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Treatment resistant bipolar depression

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https://www.readbyqxmd.com/read/28940099/influence-of-depressed-patients-expectations-prior-to-electroconvulsive-therapy-on-its-effectiveness-and-tolerability-exp-ect-a-prospective-study
#1
Lisa Krech, Michael Belz, Matthias Besse, Isabel Methfessel, Dirk Wedekind, David Zilles
Electroconvulsive therapy (ECT) is the most effective therapy for severe depressive disorders. Though there are known clinical predictors of response (e.g., higher age, presence of psychotic symptoms), there is a lack of knowledge concerning the impact of patients' expectations on treatment outcome and tolerability in terms of possible placebo/nocebo effects. In 31 patients with unipolar or bipolar depressive disorder, we used a questionnaire to investigate the patients' expectations of ECT effectiveness and tolerability prior to and in the course of the treatment...
September 22, 2017: European Archives of Psychiatry and Clinical Neuroscience
https://www.readbyqxmd.com/read/28939975/ketamine-induced-glutamatergic-mechanisms-of-sleep-and-wakefulness-insights-for-developing-novel-treatments-for-disturbed-sleep-and-mood
#2
Wallace C Duncan, Elizabeth D Ballard, Carlos A Zarate
Ketamine, a drug with rapid antidepressant effects and well-described effects on slow wave sleep (SWS), is a useful intervention for investigating sleep-wake mechanisms involved in novel therapeutics. The drug rapidly (within minutes to hours) reduces depressive symptoms in individuals with major depressive disorder (MDD) or bipolar disorder (BD), including those with treatment-resistant depression. Ketamine treatment elevates extracellular glutamate in the prefrontal cortex. Glutamate, in turn, plays a critical role as a proximal element in a ketamine-initiated molecular cascade that increases synaptic strength and plasticity, which ultimately results in rapidly improved mood...
September 23, 2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28922589/higher-baseline-proinflammatory-cytokines-mark-poor-antidepressant-response-in-bipolar-disorder
#3
Francesco Benedetti, Sara Poletti, Thomas A Hoogenboezem, Clara Locatelli, Harm de Wit, Annemarie J M Wijkhuijs, Cristina Colombo, Hemmo A Drexhage
BACKGROUND: The clinical relevance of raised levels of circulating cytokines in bipolar disorder is still unclear. Cytokines influence neurotransmitters, neuroplasticity, and white matter integrity. An inconsistent literature suggests that higher cytokine levels could hamper antidepressant response. Total sleep deprivation (TSD) and light therapy (LT) prompt a rapid antidepressant response and can provide a model treatment to study predictors of response. METHODS: We studied at baseline 15 immune-regulating compounds in 37 consecutively admitted inpatients with a major depressive episode in the course of bipolar disorder (DSM-5 criteria) and in 24 controls...
September 12, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28918241/stigma-experienced-by-patients-with-severe-mental-disorders-a-nationwide-multicentric-study-from-india
#4
Sandeep Grover, Ajit Avasthi, Aakanksha Singh, Amitava Dan, Rajarshi Neogi, Darpan Kaur, Bhavesh Lakdawala, Abhijit R Rozatkar, Naresh Nebhinani, Suravi Patra, Priya Sivashankar, Alka A Subramanyam, Adarsh Tripathi, Ab Majid Gania, Gurvinder Pal Singh, Prakash Behere
This study aimed to evaluate the stigma and its correlates among patients with severe mental disorders. Patients with diagnosis of schizophrenia (N = 707), bipolar disorder (N = 344) and recurrent depressive disorder (N = 352) currently in clinical remission from 14 participating centres were assessed on Internalized Stigma of Mental Illness Scale (ISMIS). Patients with diagnosis of schizophrenia experienced higher level of alienation, sterotype endorsement, discrimination experience and total stigma when compared to patients with bipolar disorder and recurrent depressive disorder...
