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Treatment Resistant Depression

Yusuf Olgar, Sinan Degirmenci, Aysegul Durak, Deniz Billur, Belgin Can, Gizem Kayki Mutlu, Ebru Arioglu Inan, Belma Turan
Aging in humans represents declining in cardio-protective systems, however its mechanisms are not known yet. We aimed to analyse how aging affects key mechanisms responsible for contractile dysfunction via comparing the improperly synchrony between electrical and mechanical activities in male aged-rats (24-month old) comparison to those of adult-rats (6-month old). We determined significantly increased systemic oxidative stress with decreased antioxidant capacity, clear insulin resistance and hypertrophy in aged-rats with normal fasting blood glucose...
June 13, 2018: Experimental Gerontology
Fernanda Palhano-Fontes, Dayanna Barreto, Heloisa Onias, Katia C Andrade, Morgana M Novaes, Jessica A Pessoa, Sergio A Mota-Rolim, Flávia L Osório, Rafael Sanches, Rafael G Dos Santos, Luís Fernando Tófoli, Gabriela de Oliveira Silveira, Mauricio Yonamine, Jordi Riba, Francisco R Santos, Antonio A Silva-Junior, João C Alchieri, Nicole L Galvão-Coelho, Bruno Lobão-Soares, Jaime E C Hallak, Emerson Arcoverde, João P Maia-de-Oliveira, Dráulio B Araújo
BACKGROUND: Recent open-label trials show that psychedelics, such as ayahuasca, hold promise as fast-onset antidepressants in treatment-resistant depression. METHODS: To test the antidepressant effects of ayahuasca, we conducted a parallel-arm, double-blind randomized placebo-controlled trial in 29 patients with treatment-resistant depression. Patients received a single dose of either ayahuasca or placebo. We assessed changes in depression severity with the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Hamilton Depression Rating scale at baseline, and at 1 (D1), 2 (D2), and 7 (D7) days after dosing...
June 15, 2018: Psychological Medicine
Ronald S Duman
Therapeutic medications for the treatment of depression have serious limitations, particularly delayed onset and low rates of efficacy. However, the discovery that a single subanesthetic dose of ketamine, a glutamate NMDA receptor channel blocker, can produce a rapid (within hours) antidepressant response that is sustained (about 1 week), even in patients considered treatment-resistant, has invigorated the field. In addition to these remarkable actions, ketamine has proven effective for the treatment of suicidal ideation...
2018: F1000Research
Herbert Y Meltzer, Min Young Sim, Adam Anderson, Christopher Cannistraci, Karu Jayathilake, Daniel Barrett Share, Myung Lee
INTRODUCTION: Psychotic spectrum disorder (PSD) links the syndromes of bipolar disorder, psychotic depression, and schizophrenia, often viewed as unique disorders. AIMS: Application of the PSD concept to a single patient rather than across groups of patients and demonstration of a remarkable remission of schizophrenia phenotype with recovery of gray matter in specific brain regions. RESULTS: We report a woman who experienced discrete, nonoverlapping periods of each of the above syndromes, in the order noted, over a 30-year period, followed by abrupt ending of psychosis and full remission lasting at least 7 years...
July 2018: CNS Neuroscience & Therapeutics
Martin Le Nedelec, Paul Glue, Helen Winter, Chelsea Goulton, Natalie J Medlicott
BACKGROUND: Ketamine has been shown to produce a rapid and potent antidepressant response in patients with treatment-resistant depression. Currently ketamine is most commonly administered as a 40-minute intravenous infusion, though it is unknown whether this is the optimal route of administration. AIMS: To determine the plasma concentration time course of the R- and S-enantiomers of ketamine and norketamine following administration of ketamine by four different routes of administration...
June 1, 2018: Journal of Psychopharmacology
A Bourla, E Chaneac, F Ferreri
No abstract text is available yet for this article.
June 7, 2018: L'Encéphale
Monica Sathyanesan, Michael J Watt, Jacob M Haiar, Jamie L Scholl, Shaydel R Davies, Riley T Paulsen, Jayme Wiederin, Pawel Ciborowski, Samuel S Newton
Cognitive deficits are widespread in psychiatric disorders and frequently as debilitating as the affective component. Widely prescribed antidepressants for treating depressive disorders have limited efficacy in normalizing cognitive function. Erythropoietin (Epo) has been shown to improve cognitive function in schizophrenia and treatment resistant depressed patients. However, the potent elevation of red blood cell counts by Epo can cause hematological complications in non-anemic patients. We investigated a chemically engineered, posttranslational modification of Epo, carbamoylation, which renders it non-erythropoietic...
