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Severe treatment resistant major depression

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https://www.readbyqxmd.com/read/28432029/suppression-of-reward-induced-dopamine-release-in-the-nucleus-accumbens-in-animal-models-of-depression-differential-responses-to-drug-treatment
#1
Saki Minami, Hiroshi Satoyoshi, Soichiro Ide, Takeshi Inoue, Mitsuhiro Yoshioka, Masabumi Minami
Anhedonia, the loss of interest or pleasure in previously enjoyable activities, is a core symptom of major depressive disorder, suggesting that the brain reward system may be dysfunctional in this condition. Neurochemical changes in the mesolimbic dopamine (DA) system are not fully understood in animal models of depression. We investigated reward (30% sucrose intake)-induced DA release in the nucleus accumbens (NAc) and the effect of chronic treatment with the antidepressant escitalopram (5mg/kg, intraperitoneally twice daily for 3 weeks) in two animal models of depression...
April 18, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28424861/s-ketamine-compared-to-etomidate-during-electroconvulsive-therapy-in-major-depression
#2
Maxim Zavorotnyy, Ina Kluge, Kathrin Ahrens, Thomas Wohltmann, Benjamin Köhnlein, Patricia Dietsche, Udo Dannlowski, Tilo Kircher, Carsten Konrad
Objective of the study was to compare two commonly used anesthetic drugs, S-ketamine and etomidate, regarding their influence on seizure characteristics, safety aspects, and outcome of electroconvulsive therapy (ECT) in major depression. Treatment data of 60 patients who underwent a total number of 13 ECTs (median) because of the severe or treatment-resistant major depressive disorder (DSM-IV) were analyzed. Etomidate, mean dosage (SD) = 0.25 (0.04) mg/kg, was used for anesthesia in 29 participants; 31 patients received S-ketamine, mean dosage (SD) = 0...
April 19, 2017: European Archives of Psychiatry and Clinical Neuroscience
https://www.readbyqxmd.com/read/28406327/key-updates-in-the-clinical-application-of-electroconvulsive-therapy
#3
Richard D Weiner, Irving M Reti
ECT is the oldest and most effective therapy available for the treatment of severe major depression. It is highly effective in individuals with treatment resistance and when a rapid response is required. However, ECT is associated with memory impairment that is the most concerning side-effect of the treatment, substantially contributing to the controversy and stigmatization surrounding this highly effective treatment. There is overwhelming evidence for the efficacy and safety of an acute course of ECT for the treatment of a severe major depressive episode, as reflected by the recent FDA advisory panel recommendation to reclassify ECT devices from Class III to the lower risk category Class II...
April 13, 2017: International Review of Psychiatry
https://www.readbyqxmd.com/read/28385173/novel-augmentation-strategies-in-major-depression
#4
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/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
#5
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/28341942/integrating-nimh-research-domain-criteria-rdoc-into-ptsd-research
#6
Ulrike Schmidt, Eric Vermetten
Three and a half decades of research on posttraumatic stress disorder (PTSD) has produced substantial knowledge on the pathobiology of this frequent and debilitating disease. However, despite all research efforts, so far no drug that has specifically targeted PTSD core symptoms progressed to clinical use. Instead, although not overly efficient, serotonin re-uptake inhibitors continue to be considered the gold standard of PTSD pharmacotherapy. The psychotherapeutic treatment and symptom-oriented drug therapy options available for PTSD treatment today show some efficacy, although not in all PTSD patients, in particular not in a substantial percent of those suffering from the detrimental sequelae of repeated childhood trauma or in veterans with combat related PTSD...
March 25, 2017: Current Topics in Behavioral Neurosciences
https://www.readbyqxmd.com/read/28324341/beta-amyloid-deposition-in-patients-with-major-depressive-disorder-with-differing-levels-of-treatment-resistance-a-pilot-study
#7
Peng Li, Ing-Tsung Hsiao, Chia-Yih Liu, Chia-Hsiang Chen, She-Yao Huang, Tzu-Chen Yen, Kuan-Yi Wu, Kun-Ju Lin
BACKGROUND: Lack of treatment response in patients with late-life depression is common. The role of brain beta-amyloid (Aβ) deposition in treatment outcome in subjects with late-life depression remains unclear. The present study aimed to investigate brain Aβ deposition in patients with major depressive disorder (MDD) with differing treatment outcomes in vivo using (18)F-florbetapir imaging. This study included 62 MDD patients and 18 healthy control subjects (HCs).We first employed the Maudsley staging method (MSM) to categorize MDD patients into two groups according to treatment response: mild treatment resistance (n = 29) and moderate-to-severe treatment resistance (n = 33)...
December 2017: EJNMMI Research
https://www.readbyqxmd.com/read/28318404/magnetization-transfer-imaging-of-treatment-resistant-depression
#8
Zhiyun Jia, Wei Peng, Ziqi Chen, Huaiqiang Sun, Huawei Zhang, Weihong Kuang, Xiaoqi Huang, Su Lui, Qiyong Gong
Purpose To detect biophysical abnormalities in patients with postmedication treatment-resistant depression (TRD) with magnetization transfer imaging. Materials and Methods This study was approved by the local ethics committee, and written informed consent was obtained from all participants. Participants included 69 patients with major depressive disorder (MDD) (30 with TRD; 39 with non-TRD) and 41 healthy control subjects. Age and sex were examined with one-way analysis of variance and χ(2) tests and were well matched among the three groups...
