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Treatment resistant bipolar depression

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https://www.readbyqxmd.com/read/28438472/shared-metabolic-and-immune-inflammatory-oxidative-and-nitrosative-stress-pathways-in-the-metabolic-syndrome-and-mood-disorders
#1
REVIEW
Luiz Gustavo Piccoli de Melo, Sandra Odebrecht Vargas Nunes, George Anderson, Heber Odebrecht Vargas, Décio Sabbattini Barbosa, Piotr Galecki, André F Carvalho, Michael Maes
This review examines the shared immune-inflammatory, oxidative and nitrosative stress (IO&NS) and metabolic pathways underpinning metabolic syndrome (MetS), bipolar disorder (BD) and major depressive disorder (MDD). Shared pathways in both MetS and mood disorders are low grade inflammation, including increased levels of pro-inflammatory cytokines and acute phase proteins, increased lipid peroxidation with formation of malondialdehyde and oxidized low density lipoprotein cholesterol (LDL-c), hypernitrosylation, lowered levels of antioxidants, most importantly zinc and paraoxonase (PON1), increased bacterial translocation (leaky gut), increased atherogenic index of plasma and Castelli risk indices; and reduced levels of high-density lipoprotein (HDL-c) cholesterol...
April 21, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28430672/lamotrigine-uses-in-psychiatric-practice-beyond-bipolar-prophylaxis-a-hope-or-hype
#2
Ahmed Naguy, Najah Al-Enezi
BACKGROUND: Lamotrigine (LAM), an antiepileptic, with panoply of indications and uses in neurology, is FDA approved, in psychiatry, for bipolar prophylaxis. Apart from this indication, trend of its use in psychiatry is on the rise addressing a multitude of disorders. STUDY QUESTION: LAM remains one of only few psychotropic drugs with antiglutamate activity. This might render LAM a potential therapeutic option in treatment-resistant major psychiatric disorders. We reviewed LAM pharmacology and its diverse indications while examining the extant evidence...
April 19, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28417559/asenapine-modulates-mood-related-behaviors-and-5-ht1a-7-receptors-mediated-neurotransmission
#3
Sarah Delcourte, Erika Abrial, Adeline Etiévant, Renaud Rovera, Jørn Arnt, Michael Didriksen, Nasser Haddjeri
AIM: Asenapine is a new atypical antipsychotic prescribed for the treatment of psychosis/bipolar disorders that presents higher affinity for serotonergic than dopaminergic receptors. The objective of this study was to investigate its antidepressant-like and antimanic-like properties on relevant animal models of depression and mania and to assess the acute and chronic effect of Asenapine on dorsal raphe nucleus (DRN) 5-HT cell firing activity. METHODS: We assessed the effects of Asenapine using in vivo electrophysiological and behavioral assays in rats...
April 17, 2017: CNS Neuroscience & Therapeutics
https://www.readbyqxmd.com/read/28403623/lithium-a-classic-drug-frequently-discussed-but-sadly-seldom-prescribed
#4
Olga Zivanovic
OBJECTIVE: Distinguished authors in the field have repeatedly alerted psychiatrists of the alarming trends in the treatment of bipolar disorders: decline of lithium use, paralleled by the increase of prescribing anticonvulsants and second-generation antipsychotic drugs. Research has been conducted in order to explore the factors that led to this development and to provide arguments for the need to reverse this trend. METHOD: This paper represents a narrative review of the literature containing retrieved research articles focusing on the efficacy of lithium...
April 1, 2017: Australian and New Zealand Journal of Psychiatry
https://www.readbyqxmd.com/read/28395208/increased-dopamine-receptor-expression-and-anti-depressant-response-following-deep-brain-stimulation-of-the-medial-forebrain-bundle
#5
Manoj P Dandekar, Dustin Luse, Carson Hoffmann, Patrick Cotton, Travis Peery, Christian Ruiz, Caroline Hussey, Vijayasree V Giridharan, Jair C Soares, Joao Quevedo, Albert J Fenoy
BACKGROUND: Among several potential neuroanatomical targets pursued for deep brain stimulation (DBS) for treating those with treatment-resistant depression (TRD), the superolateral-branch of the medial forebrain bundle (MFB) is emerging as a privileged location. We investigated the antidepressant-like phenotypic and chemical changes associated with reward-processing dopaminergic systems in rat brains after MFB-DBS. METHODS: Male Wistar rats were divided into three groups: sham-operated, DBS-Off, and DBS-On...
