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Severe treatment resistant major depression

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https://www.readbyqxmd.com/read/29618967/closing-the-loop-on-deep-brain-stimulation-for-treatment-resistant-depression
#1
REVIEW
Alik S Widge, Donald A Malone, Darin D Dougherty
Major depressive episodes are the largest cause of psychiatric disability, and can often resist treatment with medication and psychotherapy. Advances in the understanding of the neural circuit basis of depression, combined with the success of deep brain stimulation (DBS) in movement disorders, spurred several groups to test DBS for treatment-resistant depression. Multiple brain sites have now been stimulated in open-label and blinded studies. Initial open-label results were dramatic, but follow-on controlled/blinded clinical trials produced inconsistent results, with both successes and failures to meet endpoints...
2018: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/29577229/comparison-of-guidelines-for-the-treatment-of-unipolar-depression-a-focus-on-pharmacotherapy-and-neurostimulation
#2
REVIEW
A J Bayes, G B Parker
OBJECTIVE: To determine the level of agreement across a set of evidence-based guidelines for management of the unipolar depressive disorders and with a focus on physical treatments. METHOD: A literature search was undertaken using the terms 'depression', 'depressive' and 'guidelines', using PubMed, Cochrane Database of Systematic Reviews and the National Guideline Clearinghouse. Twelve national psychiatric or professional guideline-producing organizations were identified from the period 2007-2017, with guidelines qualitatively reviewed by two assessors...
March 25, 2018: Acta Psychiatrica Scandinavica
https://www.readbyqxmd.com/read/29560909/subgenual-anterior-cingulate-medial-orbitofrontal-functional-connectivity-in-medication-resistant-major-depression-a-neurobiological-marker-for-accelerated-intermittent-theta-burst-stimulation-treatment
#3
Chris Baeken, Romain Duprat, Guo-Rong Wu, Rudi De Raedt, Kees van Heeringen
BACKGROUND: Accelerated repetitive transcranial magnetic stimulation paradigms have been shown to result in fast decreases in depressive symptoms and suicidal ideation. Although the subgenual anterior cingulate cortex (sgACC) region has been put forward as a possible biological marker, so far, no studies evaluated the clinical effects of accelerated intermittent theta burst stimulation (aiTBS) on sgACC functional connectivity (FC). METHODS: Fifty patients with treatment-resistant depression were enrolled in this registered randomized double-blind sham-controlled crossover aiTBS treatment study...
October 2017: Biological Psychiatry: Cognitive Neuroscience and Neuroimaging
https://www.readbyqxmd.com/read/29492960/clinical-correlates-of-augmentation-combination-treatment-strategies-in-major-depressive-disorder
#4
M Dold, L Bartova, J Mendlewicz, D Souery, A Serretti, S Porcelli, J Zohar, S Montgomery, S Kasper
OBJECTIVE: This multicenter, multinational, cross-sectional study aimed to investigate clinical characteristics and treatment outcomes associated with augmentation/combination treatment strategies in major depressive disorder (MDD). METHOD: Sociodemographic, clinical, and treatment features of 1410 adult MDD patients were compared between MDD patients treated with monotherapy and augmentation/combination medication using descriptive statistics, analyses of covariance (ancova), and Spearman's correlation analyses...
February 28, 2018: Acta Psychiatrica Scandinavica
https://www.readbyqxmd.com/read/29489077/inflammation-and-improvement-of-depression-following-electroconvulsive-therapy-in-treatment-resistant-depression
#5
Jennifer L Kruse, Eliza Congdon, Richard Olmstead, Stephanie Njau, Elizabeth C Breen, Katherine L Narr, Randall Espinoza, Michael R Irwin
OBJECTIVE: Electroconvulsive therapy (ECT) is the most robust acute treatment for severe major depressive disorder, yet clinical response is variable. Inflammation is associated with depression, especially in women, and levels of C-reactive protein (CRP) and interleukin (IL)-6 predict response to antidepressant medications. This study evaluated whether markers of inflammation predicted response to electroconvulsive therapy (ECT) in patients with treatment-resistant depression and to what extent this association differed between men and women...
