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Treatment Resistant Depression

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https://www.readbyqxmd.com/read/28098427/emergence-of-mania-in-two-middle-aged-patients-with-a-history-of-unipolar-treatment-refractory-depression-receiving-vagus-nerve-stimulation
#1
Naji C Salloum, Marie C Walker, Sunil Gangwani, Charles R Conway
OBJECTIVES: We report on two patients who experienced emergence of full manic symptoms while receiving vagal nerve stimulation (VNS). METHODS: Two patients, both with a well-documented and verified history of longstanding unipolar depression, were initiated on VNS for treatment of their severe major depressive episodes. RESULTS: The two patients had emergence of full manic symptoms after 8 and 9 months of VNS, respectively. Manic symptoms were adequately managed with standard treatments (mood stabilizer and electroconvulsive therapy) and VNS was continued in the two subjects for up to 5 years without any further occurrences of manic/hypomanic episodes...
January 18, 2017: Bipolar Disorders
https://www.readbyqxmd.com/read/28097909/administration-of-ketamine-for-unipolar-and-bipolar-depression
#2
Christoph Kraus, Ulrich Rabl, Thomas Vanicek, Laura Carlberg, Ana Popovic, Marie Spies, Lucie Bartova, Gregor Gryglewski, Konstantinos Papageorgiou, Rupert Lanzenberger, Matthäus Willeit, Dietmar Winkler, Janusz K Rybakowski, Siegfried Kasper
OBJECTIVE: Clinical trials demonstrated that ketamine exhibits rapid antidepressant efficacy when administered in subanaesthetic dosages. We reviewed currently available literature investigating efficacy, response rates and safety profile. METHODS: Twelve studies investigating unipolar, seven on bipolar depression were included after search in medline, scopus and web of science. RESULTS: Randomized, placebo-controlled or open-label trials reported antidepressant response rates after 24 h on primary outcome measures at 61%...
January 18, 2017: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/28092469/investigational-drugs-in-recent-clinical-trials-for-treatment-resistant-depression
#3
Ricardo P Garay, Carlos A Zarate, Thomas Charpeaud, Leslie Citrome, Christoph U Correll, Ahcène Hameg, Pierre-Michel Llorca
The authors describe the medications for treatment-resistant depression (TRD) in phase II/III of clinical development in the EU and US and provide an opinion on how current treatment can be improved in the near future. Areas covered: Sixty-two trials were identified in US and EU clinical trial registries that included six investigational compounds in recent phase III development and 12 others in recent phase II clinical trials. Glutamatergic agents have been the focus of many studies. A single intravenous dose of the glutamatergic modulator ketamine produces a robust and rapid antidepressant effect in persons with TRD; this effect continues to remain significant for 1 week...
January 16, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28086851/efficacy-of-intermittent-theta-burst-stimulation-itbs-and-10-hz-high-frequency-repetitive-transcranial-magnetic-stimulation-rtms-in-treatment-resistant-unipolar-depression-study-protocol-for-a-randomised-controlled-trial
#4
Samuel Bulteau, Veronique Sébille, Guillemette Fayet, Veronique Thomas-Ollivier, Thibault Deschamps, Annabelle Bonnin-Rivalland, Edouard Laforgue, Anne Pichot, Pierre Valrivière, Elisabeth Auffray-Calvier, June Fortin, Yann Péréon, Jean-Marie Vanelle, Anne Sauvaget
BACKGROUND: The treatment of depression remains a challenge since at least 40% of patients do not respond to initial antidepressant therapy and 20% present chronic symptoms (more than 2 years despite standard treatment administered correctly). Repetitive transcranial magnetic stimulation (rTMS) is an effective adjuvant therapy but still not ideal. Intermittent Theta Burst Stimulation (iTBS), which has only been used recently in clinical practice, could have a faster and more intense effect compared to conventional protocols, including 10-Hz high-frequency rTMS (HF-rTMS)...
