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Refractory depression

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https://www.readbyqxmd.com/read/29347805/spectral-signatures-of-activity-dependent-neural-feedback-in-the-corticothalamic-system
#1
N Roy, P Sanz-Leon, P A Robinson
The modulation of neural quantities by presynaptic and postsynaptic activities via local feedback processes is investigated by incorporating nonlinear phenomena such as relative refractory period, synaptic enhancement, synaptic depression, and habituation. This is done by introducing susceptibilities, which quantify the response in either firing threshold or synaptic strength to unit change in either presynaptic or postsynaptic activity. Effects on the power spectra are then analyzed for a realistic corticothalamic model to determine the spectral signatures of various nonlinear processes and to what extent these are distinct...
November 2017: Physical Review. E
https://www.readbyqxmd.com/read/29336990/failure-of-intracardiac-pacing-after-fatal-propafenone-overdose-a-case-report
#2
Ivan Zeljković, Nikola Bulj, Matea Kolačević, Vedran Čabrilo, Diana Delić Brkljačić, Šime Manola
BACKGROUND: Propafenone is a sodium-channel blocker, class IC antiarrhythmic drug, frequently used to manage supraventricular dysrhythmias, especially atrial fibrillation. We report a self mono-intoxication with propafenone. CASE REPORT: A 68-year-old woman presented with a decreased level of consciousness, hypotension, and electrocardiogram showing QRS widening with atrial asystole and extreme bradycardia < 20 beats/min. After initial stabilization with transcutaneous pacing, laboratory findings detected normal electrolyte ranges and metabolic acidosis, and her medical history revealed availability of propafenone due to paroxysmal atrial fibrillation and depressive syndrome, which led to the suspicion of intoxication...
January 11, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29331701/the-use-of-triiodothyronine-t3-in-the-treatment-of-bipolar-depression-a-review-of-the-literature
#3
REVIEW
T Parmentier, P Sienaert
BACKGROUND: There is a paucity of treatment options for bipolar depression. The use of triiodothyronine (T3) has been suggested as adjunctive treatment. METHODS: A search on Medline, Limo and ScienceDirect was performed using the search terms bipolar disorder, bipolar depression, treatment resistant, treatment refractory, thyroid hormones, triiodothyronine, T3, acceleration and augmentation. RESULTS: We retrieved three open studies, one comparative study, two double blind and one retrospective chart review...
January 9, 2018: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29304922/the-appropriate-use-of-opioids-in-the-treatment-of-refractory-restless-legs-syndrome
#4
Michael H Silber, Philip M Becker, Mark J Buchfuhrer, Christopher J Earley, William G Ondo, Arthur S Walters, John W Winkelman
Restless legs syndrome (RLS) is a distinct disorder, differing from chronic pain in many ways. Refractory RLS is characterized by unresponsiveness to dopamine agonists or alpha-2-delta ligands due to inadequate efficacy, augmentation, or adverse effects. This may result in severely impaired quality of life, profound insomnia, and suicidal depression. Opioid therapy is a mainstay in the management of these patients. This article summarizes the basic science and clinical evidence in support of their use, including the positive result of a large controlled multicenter study of 306 subjects, and outlines an approach to their use in clinical practice...
January 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29303703/reasons-for-inactive-disease-and-flare-in-systemic-onset-juvenile-idiopathic-arthritis-patients-during-tocilizumab-treatment
#5
Mikhail M Kostik, Eugenia A Isupova, Irina A Chikova, Margarita F Dubko, Vera V Masalova, Ludmila S Snegireva, Olga V Kalashnikova, Vyacheslav G Chasnyk
OBJECTIVES: The aim of our study was to evaluate disease courses and outcomes of sJIA children undergoing tocilizumab (TCZ) treatment, and to establish the predictors which distinguish inactive disease and disease flares. METHODS: Our retrospective study included 48 active sJIA children who were refractory to different anti-rheumatic drugs and who were then started on TCZ. The effectiveness of TCZ was assessed by the changes of sJIA attributed signs and symptoms and the remission was judged according to the Wallace (2004) criteria...