February 27, 2018: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/29483673/deep-brain-stimulation-for-treatment-resistant-depression-an-integrative-review-of-preclinical-and-clinical-findings-and-translational-implications
#6
M P Dandekar, A J Fenoy, A F Carvalho, J C Soares, J Quevedo
Although deep brain stimulation (DBS) is an established treatment choice for Parkinson's disease (PD), essential tremor and movement disorders, its effectiveness for the management of treatment-resistant depression (TRD) remains unclear. Herein, we conducted an integrative review on major neuroanatomical targets of DBS pursued for the treatment of intractable TRD. The aim of this review article is to provide a critical discussion of possible underlying mechanisms for DBS-generated antidepressant effects identified in preclinical studies and clinical trials, and to determine which brain target(s) elicited the most promising outcomes considering acute and maintenance treatment of TRD...
February 27, 2018: Molecular Psychiatry
https://www.readbyqxmd.com/read/29465479/ketamine-associated-brain-changes-a-review-of-the-neuroimaging-literature
#7
Dawn F Ionescu, Julia M Felicione, Aishwarya Gosai, Cristina Cusin, Philip Shin, Benjamin G Shapero, Thilo Deckersbach
Major depressive disorder (MDD) is one of the most prevalent conditions in psychiatry. Patients who do not respond to traditional monoaminergic antidepressant treatments have an especially difficult-to-treat type of MDD termed treatment-resistant depression. Subanesthetic doses of ketamine-a glutamatergic modulator-have shown great promise for rapidly treating patients with the most severe forms of depression. As such, ketamine represents a promising probe for understanding the pathophysiology of depression and treatment response...
February 20, 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29455893/cognitive-behavioural-therapy-for-insomnia-cbt-i-to-treat-depression-a-systematic-review
#8
REVIEW
Jasmyn E A Cunningham, Colin M Shapiro
INTRODUCTION: Major depressive disorder is one of the most commonly diagnosed psychiatric illnesses, and it has a profound negative impact on an individual's ability to function. Up to 90% of individuals suffering from depression also report sleep and circadian disruptions. If these disruptions are not effectively resolved over the course of treatment, the likelihood of relapse into depression is greatly increased. Cognitive Behavioural Therapy for Insomnia (CBT-I) has shown promise in treating these sleep and circadian disturbances associated with depression, and may be effective as a stand-alone treatment for depression...
March 2018: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/29438781/neurobiological-links-between-depression-and-ad-the-role-of-tgf-%C3%AE-1-signaling-as-a-new-pharmacological-target
#9
REVIEW
Filippo Caraci, Simona Federica Spampinato, Maria Grazia Morgese, Fabio Tascedda, Maria Grazia Salluzzo, Maria Concetta Giambirtone, Giuseppe Caruso, Antonio Munafò, Sebastiano Alfio Torrisi, Gian Marco Leggio, Luigia Trabace, Ferdinando Nicoletti, Filippo Drago, Maria Angela Sortino, Agata Copani
In the last several years a large number of studies have demonstrated the neurobiological and clinical continuum between depression and Alzheimer's disease (AD). Depression is a risk factor for the development of AD, and the presence of depressive symptoms significantly increases the conversion of Mild Cognitive Impairment (MCI) into AD. Common pathophysiological events have been identified in depression and AD, including neuroinflammation with an aberrant Tumor Necrosis Factor-α (TNF-α) signaling, and an impairment of Brain-Derived Neurotrophic Factor (BDNF) and Transforming-Growth-Factor-β1 (TGF-β1) signaling...
February 10, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29411705/-vascular-endothelial-growth-factor-vegf-as-a-potential-biomarker-in-major-depressive-disorder
#10
Monika Elemery, Szilvia Kiss, Xenia Gonda, Peter Dome, Judit Lazary
BACKGROUND: There is growing evidence that vascular endothelial growth factor (VEGF) plays a crucial role in neurodevelopment and regeneration. Several data support that intact VEGF pathway is indispensable for therapeutic effect of antidepressants, any disruption of VEGF signaling can result treatment resistance. In our study we investigated the peripherial blood VEGF level before and 4-week after antidepressant treatment in patients with major depressive episode and we compared VEGF levels between responders and non-responders...
