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Severe treatment resistant major depression

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https://www.readbyqxmd.com/read/28642690/autonomy-in-depressive-patients-undergoing-dbs-treatment-informed-consent-freedom-of-will-and-dbs-potential-to-restore-it
#1
Timo Beeker, Thomas E Schlaepfer, Volker A Coenen
According to the World Health Organization, depression is one of the most common and most disabling psychiatric disorders, affecting at any given time approximately 325 million people worldwide. As there is strong evidence that depressive disorders are associated with a dynamic dysregulation of neural circuits involved in emotional processing, recently several attempts have been made to intervene directly in these circuits via deep brain stimulation (DBS) in patients with treatment-resistant major depressive disorder (MDD)...
2017: Frontiers in Integrative Neuroscience
https://www.readbyqxmd.com/read/28635347/ketamine-and-international-regulations
#2
Yanhui Liao, Yi-Lang Tang, Wei Hao
BACKGROUND: Ketamine is an anesthetic commonly used in low-income countries and has recently been shown to be effective for treatment-resistant depression. However, the illicit manufacturing, trafficking, and nonmedical use of ketamine are increasing globally, and its illicit use poses major public health challenges in many countries. OBJECTIVES: To review the nonmedical use of ketamine in selected countries and its regulatory control. METHODS: We conducted a review of literature identified from searches of the China National Knowledge Infrastructure (CNKI) (1979-2016) and PubMed databases, supplemented by additional references identified by the authors...
February 13, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28622206/bupropion-augmentation-in-a-case-of-compulsive-buying-disorder
#3
Gianna Sepede, Giuseppe Di Iorio, Fabiola Sarchione, Federica Fiori, Massimo Di Giannantonio
BACKGROUND: Compulsive buying disorder (CBD) is a condition characterized by excessive preoccupations, impulses, and behaviors regarding buying, resulting in serious psychological, social, and financial problems. Even though it has not been included in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, "behavioral addictions" section, CBD is a hot topic in current clinical psychiatry, because of its relevant prevalence (at least 5% in adult populations) and severe effect on quality of life...
June 16, 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28604316/when-students-become-patients-tb-disease-among-medical-undergraduates-in-cape-town-south-africa
#4
Helene-Mari Van der Westhuizen, Angela Dramowski
BACKGROUND: Medical students acquire latent tuberculosis (TB) infection at a rate of 23 cases/100 person-years. The frequency and impact of occupational TB disease in this population are unknown. METHODS: A self-administered questionnaire was distributed via email and social media to current medical students and recently graduated doctors (2010 - 2015) at two medical schools in Cape Town. Individuals who had developed TB disease as undergraduate students were eligible to participate...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28553836/a-randomized-double-blind-placebo-controlled-sequential-parallel-comparison-design-trial-of-adjunctive-riluzole-for-treatment-resistant-major-depressive-disorder
#5
Sanjay J Mathew, Ralitza Gueorguieva, Cynthia Brandt, Maurizio Fava, Gerard Sanacora
Riluzole is a glutamate-modulating agent with neuroprotective properties approved for use in amyotrophic lateral sclerosis. The efficacy and safety of riluzole vs placebo as an adjunct to antidepressant medication in outpatients with major depressive disorder (MDD) was examined in a 3-site, 8-week, randomized, double-blind, placebo-controlled, fixed-dose trial using a sequential parallel comparison design comprised of two phases of 4 weeks. Patients with MDD in a current major depressive episode (N=104) with an inadequate response to either a prospective or a historical trial of an antidepressant medication were randomized in a 2 : 3 : 3 ratio to the treatment sequences of riluzole/riluzole, placebo/placebo, and placebo/riluzole, respectively...
May 29, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28541239/psychological-parameters-of-psoriasis
#6
A Kouris, E Platsidaki, C Kouskoukis, C Christodoulou
Psoriasis is a chronic, inflammatory scaling dermatosis. The marked visible appearance of the lesions have a negative impact on body image that leads to decreased self-esteem, hence seriously compromising the patient's quality of life. The clinical picture critically affects the social well-being of the patient since the disease is commonly misunderstood and feared by the social environment as being contagious. The patient feels stigmatized and this further intensifies their lack of self-confidence and self-esteem...