March 17, 2017: Radiology
https://www.readbyqxmd.com/read/28316564/functional-circuitry-effect-of-ventral-tegmental-area-deep-brain-stimulation-imaging-and-neurochemical-evidence-of-mesocortical-and-mesolimbic-pathway-modulation
#9
Megan L Settell, Paola Testini, Shinho Cho, Jannifer H Lee, Charles D Blaha, Hang J Jo, Kendall H Lee, Hoon-Ki Min
Background: The ventral tegmental area (VTA), containing mesolimbic and mesocortical dopaminergic neurons, is implicated in processes involving reward, addiction, reinforcement, and learning, which are associated with a variety of neuropsychiatric disorders. Electrical stimulation of the VTA or the medial forebrain bundle and its projection target the nucleus accumbens (NAc) is reported to improve depressive symptoms in patients affected by severe, treatment-resistant major depressive disorder (MDD) and depressive-like symptoms in animal models of depression...
2017: Frontiers in Neuroscience
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
#10
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/28266320/different-functioning-of-prefrontal-cortex-predicts-treatment-response-after-a-selective-serotonin-reuptake-inhibitor-treatment-in-patients-with-major-depression
#11
Koji Masuda, Mari Nakanishi, Kana Okamoto, Chiwa Kawashima, Harumi Oshita, Ayako Inoue, Fuku Takita, Toshihiko Izumi, Yoshinobu Ishitobi, Haruka Higuma, Masayuki Kanehisa, Taiga Ninomiya, Yoshinori Tanaka, Jotaro Akiyoshi
BACKGROUND: Major depressive disorder (MDD) is often resistant to treatment with usual approaches. Patients with MDD have shown hypofunction of the frontotemporal cortex in verbal fluency test (VFT)-related near-infrared spectroscopy (NIRS). METHODS: We examined whether the reactions to drug treatment in treatment-naive patients with MDD could be predicted by NIRS outcomes at the initial investigation. All subjects underwent psychological testing to determine levels of anxiety and depression...
May 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28250331/elucidation-of-the-role-of-dorsal-raphe-serotonergic-neurons-in-mood-regulation-using-pharmacological-and-viral-vector-based-approaches
#12
Kazuki Nagayasu
 Growing evidence indicates that serotonergic neurons play a crucial role in brain function and dysfunction, such as in major depressive disorder. However, the complexity of serotonergic projections severely hampers the elucidation of their precise mechanisms. Here we summarize our recent studies on the effects of ketamine and olanzapine, which have been reported to be effective in treatment-resistant depression, on dorsal raphe nucleus serotonergic neurons, using microdialysis, electrophysiology experiments, and slice cultures...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/28187008/guarding-the-gate-remote-structured-assessments-to-enhance-enrollment-precision-in-depression-trials
#13
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...
April 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28184334/mixed-states-in-bipolar-disorder-etiology-pathogenesis-and-treatment
#14
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/28177952/clinical-factors-related-to-acute-electroconvulsive-therapy-outcome-for-patients-with-major-depressive-disorder
#15
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/28162976/neuromodulation-in-response-to-electroconvulsive-therapy-in-schizophrenia-and-major-depression
#16
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/28138119/the-normalization-of-brain-%C3%A2-%C3%A2-f-fluorodeoxy-d-glucose-positron-emission-tomography-hypometabolism-following-electroconvulsive-therapy-in-a-55-year-old-woman-with-treatment-resistant-late-onset-depression-a-case-report
#17
Jeongjae Bak, Sang Mi Lee, Young-Joon Kwon, Se-Hoon Shim, Joong Il Kim
Major depressive disorder, especially in later life, has heterogeneous clinical characteristics and treatment responses. Symptomatically, psychomotor retardation, lack of energy, and apathy tends to be more common in people with late-onset depression (LOD). Despite recent advances in psychopharmacologic treatments, 20% to 30% of patients with mood disorders experience inadequate responses to medication, often resulting in a trial of electroconvulsive therapy (ECT). However, the therapeutic mechanism of ECT is still unclear...
February 28, 2017: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
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
#18
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/28072660/two-versus-one-high-frequency-repetitive-transcranial-magnetic-stimulation-session-per-day-for-treatment-resistant-depression-a-randomized-sham-controlled-trial
#19
Christos Theleritis, Pavlos Sakkas, Thomas Paparrigopoulos, Silia Vitoratou, Chara Tzavara, Stefania Bonaccorso, Antonios Politis, Constantin R Soldatos, Costantin Psarros
OBJECTIVES: High-frequency repetitive transcranial magnetic stimulation (HF-rTMS) has proven antidepressant effects, but the optimal frequency of sessions remains unclear. METHODS: We conducted a 3-week, sham-controlled trial to assess the antidepressant efficacy of 1 active HF-rTMS session per day (A1 group) compared with 2 per day (A2 group) and equivalent sham sessions (once a day, S1 group; twice a day, S2 group) in patients with treatment-resistant major depression with a subsequent 2-week follow-up period...
January 9, 2017: Journal of ECT
https://www.readbyqxmd.com/read/28068461/a-new-prediction-model-for-evaluating-treatment-resistant-depression
#20
Alexander Kautzky, Pia Baldinger-Melich, Georg S Kranz, Thomas Vanicek, Daniel Souery, Stuart Montgomery, Julien Mendlewicz, Joseph Zohar, Alessandro Serretti, Rupert Lanzenberger, Siegfried Kasper
OBJECTIVE: Despite a broad arsenal of antidepressants, about a third of patients suffering from major depressive disorder (MDD) do not respond sufficiently to adequate treatment. Using the data pool of the Group for the Study of Resistant Depression and machine learning, we intended to draw new insights featuring 48 clinical, sociodemographic, and psychosocial predictors for treatment outcome. METHOD: Patients were enrolled starting from January 2000 and diagnosed according to DSM-IV...
February 2017: Journal of Clinical Psychiatry
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