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Treatment refractory major depressive disorder

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https://www.readbyqxmd.com/read/27887679/-mindfulness-based-interventions-in-obsessive-compulsive-disorder-mechanisms-of-action-and-presentation-of-a-pilot-study
#1
M Gasnier, A Pelissolo, G Bondolfi, S Pelissolo, M Tomba, L Mallet, K N'diaye
Obsessive-compulsive disorder (OCD) is a frequent and severe disease, potentially inducing a major impairment for the patient and burden for their family. Recent research in psychiatry and neuroscience have led to better comprehension of the disease's mechanisms and helped to improve its treatment. However, a large proportion of patients have refractory symptoms, including for traditional cognitive and behavioral therapy by exposure and response prevention (ERP), leading clinicians to look for new treatments...
November 22, 2016: L'Encéphale
https://www.readbyqxmd.com/read/27848034/vagus-nerve-stimulation-in-psychiatry-a-systematic-review-of-the-available-evidence
#2
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...
November 16, 2016: Journal of Neural Transmission
https://www.readbyqxmd.com/read/27672487/a-case-of-treatment-resistant-depression-and-body-dysmorphic-disorder-the-role-of-electroconvulsive-therapy-revisited
#3
Ram S Mahato, Maria Chona P San Gabriel, Carrol T Longshore, David B Schnur
Body dysmorphic disorder is a common, often disabling condition, and is frequently comorbid with major depressive disorder. Selective serotonin reuptake inhibitors constitute first line set of somatic interventions but the management of refractory patients remains challenging. Electroconvulsive therapy, an often highly beneficial treatment for medication resistant-depression, is not considered an effective therapeutic alternative for treatment refractory body dysmorphic disorder. Here we present a 50-year-old woman with body dysmorphic disorder and comorbid major depressive disorder who remained incapacitated and suicidal despite several trials with selective serotonin reuptake inhibitors and antipsychotic medication...
July 2016: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/27648916/metabolomic-signatures-of-drug-response-phenotypes-for-ketamine-and-esketamine-in-subjects-with-refractory-major-depressive-disorder-new-mechanistic-insights-for-rapid-acting-antidepressants
#4
D M Rotroff, D G Corum, A Motsinger-Reif, O Fiehn, N Bottrel, W C Drevets, J Singh, G Salvadore, R Kaddurah-Daouk
Ketamine, at sub-anesthetic doses, is reported to rapidly decrease depression symptoms in patients with treatment-resistant major depressive disorder (MDD). Many patients do not respond to currently available antidepressants, (for example, serotonin reuptake inhibitors), making ketamine and its enantiomer, esketamine, potentially attractive options for treatment-resistant MDD. Although mechanisms by which ketamine/esketamine may produce antidepressant effects have been hypothesized on the basis of preclinical data, the neurobiological correlates of the rapid therapeutic response observed in patients receiving treatment have not been established...
September 20, 2016: Translational Psychiatry
https://www.readbyqxmd.com/read/27570392/does-antiepileptic-drug-withdrawal-predispose-patients-undergoing-temporal-lobe-epilepsy-surgery-to-late-onset-of-psychiatric-morbidity-a-report-of-three-cases
#5
Garima Shukla, Priya Agarwal, Rajesh Sagar, Mamta Sood, Aditya Gupta, Ashish Suri, Ajay Garg
Surgery is an established and increasingly utilized treatment option in medically refractory temporal lobe epilepsy. Many psychiatric problems are known to complicate in the postoperative period. Most studies have a follow-up period of less than 24 months. We report the cases of three patients who developed severe psychiatric problems in the late postoperative period after successful temporal lobectomy for refractory epilepsy - Psychosis, major depression with psychosis, and severe anxiety disorder, respectively...