June 8, 2018: Translational Psychiatry
F Caraci, F Calabrese, R Molteni, L Bartova, M Dold, G M Leggio, C Fabbri, J Mendlewicz, G Racagni, S Kasper, M A Riva, F Drago
Major depressive disorder is one of the most prevalent and life-threatening forms of mental illnesses and a major cause of morbidity worldwide. Currently available antidepressants are effective for most patients, although around 30% are considered treatment resistant (TRD), a condition that is associated with a significant impairment of cognitive function and poor quality of life. In this respect, the identification of the molecular mechanisms contributing to TRD represents an essential step for the design of novel and more efficacious drugs able to modify the clinical course of this disorder and increase remission rates in clinical practice...
July 2018: Pharmacological Reviews
Maj Vinberg, Pernille Højman, Bente Klarlund Pedersen, Lars Vedel Kessing, Kamilla W Miskowiak
BACKGROUND: Erythropoietin (EPO) has been suggested to improve metabolism and also cognition, but human studies are scarce. This randomised controlled trial aimed to investigate whether EPO treatment influences body composition and fat and glycated haemoglobin (HbA1c) and fasting glucose, and whether these changes would be associated with previous observed cognitive benefits of EPO. METHOD: In total, 84 non-obese patients with treatment-resistant unipolar depression or bipolar disorder in remission were randomised to 8 weekly EPO (40,000 IU) or saline (NaCl 0...
June 8, 2018: Acta Neuropsychiatrica
Zhi Nie, Srinivasan Vairavan, Vaibhav A Narayan, Jieping Ye, Qingqin S Li
Identification of risk factors of treatment resistance may be useful to guide treatment selection, avoid inefficient trial-and-error, and improve major depressive disorder (MDD) care. We extended the work in predictive modeling of treatment resistant depression (TRD) via partition of the data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) cohort into a training and a testing dataset. We also included data from a small yet completely independent cohort RIS-INT-93 as an external test dataset...
2018: PloS One
Frederikke Hordam Gronemann, Martin B Jorgensen, Merete Nordentoft, Per K Andersen, Merete Osler
OBJECTIVE: Varying definitions of treatment-resistant depression (TRD) across studies make it difficult to estimate the size of the problem and to identify patients at increased risk. The aim of this cohort study was to examine the incidence of TRD, disease-related risk factors, and changes over time using different definitions of TRD. METHODS: From 1996 through 2014, all patients with a first-time hospital contact for depression (ICD-10 codes F32 and F33) were identified in Danish National Patient Registries...
May 29, 2018: Journal of Clinical Psychiatry
Véronique Desbeaumes Jodoin, François Richer, Jean-Philippe Miron, Marie-Pierre Fournier-Gosselin, Paul Lespérance
BACKGROUND: Treatment-resistant depression (TRD) is a serious chronic condition disabling patients functionally and cognitively. Chronic vagus nerve stimulation (VNS) is recognized for the management of TRD, but few studies have examined its long-term effects on cognitive dysfunction in unipolar and bipolar resistant depression. OBJECTIVE: The purpose of this study was to assess the course of cognitive functions and clinical symptoms in a cohort of patients treated with VNS for TRD...
June 4, 2018: Journal of ECT
Patricia D Walshaw, Laszlo Gyulai, Michael Bauer, Mark S Bauer, Brian Calimlim, Catherine A Sugar, Peter C Whybrow
OBJECTIVES: This report describes the first comparative double-blind, placebo-controlled trial of levothyroxine (L-T4 ) and triiodothyronine (T3 ) as adjunctive treatments in rapid cycling bipolar disorder. METHODS: Thirty-two treatment-resistant, rapid cycling patients who had failed a trial of lithium were randomized into three treatment arms: L-T4 , T3 , or placebo. They were followed for ≥4 months with weekly clinical and endocrine assessments. RESULTS: There were no statistically significant differences between the groups in age, gender, duration of illness, or thyroid status...
June 4, 2018: Bipolar Disorders
Amanda J Sales, Manoela V Fogaça, Ariandra G Sartim, Vitor S Pereira, Gregers Wegener, Francisco S Guimarães, Sâmia R L Joca
Currently available antidepressants have a substantial time lag to induce therapeutic response and a relatively low efficacy. The development of drugs that addresses these limitations is critical to improving public health. Cannabidiol (CBD), a non-psychotomimetic component of Cannabis sativa, is a promising compound since it shows large-spectrum therapeutic potential in preclinical models and humans. However, its antidepressant properties have not been completely investigated. Therefore, the aims of this study were to investigate in male rodents (i) whether CBD could induce rapid and sustained antidepressant-like effects after a single administration and (ii) whether such effects could be related to changes in synaptic proteins/function...
