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Roger McIntyre

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https://www.readbyqxmd.com/read/28078987/role-of-proinflammatory-cytokines-in-dopaminergic-system-disturbances-implications-for-anhedonic-features-of-mdd
#1
Zihang Pan, Joshua D Rosenblat, Walter Swardfager, Roger S McIntyre
Anhedonia, characterized by a loss of interest and/or pleasure in previously enjoyable activities, is an important diagnostic criterion of Major Depressive Disorder (MDD). Converging evidence implicates a behaviouralcausal relationship between proinflammatory cytokines and disturbances that characterize anhedonia in the context of MDD. Additionally, anhedonia has been implicated in disturbances of key central dopaminergic modulatory pathways. Emerging research into the roles of tetrahydrobiopterin, a cytokine-targeted co-enzyme in the synthesis of dopamine, and kynurenine, a product of inflammation-sensitive breakdown of tryptophan via indoleamine 2, 3-dioxygenase, have shed new light into the role of inflammation in mediating anhedonic behaviours...
January 11, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28073041/major-depressive-disorder-with-subthreshold-hypomanic-mixed-features-a-real-world-assessment-of-treatment-patterns-and-economic-burden
#2
Roger S McIntyre, Daisy Ng-Mak, Chien-Chia Chuang, Rachel Halpern, Pankaj A Patel, Krithika Rajagopalan, Antony Loebel
BACKGROUND: To compare outcomes for individuals with major depressive disorder (MDD) with or without subthreshold hypomania (mixed features) in naturalistic settings. METHODS: Using the Optum Research Database (1/1/2009─10/31/2014), a retrospective analysis of individuals newly diagnosed with MDD was conducted. Continuous enrollment for 12-months before and after the initial MDD diagnosis was required. MDD with subthreshold hypomania (mixed features) (MDD-MF) was defined based on ≥1 hypomania diagnosis within 30 days after an MDD diagnosis during the one-year follow-up period, in the absence of bipolar I diagnoses...
December 23, 2016: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28068459/does-pharmacogenomic-testing-improve-clinical-outcomes-for-major-depressive-disorder-a-systematic-review-of-clinical-trials-and-cost-effectiveness-studies
#3
Joshua D Rosenblat, Yena Lee, Roger S McIntyre
OBJECTIVE: Pharmacogenomic testing has become scalable and available to the general public. Pharmacogenomics has shown promise for predicting antidepressant response and tolerability in the treatment of major depressive disorder (MDD). In theory, pharmacogenomics can improve clinical outcomes by guiding antidepressant selection and dosing. The current systematic review examines the extant literature to determine the impact of pharmacogenomic testing on clinical outcomes in MDD and assesses its cost-effectiveness...
January 3, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28044944/a-pragmatic-approach-to-the-diagnosis-and-treatment-of-mixed-features-in-adults-with-mood-disorders
#4
Roger S McIntyre, Yena Lee, Rodrigo B Mansur
Mixed features specifier (MFS) is a new nosological entity defined and operationalized in the Diagnostic and Statistical Manual of Mental Disorders (DSM), 5th Edition. The impetus to introduce the MFS and supplant mixed states was protean, including the lack of ecological validity, high rates of misdiagnosis, and guideline discordant treatment for mixed states. Mixed features specifier identifies a phenotype in psychiatry with greater illness burden, as evidenced by earlier age at onset, higher episode frequency and chronicity, psychiatric and medical comorbidity, suicidality, and suboptimal response to conventional antidepressants...
December 2016: CNS Spectrums
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
#5
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/27935809/assessing-and-measuring-cognitive-function-in-major-depressive-disorder
#6
Renee-Marie Ragguett, Danielle S Cha, Ron Kakar, Joshua D Rosenblat, Yena Lee, Roger S McIntyre
Cognitive dysfunction is a major component of major depressive disorder (MDD). No 'gold-standard' tool exists for the assessment of cognitive dysfunction for adults with MDD. The use of measurement-based care to improve treatment outcomes invites the need for a systematic screening, evaluation and measurement tool. The aim herein was to provide a succinct summary of literature documenting clinical implication of cognitive dysfunction in MDD, and a review of available screening, diagnostic and measurement tools for cognitive dysfunction in MDD is provided...
