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Treatment resistant bipolar depression

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https://www.readbyqxmd.com/read/29093685/bipolar-spectrum-disorders-in-male-youth-the-interplay-between-symptom-severity-inflammation-steroid-secretion-and-body-composition
#1
REVIEW
Andreas Walther, Marlene Penz, Daniela Ijacic, Timothy R Rice
The morbidity and societal burden of youth bipolar spectrum disorders (BSD) are high. These disorders are multisystemic in that adult populations there are clear interactions with inflammatory processes and steroidal physiological systems. There are much less data concerning these areas of study in youth populations with BSD. This is surprising given the association of youth-onset BSD with puberty and its associated physiological changes. In this mini-review, we overview the theoretical role of inflammatory processes and steroidal physiological systems in youth BSD, describe the greater literature in adult populations, detail the literature in youth populations when available, and overview current proposed molecular mechanistic pathways and interaction effects based on the available data...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29042527/-biomarkers-for-mood-disorders-and-a-novel-antidepressant-r-ketamine
#2
Kenji Hashimoto
Depression is often misdiagnosed as major depressive disorder in patients with bipolar disorder. Therapeutic drugs for these two disorders are quite different, but the anesthetic ketamine shows fast-acting antidepressant effects in treatment-resistant patients with these disorders. Here, we discuss biomarkers for both disorders, recent findings regarding ketamine, and predictable biomarkers for ketamine's antidepressant actions.
October 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/29033643/dandy-walker-malformation-presenting-with-affective-symptoms
#3
Mert Batmaz, Zeynep Ezgi Balçik, Ürün Özer, Burcu Hamurişçi Yalçin, Şakir Özen
Dandy-Walker malformation is defined by enlarged posterior fossa, cystic dilatation of the fourth ventricle, and cerebellar hypoplasia. Although developmental delay and mental retardation are common in Dandy-Walker malformation cases, other comorbid psychiatric conditions have been rarely reported. There are limited numbers of case reports about comorbidity of bipolar disorder with Dandy-Walker malformation in the literature. Herein, a Dandy-Walker malformation case presenting affective symptoms is reported, and psychiatric symptoms which might be seen in this rare malformation are discussed along with diagnosis, treatment, and follow-up processes...
September 2017: Noro Psikiyatri Arsivi
https://www.readbyqxmd.com/read/29033629/electroconvulsive-therapy-in-the-treatment-of-mood-disorders-one-year-follow-up
#4
Sibel Çakir, Nuran Çağlar
INTRODUCTION: Electroconvulsive therapy (ECT) is known to be an effective option in the treatment of mood disorders, especially resistant depression. However, the remission achieved by ECT was reported to be not long lasting enough. The aim of the present study was to investigate the relapse/recurrence rates and associated risk factors during the first year after ECT in patients diagnosed with mood disorders. METHODS: In a naturalistic observation, patients diagnosed with unipolar depressive disorder or a depressive episode of bipolar disorder and who had achieved remission by ECT were followed up for at least one year...
September 2017: Noro Psikiyatri Arsivi
https://www.readbyqxmd.com/read/29030111/double-blind-proof-of-concept-poc-trial-of-low-field-magnetic-stimulation-lfms-augmentation-of-antidepressant-therapy-in-treatment-resistant-depression-trd
#5
Maurizio Fava, Marlene P Freeman, Martina Flynn, Bettina B Hoeppner, Richard Shelton, Dan V Iosifescu, James W Murrough, David Mischoulon, Cristina Cusin, Mark Rapaport, Boadie W Dunlop, Madhukar H Trivedi, Manish Jha, Gerard Sanacora, Gretchen Hermes, George I Papakostas
BACKGROUND: Low-Field Magnetic Stimulation (LFMS) is a novel, non-invasive, sub-threshold neuromodulation technique, shown in preliminary studies to have immediate mood elevating effects in both unipolar and bipolar depressed patients. OBJECTIVE: We aimed to assess the antidepressant augmentation effects at 48 h of LFMS administered on two consecutive days compared to sham treatment in treatment resistant depression (TRD) subjects, using the Sequential Parallel Comparison Design (SPCD)...
September 23, 2017: Brain Stimulation
https://www.readbyqxmd.com/read/28991067/a-6-month-follow-up-case-study-of-low-frequency-right-prefrontal-repetitive-transcranial-magnetic-stimulation-in-treatment-resistant-bipolar-depression
#6
Shinsuke Kito, Yuki Matsuda, Yurie Sewaki, Junpei Sekiya, Takeshi Fujii, Takamasa Noda, Satoru Ikezawa, Harumasa Takano, Kanako Nakazawa, Mami Nomura, Shiori Setoyama, Kazuyuki Nakagome
No abstract text is available yet for this article.
October 3, 2017: Journal of ECT
https://www.readbyqxmd.com/read/28953812/study-on-lithium-monitoring-amongst-patients-in-a-community-mental-health-and-primary-care-setting-in-rural-england
#7
Nicholas Savage, Jessica Green, Madhavan Seshadri, Madhusudan Deepak Thalitaya
BACKGROUND: Lithium is widely used as a mood stabilizer in managing Bipolar Disorder. It is also licensed as an augmenting agent for recurrent depression and treatment resistant depression. However, it has a narrow therapeutic index with potentially significant side effects and adverse drug interactions. Toxicity is one of the main concerns for prescribers and serum levels should be checked regularly. Also, due to the adverse effects on Kidneys and Thyroid, there are strict guidelines to monitor the kidney as well as thyroid functions periodically...
September 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/28951141/maintenance-repetitive-transcranial-magnetic-stimulation-rtms-for-relapse-prevention-in-with-depression-a-review
#8
REVIEW
Fady Rachid
Major depressive disorder is a highly prevalent condition with significant morbidity and mortality. Recurrent episodes occur in greater than 50% of patients within a one year period despite treatment with antidepressant medications, electroconvulsive therapy and psychotherapy. Longer antidepressant treatment may prevent relapses and recurrences. Urgent therapeutic alternatives are needed such as maintenance repetitive transcranial magnetic stimulation. The purpose of this review is to describe and discuss studies that have evaluated the safety and efficacy of this technique in the long-term treatment and relapse prevention of depression...
September 19, 2017: Psychiatry Research
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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...
September 2017: Bipolar Disorders
https://www.readbyqxmd.com/read/28792656/amygdala-and-regional-volumes-in-treatment-resistant-versus-nontreatment-resistant-depression-patients
#18
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
#19
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
#20
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
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