from consecutive referrals to child psychiatric clinic of Ibn-e-Sina hospital were selected and randomly divided into two categories [treatment with methylphenidate or bupropion]. Evaluations were carried out based on ADHD Rating Scale [by teacher and parent] and Global Clinical Scale [by clinician] at the beginning of the study and again after 4 and 8 weeks of the study. Adverse effects were also checked at 4 and 8 weeks. Data was analyzed using SPSS software, version 11.5. Data was normally distributed in the two categories in terms of demographic and quantitative variables. Therapeutic response, in parents' views, was better in Ritalin group and was significantly different at the end of the 8th week [p=0.014]. Ritalin was also more efficacious in teachers' views, but had no significant advantage [p=0.092]. Global clinical scale showed a significant advantage in both categories regarding response to therapy [p=0.014]. Therapy was seen efficacious by parents, teachers, and clinician [p < 0.001]. Results showed that bupropion was an effective agent in ADHD treatment, but its effect was less than methylphenidate based on the parents' report

[ effect of aromatherapy with orange essential oils on anxiety in patients undergoing hemodialysis]

All hemodialysis patients experience some degree of anxiety during hemodialysis. Anxiety increases morbidity and mortality. The aim of this research is to compare the effect of orange essential oil aromatherapy on anxiety of hemodialysis patients. In this clinical trial, sixty-two hemodialysis patients were randomly assigned to two groups: an orange oil group [n=31], and a usual care group [n=31]. In orange oil group, subjects inhaled orange oil using handkerchiefs smeared with orange oil for 15-20 minutes. This method was used three times a week for four weeks. In the usual care group, subjects received the routine care of the hemodialysis ward. The level of anxiety in the two groups was measured and compared before intervention, as well as after the first, second, third, and fourth weeks of intervention, using Spielberg State-Trait Anxiety Inventory questionnaire. Before intervention, the mean state anxiety scores were 46.9 +/- 9.7 and 48.3 +/- 11.6 and the mean trait anxiety scores were 46.5 +/- 9.2 and 47.9 +/- 11.6 in orange oil and usual care groups, respectively. After intervention, the mean state anxiety scores were 35.9 +/- 8.7 and 45.1 +/- 1.7 and the mean trait anxiety scores were 36.0 +/- 10.0 and 45.6 +/- 11.8 in orange oil and usual care groups, respectively. In orange oil group, the level of state and trait anxiety decreased significantly compared with usual care group [p < 0.001]. Also, in orange oil group, the level of state and trait anxiety decreased significantly between the first, second, third, and fourth weeks of intervention [p < 0.05]. Orange oil aromatherapy can reduce state and trait anxiety in hemodialysis patients without important complications

[Comparison of desipramine and sertraline in the treatment of depression in patients suffering from alzheimer disease]

As depression is a common comorbid disorder with Alzheimer disease, it is important to recognize treatments with more effective and less adverse effects. This study has been devised to comparatively evaluate the effects of desipramine and sertraline in this patients. In this single blind clinical trial study, during January 2005 to April 2008, 63 outpatients in Ibn-e-Sina and Ghaem University hospitals in Mashhad city [north eastern part of Iran] were randomly allocated to two groups: 29 cases were treated by desipramine and 34 patients were treated with sertraline [both 25mg/day and if needed up to 150 mg/day]. Patients were assessed at 2, 4, 8 and 12[th] week by PDRS, HRDS and MMSE and side effects of medications. Changes in mood with HRDS and CSDD have shown that sertraline was effective in all weeks [p<0.05]. In contrast, desipramine had no therapeutic effect except in the 12[th] week according to HRDS scale [p<0.05]. Differences between the groups were significant [p=0.02]. Differences between daily activating scales regarding PDRS in 8[th] and 12[th] week in desipramine group were statistically meaningful [p<0.05], but not in the sertraline group and between the two groups. Also, cognitive changes by MMSE were not significant in the two groups and between the two groups. Sertraline is more effective than desipramine in the treatment of depression in patients who suffer from alzheimer disease, but they are ineffective on cognitive problems

review on phytochemistry and medicinal properties of the genus Achillea

Achillea L. [Compositae or Asteraceae] is a widely distributed medicinal plant throughout the world and has been used since ancient time. Popular indications of the several species of this genus include treatment of wounds, bleedings, headache, infammation, pains, spasmodic diseases, fatulence and dyspepsia. Phytochemical investigations of Achillea species have revealed that many components from this genus are highly bioactive. There are many reports on the mentioned folk and traditional effects. Although, the medicinal properties of Achillea plants are recognized worldwide, there are only one review article mainly about the structures of the phytochemical constituents of Achillea. The present paper reviews the medicinal properties of various species of Achillea, which have been examined on the basis of the scientifc in vitro, in vivo or clinical evaluations. Various effects of these plants may be due to the presence of a broad range of secondary active metabolites such as favonoids, phenolic acids, coumarins, terpenoids [monoterpenes, sesquiterpenes, diterpenes, triterpenes] and sterols which have been frequently reported from Achillea species