November 2016: Evidence-based Mental Health
https://www.readbyqxmd.com/read/27913990/sirukumab-a-potential-treatment-for-mood-disorders
#7
REVIEW
Aileen J Zhou, Yena Lee, Giacomo Salvadore, Benjamin Hsu, Trehani M Fonseka, Sidney H Kennedy, Roger S McIntyre
Convergent evidence indicates that abnormalities in the innate immune system may be pertinent to the pathogenesis, phenomenology, and possible treatment of several mental disorders. In keeping with this view, the targeting of interleukin-6 with the human monoclonal antibody sirukumab may represent a possible treatment and disease modification approach, for adults with brain-based disorders (e.g., major depressive disorder). A PubMed/Medline database search was performed using the following search terms: sirukumab; anti-IL-6; IL-6; major depressive disorder; inflammation...
December 2, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27884012/gut-microbiota-bacterial-translocation-and-interactions-with-diet-pathophysiological-links-between-major-depressive-disorder-and-non-communicable-medical-comorbidities
#8
Anastasiya Slyepchenko, Michael Maes, Felice N Jacka, Cristiano A Köhler, Tatiana Barichello, Roger S McIntyre, Michael Berk, Iria Grande, Jane A Foster, Eduard Vieta, André F Carvalho
BACKGROUND: Persistent low-grade immune-inflammatory processes, oxidative and nitrosative stress (O&NS), and hypothalamic-pituitary-adrenal axis activation are integral to the pathophysiology of major depressive disorder (MDD). The microbiome, intestinal compositional changes, and resultant bacterial translocation add a new element to the bidirectional interactions of the gut-brain axis; new evidence implicates these pathways in the patho-aetiology of MDD. In addition, abnormalities in the gut-brain axis are associated with several chronic non-communicable disorders, which frequently co-occur in individuals with MDD, including but not limited to irritable bowel syndrome (IBS), chronic fatigue syndrome (CFS), obesity, and type 2 diabetes mellitus (T2DM)...
2017: Psychotherapy and Psychosomatics
https://www.readbyqxmd.com/read/27871787/selfish-brain-and-selfish-immune-system-interplay-a-theoretical-framework-for-metabolic-comorbidities-of-mood-disorders
#9
REVIEW
Ana Sayuri Yamagata, Rodrigo Barbachan Mansur, Lucas Bortolotto Rizzo, Tatiana Rosenstock, Roger S McIntyre, Elisa Brietzke
According to the "selfish brain" theory, the brain regulates its own energy supply influencing the peripheral metabolism and food intake according to its needs. The immune system has been likewise "selfish" due to independent energy consumption; and it may compete with the brain (another high energy-consumer) for glucose. In mood disorders, stress in mood episodes or physiological stress activate homeostasis mechanisms from the brain and the immune system to solve the imbalance. The interaction between the selfish brain and the selfish immune system may explain various conditions of medical impairment in mood disorders, such as Metabolic Syndrome (MetS), obesity, type 2 diabetes mellitus (T2DM) and immune dysregulation...
January 2017: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/27861191/effects-of-levomilnacipran-extended-release-on-major-depressive-disorder-patients-with-cognitive-impairments-post-hoc-analysis-of-a-phase-iii-study
#10
Keith A Wesnes, Carl Gommoll, Changzheng Chen, Angelo Sambunaris, Roger S McIntyre, Philip D Harvey
Performance-based cognitive data were collected using the Cognitive Drug Research System in a study of levomilnacipran extended-release (ER) 40-120 mg/day (NCT01034462) in adults with major depressive disorder. These data were analyzed post-hoc to explore the relationship between cognitive measures, depression symptoms (Montgomery-Åsberg Depression Rating Scale, MADRS), and self-reported psychosocial functioning (Sheehan Disability Scale; SDS). Changes from baseline were analyzed in the intent-to-treat population and subgroups with impaired attention, as indicated by baseline Cognitive Drug Research System scores for Power of Attention and Continuity of Attention...