January 13, 2017: Trials
https://www.readbyqxmd.com/read/28072660/two-versus-one-high-frequency-repetitive-transcranial-magnetic-stimulation-session-per-day-for-treatment-resistant-depression-a-randomized-sham-controlled-trial
#5
Christos Theleritis, Pavlos Sakkas, Thomas Paparrigopoulos, Silia Vitoratou, Chara Tzavara, Stefania Bonaccorso, Antonios Politis, Constantin R Soldatos, Costantin Psarros
OBJECTIVES: High-frequency repetitive transcranial magnetic stimulation (HF-rTMS) has proven antidepressant effects, but the optimal frequency of sessions remains unclear. METHODS: We conducted a 3-week, sham-controlled trial to assess the antidepressant efficacy of 1 active HF-rTMS session per day (A1 group) compared with 2 per day (A2 group) and equivalent sham sessions (once a day, S1 group; twice a day, S2 group) in patients with treatment-resistant major depression with a subsequent 2-week follow-up period...
January 9, 2017: Journal of ECT
https://www.readbyqxmd.com/read/28069387/leptin-receptor-knockout-induced-depression-like-behaviors-and-attenuated-antidepressant-effects-of-exercise-are-associated-with-stat3-socs3-signaling
#6
Weina Liu, Jiatong Liu, Jie Xia, Xiangli Xue, Hongmei Wang, Zhengtang Qi, Liu Ji
Relatively little has been known about pathophysiological mechanisms contributing to the development of neuropsychiatric symptoms in the context of metabolic syndrome. Impaired leptin signaling activation in db/db mice has been proposed as a potential link between behavioral and metabolic disorders. Our previous studies have shown that exercise has the beneficial effects on a depression-like and insulin-resistant state in mice. The present study aimed to determine whether and how leptin receptor knockout (db/db) induces depression-like behaviors, and to identify the antidepressant effects of swimming exercise in db/db mice...
January 6, 2017: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/28068788/a-double-blind-randomized-placebo-controlled-trial-of-lactobacillus-helveticus-and-bifidobacterium-longum-for-the-symptoms-of-depression
#7
Amy R Romijn, Julia J Rucklidge, Roeline G Kuijer, Chris Frampton
OBJECTIVES: This trial investigated whether probiotics improved mood, stress and anxiety in a sample selected for low mood. We also tested whether the presence or severity of irritable bowel syndrome symptoms, and levels of proinflammatory cytokines, brain-derived neurotrophic factor and other blood markers, would predict or impact treatment response. METHOD: Seventy-nine participants (10 dropouts) not currently taking psychotropic medications with at least moderate scores on self-report mood measures were randomly allocated to receive either a probiotic preparation (containing Lactobacillus helveticus and Bifidobacterium longum) or a matched placebo, in a double-blind trial for 8 weeks...
January 1, 2017: Australian and New Zealand Journal of Psychiatry
https://www.readbyqxmd.com/read/28068461/a-new-prediction-model-for-evaluating-treatment-resistant-depression
#8
Alexander Kautzky, Pia Baldinger-Melich, Georg S Kranz, Thomas Vanicek, Daniel Souery, Stuart Montgomery, Julien Mendlewicz, Joseph Zohar, Alessandro Serretti, Rupert Lanzenberger, Siegfried Kasper
OBJECTIVE: Despite a broad arsenal of antidepressants, about a third of patients suffering from major depressive disorder (MDD) do not respond sufficiently to adequate treatment. Using the data pool of the Group for the Study of Resistant Depression and machine learning, we intended to draw new insights featuring 48 clinical, sociodemographic, and psychosocial predictors for treatment outcome. METHOD: Patients were enrolled starting from January 2000 and diagnosed according to DSM-IV...
January 3, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28065792/the-analgesic-effects-of-oxytocin-in-the-peripheral-and-central-nervous-system
#9
Qing Xin, Bo Bai, Wenyan Liu
Pain is a ubiquitously unpleasant feeling among humans as well as many animal species often caused by actual and potential tissue damage. However, it is absolutely crucial for our survival in many ways. Acute pain can signal the presence of danger or life-threatenting events, which help escape noxious stimuli. By contrast, when pain becomes chronic or persistent, it becomes an encumbrance and exerts deleterious effects to the body and mind, often co-occured with anxiety and depression. Additionaly, chronic pain is more or less an economic burden for the patients because it requires immediate medical treatments and seriously hinders pepople in their work...
