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Treatment-resistant Depression

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https://www.readbyqxmd.com/read/28228087/beyond-ketamine-new-approaches-to-the-development-of-safer-antidepressants
#1
Shigeyuki Chaki
Ketamine has been reported to exert rapid and sustained antidepressant effects in patients with depression, including patients with treatment-resistant depression. However, ketamine has several drawbacks such as psychotomimetic/dissociative symptoms, abuse potential and neurotoxicity, all of which prevent its routine use in daily clinical practice. Therefore, development of novel agents with fewer safety and usage concerns for the treatment of depression has been actively investigated. From this standpoint, searching for active substances (stereoisomers and metabolites) and agents acting on the N-methyl-D-aspartate (NMDA) receptor have recently gained much attention...
February 20, 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28225086/uvrag-deficiency-exacerbates-doxorubicin-induced-cardiotoxicity
#2
Lin An, Xiao-Wen Hu, Shasha Zhang, Xiaowen Hu, Zongpei Song, Amber Naz, Zhenguo Zi, Jian Wu, Can Li, Yunzeng Zou, Lin He, Hongxin Zhu
Doxorubicin (DOX) is an effective chemotherapeutic drug in the treatment of various types of cancers. However, its clinical application has been largely limited by potential development of cardiotoxicity. Previously we have shown that ultra-violet radiation resistance-associated gene (UVRAG), an autophagy-related protein, is essential for the maintenance of autophagic flux in the heart under physiological conditions. Here, we sought to determine the role of UVRAG-mediated autophagy in DOX-induced cardiotoxicity...
February 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28222822/electroconvulsive-therapy-with-s-ketamine-anesthesia-for-catatonia-in-coexisting-depression-and-dementia
#3
Zsuzsa Litvan, Martin Bauer, Siegfried Kasper, Richard Frey
Information on efficacy and safety of electroconvulsive therapy in patients with dementia is sparse. The current case report describes a patient suffering from severe depression and dementia who received electroconvulsive therapy with S-ketamine anesthesia at our psychiatric intensive care unit for the treatment of her therapy-resistant catatonic stupor. The patient's condition improved remarkably through the treatment. By the end of 16 electroconvulsive therapy sessions, her catatonic symptoms remitted entirely, her affect was brighter and she performed markedly better at the cognitive testing...
February 22, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28218214/antidepressant-effects-of-electroconvulsive-therapy-unrelated-to-the-brain-s-functional-network-connectivity-alterations-at-an-individual-level
#4
Guang-Dong Chen, Feng Ji, Gong-Ying Li, Bo-Xuan Lyu, Wei Hu, Chuan-Jun Zhuo
BACKGROUND: Electroconvulsive therapy (ECT) can alleviate the symptoms of treatment-resistant depression (TRD). Functional network connectivity (FNC) is a newly developed method to investigate the brain's functional connectivity patterns. The first aim of this study was to investigate FNC alterations between TRD patients and healthy controls. The second aim was to explore the relationship between the ECT treatment response and pre-ECT treatment FNC alterations in individual TRD patients...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28215163/targeting-heparan-sulfate-proteoglycans-and-their-modifying-enzymes-to-enhance-anticancer-chemotherapy-efficacy-and-overcome-drug-resistance
#5
Cinzia Lanzi, Nadia Zaffaroni, Giuliana Cassinelli
Targeting heparan sulfate proteoglycans (HSPGs) and enzymes involved in heparan sulfate (HS) chain editing is emerging as a new anticancer strategy. The involvement of HSPGs in tumor cell signaling, inflammation, angiogenesis and metastasis indicates that agents able to inhibit aberrant HSPG functions can potentially act as multitarget drugs affecting both tumor cell growth and the supportive boost provided by the microenvironment. Moreover, accumulating evidence supports that an altered expression or function of HSPGs, or of the complex enzyme system regulating their activities, can also depress the tumor response to anticancer treatments in several tumor types...
February 16, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28207917/the-role-of-ect-in-posttraumatic-stress-disorder-a-systematic-review
#6
Nagy A Youssef, W Vaughn McCall, Chittaranjan Andrade
BACKGROUND: Posttraumatic stress disorder (PTSD) is associated with a high burden of disability and mortality and frequently is treatment resistant. There is little to offer patients who are not responding to standard interventions. Thus, the objective of this report is to systematically review human data on whether electroconvulsive therapy (ECT) is effective in PTSD. METHODS: We performed a systematic literature review from 1958 through August 2016 for clinical studies and case reports published in English examining the efficacy of ECT in improving PTSD symptoms...