July 2016: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/27523499/neurometabolic-disorders-potentially-treatable-abnormalities-in-patients-with-treatment-refractory-depression-and-suicidal-behavior
#6
Lisa A Pan, Petra Martin, Thomas Zimmer, Anna Maria Segreti, Sivan Kassiff, Brian W McKain, Cynthia A Baca, Manivel Rengasamy, Keith Hyland, Nicolette Walano, Robert Steinfeld, Marion Hughes, Steven K Dobrowolski, Michele Pasquino, Rasim Diler, James Perel, David N Finegold, David G Peters, Robert K Naviaux, David A Brent, Jerry Vockley
OBJECTIVE: Treatment-refractory depression is a devastating condition with significant morbidity, mortality, and societal cost. At least 15% of cases of major depressive disorder remain refractory to treatment. The authors previously identified a young adult with treatment-refractory depression and multiple suicide attempts with an associated severe deficiency of CSF tetrahydrobiopterin, a critical cofactor for monoamine neurotransmitter synthesis. Treatment with sapropterin, a tetrahydrobiopterin analogue, led to dramatic and long-lasting remission of depression...
August 13, 2016: American Journal of Psychiatry
https://www.readbyqxmd.com/read/27489070/new-use-for-an-old-drug-oral-ketamine-for-treatment-resistant-depression
#7
Kevin M Swiatek, Kim Jordan, Julie Coffman
Treatment-resistant depression (TRD) is a disabling disorder that can interfere with a patient's capacity to understand and participate in medical care and thus negatively impact individual morbidity and mortality. Hospitalised patients with TRD may require rapid alleviation of severe symptomatology, particularly when suicidal or if unable to participate in care decisions. Ketamine is well known for its anaesthetic effects and its use as a 'street' drug; however, its action as an N-methyl-D-aspartate receptor antagonist makes ketamine a potential therapy for TRD...
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27274384/pharmacotherapy-of-acute-bipolar-depression-in-adults-an-evidence-based-approach
#8
REVIEW
Ather Muneer
In the majority of cases of bipolar disorder, manic episodes are usually brief and typically responsive to currently available psychopharmacological agents. In contrast, depressive manifestations are more prevalent and persistent, and can present as major depressive/mixed episodes or residual interepisode symptoms. The depressive phase is often associated with other neuropsychiatric conditions, such as anxiety spectrum disorders, substance use disorders, stressor-related disorders, and eating disorders. It is viewed as a systemic disease with associated ailments such as metabolic syndrome, diabetes mellitus, and cardiovascular disease...
May 2016: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/27268576/the-medial-forebrain-bundle-as-a-target-for-deep-brain-stimulation-for-obsessive-compulsive-disorder
#9
Volker A Coenen, Thomas E Schlaepfer, Peter Goll, Peter C Reinacher, Ulrich Voderholzer, Ludger Tebartz van Elst, Horst Urbach, Tobias Freyer
Deep brain stimulation (DBS) is a promising putative modality for the treatment of refractory psychiatric disorders such as major depression and obsessive-compulsive disorder (OCD). Several targets have been posited; however, a clear consensus on differential efficacy and possible modes of action remain unclear. DBS to the supero-lateral branch of the medial forebrain bundle (slMFB) has recently been introduced for major depression (MD). Due to our experience with slMFB stimulation for MD, and because OCD might be related to similar dysfunctions of the reward system, treatment with slMFB DBS seams meaningful...
June 8, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27215046/deep-transcranial-magnetic-stimulation-a-promising-drug-free-treatment-modality-in-the-treatment-of-chronic-low-back-pain
#10
Erin Yates, Ganesh Balu
UNLABELLED: Deep Transcranial Magnetic Stimulation (dTMS) is the next generation of technology used to treat Major Depressive Disorder (MDD). dTMS has been proven to be a safe and effective treatment modality for MDD and may have secondary benefits in patients with chronic low back pain by reducing pain related morbidity. We are presenting two case studies with MDD and chronic low back pain to demonstrate the effectiveness of both the antidepressant and analgesic effects of dTMS. BACKGROUND: Transcranial Magnetic Stimulation (rTMS) utilizes MRI-strength magnetic pulses outside the cranium to stimulate the brain to a depth of approximately 1 cm...