Association between malnutrition and depression in elderly people in Razavi Khorasan: a population based-study in Iran

To determine the prevalence of malnutrition and depression in free-living elderly people and their relationships [If any] in Razavi Khorasan, Iran 2007. To evaluate nutritional status, we used Mini Nutritional Assessment [MNA] method in free-living elderly people [n=1565 using cluster sampling, 720 males and 845 females, aged>/= 60 yr] and their relationship to Socio Economic Conditions [SECs]. Based on the final scores, our patients were classified into three groups: score 17-23.5 [at risk for malnutrition], score less than 17 [with malnutrition], and score 24-30 [well nourished]. To determine the mood status [here depression], we used Geriatric Depression Score [GDS]. According to this score our participants turned out to be in two distinct groups: depressed [score >/=8] and non-depressed [score< 8]. From the total subjects entered the study [1495], 22.07% were depressed and 11.5% and 44% were malnourished or at risk of malnutrition respectively. In depressed group, the prevalence of malnutrition was 14.5% [48 out of 330] and the prevalence of "at risk of malnutrition" was 45.8%, whereas the prevalence of malnutrition and at risk of malnutrition in non-depressed population were 10.6% and 43.3% respectively. From the aforementioned information we have concluded that there is a significant statistical difference between the prevalence of malnutrition in depressed and non-depressed individuals [P= 0.047]. With respect to the high rate of vegetative symptoms in elderly depressed individuals, malnutrition would have a higher prevalence in the depressed people

Association between sociodemographic factors and nutritive and non-nutritive sucking habits among Iranian girls

Prolonged duration offinger-and pacifier-sucking may be a risk factor for maldevelopment of orofacial structures and dental occlusion. This study assessed the prevalence of nutritive and non-nutritive sucking habits and their association with some contributing factors among 7-year-old girls in Mashhad, Islamic Republic of Iran. Based on a questionnaire to the parents of 436 schoolgirls, the rate of current or previous pacifier-sucking was 26.6% and of finger-sucking was 10.6%. Child's birth rank and number of siblings and parents' educational level were significantly related to ever pacifier-sucking but not to finger-sucking. The highest prevalence of ever pacifier-sucking was among children who had been breast- and bottle-fed but finger-sucking was more common among exclusively breastfed children

Seasonal and yearly fluctuations in birth date of cleft lip and palate children in northern east of Iran, 1992 - 2007

Cleft lip and palate are believed to be caused by multi factorial inheritance in which genes interact with environmental agents. Thus the main aims of this study were to find out seasonal variations in the birth date as well as the sex distribution in the birth of children with cleft lip and palate. In this retrospective study, the birth dates of 358 children born in Khorasan Razavi state from 1992 to 2007 with a diagnosis corresponding to cleft palate, or cleft lip with or without cleft palate, were obtained from Cleft Lip and Palate Research Unit in Mashhad Dental School. The data were analyzed by Chi -square test to look at the sex distribution and seasonal variation. The results showed the peak incidence of cleft palate birth in autumn. Cleft lip and palate showed a different seasonal trend, with the peak occurrence in the spring and autumn for males and in the winter for females. Additionally, this study showed the yearly rate for cleft lip, isolated cleft palate and cleft lip and palate decreased from 1992 to 2007. These seasonal trends may act as a pointer to the environmental factors active in the multi factorial etiology of cleft lip and cleft palate

[Comparative efficacy of citalopram and nortriptyline in geriatric patients with major depressive disorder]

Major depressive disorder is a common and disabling disorder that causes high rates of morbidity and mortality. Nortriptyline is a tricyclic antidepressant that has been used for geriatric depression since a long time ago. Prescription of SSRIs in geriatric depression has been increased recently, because of more favorable profile of their side effects. This study designed to compare the efficacy of nortriptyline and citalopram in geriatric depression, Because of the importance of choosing the most appropriate medication in geriatric population. The present study was a single blind clinical trial, performed from February 2005 for a one year period. Patients age above 60 years referred to Ibne-sina hospital with the confirmed diagnosis of major depressive disorder, based on DSM-IV-TR criteria, were included in the study. These patients were randomly divided into two groups: one group [n= 37] taking citalopram 10-20 mg/day and the other group taking nortriptyline 25-150 mg/day [with the mean dose of 100 mg/day]. The efficacies of medications were assessed after 8 weeks based on the change in HDRS. Finally, 72 patients completed the study and 13 patients [5 from citalopram group, 8 from nortriptyline group], for different reasons discontinued the medication. Data analyzed using descriptive statistical tests and chi square. Demographic data and HDRS scores did not show statistical considerable variance in the two groups. Also, Changes in HRDS scores before the treatment and after 8 weeks were not significantly different between them. Insomnia was seen in 5 patients taking citalopram [13.4%]. Three patients [8.1%] in the citalopram group and one patient [2.8%] in the nortriptyline group complained from nausea in the early treatment phase. Headache was seen in 8.1% and 2.8% in the groups taking citalopram and nortriptyline, respectively. In the patients taking nortriptyline, the most prevalent complaints were dry mouth [28.5%] and drowsiness [22.8%]. Results showed that both drugs are efficient in the reduction of geriatric depressive symptoms and HRDS scores decrease was more than 50% in both groups. No significant difference was seen between the efficacy of two drugs and this result is consistent with the previous studies. These findings need to be confirmed with further researches