April 5, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28385173/novel-augmentation-strategies-in-major-depression
#6
Klaus Martiny
Hypothesis The hypotheses of all the four included studies share the common idea that it is possible to augment the effect of antidepressant drug treatment by applying different interventions and with each intervention attain a clinically meaningful better effect compared to a control condition, and with minor side effects, thus improving the short- and medium-term outcome in major depression. Procedures Study design The basic study design has been the double blind randomised controlled trial (RCT). In the light therapy study, all patients were treated with sertraline for the whole of the study duration...
April 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28373848/the-current-status-of-the-ketogenic-diet-in-psychiatry
#7
REVIEW
Emmanuelle C S Bostock, Kenneth C Kirkby, Bruce V M Taylor
BACKGROUND: The ketogenic diet (KD) has been used in treatment-resistant epilepsy since the 1920s. It has been researched in a variety of neurological conditions in both animal models and human trials. The aim of this review is to clarify the potential role of KD in psychiatry. METHODS: Narrative review of electronic databases PubMED, PsychINFO, and Scopus. RESULTS: The search yielded 15 studies that related the use of KD in mental disorders including anxiety, depression, bipolar disorder, schizophrenia, autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD)...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28359201/a-5-year-observational-study-of-patients-with-treatment-resistant-depression-treated-with-vagus-nerve-stimulation-or-treatment-as-usual-comparison-of-response-remission-and-suicidality
#8
Scott T Aaronson, Peter Sears, Francis Ruvuna, Mark Bunker, Charles R Conway, Darin D Dougherty, Frederick W Reimherr, Thomas L Schwartz, John M Zajecka
OBJECTIVE: The Treatment-Resistant Depression Registry investigated whether adjunctive vagus nerve stimulation (VNS) with treatment as usual in depression has superior long-term outcomes compared with treatment as usual only. METHOD: This 5-year, prospective, open-label, nonrandomized, observational registry study was conducted at 61 U.S. sites and included 795 patients who were experiencing a major depressive episode (unipolar or bipolar depression) of at least 2 years' duration or had three or more depressive episodes (including the current episode), and who had failed four or more depression treatments (including ECT)...
March 31, 2017: American Journal of Psychiatry
https://www.readbyqxmd.com/read/28291034/repetitive-transcranial-magnetic-stimulation-5-and-10%C3%A2-hz-with-modified-parameters-in-the-treatment-of-resistant-unipolar-and-bipolar-depression-in-a-private-practice-setting
#9
Fady Rachid, Clotilde Moeglin, Othman Sentissi
BACKGROUND: A limited number of studies have investigated the safety and efficacy of repetitive transcranial magnetic stimulation (rTMS) in the treatment of resistant depression in an outpatient private practice setting. We hypothesized that rTMS would be safe and effective in the treatment of resistant depression in a nonresearch population. METHODS: We treated 22 outpatients with unipolar or bipolar depression who were experiencing a moderate to severe treatment-resistant major depressive episode (MDE)...
March 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/28271731/ketamine-augmentation-rapidly-improves-depression-scores-in-inpatients-with-treatment-resistant-bipolar-depression
#10
Janusz K Rybakowski, Agnieszka Permoda-Osip, Alicja Bartkowska-Sniatkowska
OBJECTIVE: To study the clinical effect of a single ketamine infusion, 0.5 mg/kg body weight, in bipolar depressive patients receiving mood-stabilising drugs, not improving on antidepressants. Previously, in such patients, we had found a correlation between clinical efficacy, serum brain-derived neurotrophic factor and vitamin B12 levels and a rapid improvement in neurocognitive performance. METHODS: The study included 53 patients (13 men, 40 women), aged 22-81 years, receiving ≥1 mood-stabilising medications of the first and/or second generation...
March 8, 2017: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/28270633/-magnetic-stimulation-therapy-for-mood-disorder
#11
Shinsuke Kito
In Japan, approximately one million patients currently receive medical treatment for mood disorders. However, there are only a few available treatments for patients with treatment-resistant depression or bipolar depression. Repetitive transcranial magnetic stimulation (rTMS), a neuromodulation technique, has proven to be effective for treatment-resistant depression, and also has a potential therapeutic efficacy in patients with bipolar depression who do not respond to medication. Magnetic seizure therapy (MST) is an experimental technique for introducing a seizure by using rTMS, which demonstrates a therapeutic efficacy similar to that of electroconvulsive therapy (ECT), but with fewer cognitive side effects...
March 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28184334/mixed-states-in-bipolar-disorder-etiology-pathogenesis-and-treatment
#12
REVIEW
Ather Muneer
Many bipolar disorder patients exhibit mixed affective states, which portend a generally more severe illness course and treatment resistance. In the previous renditions of Diagnostic and Statistical Manual mixed states were narrowly defined in the context of bipolar I disorder, but with the advent of DSM-5 the term "mixed episode" was dropped and replaced by "mixed features" specifier which could be broadly applied to manic, hypomanic and depressive episodes in both the bipolar spectrum and major depressive disorders...