December 15, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29274805/prospective-validation-that-subgenual-connectivity-predicts-antidepressant-efficacy-of-transcranial-magnetic-stimulation-sites
#6
Anne Weigand, Andreas Horn, Ruth Caballero, Danielle Cooke, Adam P Stern, Stephan F Taylor, Daniel Press, Alvaro Pascual-Leone, Michael D Fox
BACKGROUND: The optimal target in the dorsolateral prefrontal cortex for treating depression with repetitive transcranial magnetic stimulation (rTMS) remains unknown. Better efficacy has been associated with stimulation sites that are 1) more anterior and lateral and 2) more functionally connected to the subgenual cingulate. Here we prospectively test whether these factors predict response in individual patients. METHODS: A primary cohort (Boston, n = 25) with medication-refractory depression underwent conventional open-label rTMS to the left dorsolateral prefrontal cortex...
November 10, 2017: Biological Psychiatry
https://www.readbyqxmd.com/read/29258968/refractory-chronic-epilepsy-associated-with-neuronal-auto-antibodies-could-perisylvian-semiology-be-a-clue
#7
Lisa Gillinder, Linda Tjoa, Basil Mantzioris, Stefan Blum, Sasha Dionisio
We report a case series of 10 patients with chronic medically refractory antibody-positive autoimmune epilepsy and assess their common clinical features. Immune-mediated seizures are most commonly reported in the context of encephalitis or encephalopathy, with few reports focusing on lone, chronic epilepsy in the outpatient setting. Our aim was to define the potential diagnostic clues that might be present in these cases, leading to consideration of an autoimmune cause of the epilepsy. We performed a retrospective review of all patients presenting to the outpatient department of our unit who underwent autoimmune screening...
December 20, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/29250146/advanced-research-on-deep-brain-stimulation-in-treating-mental-disorders
#8
Dongxin Wang, Xuejun Liu, Bin Zhou, Weiping Kuang, Tiansheng Guo
Deep brain stimulation is a method that involves using an electric stimulus on a specific target in the brain with stereotaxis. It is a minimally invasive, safe, adjustable and reversible nerve involvement technology. At present, this technique is widely applied to treat movement disorders and has produced promising effects on mental symptoms, including combined anxiety and depression. Deep brain stimulation has therefore been employed as a novel treatment for depression, obsessive-compulsive disorder, habituation, Tourette's syndrome, presenile dementia, anorexia nervosa and other refractory mental illnesses...
January 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29239239/depressive-disorders-in-patients-with-pharmaco-resistant-mesial-temporal-lobe-epilepsy
#9
Eleonora Borges Gonçalves, Tania Aparecida Marchiori de Oliveira Cardoso, Clarissa Lin Yasuda, Fernando Cendes
Objectives To assess depressive disorders in patients with mesial temporal lobe epilepsy (MTLE) refractory to medical treatment. Methods Adult patients with refractory MTLE completed two questionnaires (Mini International Neuropsychiatric Interview (MINI) and the Beck Depression Inventory (BDI) had a semi-structured psychiatric interview and a high resolution MRI scan. For complete neuropsychiatric diagnosis, as per International Classification of Diseases (ICD-10), the results were combined with clinical history and additional information from the patients' family...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29233194/ibuprofen-plasma-concentration-profile-in-deliberate-ibuprofen-overdose-with-circulatory-depression-treated-with-therapeutic-plasma-exchange-a-case-report
#10
Stefanie Geith, Bertold Renner, Christian Rabe, Jochen Stenzel, Florian Eyer
BACKGROUND: Inquiries relating to ibuprofen overdose have more than tripled in the last ten years in our poison control center. Although the vast majority of cases have a benign clinical course, there are few severe or even fatal cases present with refractory circulatory failure. CASE PRESENTATION: We describe a case of a 48 year-old male with suicidal mono-ingestion of approximately 72 g ibuprofen. Despite an initial rapid spontaneous drop in the total ibuprofen plasma concentration (IPC) from 550 to 275 mcg/mL within the first 5 h after admission, the patient developed a circulatory failure, refractory to aggressive fluid resuscitation and high doses of vasopressors...