February 2017: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
https://www.readbyqxmd.com/read/28187008/guarding-the-gate-remote-structured-assessments-to-enhance-enrollment-precision-in-depression-trials
#7
Marlene P Freeman, James Pooley, Martina J Flynn, Lee Baer, David Mischoulon, David Mou, Maurizio Fava
BACKGROUND: Failed treatment trials are common in major depressive disorder and treatment-resistant depression, and remotely performed multifaceted, centralized structured interviews can potentially enhance signal detection by ensuring that enrolled patients meet eligibility criteria. METHODS: We assessed the use of a specific remote structured interview that validated the diagnosis, level of treatment resistance, and depression severity. The objectives were to (1) assess the rate at which patients who were deemed eligible for participation in trials by site investigators were ineligible, (2) assess the reasons for ineligibility, (3) compare rates of ineligibility between academic and nonacademic sites, (4) compare eligibility between US and non-US sites, and (5) report the placebo response rates in trials utilizing this quality assurance approach, comparing its placebo response rates with those reported in the literature...
February 10, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28184334/mixed-states-in-bipolar-disorder-etiology-pathogenesis-and-treatment
#8
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/28179035/impact-of-deep-brain-stimulation-of-the-ventral-anterior-limb-of-the-internal-capsule-on-cognition-in-depression
#9
I O Bergfeld, M Mantione, M L C Hoogendoorn, H G Ruhé, F Horst, P Notten, J van Laarhoven, P van den Munckhof, G Beute, P R Schuurman, D Denys
BACKGROUND: Preliminary studies report no negative and a possible positive impact of deep brain stimulation (DBS) on cognition of patients with treatment-resistant depression (TRD). However, these studies neither controlled for practice effects nor compared active with sham stimulation. METHOD: To address these limitations, we compared 25 TRD patients, who underwent DBS of the ventral anterior limb of the internal capsule (vALIC), with 21 healthy controls (HCs) matched on gender, age and education level...
February 9, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28177952/clinical-factors-related-to-acute-electroconvulsive-therapy-outcome-for-patients-with-major-depressive-disorder
#10
Cheng-Chung Chen, Ching-Hua Lin, Wei-Cheng Yang, Ming-Chao Chen
The aim of this study was to explore the significant predictors associated with electroconvulsive therapy (ECT) outcome for patients with major depressive disorder. Major depressive disorder inpatients (N=130) requiring ECT were recruited from a major psychiatric center in South Taiwan. ECT was generally performed for a maximum of 12 sessions. Symptom severity was assessed using the 17-item Hamilton Depression Rating Scale (HAMD-17) and Clinical Global Impression of Severity (CGI-S) before ECT, after every three ECT sessions, and after the last ECT...
February 7, 2017: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28170003/brain-volumetric-and-metabolic-correlates-of-electroconvulsive-therapy-for-treatment-resistant-depression-a-longitudinal-neuroimaging-study
#11
M Cano, I Martínez-Zalacaín, Á Bernabéu-Sanz, O Contreras-Rodríguez, R Hernández-Ribas, E Via, A de Arriba-Arnau, V Gálvez, M Urretavizcaya, J Pujol, J M Menchón, N Cardoner, C Soriano-Mas
Recent research suggests that neuroplastic and neuroinflammatory changes may account for the mode of action of electroconvulsive therapy (ECT), although extant data do not allow for a clear disambiguation between these two hypotheses. Multimodal neuroimaging approaches (for example, combining structural and metabolic information) may help in clarifying this issue. Here we aimed to assess longitudinal changes in (i) regional gray matter (GM) volumes and (ii) hippocampal metabolite concentrations throughout an acute course of bitemporal ECT, as well as (iii) to determine the association between imaging changes and clinical improvement...
February 7, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28169947/cognitive-performance-under-electroconvulsive-therapy-ect-in-ect-naive-treatment-resistant-patients-with-major-depressive-disorder
#12
Christoph Ziegelmayer, Göran Hajak, Anne Bauer, Marion Held, Rainer Rupprecht, Wolfgang Trapp
OBJECTIVES: Although electroconvulsive therapy (ECT) is considered a safe and highly effective treatment option for major depressive disorder, there are still some reservations with regard to possible adverse cognitive adverse effects. This is the case despite a large body of evidence showing that these deficits are transient and that there even seems to be a long-term improvement of cognitive functioning level. However, most data concerning cognitive adverse effects stem from studies using mixed samples of treatment-resistant and non-treatment-resistant as well as ECT-naive and non-ECT-naive subjects...
