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Treatment refractory major depressive disorder

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https://www.readbyqxmd.com/read/29756288/mixed-states-in-bipolar-and-major-depressive-disorders-systematic-review-and-quality-appraisal-of-guidelines
#1
REVIEW
N Verdolini, D Hidalgo-Mazzei, A Murru, I Pacchiarotti, L Samalin, A H Young, E Vieta, A F Carvalho
OBJECTIVE: This systematic review provided a critical synthesis and a comprehensive overview of guidelines on the treatment of mixed states. METHOD: The MEDLINE/PubMed and EMBASE databases were systematically searched from inception to March 21st, 2018. International guidelines covering the treatment of mixed episodes, manic/hypomanic, or depressive episodes with mixed features were considered for inclusion. A methodological quality assessment was conducted with the Appraisal of Guidelines for Research and Evaluation-AGREE II...
May 13, 2018: Acta Psychiatrica Scandinavica
https://www.readbyqxmd.com/read/29751598/informed-consent-decision-making-in-deep-brain-stimulation
#2
REVIEW
Gabriele Mandarelli, Germana Moretti, Massimo Pasquini, Giuseppe Nicolò, Stefano Ferracuti
Deep brain stimulation (DBS) has proved useful for several movement disorders (Parkinson’s disease, essential tremor, dystonia), in which first and/or second line pharmacological treatments were inefficacious. Initial evidence of DBS efficacy exists for refractory obsessive-compulsive disorder, treatment-resistant major depressive disorder, and impulse control disorders. Ethical concerns have been raised about the use of an invasive surgical approach involving the central nervous system in patients with possible impairment in cognitive functioning and decision-making capacity...
May 11, 2018: Brain Sciences
https://www.readbyqxmd.com/read/29685065/noninvasive-brain-stimulation-challenges-and-opportunities-for-a-new-clinical-specialty
#3
Aaron D Boes, Michael S Kelly, Nicholas T Trapp, Adam P Stern, Daniel Z Press, Alvaro Pascual-Leone
Noninvasive brain stimulation refers to a set of technologies and techniques with which to modulate the excitability of the brain via transcranial stimulation. Two major modalities of noninvasive brain stimulation are transcranial magnetic stimulation (TMS) and transcranial current stimulation. Six TMS devices now have approved uses by the U.S. Food and Drug Administration and are used in clinical practice: five for treating medication refractory depression and the sixth for presurgical mapping of motor and speech areas...
April 24, 2018: Journal of Neuropsychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/29676713/-deep-brain-stimulation-for-psychiatric-disorders
#4
M Figee, P R Schuurman, D Denys
- Deep brain stimulation (DBS) corrects pathological activity of neuropsychiatric brain networks with high frequency current via implanted brain electrodes.- DBS is an effective and safe treatment for therapy-refractory obsessive-compulsive disorder and potentially also for therapy-refractory major depressive disorder.- Experimental psychiatric indications for DBS are Tourette syndrome, addiction, anorexia nervosa, post-traumatic stress disorder, autism and schizophrenia.- DBS influences brain networks that are relevant for a variety of psychiatric symptoms...
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29601316/clinical-trial-of-the-potassium-channel-activator-diazoxide-for-major-depressive-disorder-halted-due-to-intolerability
#5
Bashkim Kadriu, Shiwen Yuan, Cristan Farmer, Allison C Nugent, Marc S Lener, Mark J Niciu, Minkyung Park, Aaron Yazdian, Elizabeth D Ballard, Fritz A Henn, Ioline D Henter, Lawrence T Park, Carlos A Zarate
BACKGROUND: Some glutamatergic modulators have demonstrated rapid and relatively sustained antidepressant properties in patients with major depressive disorder. Because the potassium channel activator diazoxide increases glutamate uptake via potassium channel activation, we hypothesized that it might exert antidepressant effects by increasing the removal of glutamate from the synaptic cleft, thereby reducing excessive glutamate transmission. METHODS: This randomized, double-blind, placebo-controlled, crossover, single-site inpatient clinical study was conducted at the National Institute of Mental Health to assess the efficacy and safety of a 3-week course of diazoxide (200-400 mg daily, twice a day) versus a 3-week course of placebo in 6 participants with treatment-refractory major depressive disorder...