December 2017: Neuropsychopharmacologia Hungarica
https://www.readbyqxmd.com/read/29389676/decreased-cognitive-functioning-after-electroconvulsive-therapy-is-related-to-increased-hippocampal-volume-exploring-the-role-of-brain-plasticity
#11
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/29388201/benefits-of-and-barriers-to-pharmacogenomics-guided-treatment-for-major-depressive-disorder
#12
Ahmed T Ahmed, Richard Weinshilboum, Mark A Frye
Antidepressants have reduced the symptom burden for many Major Depressive Disorder (MDD) patients, but drug-related side effects and treatment resistance continue to present major challenges. Pharmacogenomics represents one approach to enhance antidepressant efficacy and avoid adverse reactions, but concerns remain with regard to the overall "value equation," and several barriers must be overcome to achieve the full potential of MDD pharmacogenomics.
February 1, 2018: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29372569/intravenous-ketamine-infusion-for-a-patient-with-treatment-resistant-major-depression-a-10-month-follow-up
#13
J H Kwon, W S Sim, J P Hong, I S Song, J Y Lee
WHAT IS KNOWN AND OBJECTIVE: Ketamine in a subanaesthetic dose has been shown to produce rapid antidepressant effects. Here, we describe a long-term follow-up case of a Korean patient with severe major depression who received repeated ketamine intravenous therapy (KIT). CASE DESCRIPTION: A 49-year-old woman with a 6-year history of treatment-resistant major depression was given KIT once every 1 or 2 weeks over 10 months, for a total of 36 treatments. Her mood stabilized, and she showed a nearly 50% reduction in the severity of her depressive symptom...
January 25, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29370485/validity-of-the-maudsley-staging-method-in-predicting-treatment-resistant-depression-outcome-using-the-netherlands-study-of-depression-and-anxiety
#14
Sjoerd M van Belkum, Hanneke Geugies, Thom S Lysen, Anthony J Cleare, Frenk P M L Peeters, Brenda W J H Penninx, Robert A Schoevers, Henricus G Ruhe
OBJECTIVE: We investigated if the degree of treatment resistance of depression, as measured by the Maudsley Staging Method (MSM), is predictive of a worse depression outcome by using a large naturalistic cohort of depressed patients. METHODS: 643 subjects from the general population, primary care, and secondary care who suffered from current depressive disorder were included from the Netherlands Study of Depression and Anxiety baseline assessment. The diagnostic criterion was major depressive disorder (MDD) in the last month, based on the Composite Interview Diagnostic Instrument (CIDI), or a CIDI diagnosis of MDD in the past 6 months with an Inventory of Depressive Symptomatology Self-Report score > 24 at baseline...
January 2018: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/29360650/exploring-nitrous-oxide-as-treatment-of-mood-disorders-basic-concepts
#15
Peter Nagele, Charles F Zorumski, Charles Conway
Nitrous oxide (laughing gas) has shown early promise as a rapidly acting antidepressant in patients with treatment-resistant major depression and is currently investigated in several clinical trials. Because nitrous oxide is rarely administered outside operating rooms or dental practices, most psychiatrists are not familiar with how nitrous oxide is administered in a medical setting and what regulations guide its use. The goal of this brief review was to educate psychiatrists about the basic concepts of nitrous oxide administration and pharmacology...
April 2018: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29282469/efficacy-and-safety-of-intranasal-esketamine-adjunctive-to-oral-antidepressant-therapy-in-treatment-resistant-depression-a-randomized-clinical-trial
#16
Ella J Daly, Jaskaran B Singh, Maggie Fedgchin, Kimberly Cooper, Pilar Lim, Richard C Shelton, Michael E Thase, Andrew Winokur, Luc Van Nueten, Husseini Manji, Wayne C Drevets
Importance: Approximately one-third of patients with major depressive disorder (MDD) do not respond to available antidepressants. Objective: To assess the efficacy, safety, and dose-response of intranasal esketamine hydrochloride in patients with treatment-resistant depression (TRD). Design, Setting, and Participants: This phase 2, double-blind, doubly randomized, delayed-start, placebo-controlled study was conducted in multiple outpatient referral centers from January 28, 2014, to September 25, 2015...
