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Treatment Resistant Anxiety Disorders

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https://www.readbyqxmd.com/read/28527083/shared-mechanisms-of-epilepsy-migraine-and-affective-disorders
#1
Davide Zarcone, Simona Corbetta
Since the nineteenth century several clinical features have been observed in common between migraine and epilepsy (such as episodic attacks, triggering factors, presence of aura, frequent familiarity), but only in recent years researchers have really engaged in finding a common pathogenic mechanism. From studies of disease incidence, we understand how either migraine among patients with epilepsy or epilepsy among migraine patients are more frequent than in the general population. This association may result from a direct causality, by the same environmental risk factors and/or by a common genetic susceptibility...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28494323/stress-regulation-in-drug-resistant-epilepsy
#2
REVIEW
Iliana Kotwas, Aileen McGonigal, Mireille Bastien-Toniazzo, Fabrice Bartolomei, Jean-Arthur Micoulaud-Franchi
The prevalence of psychological distress, especially depressive and anxiety disorders, is higher in epilepsy than in other chronic health conditions. These comorbid conditions contribute even more than epileptic seizures themselves to impaired quality of life in patients with epilepsy (PWE). The link between these comorbidities and epilepsy appears to have a neurobiological basis, which is at least partly mediated by stress through psychological and pathophysiological pathways. The impact of stress in PWE is also particularly important because it is the most frequently reported seizure trigger...
May 8, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28483076/the-multiple-diagnoses-of-comorbid-anxiety-disorders-and-higher-interpersonal-sensitivity-predict-treatment-resistant-depression
#3
Taichi Mogi, Aihide Yoshino
BACKGROUND: The present study was conducted to examine the hypothesis based on our previous studies, that the multiple diagnoses of comorbid anxiety disorders (ADs) and higher interpersonal sensitivity predict treatment-resistant depression (TRD). METHODS: The participants were 199 consecutive outpatients with major depressive disorder (MDD), who were comprehensively diagnosed using the Mini International Neuropsychiatric Interview (MINI). TRD was defined as the failure to achieve remission with two or more adequate antidepressant trials...
April 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/28442424/thioredoxin-is-not-a-marker-for-treatment-resistance-depression-but-associated-with-cognitive-function-an-rtms-study
#4
Efruz Pirdogan Aydın, Abdullah Genc, Mihriban Dalkıran, Ece Türkyilmaz Uyar, Ömer Akil Özer, Kayıhan Oğuz Karamustafalıoğlu
Elevated oxidative stress is known to play an important role in development of depression and cognitive dysfunction. To date, thioredoxin (TRX), an antioxidant protein, has been investigated as a marker for psychiatric disorders such as schizophrenia, bipolar disorder and autism but its relationship with depression is yet to be unknown. The aim of this study is to detect the TRX levels in patients with treatment-resistant depression (TRD), analyse the effect of rTMS (repetitive transcranial magnetic stimulation) application on TRX levels and display the relationship of TRX with cognitive areas...
April 22, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28441895/ketamine-s-dose-related-effects-on-anxiety-symptoms-in-patients-with-treatment-refractory-anxiety-disorders
#5
Paul Glue, Natalie J Medlicott, Sarah Harland, Shona Neehoff, Bridie Anderson-Fahey, Martin Le Nedelec, Andrew Gray, Neil McNaughton
The N-methyl-D-aspartate receptor antagonist ketamine has rapid onset activity in treatment-resistant depression, post-traumatic stress disorder and obsessive compulsive disorder. Due to similarities in brain network activity in depression and anxiety disorders, we hypothesized that ketamine might also be active in other refractory anxiety disorders. We evaluated the efficacy and safety of ketamine in 12 patients with refractory generalized anxiety disorder and/or social anxiety disorder who were not currently depressed, using an ascending single dose study design (0...