November 16, 2016: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/27835721/functional-recovery-in-major-depressive-disorder-focus-on-early-optimized-treatment
#11
Jeffrey Habert, Martin A Katzman, Oloruntoba J Oluboka, Roger S McIntyre, Diane McIntosh, Glenda M MacQueen, Atul Khullar, Roumen V Milev, Kevin D Kjernisted, Pratap R Chokka, Sidney H Kennedy
Objective: This article presents the case that a more rapid, individualized approach to treating major depressive disorder (MDD) may increase the likelihood of achieving full symptomatic and functional recovery for individual patients and that studies show it is possible to make earlier decisions about appropriateness of treatment in order to rapidly optimize that treatment. Data Sources: A PubMed search was conducted using terms including major depressive disorder, early improvement, predictor, duration of untreated illness, and function...
September 1, 2016: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/27821210/asenapine-for-the-treatment-of-adults-with-an-acute-exacerbation-of-schizophrenia-results-from-a-randomized-double-blind-fixed-dose-placebo-controlled-trial-with-olanzapine-as-an-active-control
#12
Ronald Landbloom, Mary Mackle, Xiao Wu, Linda Kelly, Linda Snow-Adami, Roger S McIntyre, Maju Mathews, Carla Hundt
OBJECTIVE: Evaluate the efficacy and safety of asenapine 2.5 mg twice daily (bid; n=97) or 5 mg bid (n=113) versus placebo (n=101) in adults with acute exacerbation of schizophrenia. METHODS: Adults with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) schizophrenia diagnosis were randomized to asenapine 2.5 mg bid, 5 mg bid, placebo, or olanzapine 15 mg once daily. The primary objective was to test superiority of asenapine versus placebo as measured by the change from baseline to day 42 in the Positive and Negative Syndrome Scale (PANSS) total score...
November 8, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27810270/the-association-between-insulin-resistance-and-depression-in-the-korean-general-population
#13
Jae-Hon Lee, Sung Keun Park, Jae-Hong Ryoo, Chang-Mo Oh, Rodrigo B Mansur, Jeffrey E Alfonsi, Danielle S Cha, Yena Lee, Roger S McIntyre, Ju Young Jung
BACKGROUND: Previous studies showed that the insulin resistance (IR) could be related to depression. However, this association is still equivocal in the general population. Herein, we aimed to investigate the association between IR and depressive symptoms in a large sample in South Korea. METHODS: A cross-sectional study was carried out for 165,443 Korean men and women who received a health checkup including various clinical parameters and the Center for Epidemiologic Studies Depression scales (CES-D)...
January 15, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/27788319/implementing-appropriate-treatment-strategies-for-varying-types-of-depression
#14
Roger S McIntyre
Reassessing a patient's diagnosis if he or she does not respond adequately to initial antidepressant pharmacotherapy is imperative. In this CME activity, evaluate the case of Melissa, a 32-year-old architect with a potential case of treatment-resistant depression, and decide on appropriate treatment strategies.
October 2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/27783998/hepatocellular-carcinoma-and-antidepressants-a-nationwide-population-based-study
#15
Vincent Chin-Hung Chen, Chiao-Fan Lin, Yi-Hsuan Hsieh, Hsin-Yi Liang, Kuo-You Huang, Wei-Che Chiu, Yena Lee, Roger S McIntyre, Hsiang-Lin Chan
Hepatocellular carcinoma (HCC) is highly prevalent in Asia. Antidepressants have been associated with increase in hepatocellular carcinoma. This is the first Asian population-based study to evaluate the association between antidepressant use and risk of HCC. Based on Taiwan's National Health Insurance Research Database, we conducted a nationwide population-based study. A total of 49,998 cases with HCC were identified and paired with 244,236 randomly selected controls. The data was analyzed via the conditional logistic regression model adjusting for several confounding factors...
