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Refractory depression

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https://www.readbyqxmd.com/read/28936808/impact-of-tocilizumab-monotherapy-on-clinical-and-patient-reported-quality-of-life-outcomes-in-patients-with-rheumatoid-arthritis
#1
Leslie R Harrold, Ani John, George W Reed, Tmirah Haselkorn, Chitra Karki, YouFu Li, Jennie Best, Steve Zlotnick, Joel M Kremer, Jeffrey D Greenberg
INTRODUCTION: Tocilizumab (TCZ) monotherapy has been proven as an effective treatment for rheumatoid arthritis (RA) in clinical trials. However, there are limited data available regarding the effectiveness of TCZ monotherapy in real-world clinical settings in the United States. The objective of this study was to evaluate the impact of TCZ monotherapy on disease activity and patient-reported outcomes (PROs) in a US-based observational cohort of patients with RA seen in routine clinical practice...
September 21, 2017: Rheumatology and Therapy
https://www.readbyqxmd.com/read/28926830/a-distinctive-ictal-amplitude-integrated-electroencephalography-pattern-in-newborns-with-neonatal-epilepsy-associated-with-kcnq2-mutations
#2
Ana Vilan, José Mendes Ribeiro, Pasquale Striano, Sarah Weckhuysen, Lauren C Weeke, Eva Brilstra, Linda S de Vries, Maria Roberta Cilio
BACKGROUND: Recurrent and prolonged seizures are harmful for the developing brain, emphasizing the importance of early seizure recognition and effective therapy. Amplitude-integrated electroencephalography (aEEG) has become a valuable tool to diagnose epileptic seizures, and, in parallel, genetic etiologies are increasingly being recognized, changing the paradigm of the workup and management of neonatal seizures. OBJECTIVE: To report the ictal aEEG pattern in neonates with KCNQ2-related epilepsy...
September 20, 2017: Neonatology
https://www.readbyqxmd.com/read/28926735/ketamine-metabolites-with-antidepressant-effects-fast-economical-and-eco-friendly-enantioselective-separation-based-on-supercritical-fluid-chromatography-sfc-and-single-quadrupole-ms-detection
#3
Georg M Fassauer, Robert Hofstetter, Mahmoud Hasan, Stefan Oswald, Christina Modeß, Werner Siegmund, Andreas Link
Increasing evidence accumulates that metabolites of the dissociative anesthetic ketamine contribute considerably to the biological effects of this drug and could be developed as next generation antidepressants, especially for acute treatment of patients with therapy-refractory major depression. Analytical methods for the simultaneous determination of the plethora of hydroxylated, dehydrogenated and/or demethylated compounds formed after administration of ketamine hydrochloride are a prerequisite for future clinical investigations and a deeper understanding of the individual role of the isomers of these metabolites...
September 8, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28926161/neural-basis-of-major-depression-beyond-monoamine-hypothesis
#4
Shuken Boku, Shin Nakagawa, Hiroyuki Toda, Akitoyo Hishimoto
Monoamine hypothesis has been accepted as the most common hypothesis of major depression for a long period because of its simplicity and understandability. Actually, most of currently used antidepressants have been considered to act based on monoamine hypothesis. However, it has been pointed out as an important problem of monoamine hypothesis that it is unable to explain the latency of response to antidepressants. In addition, a large number of patients with major depression has been refractory to currently used antidepressants yet...
September 19, 2017: Psychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/28925030/drug-repurposing-may-generate-novel-approaches-to-treating-depression
#5
REVIEW
Mohamed Elsaed Ebada
OBJECTIVES: The breakthrough advancements in scientific medical research have greatly improved our understanding of the pathogenesis of depression, encouraging drug discoverers to take a shorter path than ever through drug repurposing to generate new antidepressant medications. In addition to reduced noradrenergic and serotonergic neurotransmission in the brain, other coincidence features such as glutamate neurotoxicity, inflammation and/or cerebrovascular insufficiency are implicated in the pathogenesis of major depressive disorder and late-life depression...
September 18, 2017: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/28922961/effect-of-ketamine-dose-on-self-rated-dissociation-in-patients-with-treatment-refractory-anxiety-disorders
#6
Cameron Castle, Andrew Gray, Shona Neehoff, Paul Glue
Patients receiving ketamine for refractory depression and anxiety report dissociative symptoms in the first 60 min post-dose. The most commonly used instrument to assess this is the Clinician-Administered Dissociative States Scale (CADSS), developed based on the assessment of patients with dissociative symptoms. Its psychometric properties for ketamine-induced dissociation have not been reported. We evaluated these from a study using 0.25-1 mg/kg ketamine and midazolam (as an active control) in 18 patients with treatment-resistant anxiety...
August 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28918253/deep-brain-stimulation-of-the-medial-forebrain-bundle-elevates-striatal-dopamine-concentration-without-affecting-spontaneous-or-reward-induced-phasic-release
#7
Marianne Klanker, Matthijs Feenstra, Ingo Willuhn, Damiaan Denys
Deep brain stimulation (DBS) of the medial forebrain bundle (MFB) induces rapid improvement of depressive symptoms in patients suffering from treatment-refractory major depressive disorder. It has been hypothesized that activation of the dopamine (DA) system contributes to this effect. To investigate whether DBS in the MFB affects DA release in the striatum, we combined DBS with fast-scan cyclic voltammetry (FSCV) in freely moving rats. Animals were implanted with a stimulating electrode at the border of the MFB and the ventral tegmental area, and a FSCV microelectrode in the ventromedial striatum to monitor extracellular DA during the acute onset of DBS and subsequent continued stimulation...