March 2016: Delaware Medical Journal
https://www.readbyqxmd.com/read/27190727/the-treatment-of-adult-bipolar-disorder-with-aripiprazole-a-systematic-review
#11
REVIEW
Ather Muneer
Bipolar disorder is characterized by exacerbations of opposite mood polarity, ranging from manic to major depressive episodes. In the current nosological system of the Diagnostic and Statistical Manual - 5(th) edition (DSM-5), it is conceptualized as a spectrum disorder consisting of bipolar disorder type I, bipolar disorder type II, cyclothymic disorder, and bipolar disorder not otherwise specified. Treatment of all phases of this disorder is primarily with mood stabilizers, but many patients either show resistance to the conventional mood stabilizing medications or are intolerant to their side-effects...
2016: Curēus
https://www.readbyqxmd.com/read/27103550/a-systematic-review-of-psychiatric-indications-for-deep-brain-stimulation-with-focus-on-major-depressive-and-obsessive-compulsive-disorder
#12
Matilda Naesström, Patric Blomstedt, Owe Bodlund
BACKGROUND: Deep brain stimulation is a treatment under investigation for a range of psychiatric disorders. It has shown promising results for therapy-refractory obsessive-compulsive disorder (OCD) and major depressive disorder (MDD). Other indications under investigation include Tourette's syndrome, anorexia nervosa and substance use disorders. AIMS: To review current studies on psychiatric indications for deep brain stimulation (DBS), with focus on OCD and MDD...
October 2016: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/27080073/use-of-human-mesenchymal-stem-cell-treatment-to-prevent-anhedonia-in-a-rat-model-of-traumatic-brain-injury
#13
Ali Darkazalli, Abdol Aziz Ould Ismail, Nastaren Abad, Samuel C Grant, Cathy W Levenson
PURPOSE: Major depression and related mood disorders are the most common long-term outcomes associated with traumatic brain injury (TBI). Given the potentially debilitating consequences of depression, and the fact that TBI patients are frequently refractory to antidepressant drugs, new therapies are clearly needed. We hypothesized that human bone marrow-derived mesenchymal stem cells (hMSC), delivered intravenously, can effectively treat TBI-induced depression and other behavioral deficits associated with TBI...
April 11, 2016: Restorative Neurology and Neuroscience
https://www.readbyqxmd.com/read/27068282/the-basis-for-folinic-acid-treatment-in-neuro-psychiatric-disorders
#14
REVIEW
V T Ramaekers, J M Sequeira, E V Quadros
Multiple factors such as genetic and extraneous causes (drugs, toxins, adverse psychological events) contribute to neuro-psychiatric conditions. In a subgroup of these disorders, systemic folate deficiency has been associated with macrocytic anemia and neuropsychiatric phenotypes. In some of these, despite normal systemic levels, folate transport to the brain is impaired in the so-called cerebral folate deficiency (CFD) syndromes presenting as developmental and psychiatric disorders. These include infantile-onset CFD syndrome, infantile autism with or without neurologic deficits, a spastic-ataxic syndrome and intractable epilepsy in young children expanding to refractory schizophrenia in adolescents, and finally treatment-resistant major depression in adults...
July 2016: Biochimie
https://www.readbyqxmd.com/read/26995239/comparative-analysis-of-affective-temperament-in-patients-with-difficult-to-treat-and-easy-to-treat-major-depression-and-bipolar-disorder-possible-application-in-clinical-settings
#15
Minoru Takeshima, Takashi Oka
BACKGROUND: Difficult-to-treat major depressive disorder (MDD-DT), which involves antidepressant refractoriness or antidepressant-related adverse psychiatric effects, is bipolar in nature; therefore, it may share common temperamental features with bipolar disorder. To examine this hypothesis, affective temperament was compared between MDD-DT, easy-to-treat major depressive disorder (MDD-ET), and bipolar disorder. METHODS: Affective temperament was measured in 320 patients (69, 56, and 195 with MDD-ET, MDD-DT, and bipolar disorder, respectively) using the self-rated questionnaire version of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego (TEMPS-A), with between-group differences examined using multiple logistic regression analysis controlling for confounders...
