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Resistant major depression

Roger Mulder, Amber Hamilton, Lauren Irwin, Philip Boyce, Grace Morris, Richard J Porter, Gin S Malhi
OBJECTIVES: To evaluate the efficacy and safety of using adjunctive antipsychotics in patients with major depressive disorder. METHOD: Studies published since the last Cochrane review conducted in 2010 were identified via a literature search of recognised databases, using the keywords "adjunct*", "augment*", "antipsychotic" and "depression", and systematically evaluated. A targeted review of relevant guidelines was undertaken...
November 2018: Bipolar Disorders
Leorey N Saligan, Cristan Farmer, Elizabeth D Ballard, Bashkim Kadriu, Carlos A Zarate
BACKGROUND: Fatigue and depression are closely associated. The purpose of this secondary analysis was to understand the relationships between depression and improvements in specific depression domains on the anti-fatigue effects of ketamine, which we previously reported. METHODS: This secondary analysis re-evaluated data collected longitudinally from 39 patients with treatment-resistant Major Depressive Disorder (MDD) enrolled in a double-blind, randomized, placebo-controlled, crossover trial using a single intravenous infusion of ketamine hydrochloride (0...
October 6, 2018: Journal of Affective Disorders
Bryan Howell, Ki Sueng Choi, Kabilar Gunalan, Justin Rajendra, Helen S Mayberg, Cameron C McIntyre
Deep brain stimulation (DBS) of the subcallosal cingulate (SCC) is an emerging experimental therapy for treatment-resistant depression. New developments in SCC DBS surgical targeting are focused on identifying specific axonal pathways for stimulation that are estimated from patient-specific computational models. This connectomic-based biophysical modeling strategy has proven successful in improving the clinical response to SCC DBS therapy, but the DBS models used to date have been relatively simplistic, limiting the precision of the pathway activation estimates...
October 11, 2018: Human Brain Mapping
Emily Rosenich, Shane Gill, Patrick Clarke, Tom Paterson, Lisa Hahn, Cherrie Galletly
AIM: Depression is common in young people, and there is a need for safe, effective treatments. This study examined the efficacy of repetitive transcranial magnetic stimulation in a sample of young people aged 17 to 25 years. METHODS: This retrospective study included 15 people aged 17 to 25 years referred by their private psychiatrists affiliated with Ramsay Health Care, South Australia Mental Health Services. All patients met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for treatment-resistant Major Depressive Disorder...
October 10, 2018: Early Intervention in Psychiatry
Feng-Ying Han, Xiao-Yu Song, Jing-Jie Chen, Guo-Dong Yao, Shao-Jiang Song
Timosaponin AIII, a major steroidal saponin found in Anemarrhena asphodeloides Bge., which has been widely used as anti-pyretic, anti-diabetic, anti-inflammatory, anti-platelet aggregator and anti-depressant agents in traditional Chinese medicine. Recent pharmacological study showed that timosaponin AIII had potent cytotoxicity, which was potential to be developed as an anticancer agent, however the molecular mechanism underlying the anticancer activity has not been fully elucidated. This review aims to give a systematic summary of the study of timosaponin AIII to reveal its anti-tumor activities by investigating invasion and migration, apoptosis, autophagy and reversing multi-drug resistance...
October 5, 2018: Steroids
Soila Järvenpää, Jukka Peltola, Sirpa Rainesalo, Esa Leinonen, Kai Lehtimäki, Kaija Järventausta
OBJECTIVE: Anterior nucleus of thalamus (ANT) deep brain stimulation (DBS) is becoming a more common treatment for drug-resistant epilepsy. Epilepsy and depression display a bidirectional association. Anterior nucleus of thalamus has connections to anterior cingulate cortex and orbitomedial prefrontal cortex, hence, a possible role in emotional and executive functions, and thus, ANT DBS might exert psychiatric adverse effects. Our aim was to evaluate previous and current psychiatric symptoms in patients with epilepsy undergoing ANT DBS surgery and assess the predictability of psychiatric adverse effects...