March 29, 2018: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29593576/vagus-nerve-as-modulator-of-the-brain-gut-axis-in-psychiatric-and-inflammatory-disorders
#6
REVIEW
Sigrid Breit, Aleksandra Kupferberg, Gerhard Rogler, Gregor Hasler
The vagus nerve represents the main component of the parasympathetic nervous system, which oversees a vast array of crucial bodily functions, including control of mood, immune response, digestion, and heart rate. It establishes one of the connections between the brain and the gastrointestinal tract and sends information about the state of the inner organs to the brain via afferent fibers. In this review article, we discuss various functions of the vagus nerve which make it an attractive target in treating psychiatric and gastrointestinal disorders...
2018: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29574297/gender-differences-in-prevalence-of-psychiatric-disorders-levels-of-alexithymia-and-coping-strategies-in-patients-with-refractory-mesial-temporal-epilepsy-and-comorbid-psychogenic-nonepileptic-seizures
#7
Amanda Cristian Serafim de Barros, Ana Eliza Romano Furlan, Lucia Helena Neves Marques, Gerardo Maria de Araújo Filho
OBJECTIVE: The objective of this study was to investigate the psychological aspects and psychiatric disorders (PDs) in patients dually diagnosed with refractory temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS) with psychogenic nonepileptic seizures (PNES) treated in a tertiary center in order to find any gender differences in psychiatric, clinical, and sociodemographic characteristics. METHOD: Psychiatric assessment was performed through the Diagnostic and Statistical Manual for Psychiatric Disorders - 5th edition (DSM-5)...
March 22, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29545905/s100b-homocysteine-vitamin-b12-folic-acid-and-procalcitonin-serum-levels-in-remitters-to-electroconvulsive-therapy-a-pilot-study
#8
Hannah Maier, Saskia Helm, Sermin Toto, Nicole Moschny, Wolfgang Sperling, Thomas Hillemacher, Kai G Kahl, Ewgeni Jakubovski, Stefan Bleich, Helge Frieling, Alexandra Neyazi
Background: Electroconvulsive therapy (ECT) is one of the most effective treatment options for refractory depressed patients. To date, there are only a few predictors of response. Aim: The aim was to identify predictive biomarkers of remission to ECT on a molecular level. Methods: 11 patients suffering from a major depressive episode-according to the Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)-underwent 10 ECT sessions...
2018: Disease Markers
https://www.readbyqxmd.com/read/29497194/electroconvulsive-therapy-for-medication-refractory-depression-in-a-patient-with-ruptured-intracranial-dermoid-cyst-meningioma-and-neurofibromatosis
#9
Priyanka Thukral-Mahajan, Nilesh Shah, Gurvinder Kalra, Chittaranjan Andrade
Electroconvulsive therapy (ECT) is considered relatively contraindicated in patients with intracranial space-occupying lesions. A 53-year-old male presented with a 5-year history of medication-refractory major depressive disorder. Brain imaging findings suggested the presence of a ruptured dermoid cyst in the transverse sinus and a calcified meningioma in the temporal lobe sulcal space. There was no evidence of mass effect. Neurofibromatosis was the only other clinical condition present. The patient had no clinical neurological deficits...
October 2017: Indian Journal of Psychiatry
https://www.readbyqxmd.com/read/29490377/lithium-treatment-in-children-and-adolescents
#10
Anne Duffy, Paul Grof
INTRODUCTION: There is a resurgence of interest in lithium treatment of bipolar disorders in part related to its unique anti-suicidal and neuroprotective effects. METHODS: This is a narrative review of key studies pertaining to the effectiveness and tolerability of lithium treatment in pediatric populations. RESULTS: Evidence supports that lithium is an effective and generally well-tolerated acute treatment for pediatric mania compared to placebo...
February 28, 2018: Pharmacopsychiatry
https://www.readbyqxmd.com/read/29490210/royal-australian-and-new-zealand-college-of-psychiatrists-clinical-practice-guidelines-for-mood-disorders-major-depression-summary
#11
Gin S Malhi, Tim Outhred, Amber Hamilton, Philip M Boyce, Richard Bryant, Paul B Fitzgerald, Bill Lyndon, Roger Mulder, Greg Murray, Richard J Porter, Ajeet B Singh, Kristina Fritz
In December 2015, the Royal Australian and New Zealand College of Psychiatrists published a comprehensive set of mood disorder clinical practice guidelines for psychiatrists, psychologists and mental health professionals. This guideline summary, directed broadly at primary care physicians, is an abridged version that focuses on major depression. It emphasises the importance of shared decision making, tailoring personalised care to the individual, and delivering care in the context of a therapeutic relationship...