December 12, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29228889/acute-and-chronic-changes-in-brain-activity-with-deep-brain-stimulation-for-refractory-depression
#11
Silke Conen, Julian C Matthews, Nikunj K Patel, José Anton-Rodriguez, Peter S Talbot
Deep brain stimulation is a potential option for patients with treatment-refractory depression. Deep brain stimulation benefits have been reported when targeting either the subgenual cingulate or ventral anterior capsule/nucleus accumbens. However, not all patients respond and optimum stimulation-site is uncertain. We compared deep brain stimulation of the subgenual cingulate and ventral anterior capsule/nucleus accumbens separately and combined in the same seven treatment-refractory depression patients, and investigated regional cerebral blood flow changes associated with acute and chronic deep brain stimulation...
December 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/29222646/evidence-for-the-involvement-of-opioid-system-in-the-antidepressant-like-effect-of-ascorbic-acid
#12
Morgana Moretti, Camille M Ribeiro, Vivian B Neis, Luis Eduardo B Bettio, Priscila B Rosa, Ana Lúcia S Rodrigues
Considering the involvement of the opioid system in major depressive disorder (MDD), mainly concerning refractory MDD, and the evidence that ascorbic acid may exert a beneficial effect for the treatment of this disorder, this study investigated the involvement of the opioid system in the antidepressant-like effect of ascorbic acid in the tail suspension test (TST). Treatment of Swiss mice with the non-selective opioid receptor antagonist naloxone (1 mg/kg, i.p.) prevented the reduced immobility time caused by ascorbic acid (1 mg/kg, p...
December 8, 2017: Naunyn-Schmiedeberg's Archives of Pharmacology
https://www.readbyqxmd.com/read/29200045/the-addition-of-dexmedetomidine-as-an-adjunctive-therapy-to-benzodiazepine-use-in-alcohol-withdrawal-syndrome-a-literature-review
#13
Tarenne A Ferenchak
Alcohol withdrawal syndrome (AWS) is commonly encountered in the intensive care unit population. Currently, the mainstay treatment for AWS is the use of benzodiazepines. However, some patients are refractory to benzodiazepine treatment due to heavy alcohol abuse. In addition, escalating doses of benzodiazepines can lead to respiratory depression, requiring intubation and mechanical ventilation. Intubation and mechanical ventilation increase both intensive care unit and hospital length of stay. The addition of pharmacological agents to reduce the amount of benzodiazepine use in AWS has recently been studied...
October 2017: Journal of Addictions Nursing
https://www.readbyqxmd.com/read/29178511/neurostimulation-for-refractory-cervicogenic-headache-a-three-year-retrospective-study
#14
Marzieh Eghtesadi, Elizabeth Leroux, Marie-Pierre Fournier-Gosselin, Paul Lespérance, Luc Marchand, Heather Pim, Andreea Adelina Artenie, Line Beaudet, Guy Pierre Boudreau
BACKGROUND: Occipital nerve stimulation (ONS) has been used for the treatment of neuropathic pain conditions and could be a therapeutic approach for refractory cervicogenic headache (CeH). AIM: The aim of this study is to assess the efficacy and safety of unilateral ONS in patients suffering from refractory CeH. METHODS: We conducted a retrospective chart review on patients implanted from 2011 to 2013 at CHUM. The primary outcome was a 50% reduction in headache days per month...
November 27, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29173781/psychopharmacology-of-bipolar-disorders-in-children-and-adolescents
#15
REVIEW
Ekaterina Stepanova, Robert L Findling
Bipolar disorder is a debilitating illness that often leads to functional impairment when untreated. Monotherapy with mood stabilizers is preferable, although combination therapy may be necessary in refractory cases. Most studies focus on the use of lithium, anticonvulsants, and second-generation antipsychotics in the treatment of acute manic or depressive phases, as well as maintaining adequate response after the episode. More research is needed in the area of psychopharmacology of pediatric bipolar disorder to bridge the gap between clinical needs and the available data...
December 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/29169124/dorsomedial-frontal-cortical-metabolic-differences-of-comorbid-generalized-anxiety-disorder-in-refractory-major-depression-a-18f-fdg-pet-brain-imaging-study
#16
Chris Baeken, Guo-Rong Wu, Rudi De Raedt
BACKGROUND: Refractory major depressive disorder (MDD) is a severe mental disorder, chronic and difficult to treat. Although generalized anxiety disorder (GAD) is frequently observed as a comorbid diagnosis, little is known on the comorbid neurobiological substrate. Better insights may improve adequate treatment algorithms. OBJECTIVE: To examine this poorly understood clinical question, we recruited 52 individuals to participate in a [18F] FDG PET brain imaging study...