April 2016: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/26917855/maois-does-the-evidence-warrant-their-resurrection
#16
David Menkes, Peter Bosanac, David Castle
OBJECTIVE: The place of monoamine oxidase inhibitors (MAOIs) in psychiatry is reviewed, and the question posed as to whether they are now justifiably disregarded by prescribers. METHOD: Multiple databases (PubMed, Medline, Embase, Cochrane) were interrogated to provide an overview regarding the use, efficacy and toxicity of MAOIs. Data regarding funded use of these agents in New Zealand were obtained from PHARMAC. RESULTS: Evidence supports the use of MAOIs in major depressive disorder, certain anxiety disorders and, to lesser extent, bipolar depression...
August 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/26867988/single-dose-infusion-ketamine-and-non-ketamine-n-methyl-d-aspartate-receptor-antagonists-for-unipolar-and-bipolar-depression-a-meta-analysis-of-efficacy-safety-and-time-trajectories
#17
T Kishimoto, J M Chawla, K Hagi, C A Zarate, J M Kane, M Bauer, C U Correll
BACKGROUND: Ketamine and non-ketamine N-methyl-d-aspartate receptor antagonists (NMDAR antagonists) recently demonstrated antidepressant efficacy for the treatment of refractory depression, but effect sizes, trajectories and possible class effects are unclear. METHOD: We searched PubMed/PsycINFO/Web of Science/clinicaltrials.gov until 25 August 2015. Parallel-group or cross-over randomized controlled trials (RCTs) comparing single intravenous infusion of ketamine or a non-ketamine NMDAR antagonist v...
May 2016: Psychological Medicine
https://www.readbyqxmd.com/read/26860589/detection-and-treatment-of-omega-3-fatty-acid-deficiency-in-psychiatric-practice-rationale-and-implementation
#18
Erik Messamore, Robert K McNamara
A body of translational evidence has implicated dietary deficiency in long-chain omega-3 (LCn-3) fatty acids, including eicosapenaenoic acid (EPA) and docosahexaenoic acid (DHA), in the pathophysiology and potentially etiology of different psychiatric disorders. Case-control studies have consistently observed low erythrocyte (red blood cell) EPA and/or DHA levels in patients with major depressive disorder, bipolar disorder, schizophrenia, and attention deficit hyperactivity disorder. Low erythrocyte EPA + DHA biostatus can be treated with fish oil-based formulations containing preformed EPA + DHA, and extant evidence suggests that fish oil supplementation is safe and well-tolerated and may have therapeutic benefits...
2016: Lipids in Health and Disease
https://www.readbyqxmd.com/read/26837935/critical-appraisal-of-selegiline-transdermal-system-for-major-depressive-disorder
#19
REVIEW
Mario A Cristancho, Michael E Thase
INTRODUCTION: Although safer and easier to use antidepressants (ie.,SSRIs/SNRIs) have largely displaced MAOIs, these medications still have a role in difficult to treat conditions. Efforts to improve MAOIs benefit-risk profile resulted on the reversible MAOI and in the first antidepressant patch (selegiline transdermal delivery system-STS). The later had been available in the US since 2006. Thus a review on its safety profile and comparative efficacy is timely. AREAS COVERED: This review provides an overview of STS's clinical pharmacology and summarizes what has been learned across nearly a decade of experience...
2016: Expert Opinion on Drug Delivery
https://www.readbyqxmd.com/read/26827636/influence-of-interactions-between-genes-and-childhood-trauma-on-refractoriness-in-psychiatric-disorders
#20
Ji Sun Kim, Seung-Hwan Lee
Psychiatric disorders are excellent disease models in which gene-environmental interaction play a significant role in the pathogenesis. Childhood trauma has been known as a significant environmental factor in the progress of, and prognosis for psychiatric illness. Patients with refractory illness usually have more severe symptoms, greater disability, lower quality of life and are at greater risk of suicide than other psychiatric patients. Our literature review uncovered some important clinical factors which modulate response to treatment in psychiatric patients who have experienced childhood trauma...
October 3, 2016: Progress in Neuro-psychopharmacology & Biological Psychiatry
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