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Remission depression

Bradley Gaynes
Many patients will not respond adequately to their initial trial of antidepressant medication or subsequent trials. By identifying features that can signal potential treatment-resistant or difficult-to-treat depression early in the course of illness, clinicians may be able to find the right balance of treatment strategies to help patients achieve remission. Here, follow the case of Alice, a 32-year-old lawyer with a treatment-resistant depressive episode.
September 2016: Journal of Clinical Psychiatry
Elizabeth Q Cox, Nathaniel A Sowa, Samantha E Meltzer-Brody, Bradley N Gaynes
OBJECTIVE: Perinatal depression is a common and costly health concern with serious implications for the mother and child. We sought to quantify the "Perinatal Depression Treatment Cascade"-the cumulative shortfalls in clinical recognition, initiation of treatment, adequacy of treatment, and treatment response for women with antenatal (AND) and postpartum depression (PPD). DATA SOURCES: A systematic search was conducted to identify articles about diagnostic rates, treatment rates, adequate treatment rates, and remission rates for AND and PPD...
September 2016: Journal of Clinical Psychiatry
Chad A Bousman, Daniel J Müller, Chee H Ng, Keith Byron, Michael Berk, Ajeet B Singh
BACKGROUND: Pharmacogenetic-based dosing support tools have been developed to personalize antidepressant-prescribing practice. However, the clinical validity of these tools has not been adequately tested, particularly for specific antidepressants. OBJECTIVE: To examine the concordance between the actual dose and a polygene pharmacogenetic predicted dose of desvenlafaxine needed to achieve symptom remission. MATERIALS AND METHODS: A 10-week, open-label, prospective trial of desvenlafaxine among Caucasian adults with major depressive disorder (n=119) was conducted...
October 24, 2016: Pharmacogenetics and Genomics
Ling Fan, Zhao Chen, Wenbin Fu, Nenggui Xu, Jianhua Liu, Aiping Lu, Ziping Li, Shengyong Su, Taixiang Wu, Aihua Ou
This study aims to investigate the molecular mechanisms of acupuncture in the remission of depression. A depressive disorder model was induced by exposing Sprague-Dawley rats to chronic unpredictable stress. The rats were divided into five groups: healthy (blank group) and stressed rats (model group), and stressed rats treated with acupuncture (acupuncture group), riluzole (riluzole group), acupuncture combined with botulinum toxin A (BTX-A) injection (acupuncture+BTX-A group) or riluzole combined with BTX-A injection (riluzole+BTX-A group)...
October 2016: Journal of Acupuncture and Meridian Studies
Sahoo Swapnajeet, Subodh Bn, Gupta Gourav
Apart from sleep wake disorders, nowadays, modafinil is being prescribed for several psychiatric disorders including depression. Despite being reported as to be having very low abuse potential, cases of modafinil dependence had come to the limelight. In this case report, we describe a 35 year old man with bipolar affective disorder while in remission who developed modafinil dependence and later on, had hypersexuality when he increased the dose of modafinil from 400 to 1,000 mg/day. Existing literature suggests that modafinil when taken above prescribed doses can cause many side effects ranging from nausea, vomiting to psychotic exacerbation and mania...
November 30, 2016: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
Esma Akpınar, Cem Cerit, Anıl Talas, Ümit Tural
Objective: In this open-labeled, 12 weeks follow-up study, we aimed to compare the efficacy and tolerability of agomelatine with sertraline. Methods: The outpatients of adult psychiatry clinic who have a new onset of depression and diagnosed as 'major depressive episode' by clinician according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition and prescribed agomelatine (25 mg/day) or sertraline (50 mg/day) were included in the study. Results: The decline of mean Montgomery-Asberg Depression Rating Scale (MADRS) scores of agomelatine group was significantly higher than the sertraline group at the end of 2nd week; however, the difference was not significant at the end of 3 months...
November 30, 2016: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
Dohee Lim, Won Kyung Lee, Hyesook Park
The purpose of this study was to estimate the national burden of mental substance disorders on medical care utilization in Korea using National Health Insurance System (NHIS) data and updated disability weight, in terms of disability-adjusted life years (DALYs). For each of the 24 disorders, the incident years lived with disability (YLDs) was calculated, using NHIS data to estimate prevalence and incidence rates. The DisMod-II software program was used to model duration and remission. The years of life lost (YLLs) due to premature death were calculated from causes of death statistics...