Compression of risperidone and olanzapine in behavioral disturbances of Alzheimer: a randomized double blind clinical trial

There are some doubts about therapeutic effects of olanzapine and risperidone two antipsychotic drugs on behavioral disturbances in patients with Alzheimer's disease and concerns about safety have emerged. We assessed the effectiveness of these two atypical antipsychotic drugs in outpatients with Alzheimer's disease. In this double-blind trial, 69 outpatients with Alzheimer's disease and psychosis, aggression, or agitation were randomly assigned to receive olanzapine [dose, 2.5- 7.5 mg per day] or risperidone [dose, 0.5-4.5 mg per day]. Patients were followed for up to 10 weeks. The main outcomes were the scores of the Clinical Global Impression of Change [CGI] scale and Brief Psychiatric Rating Scale [BPRS]. There were no significant differences among treatments with regard to improvement in risperidone and olanzapine group on the CGI [3.2 +/- 4.3 vs. 3.5 +/- 5.8 and P Value=0.564] and BPRS scale [8.2 +/- 9.2.vs. 8.8 +/- 9.2 and P Value = 0.522] .Furthermore, although the number of patients who had left the study cause of side effects, was greater in risperidone group, sedation and headache are more common with olanzapine than risperidone. Both risperidone and olanzapine might be useful and reasonable treatment for patients who suffering from behavioral disturbances due to psychosis in Alzheimer disease

[Comparison of psychopathology in medical and non medical College students of Mashhad University of Medical Sciences]

Some psychopathologies and high rates of stress have been reported among medical students higher than others in some reseavehes. Based on importance of mental health in physicians and their responsibilities we designed this study to assess the role of field of study in psychopathology of college students. In this cross-sectional study, 69 medical interns and 57 MSC and PhD students of Mashhad University of Medical Sciences, were assessed by a questionnaire concerning age, sex, marital status, habitat and income. Psychiatric evaluation was performed by the use of SCL-25 pnestionaire. The two groups were selected by simple cluster method, then they were compared in their 9 subscore of SCL-25 onestionair Relation between the age, sex, and other variables and psychopathology was assessed. There was no signification difference between the two groups in 9 sub scores of SCL-25 one stionaire [p>0.05]. Psychopathology in general and interpersonal hostility in especial were higher among male students of the two groups. Somatization in married students and depression in single members of both groups was highest. Phobia and paranoid ideas were not related to age, sex, and marietal status. Based on this study no endence was Round to rvove the velation between psychopathology and standing Medicine but other factors like sep and marietnl field of academic study does not related psychopathology and such factors as sex and marietal status seem to need move resemches and have move important role

[Compression of coping responses and life events in males with coronary artery disease]

Cardiovascular disorders CVD account for a vast proportion of mortality in developed countries. There are various risk factors identified for such condition, including Psychological stressors which play on important role in creating exaggeration or prolonging the above disorders. This study aims to assess the different copping response style to recent life events in patient with CVD and control group. Study populations are inpatient clinic of Ghaem hospital. They are 50 men with CVD and 50 men without CVD who were matched in marital status, education, job, number of children, state, history of psychiatric assessment, mean systolic blood pressure and mean cholesterol. We use Belongs and Moos test and paykel recent life event questionnaire. Emotion oriented copying style was significantly higher in CVD group and the cognitive oriented reaction was significantly lower in this group. Social supports were higher in control than CVD patients, but this difference was nonsignificant. Also, Somatization was nonsignificantly more common in CVD group. No signifact difference was shown in vecent life events between two groups. It seems the change of copping methods and management of stressful events can help to decrease the risk of coronary artery disease

[Comparison of the cognition status of patients with schizophrenia and schizoaffective]

Schizophrenia and schizoaffective are chronic psychiatric disorders that decrease cognitive ability. In this study we examined the cognitive problem in patients with these disorders. This study is a descriptive- analysis research conducted 309 men hospitalized in Ebne-Sina hospital in Mashhad, including 195 paranoid schizophrenia and 114 schizoaffective [Bipolar type]. All the patients underwent the MMSE test -with 6 domains; then the results were analyzed. Cognitive impairment in Schizophrenic patients was more significant than schizoaffective patients [P =0.04] particularly in speech and motoric aspects [P = 0.032]. Speech and motoric skills in schizophrenic patients get badly damaged; therefore, paying attention to this cognitive impairment in the process of treatment is necessary. Schizoaffective patients have less cognitive impairment but they suffer from attention insufficiency and calculation problems. This difference could be a root for ethiological differences