April 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28427306/prefrontal-tdcs-and-sertraline-in-obsessive-compulsive-disorder-a-case-report-and-review-of-the-literature
#6
Ulrich Palm, Bianka Leitner, Beatrice Kirsch, Nora Behler, Ulrike Kumpf, Linda Wulf, Frank Padberg, Alkomiet Hasan
Obsessive-compulsive (OC) disorder is a disabling disorder resulting in tremendous individual and social burden. It has a large overlap with depression and anxiety disorders and shows treatment resistance in a relevant proportion of patients. Since a couple of years, different noninvasive brain stimulation methods have been investigated to improve OC symptoms. The application of transcranial direct current stimulation (tDCS) has shown inconsistent results which can probably be attributed to a lack in randomized controlled trials with adequate sample size...
April 21, 2017: Neurocase
https://www.readbyqxmd.com/read/28407553/high-frequency-repetitive-transcranial-magnetic-stimulation-treatment-for-major-depression-dissociated-effects-on-psychopathology-and-neurocognition
#7
Santiago Tovar-Perdomo, Alexander McGirr, Frederique Van den Eynde, Nicole Rodrigues Dos Santos, Marcelo T Berlim
OBJECTIVES: This open-label pilot study explored the effects of a course of accelerated high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) on two neurocognitive domains (decision-making and impulse control) in patients with major depressive disorder (MDD). METHODS: Participants with MDD and a treatment resistant major depressive episode (n=24) underwent twice-daily HF-rTMS targeted at the left dorsolateral prefrontal cortex (lDLPFC) over two weeks...
April 6, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28403933/knocking-down-amygdalar-ptp1b-in-diet-induced-obese-rats-improves-insulin-signaling-action-decreases-adiposity-and-may-alter-anxiety-behavior
#8
Natalia Ferreira Mendes, Gisele Castro, Dioze Guadagnini, Natalia Tobar, Susana Quiros Cognuck, Lucila Leico Kagohara Elias, Patricia Aline Boer, Patricia Oliveira Prada
OBJECTIVE: Protein tyrosine phosphatase 1B (PTP1B) has been extensively implicated in the regulation of body weight, food intake, and energy expenditure. The role of PTP1B appears to be cell and brain region dependent. RESULTS: Herein, we demonstrated that chronic high-fat feeding enhanced PTP1B expression in the central nucleus of the amygdala (CeA) of rats compared to rats on chow. Knocking down PTP1B with oligonucleotide antisense (ASO) decreased its expression and was sufficient to improve the anorexigenic effect of insulin through IR/Akt signaling in the CeA...
May 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28384832/obsessive-compulsive-disorder-advances-in-diagnosis-and-treatment
#9
Matthew E Hirschtritt, Michael H Bloch, Carol A Mathews
Importance: Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder associated with significant impairment and a lifetime prevalence of 1% to 3%; however, it is often missed in primary care settings and frequently undertreated. Objective: To review the most current data regarding screening, diagnosis, and treatment options for OCD. Evidence Review: We searched PubMed, EMBASE, and PsycINFO to identify randomized controlled trials (RCTs), meta-analyses, and systematic reviews that addressed screening and diagnostic and treatment approaches for OCD among adults (≥18 years), published between January 1, 2011, and September 30, 2016...
April 4, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28373848/the-current-status-of-the-ketogenic-diet-in-psychiatry
#10
REVIEW
Emmanuelle C S Bostock, Kenneth C Kirkby, Bruce V M Taylor
BACKGROUND: The ketogenic diet (KD) has been used in treatment-resistant epilepsy since the 1920s. It has been researched in a variety of neurological conditions in both animal models and human trials. The aim of this review is to clarify the potential role of KD in psychiatry. METHODS: Narrative review of electronic databases PubMED, PsychINFO, and Scopus. RESULTS: The search yielded 15 studies that related the use of KD in mental disorders including anxiety, depression, bipolar disorder, schizophrenia, autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD)...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28332861/treatment-of-nightmares-in-psychiatric-inpatients-with-imagery-rehearsal-therapy-an-open-trial-and-case-series
#11
Thomas E Ellis, Katrina A Rufino, Michael R Nadorff
OBJECTIVES: This study sought to assess the utility of Imagery Rehearsal Therapy (IRT) for nightmares in an inpatient psychiatric setting. Although IRT enjoys a substantial evidence base for efficacy in various populations, data with psychiatric inpatients are lacking. PARTICIPANTS: Participants were 20 adult psychiatric inpatients (11 male, 9 female; mean age=43.4), in an extended stay psychiatric inpatient facility. All participants were diagnosed with multiple, treatment resistant, comorbid conditions, including mood disorders, anxiety disorders, personality disorders, and substance-related disorders...