November 14, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29152502/target-specific-deep-brain-stimulation-of-the-ventral-capsule-ventral-striatum-for-the-treatment-of-neuropsychiatric-disease
#17
Chencheng Zhang, Dianyou Li, Haiyan Jin, Kristina Zeljic, Bomin Sun
Deep brain stimulation (DBS) is a well-established therapy for Parkinson's disease and other movement disorders. An accumulating body of evidence supports the extension of DBS application for the treatment of refractory psychiatric disorders. The ventral capsule/ventral striatum (VC/VS) is the most common anatomical target for obsessive-compulsive disorder (OCD), addiction, and depression. However, no specific electrode is available for the clinical targeting of these areas for DBS. According to the anatomical features of the VC/VS, a novel electrode was developed for simultaneous and independently programmed stimulation of the nucleus accumbens (NAc) and the anterior limb of the internal capsule (ALIC)...
October 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29122526/extracorporeal-myocardial-shockwave-therapy-a-precious-blast-for-refractory-angina-patients
#18
Massimo Slavich, Giuseppe Pizzetti, Anna Maria Vella, Claudia Carlucci, Davide Margonato, Roberto Spoladore, Gabriele Fragasso, Alberto Margonato
INTRODUCTION: Refractory Angina Pectoris (RAP) dramatically affects patients' life quality and medical costs. External Shockwave Myocardial Revascularization (ESMR) improves the cardiac blood flow thanks to its pro-angiogenetic action on ischaemic tissues. We hereby describe our experience of ESMR in RAP patients. MATERIALS AND METHODS: This is a retrospective study encompassing all patients referred to OSR for RAP treatment. Efficacy of ESMR was assessed considering the difference between pre and post therapy data in SAQ score and CCS, stress test performance, 24h ECG monitoring, NT-proBNP and echocardiographic measures...
October 3, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29101095/smartphone-cognitive-behavioral-therapy-as-an-adjunct-to-pharmacotherapy-for-refractory-depression-randomized-controlled-trial
#19
Akio Mantani, Tadashi Kato, Toshi A Furukawa, Masaru Horikoshi, Hissei Imai, Takahiro Hiroe, Bun Chino, Tadashi Funayama, Naohiro Yonemoto, Qi Zhou, Nao Kawanishi
BACKGROUND: In the treatment of major depression, antidepressants are effective but not curative. Cognitive behavioral therapy (CBT) is also effective, alone or in combination with pharmacotherapy, but accessibility is a problem. OBJECTIVE: The aim is to evaluate the effectiveness of a smartphone CBT app as adjunctive therapy among patients with antidepressant-resistant major depression. METHODS: A multisite, assessor-masked, parallel-group randomized controlled trial was conducted in 20 psychiatric clinics and hospitals in Japan...
November 3, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29089909/effects-of-anterior-capsulotomy-on-decision-making-in-patients-with-refractory-obsessive-compulsive-disorder
#20
Chencheng Zhang, Yilin Chen, Shuaiwei Tian, Tao Wang, Yile Xie, Haiyan Jin, Guozhen Lin, Hengfen Gong, Kristina Zeljic, Bomin Sun, Tianming Yang, Shikun Zhan
Despite various lines of evidence implicating impaired decision-making ability in individuals with obsessive-compulsive disorder (OCD), neuropsychological investigation has generated inconsistent findings. Although the cortico-striato-thalamo-cortical (CSTC) circuitry has been suggested, the involvement of the cortex has not yet been fully demonstrated. Moreover, it is unknown whether surgical intervention on the CSTC circuitry results in a predicted improvement of decision-making ability of OCD. Here we present a study of decision making based on the Iowa Gambling Task (IGT) to investigate decision making in a large sample of individuals with treatment-resistant OCD with and without anterior capsulotomy (AC)...
2017: Frontiers in Psychology
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