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Severe treatment resistant major depression

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https://www.readbyqxmd.com/read/28324341/beta-amyloid-deposition-in-patients-with-major-depressive-disorder-with-differing-levels-of-treatment-resistance-a-pilot-study
#1
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
#2
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
#3
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
#4
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
#5
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...
March 4, 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
#6
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
#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...
April 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/28177952/clinical-factors-related-to-acute-electroconvulsive-therapy-outcome-for-patients-with-major-depressive-disorder
#9
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
#10
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
#11
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
#12
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...
January 18, 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
#13
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
#14
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
https://www.readbyqxmd.com/read/28049085/high-frequency-repetitive-transcranial-magnetic-stimulation-over-the-left-dlpfc-for-major-depression-session-dependent-efficacy-a-meta-analysis
#15
S Teng, Z Guo, H Peng, G Xing, H Chen, B He, M A McClure, Q Mu
BACKGROUND: Depression is a major debilitating psychiatric disorder. Current antidepressant drugs are often associated with side effects or treatment resistance. The aim of this meta-analysis was to evaluate therapeutic effects of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) in major depression (MD). METHODS: The medical data bases of PubMed, Medline, Embase and Cochrane Central Register were searched for randomized controlled trials (RCTs) reporting the therapeutic effects of high-frequency rTMS for depression, which were published in English between January 1990 and June 2016...
March 2017: European Psychiatry: the Journal of the Association of European Psychiatrists
https://www.readbyqxmd.com/read/28035869/comparative-efficacy-and-tolerability-of-pharmacological-and-somatic-interventions-in-adult-patients-with-treatment-resistant-depression-a-systematic-review-and-network-meta-analysis
#16
Katerina Papadimitropoulou, Carla Vossen, Andreas Karabis, Christina Donatti, Nicole Kubitz
OBJECTIVE: Major depressive disorder (MDD) affects about 10-15% of the general population in a lifetime. A considerable number of patients fail to achieve full symptom remission despite adequate treatment and are considered treatment resistant (TRD). The current study compared the relative efficacy and tolerability of pharmacological and somatic TRD interventions by means of a Bayesian network meta-analysis. RESEARCH DESIGN AND METHODS: An electronic literature search of MEDLINE, MEDLINE In-Process, EMBASE, PsycInfo, EconLit and Cochrane Library databases for trials published between September 2003 and September 2014 was conducted...
February 6, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27876102/structural-functional-brain-changes-in-depressed-patients-during-and-after-electroconvulsive-therapy
#17
Antoine Yrondi, Patrice Péran, Anne Sauvaget, Laurent Schmitt, Christophe Arbus
OBJECTIVES: Electroconvulsive therapy (ECT) is a non-pharmacological treatment that is effective in treating severe and treatment-resistant depression. Although the efficacy of ECT has been demonstrated to treat major depressive disorder (MDD), the brain mechanisms underlying this process remain unclear. Structural-functional changes occur with the use of ECT as a treatment for depression based on magnetic resonance imaging (MRI). For this reason, we have tried to identify the changes that were identified by MRI to try to clarify some operating mechanisms of ECT...
November 23, 2016: Acta Neuropsychiatrica
https://www.readbyqxmd.com/read/27866918/-children-and-adolescents-anxiety-disorders
#18
H Denis, A Baghdadli
Anxiety disorders were long underestimated in children by healthcare professionals, but they are now better diagnosed. They account for the most frequent psychiatric diagnosis between 6 and 18 years of age, with differences in prevalence or risk factors related to the clinical forms. Different clinical subtypes of anxiety disorders are detailed in this article: separation anxiety, specific phobia, generalized anxiety, social anxiety, panic disorder, post-traumatic stress syndrome, and obsessional-compulsive disorder...
January 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27836553/how-much-alcohol-is-in-ketamine-s-antidepressant-action
#19
REVIEW
Udo Bonnet
Ketamine is approved to start and maintain anaesthesia or analgesia. Ketamine is also known to be neurotoxic and an old drug of abuse. Numerous studies have proven a rapid and strong antidepressant response (AR) following parenteral sub-anaesthetic ketamine doses when applied the first time to patients with treatment resistant unipolar or bipolar major depression. This rapid and robust AR is encouraging, though short-lived (usually up to seven days). There is growing evidence that repeated und escalating ketamine administrations exert longer-lasting AR than single infusions...
January 1, 2017: Life Sciences
https://www.readbyqxmd.com/read/27832812/a-longitudinal-cohort-study-of-acute-puerperal-metritis-cases-in-swedish-dairy-cows
#20
Anna Ordell, Helle Ericsson Unnerstad, Ann Nyman, Hans Gustafsson, Renée Båge
BACKGROUND: Acute puerperal metritis affects cows during the early postpartum period and causes fever, fetid vaginal discharge and general depression. The disease is severe and treatment with antimicrobials is often required. This study followed 79 Swedish dairy cows with acute puerperal metritis with registered treatment and outcome in terms of recovery. Bacteria isolated from the uterus and their susceptibility to penicillin were studied. Clinical cases were assigned by participating practitioners who examined the cows, performed uterine swab sampling, decided treatment and provided information about cow health and calving conditions...
November 10, 2016: Acta Veterinaria Scandinavica
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