Atypical features

Some patients present with "atypical features" of depression ... 

In contrast, a less extensive but still convincing database has identified important clinical differences in efficacy for antidepressants used to treat patients with atypical or comorbid depression. Individuals with atypical depression (distinct quality of mood, hyperphagia, hypersomnia, psychomotor retardation, rejection sensitivity, and such unusual atypical features as chocolate craving] have superior responses to monoamine oxidase inhibitors (MAOIs], selective serotonin reuptake inhibitors (SSRIs), and perhaps venlafaxine, and most do not respond well to tricyclic antidepressants (TCAs] (Davidson et al. 1982 Liebowitz et al. 1988 Quitkin et al. 1988, 1991). Despite these data, TCAs unfortunately have been the first choice for most atypical patients until SSRIs were introduced. 

Depression with atypical features SSRI, MAOT... 

Feature, Atypical Feature, Catatonic Feature, or Postpartum. 95... 

In clinical studies, major depressive disorder has had four specifiers, including melancholic feature, atypical feature, catatonic feature, and postpartum onset. In the future, we should investigate the distributions of the four specifiers of depression among patients with physical illness and discuss which biological markers could link the depressive disorder and the physical illness. 

Although there are papers that discuss the relationships between cholesterol, lipid profiles, and major depression [34-39], there are few data that discuss the association between lipid profiles and depressive disorders with different phenotypes. Huang and Chen investigated the correlation between serum lipid, lipoprotein concentration, and major depressive disorder in patients evaluated for general health screening [41]. They found that analysis of covariance after age adjustment revealed significant differences in patients with melancholic feature and patients with atypical feature in serum concentrations of TG and VLDL in men and HDL in women [41]. However, there are still no reports that discuss the relationships between lipid profiles and major depression with postpartum onset or catatonic feature. In the future, large sample numbers will be needed to clarify the clinical differences in this field. 

Huang TL, Chen JF. Lipid and lipoprotein levels in depressive disorders with melancholic feature or atypical feature and dysthymia. Psychiatry Clin Neurosci 2004 58 295-299. 

Severe cardiac pain, chest tightness, sweating, breathlessness and nausea. Some patients may present with atypical features including indigestion, pleuritic chest pain or dyspnoea. 

Parkinsonism whereas in other families with the same mutation, an autosomal dominant pattern of inheritance is present (Munoz et al., 2002 Tan et al 2003). Some reports suggest that carriers of PRKN mutations are more likely to have dystonia and symmetric symptoms than noncarriers, and some may even have atypical features such as psychiatric manifestations (Khan et al., 2003 Lucking et al., 2000). However, a wide overlap of Parkinsonian symptoms between some groups suggests that no specific diagnostic clinical feature can be demonstrated (Munhoz et al.,... 

A review of furosemide-induced skin reactions included a description of a unique case of an 88-year-old man who developed an eruption that clinically and histologically simulated Sweet s syndrome (acute febrile neutrophilic vasculitis) after 6 weeks (15). Atypical features and rapid resolution suggested a drug eruption rather than true Sweet s syndrome. However, a similar mechanism may have been implicated a hypersensitivity reaction involving immune complexes. 

Many atypical features common compared to other causes of meningitis, i.e., seizures, changing mental status, movement disorders... 

There are accnmnlating data to support that 50% to 60% of previously treatment-resistant depressed patients respond to adequate doses of SSRIs. MAOIs can be considered in the truly treatment-resistant population, especially for the patient with atypical features. ... 

Parkinsonism—A constellation of symptoms with atypical features such that a diagnosis of idiopathic Parkinson s disease cannot be made. 

C. In a large-scale attack, the diagnosis will be simplified by the epidemiological distribution of the casualties. It is better to look for characteristics common to all or most casualties, than to be overly impressed with atypical features. 

With atypical features Within this specifier there are incongruent findings to some of the established criteria (e.g., mood brightens when exposed to a pleasant event, or unusual features related to the condition exist such as overeating, oversleeping, or patterns of hypersubjectivity to rejection). 

The medications known as anticonvulsants are often used as front-line treatment of the bipolar disorders. The most common of these medications include Tegretol (carbamazepine), Depakene or Depakote (valproate or valproic acid), and Klonopin (clonazepam), and they are used under the following circumstances (a) inadequate response or intolerance to antipsy-chotics or lithium (b) manic symptoms (c) rapid cycling of the condition (d) EEG abnormalities and (e) head trauma (Kaplan Sadock, 1996). In practice, these medications seem particularly effective for clients who suffer from schizoaffective disorders or agitated depression of a cyclic nature. They are considered the medication of choice if an individual has a history of brain damage or of severe or rapid mood swings (Dulcan, 1999). Furthermore, if an individual has atypical features of the mental... 

In conclusion, even under steady state treatment with twice the dose recommended for depressive disorders, only a minimal increase in daylight sensitivity was found along with a mildly enhanced tanning reaction. This ties in with the results of in vitro and animal studies and the fact that only one case of phototoxicity in a patient taking the antidepressive dose has been documented thus far. And even this case is of questionable relevance because of atypical features. 

Major depressive disorder (MDD) with atypical features... 

For MDD with atypical features, fluoxetine, moclobemide, and sertraline... 

The atypical features in the linear sweep/cyclic voltammograms include the asymmetry in shape between anodic and cathodic current peaks, and the abnormal dependence of peak current on potential scan rate. The cell-impedance controlled lithium transport concept is expected to provide a reasonable explanation of these atypical voltammetric responses, and give us a new insight into the lithium transport behavior during potential scanning. 

Compression set is atypical feature of PVC sealants because gelled PVC has plastic properties (no rubbery behavior). Addition of crosslinked nitrile rubber adds rubbery particles which are able to reduce compression set. 

McKinney, C D, Golden, W. L., Gemma, N W, Swerdlow, S H, and Williams, M. E. (1994) RARA and PML gene rearrangements in acute promyelocytic leukaemia with complex translocations and atypical features Genes, Chromosomes Cancer 9,49-56... 

Prevention of recnrrence of affective disorder Insight into how best to use lithium to reduce the recurrence of new mood episodes continues to accrue. In long-term prospective study in five centers, the International Group for the Study of Lithium-Treated Patients examined the relative stability of patients with predominantly atypical features (n = 100 e.g. mixed states or rapid cycling) or more typical bipolar features (n = 142) over a mean of 10 years [16 f. There were no differences in the overall measures of morbidity in the two groups. 

Trivedi MH, Thase ME, Fava M, Nelson CJ, Yang H, Qi Y, Tran QV, Pikalov A, Carlson BX, Marcus RN, Berman RM. Adjunctive aripiprazole in major depressive disorder analysis of efficacy and safety in patients with anxious and atypical features. J Clin Psychiatry 2008 69(12) 1928-36. 

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