January 5, 2017: Neurochemistry International
https://www.readbyqxmd.com/read/28062251/opioid-suppression-of-conditioned-anticipatory-brain-responses-to-breathlessness
#10
Anja Hayen, Vishvarani Wanigasekera, Olivia K Faull, Stewart F Campbell, Payashi S Garry, Simon J M Raby, Josephine Robertson, Ruth Webster, Richard G Wise, Mari Herigstad, Kyle T S Pattinson
Opioid painkillers are a promising treatment for chronic breathlessness, but are associated with potentially fatal side effects. In the treatment of breathlessness, their mechanisms of action are unclear. A better understanding might help to identify safer alternatives. Learned associations between previously neutral stimuli (e.g. stairs) and repeated breathlessness induce an anticipatory threat response that may worsen breathlessness, contributing to the downward spiral of decline seen in clinical populations...
January 3, 2017: NeuroImage
https://www.readbyqxmd.com/read/28060760/pi3k-mtor-dual-inhibitor-bez235-and-histone-deacetylase-inhibitor-trichostatin-a-synergistically-exert-anti-tumor-activity-in-breast-cancer
#11
Liyan Chen, Tiefeng Jin, Kun Zhu, Yingshi Piao, Taihao Quan, Chunji Quan, Zhenhua Lin
Molecule-targeted therapy has achieved great progress in cancer therapy. Effective drug combinations are one way to enhance the therapeutic efficacy and combat resistance. Here, we determined the effect of the PI3K/mTOR dual inhibitor BEZ235 and the histone deacetylase inhibitor Trichostatin A (TSA) on human breast cancer. We demonstrated that the combination of BEZ235 and TSA results in significant synergistic growth inhibition of multiple breast cancer cell lines. Mechanistic studies revealed that the combined therapy induced apoptosis in a caspase-dependent manner, which might be related to the further depression of the PI3K/Akt/mTOR signalling pathway...
January 2, 2017: Oncotarget
https://www.readbyqxmd.com/read/28052180/advances-in-psoriasis
#12
Jaclyn Smith, Abigail Cline, Steven R Feldman
Psoriasis treatments range from topical treatments and phototherapy to oral systemic medications and injections. Despite good control of the disease when applying appropriate treatments (according to disease severity, insurance parameters, patient preference, and patients' ability to adhere), continued advancements will allow even better symptomatic control, reduced adverse effects, and patient satisfaction. This review aims to assess traditional and new psoriasis treatments and how to apply them in clinical practice...
January 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28049085/high-frequency-repetitive-transcranial-magnetic-stimulation-over-the-left-dlpfc-for-major-depression-session-dependent-efficacy-a-meta-analysis
#13
S Teng, Z Guo, H Peng, G Xing, H Chen, B He, M A McClure, Q Mu
BACKGROUND: Depression is a major debilitating psychiatric disorder. Current antidepressant drugs are often associated with side effects or treatment resistance. The aim of this meta-analysis was to evaluate therapeutic effects of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) in major depression (MD). METHODS: The medical data bases of PubMed, Medline, Embase and Cochrane Central Register were searched for randomized controlled trials (RCTs) reporting the therapeutic effects of high-frequency rTMS for depression, which were published in English between January 1990 and June 2016...
December 30, 2016: European Psychiatry: the Journal of the Association of European Psychiatrists
https://www.readbyqxmd.com/read/28043839/primary-pediatric-care-psychopharmacology-focus-on-medications-for-adhd-depression-and-anxiety
#14
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...
December 30, 2016: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/28043613/emotional-distress-patients-with-several-types-of-tuberculosis-a-pilot-study-with-patients-from-the-sanatorium-hospital-of-huambo
#15
Benvinda Xavier Paulo, Bruno Peixoto
BACKGROUND: There is growing evidence that emotional distress expressed in terms of anxiety and depression it is very high among tuberculosis (TB) patients. OBJECTIVES: This study aims to determine levels of anxiety, depression and emotional distress in patients with several types of TB and to determine the association between social-demographic and economical factors, clinical variables and anxiety, depression and emotional distress. METHODS: A cross-sectional study was performed in a sample of 81 TB patients...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28041002/neurometabolic-abnormalities-in-treatment-resistant-depression
#16
Sanjay J Mathew, Marijn Lijffijt
No abstract text is available yet for this article.