August 17, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28866718/hypersomnia-and-cognitive-impairment-in-a-patient-with-bipolar-disorder-a-case-report
#5
Katarzyna Szaulińska, Anna Antosik-Wójcińska, Ewa Paszkowska, Łukasz Święcicki, Marek Jarema, Adam Wichniak
OBJECTIVES: Obstructive sleep apnea (OSA) is a common clinical problem that can have serious health consequences and complicate the course of mental disorders. It is estimated that the prevalence of sleep apnea in patients with bipolar disorder can be 21-47.5%. Some symptoms of OSA are the same as the symptoms of depression: daytime drowsiness, cognitive dysfunction, decreased drive, apathy, depressed mood, anhedonia. METHODS: We present a case of a patient whose depressive symptoms persisted despite repeated changes of pharmacological treatment and were exacerbated by severe sleep disorder...
June 18, 2017: Psychiatria Polska
https://www.readbyqxmd.com/read/28860774/bipolar-ii-disorder-as-the-initial-presentation-of-cadasil-an-underdiagnosed-manifestation
#6
Jianjun Wang, Jinfang Li, Fanxin Kong, Hanqing Lv, Zhouke Guo
Mood disturbances have been documented in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). The highly varied morbidity indicates that the affective symptoms in CADASIL have not been cataloged systematically, leading to ineffective treatment, affecting the patients' quality of life, and possibly resulting in suicide. We present a case of CADASIL with bipolar II disorder as the first manifestation. A middle-aged female reported recurrent depressive episodes and appeared treatment resistant to adequate dosages and durations of antidepressants...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28840042/a-review-of-the-conceptualisation-and-risk-factors-associated-with-treatment-resistant-depression
#7
REVIEW
Jenifer A Murphy, Jerome Sarris, Gerard J Byrne
Major depression does not always remit. Difficult-to-treat depression is thought to contribute to the large disease burden posed by depression. Treatment-resistant depression (TRD) is the conventional term for nonresponse to treatment in individuals with major depression. Indicators of the phenomenon are the poor response rates to antidepressants in clinical practice and the overestimation of the efficacy of antidepressants in medical scientific literature. Current TRD staging models are based on anecdotal evidence without an empirical rationale to rank one treatment strategy above another...
2017: Depression Research and Treatment
https://www.readbyqxmd.com/read/28811917/drug-information-update-lithium-and-chronic-kidney-disease-debates-and-dilemmas
#8
Sumeet Gupta, Udayan Khastgir
Lithium is an established treatment for bipolar disorder and an augmenting agent for treatment-resistant depression. Despite awareness of renal adverse effects, including chronic kidney disease, for the past five decades, there has been a lack of research evidence. This has led to debates around the existence and magnitude of the risk. This article discusses the current evidence base regarding the link between lithium and chronic kidney disease, monitoring of renal functions and its clinical implications.
August 2017: BJPsych Bulletin
https://www.readbyqxmd.com/read/28796415/white-matter-tract-integrity-is-associated-with-antidepressant-response-to-lurasidone-in-bipolar-depression
#9
Martin J Lan, Harry Rubin-Falcone, Fatima Motiwala, Ying Chen, Jonathan W Stewart, David J Hellerstein, J John Mann, Patrick J McGrath
OBJECTIVES: Patients with bipolar disorder spend the most time in the depressed phase, and that phase is associated with the most morbidity and mortality. Treatment of bipolar depression lacks a test to determine who will respond to treatment. White matter disruptions have been found in bipolar disorder. Previous reports suggest that white matter disruptions may be associated with resistance to antidepressant medication, but this has never been investigated in a prospective study using a Food and Drug Administration (FDA)-approved medication...