November 2016: Journal of Korean Medical Science
Andrew F Leuchter, Aimee M Hunter, Felipe A Jain, Molly Tartter, Caroline Crump, Ian A Cook
Serotonin modulates brain oscillatory activity, and serotonergic projections to the thalamus and cortex modulate the frequency of prefrontal rhythmic oscillations. Changes in serotonergic tone have been reported to shift oscillations between the combined delta-theta (2.5-8 Hz) and the alpha (8-12 Hz) frequency ranges. Such frequency shifts may constitute a useful biomarker for the effects of selective serotonin reuptake inhibitor (SSRI) medications in Major Depressive Disorder (MDD). We utilized quantitative electroencephalography (qEEG) to measure shifts in prefrontal rhythmic oscillations early in treatment with either the SSRI escitalopram or placebo, and examined the relationship between these changes and remission of depressive symptoms...
October 7, 2016: Journal of Psychiatric Research
E Saralidze, L Khuchua, I Kobaidze
The interaction between different brain structures could be crucial to predicting seizure occurrence, threshold and spread. Moreover, the sleep-wake cycle and electrical activity of brain structures in different phases of sleep could significantly affect the pattern and extent of seizure spread, and therefore the characteristics of epileptic activity. In this animal model using 15 Wistar rats, we show that the duration of hippocampal seizures, induced by electrical stimulation of the hippocampus, is significantly increased during slow sleep...
September 2016: Georgian Medical News
Alexander J Steiner, Nathalie Boulos, James Mirocha, Stephanie M Wright, Katherine L Collison, Waguih W IsHak
OBJECTIVES: Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) often have high comorbidity, consequently influencing patient-reported outcomes of depressive symptom severity, quality of life (QOL), and functioning. We hypothesized that the combined effects of concurrent PTSD and MDD would result in worse treatment outcomes, whereas individuals who achieved MDD remission would have better treatment outcomes. METHODS: We analyzed 2280 adult participants who received level 1 treatment (citalopram monotherapy) in the Sequenced Treatment Alternatives to Relieve Depression study, including 2158 participants with MDD without comorbid PTSD and 122 participants with MDD with comorbid PTSD (MDD + PTSD)...
October 18, 2016: Clinical Neuropharmacology
Alonso Montoya, Jeremie Lebrec, Karen Mary Keane, Irene Fregenal, Antonio Ciudad, Ángel Moríñigo, Luis Agüera-Ortiz, Irene Romera, Inmaculada Gilaberte, Mark Zimmerman
BACKGROUND: Goals of treating major depressive disorder (MDD) include achieving remission and avoiding relapse. It is possible that patients may have a broader view of remission than what is captured via clinician-rated scales. This patient perspective may, in turn, have an impact on treatment outcomes. METHODS: The association between a broader conceptualization of remission, based on the Remission from Depression Questionnaire (RDQ) score at baseline, and being in symptomatic remission after 6 months was evaluated in subjects (N = 613) with MDD in symptomatic remission at baseline (17-item Hamilton Rating Scale for Depression [HAMD-17] ≤7)...
October 19, 2016: BMC Psychiatry
U C Wieshmann, G Baker
OBJECTIVE: To ascertain efficacy and tolerability of carbamazepine (CBZ), sodium valproate (VPA), lamotrigine (LTG) and levetiracetam (LEV) using the UKAED register ( METHODS: Patients on CBZ (n=91), VPA (n=61), LTG (n=105), LEV (n=72) and healthy control subjects (CTR) on no medication (n=51) were extracted. All patients had anonymously provided information on seizure type and frequency and completed the Liverpool Adverse Event Profile (LAEP). RESULTS: The number of seizure-free patients in the last 4 weeks was overall CBZ/VPA/LTG/LEV=60%/79%/67%/67%, for generalized epilepsy was CBZ/VPA/LTG/LEV=67%/89%/65%/94%, and for localization-related epilepsy was CBZ/VPA/LTG/LEV=59%/71%/67%/57%...
October 18, 2016: Acta Neurologica Scandinavica
Benedetta Vai, Chiara Bulgarelli, Beata R Godlewska, Philip J Cowen, Francesco Benedetti, Catherine J Harmer
The timely selection of the optimal treatment for depressed patients is critical to improve remission rates. The detection of pre-treatment variables able to predict differential treatment response may provide novel approaches for treatment selection. Selective serotonin reuptake inhibitors (SSRIs) modulate the fronto-limbic functional response and connectivity, an effect preceding the overt clinical antidepressant effects. Here we investigated whether the cortico-limbic connectivity associated with emotional bias measured before SSRI administration predicts the efficacy of antidepressant treatment in MDD patients...
