La depresión: un desafío en la práctica médica general / La depresión: un desafío en la práctica médica general

Asociada o no a una enfermedad orgánica, la depresión tiene gran prevalencia en la práctica médica pero es subdiagnosticada. El trastorno del ánimo suele coexistir con variadas quejas somáticas y dolores crónicos, configurando síndromes mixtos con un diagnóstico diferencial complejo. En este artículo se describen distintas presentaciones clínicas de la depresión en medicina general, con énfasis en los estados depresivos atípicos, depresiones enmascaradas muy relevantes por su frecuencia y consecuencias: depresión posquirúrgica, cuadros dolorosos crónicos como cefaleas o lumbago, la fatiga crónica y la fibromialgia. Solo el reconocimiento y diagnóstico de la depresión subyacente posibilitará la implementación de las adecuadas intervenciones terapéuticas. Se revisan también algunas recomendaciones para el uso de antidepresivos en atención primaria y la eventual consulta psiquiátrica. (AU)

Associated or not with an organic disease, depression has a high prevalence in medical practice but is underdiagnosed. The mood disorder usually coexists with varied somatic complaints and chronic pain, forming mixed syndromes with a complex differential diagnosis. This article describes different clinical presentations of depression in general medicine, with emphasis on atypical depressive states, masked depressions very relevant for their frequency and consequences: post-surgical depression, chronic painful conditions such as headaches or lumbago, chronic fatigue and fibromyalgia. Only the recognition and diagnosis of the underlying depression will enable the implementation of appropriate therapeutic interventions. Some recommendations for the use of antidepressant drugs in primary care and the eventual psychiatric consultation are also reviewed. (AU)

role of Coenzyme Ubquinone CoQ10 in modulating the changes induced by the antidepressant Venlafaxine in albino rats fetuses

The present study was done to investigate the role played by CoQ10 in the control of the morphological and histological changes induced in the fetuses of rats injected by the antidepressant Venlafaxine. 70 pregnant Wister wister rats were injected Intraperitonealy during the organogenesis period with the antidepressant Venlafaxine [0.25mg /100g.body weight] on day 7of gestation.Mean number of alive embryos,weight and length of them were recorded with the noticeable malformations beside maternal weights.The protective role of CoQ10 [0.6 mg. /100g. body weight] was also detected. Venlafaxine injection induced a very highly significant decrease in the mean maternal and fetal body weights, the two horns of the uteri appeared unequal as well as the fetuses were unequally distributed between them, beside the appearance of a lot of resorbed bodies into them, also fat sacs were clear, a case of ectopic pregnancy was obvious, as well as very highly significant decrease in the mean number of alive fetuses was noticed, fetal growth retardation beside lots of rat fetal malformations were observed such as subcutaneous blood bleeding, cleft lips and anomalies of the fore and hind limbs as well as kyphosis of the body. Intraperitonealy injection of Venlafaxine by the fractionated dose [0.75mg. / 100g body weight] on days 7, 10 and 13 of gestation 0.25mg. /100g each resulted in the death of all the pregnant rats. CoQ10 [0.6 mg. /100g. body weight] orally injected to the pregnant rats before Venlafaxine treatment at the two doses [0.25 and 0.75mg./100g.body weight] improved the above morphometric and morphological as well as the skeletal system changes. CoQ10 [0.6 mg. /100g. body weight] orally injected to the pregnant rats treated with Venlafaxine showed protective effect against the dangerous changes induced by this antidepressant