October 2, 2018: Epilepsy & Behavior: E&B
Dawn F Ionescu, Kate H Bentley, Matthias Eikermann, Norman Taylor, Oluwaseun Johnson-Akeju, Michaela B Swee, Kara J Pavone, Samuel R Petrie, Christina Dording, David Mischoulon, Jonathan E Alpert, Emery N Brown, Lee Baer, Matthew K Nock, Maurizio Fava, Cristina Cusin
BACKGROUND: Several studies indicate that ketamine has rapid antidepressant effects in patients with treatment-resistant depression (TRD). The extent to which repeated doses of ketamine (versus placebo) reduce depression in the short and long term among outpatients with TRD and chronic, current suicidal ideation remains unknown. METHODS: Twenty-six medicated outpatients with severe major depressive disorder with current, chronic suicidal ideation were randomized in a double-blind fashion to six ketamine infusions (0...
January 15, 2019: Journal of Affective Disorders
Sabri Aydın, Huseyin Canaz, Barıs Topcular, Zuzana Benackova
Deep brain stimulation (DBS) is a new alternative treatment for treatment-resistant major depression (MD) and obsessive-compulsive disorder (OCD). Various DBS targets were defined for MD and OCD. Nucleus accumbens (NAcc) comes out among the other targets in patients with MD and comorbid OCD when physiopathology and limited side effects are taken into account. We report a 27-year-old male with MD and OCD who was treated by bilateral NAcc-DBS. The aim of this study is to discuss NAcc as a DBS target in patients with MD and OCD and to report the first case of a psychiatric disorder treated with DBS in Turkey...
July 2018: Asian Journal of Neurosurgery
Dan Kaufmann, K C Brennan
Migraine is a disabling neurological disorder affecting 12% of the world's population. Stress is a major reported trigger and exacerbator of migraine. We evaluated the effects of two chronic stress paradigms on migraine relevant phenotypes in male C57Bl/6 mice. Methods: Fifty six mice were used in a 14 day social defeat stress (SDS) and twenty three mice were used in a 40 day chronic variable stress (CVS) paradigm. Anxiety measures were evaluated using the open field and elevated plus maze (EPM) tests. Migraine relevant phenotypes were evaluated using the nitroglycerin (NTG) and cortical spreading depression (CSD) models...
2018: Frontiers in Cellular Neuroscience
Alessandra A Gorgulho, Fernando Fernandes, Lucas P Damiani, Daniel A N Barbosa, Abrão Cury, Camila M Lasagno, Priscila R T Bueno, Bruno F O Santos, Renato H N Santos, Otávio Berwanger, Alexandre B Cavalcanti, Manoel J Teixeira, Ricardo A Moreno, Antonio A F De Salles
BACKGROUND: More than 30% of major depressive disorder patients fail to respond to adequate trials of medications and psychotherapy. While modern neuromodulation approaches (ie, vagal nerve stimulation, deep brain stimulation) are yet to prove their efficacy for such cases in large randomized controlled trials, trigeminal nerve stimulation (TNS) has emerged as an alternative with promising effects on mood disorders. OBJECTIVE: To assess efficacy, safety, tolerability, and placebo effect duration of continuous subcutaneous TNS (sTNS) in treatment-resistant depression (TRD)...
September 28, 2018: Neurosurgery
Linda van Diermen, Kaat Hebbrecht, Didier Schrijvers, Bernard C G Sabbe, Erik Fransen, Tom K Birkenhäger
OBJECTIVE: To investigate the potential role of the Maudsley Staging Method (MSM) in the prediction of electroconvulsive therapy (ECT) outcome in severely depressed adults. METHOD: Between August 2015 and August 2017, 73 consecutive patients with a major depressive episode (DSM-IV-TR) scheduled for ECT were recruited. Prior to their first ECT session, the MSM was completed to assess the level of therapy resistance. To determine the reduction in depression severity and response and remission rates, symptom severity was assessed at baseline and within one week after the last ECT session using the 17-item Hamilton Depression Rating Scale (HDRS17)...