October 23, 2016: Oncotarget
https://www.readbyqxmd.com/read/27780334/efficacy-of-vortioxetine-on-cognitive-functioning-in-working-patients-with-major-depressive-disorder
#16
Roger S McIntyre, Ioana Florea, Brigitte Tonnoir, Henrik Loft, Raymond W Lam, Michael Cronquist Christensen
OBJECTIVE: This post hoc analysis investigates the effect of vortioxetine on cognitive functioning and depressive symptoms in working adults with major depressive disorder (MDD). METHODS: Population data from FOCUS, a double-blind, randomized, placebo-controlled study investigating the efficacy of vortioxetine versus placebo on cognitive functioning and depression in patients with MDD, were used to analyze mean change from baseline scores for the Digit Symbol Substitution Test (DSST), Trail Making Test A/B (TMT-A/B), Stroop, and Perceived Deficits Questionnaire (PDQ)...
October 25, 2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/27744223/antidepressants-and-colorectal-cancer-a-population-based-nested-case-control-study
#17
Hsiu-Chiung Lee, Wei-Che Chiu, Tsu-Nai Wang, Yin-To Liao, I-Chia Chien, Yena Lee, Roger S McIntyre, Pau-Chung Chen, Vincent Chin-Hung Chen
BACKGROUND: Experimental evidence indicates that serotonin is associated with both proliferative and pro-carcinogenic effects on colorectal tumors. The present study aims to investigate the associations between antidepressant use and colorectal cancer in an epidemiological sample. METHODS: We conducted a population-based case-control study utilizing Taiwan's National Health Insurance Research Database (NHIRD). We identified 49,342 cases with colorectal cancer and 240,985 controls between 1997 and 2008...
October 1, 2016: Journal of Affective Disorders
https://www.readbyqxmd.com/read/27721184/liraglutide-promotes-improvements-in-objective-measures-of-cognitive-dysfunction-in-individuals-with-mood-disorders-a-pilot-open-label-study
#18
Rodrigo B Mansur, Juhie Ahmed, Danielle S Cha, Hanna O Woldeyohannes, Mehala Subramaniapillai, Julie Lovshin, Jung G Lee, Jae-Hon Lee, Elisa Brietzke, Eva Z Reininghaus, Kang Sim, Maj Vinberg, Natalie Rasgon, Tomas Hajek, Roger S McIntyre
BACKGROUND: There is a paucity of treatments that are capable of reliably and robustly improving cognitive function in adults with mood disorders. Glucagon-like peptide-1 is synthesized centrally and its receptors are abundantly expressed in neural circuits subserving cognitive function. We aimed to determine the effects of liraglutide, a GLP-1 receptor (GLP-1R) agonist, on objective measures of cognition in adults with a depressive or bipolar disorder. METHODS: In this 4-week, pilot, open-label, domain-based study (e...
January 1, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/27629159/treatment-recommendations-for-dsm-5-defined-mixed-features
#19
Joshua D Rosenblat, Roger S McIntyre
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) mixed features specifier provides a less restrictive definition of mixed mood states, compared to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), including mood episodes that manifest with subthreshold symptoms of the opposite mood state. A limited number of studies have assessed the efficacy of treatments specifically for DSM-5-defined mixed features in mood disorders. As such, there is currently an inadequate amount of data to appropriately inform evidence-based treatment guidelines of DSM-5 defined mixed features...
September 15, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27618746/treatment-of-mixed-features-in-bipolar-disorder
#20
Joshua D Rosenblat, Roger S McIntyre
Mood episodes with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)-defined mixed features are highly prevalent in bipolar disorder (BD), affecting ~40% of patients during the course of illness. Mixed states are associated with poorer clinical outcomes, greater treatment resistance, higher rates of comorbidity, more frequent mood episodes, and increased rates of suicide. The objectives of the current review are to identify, summarize, and synthesize studies assessing the efficacy of treatments specifically for BD I and II mood episodes (ie, including manic, hypomanic, and major depressive episodes) with DSM-5-defined mixed features...
September 13, 2016: CNS Spectrums
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