March 23, 2017: Behavioral Sleep Medicine
https://www.readbyqxmd.com/read/28273494/cortisol-as-a-predictor-of-psychological-therapy-response-in-anxiety-disorders-systematic-review-and-meta-analysis
#12
REVIEW
Susanne Fischer, Anthony J Cleare
BACKGROUND: Although psychotherapy generally is effective in anxiety disorders, many patients are treatment-resistant. At the same time, some patients with anxiety disorders show alterations in the hypothalamic-pituitary-adrenal (HPA) axis, one of the major stress-responsive systems. Since raised levels of the end product of the HPA axis, cortisol, adversely affect cognition, we hypothesised that more pronounced alterations in cortisol levels would be associated with a less favourable response to psychotherapy...
February 24, 2017: Journal of Anxiety Disorders
https://www.readbyqxmd.com/read/28270744/use-of-the-exponential-and-exponentiated-demand-equations-to-assess-the-behavioral-economics-of-negative-reinforcement
#13
Jennifer E C Fragale, Kevin D Beck, Kevin C H Pang
Abnormal motivation and hedonic assessment of aversive stimuli are symptoms of anxiety and depression. Symptoms influenced by motivation and anhedonia predict treatment success or resistance. Therefore, a translational approach to the study of negatively motivated behaviors is needed. We describe a novel use of behavioral economics demand curve analysis to investigate negative reinforcement in animals that separates hedonic assessment of footshock termination (i.e., relief) from motivation to escape footshock...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28266320/different-functioning-of-prefrontal-cortex-predicts-treatment-response-after-a-selective-serotonin-reuptake-inhibitor-treatment-in-patients-with-major-depression
#14
Koji Masuda, Mari Nakanishi, Kana Okamoto, Chiwa Kawashima, Harumi Oshita, Ayako Inoue, Fuku Takita, Toshihiko Izumi, Yoshinobu Ishitobi, Haruka Higuma, Masayuki Kanehisa, Taiga Ninomiya, Yoshinori Tanaka, Jotaro Akiyoshi
BACKGROUND: Major depressive disorder (MDD) is often resistant to treatment with usual approaches. Patients with MDD have shown hypofunction of the frontotemporal cortex in verbal fluency test (VFT)-related near-infrared spectroscopy (NIRS). METHODS: We examined whether the reactions to drug treatment in treatment-naive patients with MDD could be predicted by NIRS outcomes at the initial investigation. All subjects underwent psychological testing to determine levels of anxiety and depression...
May 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28249076/a-consensus-statement-on-the-use-of-ketamine-in-the-treatment-of-mood-disorders
#15
REVIEW
Gerard Sanacora, Mark A Frye, William McDonald, Sanjay J Mathew, Mason S Turner, Alan F Schatzberg, Paul Summergrad, Charles B Nemeroff
Importance: Several studies now provide evidence of ketamine hydrochloride's ability to produce rapid and robust antidepressant effects in patients with mood and anxiety disorders that were previously resistant to treatment. Despite the relatively small sample sizes, lack of longer-term data on efficacy, and limited data on safety provided by these studies, they have led to increased use of ketamine as an off-label treatment for mood and other psychiatric disorders. Observations: This review and consensus statement provides a general overview of the data on the use of ketamine for the treatment of mood disorders and highlights the limitations of the existing knowledge...