October 1, 2018: Acta Psychiatrica Scandinavica
James Paul Pandarakalam
Guidelines for the management of treatment-resistant depression (TRD) do not meet the criteria of evidence-based medicine and better-quality research is required to inform clinical practice. Current treatments of resistant depression remains largely empirical. There are no bench-mark antidepressants. Clear and justifiable rationale should be followed while initiating new treatment strategies; systematic planning and careful monitoring of progress implemented while new treatment components are added. Biological psychiatrists should give due importance to the non-biological aspects of depression and psychotherapists should not overlook the biological correlates...
September 2018: Psychiatria Danubina
Mandakh Bekhbat, Karen Chu, Ngoc-Anh Le, Bobbi J Woolwine, Ebrahim Haroon, Andrew H Miller, Jennifer C Felger
The tumor necrosis factor (TNF) antagonist infliximab was previously found to reduce depressive symptoms in patients with treatment-resistant major depression (TRD) who exhibited high baseline inflammation, as reflected by plasma C-reactive protein (CRP) >5 mg/L. Further predictors of antidepressant response to infliximab included differential expression of peripheral blood gene transcripts that were related not only to inflammation but also to glucose and lipid metabolism. To determine whether plasma biomarkers of glucose and lipid metabolism were similarly associated with antidepressant response to infliximab and with relevant gene transcripts, we measured concentrations of glucose, insulin, and protein hormones that regulate glucose homeostasis and metabolism (leptin, resistin, and adiponectin), as well as cholesterols, triglycerides, and non-esterified fatty acids (NEFA), in medically-stable TRD outpatients at baseline and 2 weeks after the first infusion of infliximab (n = 26) or placebo (n = 26)...
September 6, 2018: Psychoneuroendocrinology
Maria Filip, Justyna Jasionowska, Piotr Gałecki
Depressive disorders are the most common disease entities in psychiatry. Slightly more than 50% of patients diagnosed with major depressive disorder (MDD) were treated using available antidepressants have shown the complete remission, and over 1/3 of patients have not responded to conventional treatment presenting treatment-resistant depression (TRD). Possible treatment of this type of disorder is pharmacotherapy, which in some cases turns out to be ineffective. Scientists studying this problem suggest using ketamine - a drug known for being used in anaesthesiology and intensive therapy...
September 21, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Thomas Liebe, Meng Li, Lejla Colic, Matthias H J Munk, Catherine M Sweeney-Reed, Marie Woelfer, Moritz A Kretzschmar, Johann Steiner, Felicia von Düring, Gusalija Behnisch, Björn H Schott, Martin Walter
BACKGROUND: Ketamine is receiving increasing attention as a rapid-onset antidepressant in patients suffering from major depressive disorder (MDD) with treatment resistance or severe suicidal ideation. Ketamine modulates several neurotransmitter systems, including norepinephrine via the norepinephrine transporter (NET), both peripherally and centrally. The locus coeruleus (LC), which has high NET concentration, has been attributed to brain networks involved in depression. Thus we investigated the effects of single-dose of racemic ketamine on the LC using resting state functional MRI...
September 4, 2018: NeuroImage: Clinical
Fernanda S Correia-Melo, Gustavo C Leal, Michelle S Carvalho, Ana Paula Jesus-Nunes, Carolina B N Ferreira, Flávia Vieira, Guilherme Magnavita, Lucas A S Vale, Rodrigo P Mello, Carolina Nakahira, Felipe C Argolo, Tanise Cardoso, Cezar D S Souza, Ana Teresa C Fontes, Marcelo B Ferreira, Lucas Araújo-de-Freitas, Marco A Tuena, Mariana V F Echegaray, Diogo E Cavalcanti, Ana C Lucchese, Igor D Bandeira, Manuela Telles, Cássio S Lima, Aline S Sampaio, Samantha S Silva, Roberta F Marback, José A Del-Porto, José Neander Abreu, Luciana M Sarin, Camilla S Paixão, Lucas P Carvalho, Paulo R L Machado, Gustavo Turecki, Acioly L T Lacerda, Lucas C Quarantini
INTRODUCTION: The use of ketamine as an option in the treatment of depressive disorder is growing rapidly, supported by numerous clinical trials attesting its efficacy and safety. Esketamine, the S (+) enantiomer of ketamine, is the most widely used form in the anesthetic environment in some countries, and new studies have shown that it may also be effective in depression and with better tolerability. However, no study so far has directly compared esketamine with racemic ketamine. Here we propose a protocol of a clinical trial to evaluate esketamine as a noninferior medication when compared to ketamine in the treatment of patients with treatment-resistant depression...