January 2017: Chonnam Medical Journal
https://www.readbyqxmd.com/read/28145409/treatment-of-bipolar-depression-with-deep-tms-dtms-results-from-a-double-blind-randomized-parallel-group-sham-controlled-clinical-trial
#13
Diego F Tavares, Martin L Myczkowski, Rodrigo L Alberto, Leandro Valiengo, Rosa M Rios, Pedro Gordon, Bernardo de Sampaio-Junior, Izio Klein, Carlos G Mansur, Marco Antonio Marcolin, Beny Lafer, Ricardo A Moreno, Wagner Gattaz, Jeff Z Daskalakis, André R Brunoni
Bipolar depression (BD) is a highly prevalent condition with limited therapeutic options. Deep (H1-coil) transcranial magnetic stimulation (dTMS) is a novel TMS modality with established efficacy for unipolar depression. We conducted a randomized sham-controlled trial to evaluate the efficacy and safety of dTMS in treatment-resistant BD patients. Patients received 20 sessions of active or sham dTMS over the left dorsolateral prefrontal cortex (H1-coil, 55 18 Hz 2-sec 120% MT trains). The primary outcome was changes in the 17-item Hamilton Depression Rating Scale (HDRS-17) from baseline to endpoint (week 4)...
February 1, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28144880/use-of-stimulants-in-bipolar-disorder
#14
REVIEW
Giulio Perugi, Giulia Vannucchi, Fulvio Bedani, Ettore Favaretto
Several international guidelines indicate stimulants, including methylphenidate (MPH), amphetamines and derivatives, modafinil, and armodafinil among the second-third-line choices for bipolar depression. Efficacy of stimulants has been also reported for the management of residual depressive symptoms such as fatigue and sleepiness and for the management of affective, cognitive, and behavioral symptoms in children and adult bipolar patients with comorbid ADHD. Few case reports show positive results with MPH in the treatment of resistant mania...
January 2017: Current Psychiatry Reports
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
#15
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...
February 2017: Bipolar Disorders
https://www.readbyqxmd.com/read/28097909/administration-of-ketamine-for-unipolar-and-bipolar-depression
#16
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%...
March 2017: International Journal of Psychiatry in Clinical Practice
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
#17
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/27976600/clinical-improvements-following-bilateral-anterior-capsulotomy-in-treatment-resistant-depression
#18
L Subramanian, T Bracht, P Jenkins, S Choppin, D E J Linden, G Phillips, B A Simpson
BACKGROUND: The purpose of this study was to evaluate a programme of lesion surgery carried out on patients with treatment-resistant depression (TRD). METHOD: This was a retrospective study looking at clinical and psychometric data from 45 patients with TRD who had undergone bilateral stereotactic anterior capsulotomy surgery over a period of 15 years, with the approval of the Mental Health Act Commission (37 with unipolar depression and eight with bipolar disorder)...
December 15, 2016: Psychological Medicine
https://www.readbyqxmd.com/read/27871720/-guidelines-for-the-prescription-of-mood-stabilizers-for-adolescents-a-literature-review
#19
G Munch, N Godart
INTRODUCTION: Adolescence is a unique phase of the human developmental process. In adolescents, psychotropic medications may have different efficacy and tolerance profiles compared to those at other stages of the lifespan. Mood stabilizers are a complex pharmacological category including lithium, some anticonvulsants, and some second generation antipsychotics. Focusing on this class of pharmacological agents, we aim to answer the following questions: in which indications and according to which modalities should mood stabilizers be prescribed during adolescence? METHODS: Information was sought from the websites of the French Haute Autorité de santé (HAS) and Agence nationale de sécurité du médicament et des produits de santé (ANSM), the American Food and Drug Administration (FDA) and the British National Institute for Health and Clinical Excellence (NICE)...
November 18, 2016: L'Encéphale
https://www.readbyqxmd.com/read/27848034/vagus-nerve-stimulation-in-psychiatry-a-systematic-review-of-the-available-evidence
#20
REVIEW
Camelia-Lucia Cimpianu, Wolfgang Strube, Peter Falkai, Ulrich Palm, Alkomiet Hasan
Invasive and non-invasive vagus nerve stimulation (VNS) is a promising add-on treatment for treatment-refractory depression, but is also increasingly evaluated for its application in other psychiatric disorders, such as dementia, schizophrenia, somatoform disorder, and others. We performed a systematic review aiming to give a detailed overview of the available evidence of the efficacy of VNS for the treatment of psychiatric disorders. Data derived from animal models, experimental trials without health-related outcomes, case reports, single-session studies, and reviews were excluded...
January 2017: Journal of Neural Transmission
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