April 1, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28238701/deep-brain-stimulation-of-the-subcallosal-cingulate-for-treatment-refractory-anorexia-nervosa-1-year-follow-up-of-an-open-label-trial
#16
Nir Lipsman, Eileen Lam, Matthew Volpini, Kalam Sutandar, Richelle Twose, Peter Giacobbe, Devin J Sodums, Gwenn S Smith, D Blake Woodside, Andres M Lozano
BACKGROUND: Anorexia nervosa is a life-threatening illness. Brain circuits believed to drive anorexia nervosa symptoms can be accessed with surgical techniques such as deep brain stimulation (DBS). Initial results suggest that DBS of the subcallosal cingulate is safe and associated with improvements in mood and anxiety. Here, we investigated the safety, clinical, and neuroimaging outcomes of DBS of the subcallosal cingulate in a group of patients during 12 months of active stimulation...
February 23, 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28197107/augmentation-of-psychotherapy-through-alternative-preconscious-priming-a-case-series-exploring-effects-on-residual-symptoms
#17
Melha Zidani, Jean-Sébastien Audet, François Borgeat, Frederick Aardema, Kieron Philip O'Connor, Yasser Khazaal
The current paper describes a case series using a new strategy for facilitating change based on Augmentation of Psychotherapy through Alternative Preconscious Priming (APAP) (1) in the treatment of eight treatment-resistant patients suffering from social phobia or generalized anxiety disorder. The patients had previously only shown a partial response to cognitive behavioral therapy (CBT) despite good treatment adherence. The patients completed APAP using a computerized program, which consisted of three steps during which alternative, more functional thoughts and beliefs relevant to the idiosyncratic difficulties experienced by the patients were formulated...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28141723/anxiety-associated-with-asthma-exacerbations-and-overuse-of-medication-the-role-of-cultural-competency
#18
Yousuke T Horikawa, Tina Y Udaka, Janet K Crow, John I Takayama, Martin T Stein
Toshi, a 14-year-old Japanese boy, had uncontrolled asthma after relocating from Japan with his family 1 year ago. In Japan, he was diagnosed with moderate, persistent asthma, which was controlled with salmeterol and albuterol on an as needed basis. Since moving to the United States, Toshi complained of frequent dyspnea.Initially, he was seen by a Japanese physician who prescribed 200 mg of fluticasone 3 times a day and albuterol nebulization as needed. When Toshi came to the Pediatric Primary Care Clinic, he reported using his nebulizer up to 25 times daily...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28061973/the-melatonergic-system-in-anxiety-disorders-and-the-role-of-melatonin-in-conditional-fear
#19
F Huang, Z Yang, C-Q Li
BACKGROUND: Resistance to extinction of certain conditioned responses forms the basis of anxieties, phobias, and compulsions. There has been an available effective means of extinction-based exposure psychotherapy for the treatment of anxiety disorders, such as posttraumatic stress disorder (PTSD) that has been hypothesized to result from impaired extinction of fear memory. PTSD is considered as a memory disorder within a Pavlovian fear conditioning and extinction framework. Therefore, the aim of this review was to report the preclinical profile of melatonin, a pineal gland hormone, as a potential pharmacological option in the treatment of anxiety disorders such as PTSD, tested with the Pavlovian fear conditioning paradigm...
2017: Vitamins and Hormones
https://www.readbyqxmd.com/read/28043839/primary-pediatric-care-psychopharmacology-focus-on-medications-for-adhd-depression-and-anxiety
#20
REVIEW
Jeffrey R Strawn, Eric T Dobson, Lisa L Giles
The evidence base for psychopharmacologic interventions in youth with depressive and anxiety disorders as well as attention/deficit hyperactivity disorder (ADHD) has dramatically increased over the past two decades. Psychopharmacologic interventions commonly utilized in the pediatric primary care setting-selective serotonin (norepinephrine) reuptake inhibitors (SSRIs/SSNRIs), stimulants and α2 agonists-are reviewed. General pharmacologic principles are summarized along with class-related side effects and tolerability concerns (e...
January 2017: Current Problems in Pediatric and Adolescent Health Care
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