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Severe treatment resistant major depression

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https://www.readbyqxmd.com/read/28822460/-french-society-for-biological-psychiatry-and-neuropsychopharmacology-and-fondation-fondamental-task-force-formal-consensus-for-the-management-of-treatment-resistant-depression
#1
T Charpeaud, J-B Genty, S Destouches, A Yrondi, S Lancrenon, N Alaïli, F Bellivier, D Bennabi, T Bougerol, V Camus, T D'amato, O Doumy, F Haesebaert, J Holtzmann, C Lançon, M Lefebvre, F Moliere, I Nieto, R Richieri, L Schmitt, F Stephan, G Vaiva, M Walter, M Leboyer, W El-Hage, E Haffen, P-M Llorca, P Courtet, B Aouizerate
Major depression represents among the most frequent psychiatric disorders in the general population with an estimated lifetime prevalence of 16-17%. It is characterized by high levels of comorbidities with other psychiatric conditions or somatic diseases as well as a recurrent or chronic course in 50 to 80% of the cases leading to negative repercussions on the daily functioning, with an impaired quality of life, and to severe direct/indirect costs. Large cohort studies have supported that failure of a first-line antidepressant treatment is observed in more than 60% of patients...
September 2017: L'Encéphale
https://www.readbyqxmd.com/read/28758582/potential-novel-treatments-for-bipolar-depression-ketamine-fatty-acids-anti-inflammatory-agents-and-probiotics
#2
G H Vázquez, S Camino, L Tondo, Ross J Baldessarini
BACKGROUND: Treatments for depression in bipolar disorder (BD) are far less well developed than for unipolar major depressive disorder. Several innovative and experimental approaches have been emerging recently, including use of the dissociative anesthetic ketamine and other antagonists of central NMDA glutamate receptors, as well as unsaturated fatty acids, anti-inflammatory agents, and possibly probiotic methods. METHODS: We reviewed relevant reports from the past decade...
July 28, 2017: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/28744230/primary-sjogren-s-syndrome-associated-with-treatment-resistant-obsessive-compulsive-disorder
#3
Lawrence T C Ong, Gary Galambos, David A Brown
There is an increasing awareness that autoimmune diseases can present with neuropsychiatric manifestations. We present the case of a 17-year-old female requiring psychiatric hospitalization for obsessive-compulsive disorder and major depressive disorder with mixed affective features, who was subsequently diagnosed with primary Sjogren's syndrome. Treatment with potent immunosuppression resulted in remission of psychiatric illness. Due to a lack of awareness and/or the lack of specific biomarkers, clinicians may not associate psychiatric symptoms with autoimmune disease, including primary Sjogren's syndrome...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28723697/the-history-and-future-of-ablative-neurosurgery-for-major-depressive-disorder
#4
Matthew Volpini, Peter Giacobbe, G Rees Cosgrove, Anthony Levitt, Andres M Lozano, Nir Lipsman
BACKGROUND: There is an urgent need to develop safe and effective treatments for patients with treatment-resistant depression (TRD). Several neurosurgical procedures have been developed to treat the dysfunctional brain circuits implicated in major depression. OBJECTIVES: This review describes the most common ablative procedures used to treat major depressive disorder: anterior cingulotomy, subcaudate tractotomy, limbic leucotomy, and anterior capsulotomy. The efficacy and safety of each are discussed and compared with other current and emerging modalities, including deep brain stimulation (DBS) and MR-guided focused ultrasound (MRgFUS)...
July 20, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28714751/antidepressant-efficacy-of-electroconvulsive-therapy-is-associated-with-a-reduction-of-the-innate-cellular-immune-activity-in-the-cerebrospinal-fluid-in-patients-with-depression
#5
Laura Kranaster, Carolin Hoyer, Suna S Aksay, J Malte Bumb, Norbert Müller, Peter Zill, Markus J Schwarz, Alexander Sartorius
OBJECTIVES: A bidirectional link between the antidepressant effects of electroconvulsive therapy (ECT) and the modulation of the immune system has been proposed. To elucidate the interplay between antidepressant treatment and macrophage/microglia activation in humans, we performed a study on the effects of the antidepressant treatment by ECT on markers of macrophage/microglia activation in patients with depression. METHODS: We measured six different markers (IL-6, neopterin, sCD14, sCD163 MIF and MCP1) of macrophage/microglia activation in the cerebrospinal fluid (CSF) and blood of 12 patients with a severe, treatment-resistant depressive episode before and after a course of ECT...
July 17, 2017: World Journal of Biological Psychiatry
https://www.readbyqxmd.com/read/28707590/combining-drug-and-psychological-treatments-for-obsessive-compulsive-disorder-what-is-the-evidence-when-and-for-whom
#6
Umberto Albert, Gabriele Di Salvo, Francesca Solia, Gianluca Rosso, Giuseppe Maina
BACKGROUND: serotonin reuptake inhibitors (SRIs) and cognitive-behavioral psychotherapy (CBT) are first-line treatments for obsessive-compulsive disorder (OCD). Since response is often inadequate, in recent years researchers investigated whether combining CBT and SRIs, either ab initio or sequentially, results in a greater reduction of obsessive-compulsive symptoms. OBJECTIVE: the aims of the present paper are to assess if combination treatment seems adding benefits as compared to either monotherapy alone and if sequential strategies may be effective in converting partial or non responders to a first-line treatment into responders...
July 12, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28642690/autonomy-in-depressive-patients-undergoing-dbs-treatment-informed-consent-freedom-of-will-and-dbs-potential-to-restore-it
#7
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
#8
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...
September 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28622206/bupropion-augmentation-in-a-case-of-compulsive-buying-disorder
#9
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...
July 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28604316/when-students-become-patients-tb-disease-among-medical-undergraduates-in-cape-town-south-africa
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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