March 5, 2018: Medical Journal of Australia
https://www.readbyqxmd.com/read/29452218/tnf%C3%AE-disrupts-blood-brain-barrier-integrity-to-maintain-prolonged-depressive-like-behavior-in-mice
#12
Yuyan Cheng, Sachi Desse, Ana Martinez, Ryan J Worthen, Richard S Jope, Eleonore Beurel
Recovery from major depressive disorder is difficult, particularly in patients who are refractory to antidepressant treatments. To examine factors that regulate recovery, we developed a prolonged learned helplessness depression model in mice. After the induction of learned helplessness, mice were separated into groups that recovered or did not recover within 4 weeks. Comparisons were made between groups in hippocampal proteins, inflammatory cytokines, and blood brain barrier (BBB) permeability. Compared with mice that recovered and control mice, non-recovered mice displaying prolonged learned helplessness had greater hippocampal activation of glycogen synthase kinase-3 (GSK3), higher levels of tumor necrosis factor-α (TNFα), interleukin-17A, and interleukin-23, increased permeability of the blood brain barrier (BBB), and lower levels of the BBB tight junction proteins occludin, ZO1, and claudin-5...
March 2018: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/29389676/decreased-cognitive-functioning-after-electroconvulsive-therapy-is-related-to-increased-hippocampal-volume-exploring-the-role-of-brain-plasticity
#13
Iris van Oostrom, Philip van Eijndhoven, Elke Butterbrod, Maria H van Beek, Joost Janzing, Rogier Donders, Aart Schene, Indira Tendolkar
OBJECTIVE: Electroconvulsive therapy (ECT) is still the most effective treatment of severe and therapy-refractory major depressive disorder. Cognitive side effects are the major disadvantage of ECT. Cognitive deficits are generally temporary in nature and may be mediated by the hippocampus. Recent studies have shown a temporary increase in hippocampal volume and a temporary decrease in cognitive functioning post-ECT compared with pre-ECT. This study investigates whether these volumetric changes are related to changes in cognitive functioning after ECT...
January 31, 2018: Journal of ECT
https://www.readbyqxmd.com/read/29371415/charting-the-road-forward-in-psychiatric-neurosurgery-proceedings-of-the-2016-american-society-for-stereotactic-and-functional-neurosurgery-workshop-on-neuromodulation-for-psychiatric-disorders
#14
Ausaf A Bari, Charles B Mikell, Aviva Abosch, Sharona Ben-Haim, Robert J Buchanan, Allen W Burton, Stephen Carcieri, G Rees Cosgrove, Pierre-Francois D'Haese, Zafiris Jeffrey Daskalakis, Emad N Eskandar, Jason L Gerrard, Wayne K Goodman, Benjamin David Greenberg, Robert E Gross, Clement Hamani, Zelma H T Kiss, Peter Konrad, Brian H Kopell, Lothar Krinke, Jean-Philippe Langevin, Andres M Lozano, Donald Malone, Helen S Mayberg, Jonathan P Miller, Parag G Patil, DeLea Peichel, Erika A Petersen, Ali R Rezai, R Mark Richardson, Patricio Riva-Posse, Tejas Sankar, Jason M Schwalb, Helen Blair Simpson, Konstantin Slavin, Paul H Stypulkowski, Tor Tosteson, Peter Warnke, Jon T Willie, Kareem A Zaghloul, Joseph S Neimat, Nader Pouratian, Sameer A Sheth
OBJECTIVE: Refractory psychiatric disease is a major cause of morbidity and mortality worldwide, and there is a great need for new treatments. In the last decade, investigators piloted novel deep brain stimulation (DBS)-based therapies for depression and obsessive-compulsive disorder (OCD). Results from recent pivotal trials of these therapies, however, did not demonstrate the degree of efficacy expected from previous smaller trials. To discuss next steps, neurosurgeons, neurologists, psychiatrists and representatives from industry convened a workshop sponsored by the American Society for Stereotactic and Functional Neurosurgery in Chicago, Illinois, in June of 2016...
January 25, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29353887/p11-promoter-methylation-predicts-the-antidepressant-effect-of-electroconvulsive-therapy
#15
Alexandra Neyazi, Wiebke Theilmann, Claudia Brandt, Tomi Rantamäki, Nobuaki Matsui, Mathias Rhein, Johannes Kornhuber, Malek Bajbouj, Wolfgang Sperling, Stefan Bleich, Helge Frieling, Wolfgang Löscher
Although electroconvulsive therapy (ECT) is among the most effective treatment options for pharmacoresistant major depressive disorder (MDD), some patients still remain refractory to standard ECT practise. Thus, there is a need for markers reliably predicting ECT non/response. In our study, we have taken a novel translational approach for discovering potential biomarkers for the prediction of ECT response. Our hypothesis was that the promoter methylation of p11, a multifunctional protein involved in both depressive-like states and antidepressant treatment responses, is differently regulated in ECT responders vs...