September 2018: Medicine (Baltimore)
Tsuyoshi Miyaoka, Misako Kanayama, Rei Wake, Sadayuki Hashioka, Maiko Hayashida, Michiharu Nagahama, Shihoh Okazaki, Satoko Yamashita, Shoko Miura, Hiroyuki Miki, Hiroyuki Matsuda, Masahiro Koike, Muneto Izuhara, Tomoko Araki, Keiko Tsuchie, Ilhamuddin Abdul Azis, Ryosuke Arauchi, Rostia Arianna Abdullah, Arata Oh-Nishi, Jun Horiguchi
AIM: Up to 60% of depressed patients do not obtain sufficient relief from a course of antidepressant therapy, and these treatment-resistant major depressive disorder (TRD) patients are at increased risk for relapse, chronicity, persistent psychosocial impairments, and suicide. Probiotics actively participate in treatment of neuropsychiatric disorders. However, the role of gut microbiota in brain disorders and depression remains unclear. We performed a prospective study to evaluate the effects of Clostridium butyricum MIYAIRI 588 (CBM588)...
September 2018: Clinical Neuropharmacology
Morgane Roulot, Alessandra Minelli, Marco Bortolomasi, Elisabetta Maffioletti, Massimo Gennarelli, Marc Borsotto, Catherine Heurteaux, Jean Mazella
Purpose: Sortilin-derived propeptide (PE) and its synthetic analog spadin show strong antidepressant activity in rodents and, therefore, could be used as a biomarker to evaluate the clinical efficacy of antidepressant treatments. The aim of this study was to determine whether electroconvulsive therapy (ECT) modulates serum PE concentration in patients with treatment-resistant depression (TRD). Patients and methods: Forty-five patients with major depressive disorder, who met the Diagnostic and Statistical Manual of Mental Disorders-IV criteria, were selected for this study...
2018: Neuropsychiatric Disease and Treatment
Britta Stapel, Irina Sieve, Christine S Falk, Stefan Bleich, Denise Hilfiker-Kleiner, Kai G Kahl
Schizophrenia and major depression are associated with alterations in peripheral inflammatory markers, and anti-inflammatory therapy has been proposed as a promising add-on approach in the pharmacologic treatment of both disorders. Second-generation atypical antipsychotics are currently first-line drugs in the treatment of schizophrenia and are also used as augmentation strategies in treatment-resistant major depression. Furthermore, these drugs have been reported to exhibit distinct metabolic side effects and to influence inflammatory processes...
October 2018: Journal of Psychiatric Research
Savannah N Gosnell, Kaylah N Curtis, Kenia Velasquez, J Christopher Fowler, Alok Madan, Wayne Goodman, Ramiro Salas
INTRODUCTION: The habenula (Hb) is a small midbrain structure that signals negative events and may play a major role in the etiology of psychiatric disorders including depression. The lateral Hb has three major efferent connections: serotonergic raphe nuclei, noradrenergic locus coeruleus, and dopaminergic ventral tegmental area/substantia nigra compacta. We wanted to test whether Hb connectivity may be important to predict treatment outcomes in depression patients. METHODS: We studied whether habenular connectivity at admission into a psychiatric clinic can predict treatment response...
January 1, 2019: Journal of Affective Disorders
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