January 2017: Psychiatrikē, Psychiatriki
https://www.readbyqxmd.com/read/28525197/-treatment-resistant-depression-actuality-and-perspectives-in-2017
#7
REVIEW
N Lucas, P Hubain, G Loas, F Jurysta
Major depressive disorder (MDD) affects 3 to 17 % of adults. 15 to 30 % of patients with MDD suffer from treatment resistant depression (TRD). No international consensus defines TRD. The most common definition is " MDD that is not enough improved after two successive and different classes of antidepressant treatments in appropriate dose and duration ". The appropriate dose corresponds to maximal dose accepted by scientific reports and clinical recommendations, while the appropriate duration is around 6 weeks...
2017: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/28503892/the-ethics-of-clinical-trials-research-in-severe-mood-disorders
#8
Allison C Nugent, Franklin G Miller, Ioline D Henter, Carlos A Zarate
Mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD), are highly prevalent, frequently disabling, and sometimes deadly. Additional research and more effective medications are desperately needed, but clinical trials research in mood disorders is fraught with ethical issues. Although many authors have discussed these issues, most do so from a theoretical viewpoint. This manuscript uses available empirical data to inform a discussion of the primary ethical issues raised in mood disorders research...
July 2017: Bioethics
https://www.readbyqxmd.com/read/28503107/the-role-of-electroconvulsive-therapy-ect-in-bipolar-disorder-effectiveness-in-522-patients-with-bipolar-depression-mixed-state-mania-and-catatonic-features
#9
Giulio Perugi, Pierpaolo Medda, Cristina Toni, Michela Giorgi Mariani, Chiara Socci, Mauro Mauri
OBJECTIVE: We evaluated the effectiveness of Electroconvulsive Therapy (ECT) in the treatment of Bipolar Disorder (BD) in a large sample of bipolar patients with drug resistant depression, mania, mixed state and catatonic features. METHOD: 522 consecutive patients with DSM-IV-TR BD were evaluated prior to and after the ECT course. Responders and nonresponders were compared in subsamples of depressed and mixed patients. Descriptive analyses were reported for patients with mania and with catatonic features...
April 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28483102/use-of-buprenorphine-in-treatment-of-refractory-depression-a-review-of-current-literature
#10
REVIEW
Cornel N Stanciu, Oliver M Glass, Thomas M Penders
OBJECTIVE: Current treatment strategies for depressive disorders have limited efficacy, leaving many patients unimproved or with significant residual symptoms. The development of additional treatments represent a significant unmet need for providers. Several lines of evidence suggest that the opioid system may be involved in regulation of mood and incentives salience. Intervention based on modifying central opioid receptors may represent a novel approach to treatment of depressive disorders among those unresponsive to accepted treatments...
April 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/28438543/modulation-of-motor-cortex-excitability-predicts-antidepressant-response-to-prefrontal-cortex-repetitive-transcranial-magnetic-stimulation
#11
Albino J Oliveira-Maia, Daniel Press, Alvaro Pascual-Leone
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) targeting the left dorsolateral prefrontal cortex (DLPFC) is a treatment option for patients with medication-resistant major depressive disorder (MDD). However, antidepressant response is variable and there are currently no response predictors with sufficient accuracy for clinical use. OBJECTIVE: We report on results of an observational open-label study to determine whether the modulatory effect of 10 Hz motor cortex (MC) rTMS is predictive of the antidepressant effect of 10 Hz DLPFC rTMS...
July 2017: Brain Stimulation
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
#12
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 19, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28424861/s-ketamine-compared-to-etomidate-during-electroconvulsive-therapy-in-major-depression
#13
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
#14
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 2017: International Review of Psychiatry
https://www.readbyqxmd.com/read/28385173/novel-augmentation-strategies-in-major-depression
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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