January 22, 2018: Translational Psychiatry
https://www.readbyqxmd.com/read/29222646/evidence-for-the-involvement-of-opioid-system-in-the-antidepressant-like-effect-of-ascorbic-acid
#16
Morgana Moretti, Camille M Ribeiro, Vivian B Neis, Luis Eduardo B Bettio, Priscila B Rosa, Ana Lúcia S Rodrigues
Considering the involvement of the opioid system in major depressive disorder (MDD), mainly concerning refractory MDD, and the evidence that ascorbic acid may exert a beneficial effect for the treatment of this disorder, this study investigated the involvement of the opioid system in the antidepressant-like effect of ascorbic acid in the tail suspension test (TST). Treatment of Swiss mice with the non-selective opioid receptor antagonist naloxone (1 mg/kg, i.p.) prevented the reduced immobility time caused by ascorbic acid (1 mg/kg, p...
February 2018: Naunyn-Schmiedeberg's Archives of Pharmacology
https://www.readbyqxmd.com/read/29169124/dorsomedial-frontal-cortical-metabolic-differences-of-comorbid-generalized-anxiety-disorder-in-refractory-major-depression-a-18-f-fdg-pet-brain-imaging-study
#17
Chris Baeken, Guo-Rong Wu, Rudi De Raedt
BACKGROUND: Refractory major depressive disorder (MDD) is a severe mental disorder, chronic and difficult to treat. Although generalized anxiety disorder (GAD) is frequently observed as a comorbid diagnosis, little is known on the comorbid neurobiological substrate. Better insights may improve adequate treatment algorithms. OBJECTIVE: To examine this poorly understood clinical question, we recruited 52 individuals to participate in a [18 F] FDG PET brain imaging study...
February 2018: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29016792/antidepressant-like-actions-of-inhibitors-of-poly-adp-ribose-polymerase-in-rodent-models
#18
Gregory A Ordway, Attila Szebeni, Liza J Hernandez, Jessica D Crawford, Katalin Szebeni, Michelle J Chandley, Katherine C Burgess, Corwin Miller, Erol Bakkalbasi, Russell W Brown
Background: Many patients suffering from depressive disorders are refractory to treatment with currently available antidepressant medications, while many more exhibit only a partial response. These factors drive research to discover new pharmacological approaches to treat depression. Numerous studies demonstrate evidence of inflammation and elevated oxidative stress in major depression. Recently, major depression has been shown to be associated with elevated levels of DNA oxidation in brain cells, accompanied by increased gene expression of the nuclear base excision repair enzyme, poly(ADP-ribose) polymerase-1...
December 1, 2017: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28918253/deep-brain-stimulation-of-the-medial-forebrain-bundle-elevates-striatal-dopamine-concentration-without-affecting-spontaneous-or-reward-induced-phasic-release
#19
Marianne Klanker, Matthijs Feenstra, Ingo Willuhn, Damiaan Denys
Deep brain stimulation (DBS) of the medial forebrain bundle (MFB) induces rapid improvement of depressive symptoms in patients suffering from treatment-refractory major depressive disorder (MDD). It has been hypothesized that activation of the dopamine (DA) system contributes to this effect. To investigate whether DBS in the MFB affects DA release in the striatum, we combined DBS with fast-scan cyclic voltammetry (FSCV) in freely moving rats. Animals were implanted with a stimulating electrode at the border of the MFB and the ventral tegmental area, and a FSCV microelectrode in the ventromedial striatum to monitor extracellular DA during the acute onset of DBS and subsequent continued stimulation...
November 19, 2017: Neuroscience
https://www.readbyqxmd.com/read/28860968/differential-peripheral-proteomic-biosignature-of-fluoxetine-response-in-a-mouse-model-of-anxiety-depression
#20
Indira Mendez-David, Céline Boursier, Valérie Domergue, Romain Colle, Bruno Falissard, Emmanuelle Corruble, Alain M Gardier, Jean-Philippe Guilloux, Denis J David
The incorporation of peripheral biomarkers in the treatment of major depressive disorders (MDD) could improve the efficiency of treatments and increase remission rate. Peripheral blood mononuclear cells (PBMCs) represent an attractive biological substrate allowing the identification of a drug response signature. Using a proteomic approach with high-resolution mass spectrometry, the present study aimed to identify a biosignature of antidepressant response (fluoxetine, a Selective Serotonin Reuptake Inhibitor) in PBMCs in a mouse model of anxiety/depression...
2017: Frontiers in Cellular Neuroscience
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