Depression urinary incontinence

TK NK2r antagonists showed interesting activities in preclinical models of depression, anxiety, asthma, gastrointestinal dysmotility and hypersensitivity, and urinary incontinence [1,3]. In clinical, NK2r antagonists antagonize NKA-induced bronchoconstriction and NKA-induced intestinal dysmotility. However, a pilot trial in asthma failed to show any clinical benefit by... 

Nausea, diarrhea, stomatitis, hypotension, anorexia, bone marrow depression, pulmonary congestion, dyspnea, oliguria Dysuria, urinary frequency, cystitis, hematuria, urinary incontinence... 

Urinary incontinence (UI) is defined as the complaint of involuntary leakage of urine.1 It is often associated with other bothersome lower urinary tract symptoms such as urgency, increased daytime frequency, and nocturia. Despite its prevalence across the lifespan and in both sexes, it remains an underdetected and underreported health problem that can have significant negative consequences for the individual s quality of life. Patients with UI may be depressed due to a... 

Geriatric Considerations - Summary Compared to placebo, duloxetine is effective for the treatent of depression and painful diabetic neuropathy Few head-to-head studies are available comparing duloxetine to other agents in the treatment of depression or painful neuropathy. Because this agent may increase urethral sphincter activity, it is now being assessed as an agent for the treatment of stress urinary incontinence. This same property may increase the risk of urinary retention, although this has not been well documented. Duloxetine has not been well studied with respect to falls. 

Ocular adverse events, including accidental injury, angina pectoris, anxiety, arthritis, back pain, bradycardia, bronchitis, chest pain, cold syndrome, depression, dyspepsia, gastrointestinal disorder, headache, hypercholesterolemia, hypertension, hypotension, infection, pain, prostate disorder, sinusitis, urinary incontinence, and urinary tract infection, occur rarely. 

Neurokinins comprise a group of peptides involved in nerve transmission. Specific members of this class of mediators control such diverse functions as visceral regulation and CNS function. The nonpeptide neurokinin antagonist talnetant (32-6), for example, has been evaluated for its effect on irritable bowel syndrome and urinary incontinence as well as depression and schizophrenia [36]. The quinoline portion of this compound is prepared by base-catalyzed Pfitzinger condensation of isatin (32-1) with the methoxy acetophenone (32-2). The methoxy ether in the product (32-3) is next cleaved by means of hydrogen bromide (32-4). Amide formation with the chiral a-phenylpropylamine (32-5) affords the neurokinin antagonist talnetant (32-6) [37]. 

Some of the growth in antidepressant use may be related to the broad application of these agents for conditions other than major depression. For example, antidepressants have received FDA approvals for the treatment of panic disorder, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD). In addition, antidepressants are commonly used to treat pain disorders such as neuropathic pain and the pain associated with fibromyalgia. Some antidepressants are used for treating premenstrual dysphoric disorder (PMDD), mitigating the vasomotor symptoms of menopause, and treating stress urinary incontinence. Thus, antidepressants have a broad... 

The SNRIs include venlafaxine, its metabolite desvenlafaxine, and duloxetine. Another SNRI, milnacipran, is in late clinical trials in the USA but has been available in Europe for several years. In addition to their use in major depression, other applications of the SNRIs include the treatment of pain disorders including neuropathies and fibromyalgia. SNRIs are also used in the treatment of generalized anxiety, stress urinary incontinence, and vasomotor symptoms of menopause. 

Urinary incontinence, or leakage, that may be associated with diuretic use can cause social embarrassment, self-esteem issues, depression, and anxiety. A person suffering from incontinence may stop participating in social activities, sports, and other activities they once enjoyed because of the risk of embarrassing accidents. Bladder training, biofeedback, pelvic toning exercises, or special urethral or vaginal inserts may help to treat urinary incontinence problems related to diuretics. 

A 38-year-old Caucasian woman, who had taken heroin vapor 2 weeks before, developed confusion, ataxia, and urinary incontinence. She was afebrile and spoke with a slow low-volume monotonous voice. She had marked truncal ataxia with absent postural reflexes, cogwheel rigidity in her limbs, and marked bradykine-sia. She had used non-prescription amfetamine up to 4 g/day intermittently for 8 years. After a bout of depression, she came under the care of a psychiatrist and stopped taking amfetamine after she was given chlorpromazine and diazepam. She then started using... 

Dosing for neuropathic pain and fibromyalgia may be similar to that for depression but different from dosing for stress urinary incontinence, but clinical experience is still evolving... 

Muscarinic hyperstimulation leads to a clinical presentation of miosis, lacrimation, salivation, bradyarrhythmias, urinary incontinence, and intestinal hypermotility (Levy-Khademi et al, 2007). Nicotinic hyperstimulation leads to fasciculations, weakness, and paralysis of skeletal muscles. CNS effects include depression and agitation with coma and... 

Side effects/ adverse reactions Frequent Nausea, vomiting, diarrhea, anorexia Occasional Abdominal pain, insomnia, depression, headache, dizziness, fatigue, rhinitis Rare Tremors, constipation, confusion, cough, anxiety, urinary incontinence Adverse/toxic Overdose can cause cholinergic crises (increased salivation, lacrimation, urination, defecation, bradycardia, hypotension, increased muscle weakness). Treatment aimed at general supportive measures, use of anticholinergics (e.g., atropine)... 

Adverse effects include drowsiness, depression and postural hypotension especially in the elderly, which restricts their use to resistant hypertension. a antagonists should not be used in patients with an enlarged prostate or urinary incontinence. 

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