January 1, 2017: American Journal of Psychiatry
https://www.readbyqxmd.com/read/28035869/comparative-efficacy-and-tolerability-of-pharmacological-and-somatic-interventions-in-adult-patients-with-treatment-resistant-depression-a-systematic-review-and-network-meta-analysis
#17
Katerina Papadimitropoulou, Carla Vossen, Andreas Karabis, Christina Donatti, Nicole Kubitz
OBJECTIVE: Major depressive disorder (MDD) affects about 10-15% of the general population in a lifetime. A considerable number of patients fail to achieve full symptom remission despite adequate treatment and are considered treatment-resistant (TRD). The current study compared the relative efficacy and tolerability of pharmacological and somatic TRD interventions by means of a Bayesian network meta-analysis. RESEARCH DESIGN AND METHODS: An electronic literature search of MEDLINE, MEDLINE In-Process, EMBASE, PsycInfo, EconLit and Cochrane Library databases for trial published between September 2003 and September 2014 was conducted...
December 30, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28013123/a-randomized-double-blind-placebo-controlled-crossover-trial-evaluating-the-effect-of-intranasal-insulin-on-cognition-and-mood-in-individuals-with-treatment-resistant-major-depressive-disorder
#18
Danielle S Cha, Michael W Best, Christopher R Bowie, Laura Ashley Gallaugher, Hanna O Woldeyohannes, Joanna K Soczynska, Gary Lewis, Glenda MacQueen, Barbara J Sahakian, Sidney H Kennedy, Jane P Lui, Rodrigo B Mansur, Roger S McIntyre
BACKGROUND: Cognitive dysfunction in major depressive disorder (MDD) is identified as a primary therapeutic target; no current treatment is approved for the treatment of cognitive dysfunction in MDD. We examined whether intranasal insulin offered a beneficial effect across measures of cognitive function in adults with MDD. METHODS: Thirty-five adults (18-65 years of age: 47.09±9.89) meeting criteria for a major depressive episode as per the Diagnostic and Statistical Manual (DSM)-IV-Treatment Revised were included in this randomized, double blind, placebo-controlled, crossover design study...
December 18, 2016: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28004621/augmentation-of-phenelzine-with-aripiprazole-and-quetiapine-in-a-treatment-resistant-patient-with-psychotic-unipolar-depression-case-report-and-literature-review
#19
Jonathan M Meyer, Michael A Cummings, George Proctor
Irreversible monoamine oxidase inhibitor (MAOI) antidepressants have significant efficacy in treatment-resistant unipolar depression, but in some instances patients may not achieve remission. Among the adjunctive and augmentation strategies, certain second-generation antipsychotics (SGAs) have approval for inadequate responders to antidepressant therapy, including aripiprazole, brexpiprazole, and quetiapine, with lurasidone and the olanzapine/fluoxetine combination indicated for bipolar depression. Clinicians may eschew SGA options in part due to the limited literature on SGA-MAOI combinations, with only one published case involving aripiprazole, and none for olanzapine, lurasidone, or brexpiprazole...
December 22, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/28003938/an-interventional-study-on-the-clinical-usefulness-and-outcomes-of-electroconvulsive-therapy-in-medication-resistant-mental-disorders
#20
Rameshwar S Manhas, Raheel Mushtaq, Shah Faisal Ahmad Tarfarosh, Sheikh Shoib, Mohammad Maqbool Dar, Arshad Hussain, Tabindah Shah, Sahil Shah, Mushbiq Manzoor
BACKGROUND: Resistance to recommended medications has been an issue in dealing with a number of psychiatric ailments, and it is showing up as an ongoing challenge for contemporary mental health experts. Resistant psychiatric disorders not only increase the morbidity of patients suffering from such severe conditions but also intensify the problems of their caretakers. This has vigorously started to cause the costs to increase for healthcare services. Thanks to electroconvulsive therapy (ECT), we now have an effective method that is proving to be a fruitful final course of action in this micro-epidemic of resistant psychiatric diseases...
October 17, 2016: Curēus
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