February 1, 2018: JAMA Psychiatry
https://www.readbyqxmd.com/read/29275697/the-economic-cost-of-treatment-resistant-depression-in-patients-referred-to-a-specialist-service
#17
Paul McCrone, Felicitas Rost, Leonardo Koeser, Iakovina Koutoufa, Stephanie Stephanou, Martin Knapp, David Goldberg, David Taylor, Peter Fonagy
BACKGROUND: Patients with treatment-resistant depression (TRD) suffer very significant morbidity and are at a disadvantage concerning optimal clinical management. There are high associated societal costs. AIMS: A detailed analysis of health economic costs in the United Kingdom in a group manifesting a severe form of TRD in the 12 months before their participation in a major randomized controlled treatment trial. METHODS: The sample consisted of 118 participants from the Tavistock Adult Depression Study...
December 23, 2017: Journal of Mental Health
https://www.readbyqxmd.com/read/29273063/nitrous-oxide-n-2-o-and-subsequent-open-label-ssri-treatment-of-adolescents-with-depression-notad-study-protocol-for-a-randomised-controlled-trial
#18
Richard M Stewart, Janice W Y Wong, Kevin C Runions, Pradeep Rao, Julia K Moore, Simon R Davies, Britta S von Ungern-Sternberg, David Sommerfield, Florian Daniel Zepf
BACKGROUND: The first line of pharmacological treatment for severe depressive disorders in young people is selective serotonin reuptake inhibitors (SSRIs). However, beneficial clinical effects are rarely observed before several weeks into treatment. Nitrous oxide (N2 O) has a long-standing safety record for pain relief and has been used in adults and young people. In adults with severe treatment-resistant depression, a single dose of N2 O had significant antidepressant effects, with maximum antidepressant effects observed 24 h after administration...
December 22, 2017: Trials
https://www.readbyqxmd.com/read/29235659/effect-of-metabolic-syndrome-on-late-life-depression-associations-with-disease-severity-and-treatment-resistance
#19
RANDOMIZED CONTROLLED TRIAL
John S Mulvahill, Ginger E Nicol, David Dixon, Eric J Lenze, Jordan F Karp, Charles F Reynolds, Daniel M Blumberger, Benoit H Mulsant
BACKGROUND/OBJECTIVES: Metabolic syndrome (MetS) is the co-occurrence of obesity and metabolic derangements. Prior research implicates MetS in prolongation of the course of depression in older adults, but its effect on antidepressant response is unknown in this population. The objective was to determine whether MetS and related metabolic dyscrasias are associated with decreased rate of remission from depression in older adults treated pharmacologically for depression. DESIGN: Secondary analysis of a randomized controlled trial...
December 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29228516/refining-prediction-in-treatment-resistant-depression-results-of-machine-learning-analyses-in-the-trd-iii-sample
#20
Alexander Kautzky, Markus Dold, Lucie Bartova, Marie Spies, Thomas Vanicek, Daniel Souery, Stuart Montgomery, Julien Mendlewicz, Joseph Zohar, Chiara Fabbri, Alessandro Serretti, Rupert Lanzenberger, Siegfried Kasper
OBJECTIVE: The study objective was to generate a prediction model for treatment-resistant depression (TRD) using machine learning featuring a large set of 47 clinical and sociodemographic predictors of treatment outcome. METHOD: 552 Patients diagnosed with major depressive disorder (MDD) according to DSM-IV criteria were enrolled between 2011 and 2016. TRD was defined as failure to reach response to antidepressant treatment, characterized by a Montgomery-Asberg Depression Rating Scale (MADRS) score below 22 after at least 2 antidepressant trials of adequate length and dosage were administered...
January 2018: Journal of Clinical Psychiatry
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