October 15, 2016: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
Guillermina Natera Rey, Perla Sonia Medina Aguilar, Fransilvania Callejas Pérez, Jim Orford, Guillermo Salinas Escudero, Marcela Tiburcio Sainz
Objective Estimate the cost-effectiveness ratio of a five-step brief intervention aimed at reducing the stress and symptoms of depression caused by living with an alcohol abuser. Methods The cost-effectiveness analysis was carried out with a decision tree, based on symptoms of depression measured on the CES-D scale. The effectiveness of the brief intervention was evaluated by comparing a group of indigenous women who received the intervention (n = 43) with a similar group who did not (n = 30). The groups were evaluated before, immediately after, and 12 months after the intervention, in the state of Hidalgo (Mexico)...
February 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
Cherrie A Galletly, Benjamin L Carnell, Patrick Clarke, Shane Gill
BACKGROUND: A great deal of research has established the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the treatment of depression. However, questions remain about the optimal method to deliver treatment. One area requiring consideration is the difference in efficacy between bilateral and unilateral treatment protocols. OBJECTIVE: This study aimed to compare the effectiveness of sequential bilateral rTMS and right unilateral rTMS. METHODS: A total of 135 patients participated in the study, receiving either bilateral rTMS (N = 57) or right unilateral rTMS (N = 78)...
October 7, 2016: Journal of ECT
Kyu-Man Han, Daseul Kim, Youngbo Sim, June Kang, Aram Kim, Eunsoo Won, Woo-Suk Tae, Byung-Joo Ham
BACKGROUND: Morphologic changes of the brainstem in major depressive disorder (MDD) have rarely been reported in neuroimaging studies, even though, monoaminergic neurotransmitters are synthesized in several brainstem regions. We aimed to investigate volume changes in each region of the brainstem and their association with antidepressant use or the remission status of MDD. METHODS: A total of 126 patients with MDD and 101 healthy controls underwent T1-weighted structural magnetic resonance imaging...
October 11, 2016: Journal of Affective Disorders
Stefania Prendes-Alvarez, Charles B Nemeroff
Personalized or precision medicine is a medical discipline that proposes tailoring health care to each individual by integrating data from their genetic makeup, epigenetic modifications, other biomarkers, clinical symptoms and environmental exposures. Currently, patients typically present for treatment of mood disorders relatively late in the disease course and this is of great concern both because delay in attaining remission reduces the success of subsequent treatment and depressive episodes have negative cumulative effects on the brain and body...
October 13, 2016: Neuroscience Letters
Amanda McIntyre, Spencer Thompson, Amer Burhan, Swati Mehta, Robert Teasell
OBJECTIVE: This study aims to perform a systematic review evaluating the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in improving depression resulting from cerebrovascular disease including vascular depression (VD) and poststroke depression (PSD). METHODS: A literature search of multiple scientific databases was conducted for English studies published from January 1980 to June 2016. Studies were included if the sample consisted of 50% or more adult humans with VD or PSD and had 3 or more subjects, the intervention applied was rTMS, and depression was assessed pre- and post intervention using a formal outcome measure...
October 12, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
R Hamish McAllister-Williams, Kate Bones, Guy M Goodwin, John Harrison, Cornelius Katona, Jill Rasmussen, Sarah Strong, Allan H Young
BACKGROUND: Cognitive dysfunction occurs in depression and can persist into remission. It impacts on patient functioning but remains largely unrecognised, unmonitored and untreated. We explored understanding of cognitive dysfunction in depression among UK clinicians. METHODS: A multi-step consultation process. Step 1: a multi-stakeholder steering committee identified key themes of burden, detection and management of cognitive dysfunction in depression, and developed statements on each to explore understanding and degree of agreement among clinicians...
September 28, 2016: Journal of Affective Disorders
Jiaolong Qin, Haiyan Liu, Maobin Wei, Ke Zhao, Jianhuai Chen, Jingyu Zhu, Xiangyu Shen, Rui Yan, Zhijian Yao, Qing Lu
BACKGROUND: The role of abnormal communications among large-scale brain networks have been given increasing attentions in the pathophysiology of major depressive disorder (MDD). However, few studies have investigated the effect of antidepressant medication treatment on the information communication of structural brain networks, especially converged from the individual analysis. METHODS: Nineteen unipolar MDD patients completed two diffusion tensor imaging (DTI) scans before and after 8-week treatment with selective serotonin reuptake inhibitor...
September 29, 2016: Journal of Affective Disorders
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