June 4, 2018: Molecular Neurobiology
Ana C de Menezes Galvão, Raíssa N de Almeida, Erick A Dos Santos Silva, Fúlvio A M Freire, Fernanda Palhano-Fontes, Heloisa Onias, Emerson Arcoverde, João P Maia-de-Oliveira, Dráulio B de Araújo, Bruno Lobão-Soares, Nicole L Galvão-Coelho
Major depression is a highly prevalent mood disorder, affecting about 350 million people, and around 30% of the patients are resistant to currently available antidepressant medications. Recent evidence from a randomized controlled trial (RCT) supports the rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression. The aim of this study was to explore the effect of ayahuasca on plasma cortisol and awakening salivary cortisol response, in the same group of treatment-resistant patients (MD) and in healthy volunteers (C)...
2018: Frontiers in Psychiatry
Farah Chamaa, Hisham F Bahmad, Ahmad-Kareem Makkawi, Reda M Chalhoub, Elie D Al-Chaer, George B Bikhazi, Ziad Nahas, Wassim Abou-Kheir
The identification of distinct and more efficacious antidepressant treatments is highly needed. Nitrous oxide (N2 O) is an N-methyl-D-aspartic acid (NMDA) antagonist that has been reported to exhibit antidepressant effects in treatment-resistant depression (TRD) patients. Yet, no studies have investigated the effects of sub-anesthetic dosages of N2 O on hippocampal cell proliferation and neurogenesis in adult brain rats. In our study, adult male Sprague-Dawley rats were exposed to single or multiple exposures to mixtures of 70% N2 O and 30% oxygen (O2 )...
2018: Frontiers in Cellular Neuroscience
Albert J Fenoy, Paul E Schulz, Sudhakar Selvaraj, Christina L Burrows, Giovanna Zunta-Soares, Kathryn Durkin, Paolo Zanotti-Fregonara, Joao Quevedo, Jair C Soares
Deep brain stimulation (DBS) to the superolateral branch of the medial forebrain bundle (MFB) has been reported to lead to rapid antidepressant effects. In this longitudinal study, we expand upon the initial results we reported at 26 weeks (Fenoy et al., 2016), showing sustained antidepressant effects of MFB DBS on six patients with treatment-resistant depression (TRD) over 1 year. The Montgomery-Åsberg Depression Rating Scale (MADRS) was used as the primary assessment tool. Deterministic fiber tracking was used to individually map the target area; analysis was performed to compare modulated fiber tracts between patients...
June 4, 2018: Translational Psychiatry
Manjeet Singh Jangra, Manik Chhabra
INTRODUCTION: Cycloserine and Kanamycin are approved for treatment of multidrug-resistant tuberculosis with good tolerability in Tuberculosis patients and have various labeled adverse reactions but the neuropsychiatric adverse drug reactions with the cycloserine are rarely explained. METHODS: We present a case report on Cycloserine induced Suicidal tendencies and Kanamycin induced decrease in hearing sensation in Indian MDR-TB patient. CASE REPORT: A 55-year-old male patient who was diagnosed with MDR-TB was prescribed with category IV anti-tubercular therapy...
June 4, 2018: Current Drug Safety
Alma Mihaljević-Peleš, Maja Bajs Janović, Ana Stručić, Marina Šagud, Milena Skočić HanŽek, Maja Živković, Špiro Janović
Despite controversy, ECT has been recognized as significantly effective for the treatment of mental disorders since 1938, when Cerletti and Bini introduced ECT in clinical psychiatric practice for treatment of schizophrenia. In the next period, indication for ECT switched more toward depression and catatonia. ECT was even banned from psychiatric training in 1960's, due to the anti-psychiatric movement, which were fortified by Oscar winning movie "One Flew over the Cuckoo's Nest". Due to its robust effectiveness, ECT revived in the early 1980's and today holds its position in clinical psychiatric practices around the world...
June 2018: Psychiatria Danubina
Markus Dold, Lucie Bartova, Gernot Fugger, Alexander Kautzky, Daniel Souery, Julien Mendlewicz, George N Papadimitriou, Dimitris Dikeos, Panagiotis Ferentinos, Stefano Porcelli, Alessandro Serretti, Joseph Zohar, Stuart Montgomery, Siegfried Kasper
Background: This European multicenter study aimed to elucidate suicidality in major depressive disorder. Previous surveys suggest a prevalence of suicidality in major depressive disorder of ≥50%, but little is known about the association of different degrees of suicidality with socio-demographic, psychosocial, and clinical characteristics. Methods: We stratified 1410 major depressive disorder patients into 3 categories of suicidality based on the Hamilton Rating Scale for Depression item 3 (suicidality) ratings (0=no suicidality; 1-2=mild/moderate suicidality; 3-4=severe suicidality)...
June 1, 2018: International Journal of Neuropsychopharmacology
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