August 10, 2017: Bipolar Disorders
https://www.readbyqxmd.com/read/28792656/amygdala-and-regional-volumes-in-treatment-resistant-versus-nontreatment-resistant-depression-patients
#10
Anca-Larisa Sandu, Eric Artiges, André Galinowski, Thierry Gallarda, Frank Bellivier, Hervé Lemaitre, Bernard Granger, Damien Ringuenet, Eleni T Tzavara, Jean-Luc Martinot, Marie-Laure Paillère Martinot
BACKGROUND: Although treatment-resistant and nontreatment-resistant depressed patients show structural brain anomalies relative to healthy controls, the difference in regional volumetry between these two groups remains undocumented. METHODS: A whole-brain voxel-based morphometry (VBM) analysis of regional volumes was performed in 125 participants' magnetic resonance images obtained on a 1.5 Tesla scanner; 41 had treatment-resistant depression (TRD), 40 nontreatment-resistant depression (non-TRD), and 44 were healthy controls...
August 9, 2017: Depression and Anxiety
https://www.readbyqxmd.com/read/28790825/rapid-infusion-of-esketamine-for-unipolar-and-bipolar-depression-a-retrospective-chart-review
#11
Fernanda S Correia-Melo, Felipe C Argolo, Lucas Araújo-de-Freitas, Gustavo Carneiro Leal, Flávio Kapczinski, Acioly Luiz Lacerda, Lucas C Quarantini
BACKGROUND: This study evaluated efficacy and safety of intravenous subanesthetic doses of esketamine using an administration time of 10 minutes in patients with treatment-resistant depression and bipolar depression. METHODS: A retrospective chart review was conducted to identify patients who met the inclusion criteria for treatment-resistant depression and bipolar depression according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria, and these patients received rapid infusion of esketamine between June 2012 and December 2015...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28758582/potential-novel-treatments-for-bipolar-depression-ketamine-fatty-acids-anti-inflammatory-agents-and-probiotics
#12
G H Vázquez, S Camino, L Tondo, Ross J Baldessarini
BACKGROUND: Treatments for depression in bipolar disorder (BD) are far less well developed than for unipolar major depressive disorder. Several innovative and experimental approaches have been emerging recently, including use of the dissociative anesthetic ketamine and other antagonists of central NMDA glutamate receptors, as well as unsaturated fatty acids, anti-inflammatory agents, and possibly probiotic methods. METHODS: We reviewed relevant reports from the past decade...
July 28, 2017: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/28714575/rate-and-predictors-of-conversion-from-unipolar-to-bipolar-disorder-a-systematic-review-and-meta-analysis
#13
REVIEW
Lars Vedel Kessing, Inge Willer, Per Kragh Andersen, Jens Drachman Bukh
OBJECTIVES: For the first time to present a systematic review and meta-analysis of the conversion rate and predictors of conversion from unipolar disorder to bipolar disorder. METHODS: A systematic literature search up to October 2016 was performed. For the meta-analysis, we only included studies that used survival analysis to estimate the conversion rate. RESULTS: A total of 31 studies were identified, among which 11 used survival analyses, including two register-based studies...
August 2017: Bipolar Disorders
https://www.readbyqxmd.com/read/28666206/low-dose-ketamine-for-treatment-resistant-depression-in-an-academic-clinical-practice-setting
#14
David Feifel, Benjamin Malcolm, Danielle Boggie, Kelly Lee
BACKGROUND: Recent studies demonstrating a rapid, robust improvement in treatment resistant depression (TRD) following a single sub-anesthetic infusion of ketamine have generated much excitement. However, these studies are limited in their generalizability to the broader TRD population due to their subject exclusion criteria which typically limit psychiatric comorbidity, concurrent medication, and level of suicide risk. This paper describes the safety and efficacy of sub-anesthetic ketamine infusions in a naturalistic TRD patient sample participating in a real-world TRD treatment program within a major university health system...
October 15, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28622159/weeding-out-the-justification-for-marijuana-treatment-in-patients-with-developmental-and-behavioral-conditions
#15
Theodora Nelson, Yi Hui Liu, Kara S Bagot, Martin T Stein
Alex is a 13-year-old adolescent with high-functioning autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD)-combined type, anxiety, and depression. He has been resistant to engaging in therapy and treatment with various medications has been unsuccessful. Alex's parents are concerned about his anxiety, isolation, oppositional behaviors, academic underachievement, truancy, and substance use. A recent altercation with his stepfather led to a police intervention and a brief removal of Alex from the home...