February 7, 2017: Journal of ECT
https://www.readbyqxmd.com/read/28162976/neuromodulation-in-response-to-electroconvulsive-therapy-in-schizophrenia-and-major-depression
#13
Philipp Arthur Thomann, Robert Christian Wolf, Henrike Maria Nolte, Dusan Hirjak, Stefan Hofer, Ulrich Seidl, Malte Sebastian Depping, Bram Stieltjes, Klaus Maier-Hein, Fabio Sambataro, Torsten Wüstenberg
BACKGROUND: Electroconvulsive therapy (ECT) is one of the most effective treatments in severe and treatment-resistant major depressive disorder (MDD). ECT has been also shown to be effective in schizophrenia (SZ), particularly when rapid symptom reduction is needed or in cases of resistance to drug-treatment. However, its precise mechanisms of action remain largely unknown. OBJECTIVE/HYPOTHESIS: This study examined whether ECT exerts disorder-specific or unspecific modulation of brain structure and function in SZ and MDD...
January 16, 2017: Brain Stimulation
https://www.readbyqxmd.com/read/28156615/investigating-high-concentration-8-capsaicin-patch-in-chronic-cancer-treatment-related-peripheral-neuropathic-pain
#14
Barry Laird, Linda J Williams, Marie T Fallon
: 208 Background: Cancer-treatment related peripheral neuropathic pain is a challenging clinical problem as current interventions have limited efficacy and significant toxicities. This study aims to examine the analgesic effect of high-concentration 8% capsaicin patch in this cohort of patients. METHODS: A single arm study was conducted. Patients with long-term peripheral neuropathic pain received a single application of 8% transdermal capsaicin patch to the affected area (chest wall, hands or feet)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28155119/a-combination-of-probiotics-and-magnesium-orotate-attenuate-depression-in-a-small-ssri-resistant-cohort-an-intestinal-anti-inflammatory-response-is-suggested
#15
Matthew Bambling, Sophie C Edwards, Sean Hall, Luis Vitetta
Approximately, one-third of those who develop major depression will have a poor response to treatment and over time can become treatment resistant. Intestinal dysbiosis has been implicated in depression with systemic inflammation and vagal and enteric nerve impairment. We report on a sequel pilot study (n = 12) with a combination probiotics/magnesium orotate formulation adjuvant administered with SSRIs for treatment resistant depression. At the end of an 8-week intervention mean changes for depression scores and quality of life in the group was clinically significantly improved (p < 0...
February 2, 2017: Inflammopharmacology
https://www.readbyqxmd.com/read/28154905/changes-in-dorsolateral-prefrontal-connectivity-after-rtms-in-treatment-resistant-depression-a-brain-perfusion-spect-study
#16
Raphaëlle Richieri, Damien Jouvenoz, Antoine Verger, Patrick Fiat, Laurent Boyer, Christophe Lançon, Eric Guedj
PURPOSE: Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive and safe alternative to electroconvulsive therapy for treatment-resistant depression (TRD). After rTMS, changes in brain SPECT perfusion have been remotely identified within medial temporal limbic areas, while no local effects have been found within the left dorsolateral prefrontal cortex (DLPFC)-i.e. under the coil. Functional changes in connectivity may underlie these remote effects. Interestingly, functional connectivity has been recently investigated using perfusion SPECT, and abnormalities identified in TRD patients...
February 3, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28151400/factors-associated-with-new-onset-depression-following-ischemic-stroke-the-women-s-health-initiative
#17
Joel Salinas, Roberta M Ray, Rami Nassir, Kamakshi Lakshminarayan, Christina Dording, Jordan Smoller, Sylvia Wassertheil-Smoller, Jonathan Rosand, Erin C Dunn
BACKGROUND: Psychosocial characteristics have a strong effect on risk of depression, and their direct treatment with behavioral interventions reduces rates of depression. Because new-onset poststroke depression (NPSD) is frequent, devastating, and often treatment-resistant, novel preventive efforts are needed. As a first step toward developing behavioral interventions for NPSD, we investigated whether prestroke psychosocial factors influenced rates of NPSD in a manner similar to the general population...
February 1, 2017: Journal of the American Heart Association
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
#18
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
#19
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/28142056/using-probabilistic-tractography-to-target-the-subcallosal-cingulate-cortex-in-patients-with-treatment-resistant-depression
#20
Evangelia Tsolaki, Randall Espinoza, Nader Pouratian
The lack of efficacy of deep brain stimulation (DBS) of subcallosal cingulate (SCC) in treatment resistant depression (TRD) may be due in part to suboptimal targeting. In two patients treated with SCC DBS for TRD we assessed the voxel-wise probabilistic connectivity of SCC with four tractography-defined target areas implicated in depression, thereby identifying the tractography-optimized target (TOT). Compared to the non-responder, the responder's DBS leads were implanted and stimulation was delivered closer to the TOT...
January 20, 2017: Psychiatry Research
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