July 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28585221/vagal-nerve-stimulation-for-treatment-resistant-depression
#16
REVIEW
Flavia R Carreno, Alan Frazer
Major depressive disorder (MDD) is prevalent. Although standards antidepressants are more effective than placebo, up to 35% of patients do not respond to 4 or more conventional treatments and are considered to have treatment-resistant depression (TRD). Considerable effort has been devoted to trying to find effective treatments for TRD. This review focuses on vagus nerve stimulation (VNS), approved for TRD in 2005 by the Food and Drugs Administration. Stimulation is carried by bipolar electrodes on the left cervical vagus nerve, which are attached to an implanted stimulator generator...
July 2017: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/28558366/antidepressant-induced-hypomania-mania-in-patients-with-major-depression-evidence-from-the-bridge-ii-mix-study
#17
Margherita Barbuti, Isabella Pacchiarotti, Eduard Vieta, Jean-Michel Azorin, Jules Angst, Charles L Bowden, Sergey Mosolov, Allan H Young, Giulio Perugi
BACKGROUND: The issue of antidepressant-induced mood switches to hypomania, mania, or mixed states within the course of mayor depressive disorder (MDD) has been a controversial topic. The present post-hoc analysis of the BRIDGE-II-MIX study focuses on the clinical features of patients with history of antidepressant-induced hypomania/mania (AIHM) in a large international sample of patients with major depressive episode (MDE). METHODS: 2811 subjects with major depression were enrolled in this multicentre cross-sectional study...
May 24, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28540033/use-of-repeated-intravenous-ketamine-therapy-in-treatment-resistant-bipolar-depression-with-suicidal-behaviour-a-case-report-from-spain
#18
REVIEW
Álvaro López-Díaz, José Luis Fernández-González, José Evaristo Luján-Jiménez, Sara Galiano-Rus, Luis Gutiérrez-Rojas
The rapidly-acting antidepressant properties of ketamine are a trend topic in psychiatry. Despite its robust effects, these are ephemeral and can lead to certain adverse events. For this reason, there is still a general concern around the off-label use of ketamine in clinical practice settings. Nonetheless, for refractory depression, it should be an indication to consider. We report the case of a female patient admitted for several months due to a treatment-resistant depressive bipolar episode with chronic suicidal behaviour...
April 2017: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/28503892/the-ethics-of-clinical-trials-research-in-severe-mood-disorders
#19
Allison C Nugent, Franklin G Miller, Ioline D Henter, Carlos A Zarate
Mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD), are highly prevalent, frequently disabling, and sometimes deadly. Additional research and more effective medications are desperately needed, but clinical trials research in mood disorders is fraught with ethical issues. Although many authors have discussed these issues, most do so from a theoretical viewpoint. This manuscript uses available empirical data to inform a discussion of the primary ethical issues raised in mood disorders research...
July 2017: Bioethics
https://www.readbyqxmd.com/read/28503107/the-role-of-electroconvulsive-therapy-ect-in-bipolar-disorder-effectiveness-in-522-patients-with-bipolar-depression-mixed-state-mania-and-catatonic-features
#20
Giulio Perugi, Pierpaolo Medda, Cristina Toni, Michela Giorgi Mariani, Chiara Socci, Mauro Mauri
OBJECTIVE: We evaluated the effectiveness of Electroconvulsive Therapy (ECT) in the treatment of Bipolar Disorder (BD) in a large sample of bipolar patients with drug resistant depression, mania, mixed state and catatonic features. METHOD: 522 consecutive patients with DSM-IV-TR BD were evaluated prior to and after the ECT course. Responders and nonresponders were compared in subsamples of depressed and mixed patients. Descriptive analyses were reported for patients with mania and with catatonic features...
April 2017: Current Neuropharmacology
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