September 13, 2017: Neuroscience
https://www.readbyqxmd.com/read/28901169/predictors-of-response-to-occipital-nerve-stimulation-in-refractory-chronic-headache
#8
Sarah Miller, Laurence Watkins, Manjit Matharu
Background Occipital nerve stimulation is a promising treatment for refractory chronic headache disorders, but is invasive and costly. Identifying predictors of response would be useful in selecting patients. We present the results of an open-label prospective cohort study of 100 patients (35 chronic migraine, 33 chronic cluster headache, 20 short-lasting unilateral neuralgiform headache attacks and 12 hemicrania continua) undergoing occipital nerve stimulation, using a multivariate binary regression analysis to identify predictors of response...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28860968/differential-peripheral-proteomic-biosignature-of-fluoxetine-response-in-a-mouse-model-of-anxiety-depression
#9
Indira Mendez-David, Céline Boursier, Valérie Domergue, Romain Colle, Bruno Falissard, Emmanuelle Corruble, Alain M Gardier, Jean-Philippe Guilloux, Denis J David
The incorporation of peripheral biomarkers in the treatment of major depressive disorders (MDD) could improve the efficiency of treatments and increase remission rate. Peripheral blood mononuclear cells (PBMCs) represent an attractive biological substrate allowing the identification of a drug response signature. Using a proteomic approach with high-resolution mass spectrometry, the present study aimed to identify a biosignature of antidepressant response (fluoxetine, a Selective Serotonin Reuptake Inhibitor) in PBMCs in a mouse model of anxiety/depression...
2017: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/28860873/effects-of-intravenous-ketamine-in-a-patient-with-post-treatment-lyme-disease-syndrome
#10
Ashraf F Hanna, Bishoy Abraham, Andrew Hanna, Adam J Smith
Post-treatment Lyme disease syndrome (PTLDS) is a pain disorder for which there remains no gold standard treatment option. Here, we report a case of PTLDS in a female patient whose pain was refractory to treatment options such as radiofrequency ablation, vitamin infusion therapy, opioid analgesics, and other pharmacotherapies. The patient commenced an experimental intravenous ketamine infusion therapy at the Florida Spine Institute (Clearwater, FL, USA) and achieved relief from her chronic pain, an improved quality of life, reduced depression and suicidal ideation, and reduced opioid consumption...
2017: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/28858839/axonal-excitability-and-conduction-alterations-caused-by-levobupivacaine-in-rat
#11
Seçkin Tuncer, Tülay Tuncer Peker, İlksen Burat, Erhan Kiziltan, Barkin İlhan, Nizamettin Dalkiliç
In this study, effects of the long-acting amide-type local anesthetic levobupivacaine on axonal conduction and excitability parameters of the rat sciatic nerve were thoroughly examined both in vitro and in vivo. In order to deduce its effects on isolated nerve conduction, compound nerve action potential (CNAP) recordings were performed using the suction method over sciatic nerves of Wistar rats before and after administration of 0.05 % (1.7 mmol L-1) levobupivacaine. Levobupivacaine caused complete CNAP area and amplitude depression by blocking conduction in a time-dependent manner...
September 1, 2017: Acta Pharmaceutica
https://www.readbyqxmd.com/read/28858450/ketamine-for-depression-5-potential-pharmacokinetic-and-pharmacodynamic-drug-interactions
#12
REVIEW
Chittaranjan Andrade
Ketamine, administered in subanesthetic doses, is gaining recognition as an off-label treatment for severe and even treatment-refractory depression. This article explores potential pharmacokinetic and pharmacodynamic drug interactions of relevance to the use of ketamine in depression. Sparse evidence suggests that ketamine will not induce clinically significant drug interactions except to the extent that these are predictable by its clinical actions. A small body of literature indicates that drugs that induce cytochrome P450 (CYP)2B6 and CYP3A4 will reduce exposure to ketamine and that drugs that inhibit these enzymes will increase exposure to ketamine...
July 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28856580/can-matching-adjusted-indirect-comparison-methods-mitigate-placebo-response-differences-among-patient-populations-in-adjunctive-trials-of-brivaracetam-and-levetiracetam
#13
Elyse Swallow, Anna Fang, James Signorovitch, Jonathan Plumb, Simon Borghs
BACKGROUND AND OBJECTIVE: Patients with focal seizures recruited into adjunctive antiepileptic drug (AED) trials have become more refractory and severe over time; concurrently, placebo responses have increased. To attempt to account for heterogeneity among trials, propensity-score weighted patient-level data were used to indirectly compare placebo responses reported in brivaracetam and levetiracetam trials. METHODS: Patient-level data from randomised, placebo-controlled brivaracetam (recruited 2007-2014) and levetiracetam (1993-1998) trials were pooled...
August 30, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28854963/takayasu-s-arteritis-a-case-with-relapse-after-urgent-coronary-revascularization
#14
Klaus Empen, Astrid Hummel, Daniel Beug, Stephan B Felix, Mathias C Busch, Piotr M Kaczmarek
BACKGROUND: Vasculitides are commonly unrecognized causes of coronary stenosis and myocardial ischemia. We report on a 24-year old patient with Takayasu's arteritis who underwent urgent percutaneous coronary intervention, suffered from symptomatic restenosis of the left main coronary artery during standard immunosuppressive therapy. CASE PRESENTATION: A 24-year old woman was referred for coronary angiography because of typical progressive angina pectoris. On bicycle ergometry, there were both reproducible symptoms and deep ST segment depressions on precordial leads...
July 25, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28851798/study-protocol-for-a-multi-institutional-randomised-double-blinded-placebo-controlled-phase-iii-trial-investigating-additive-efficacy-of-duloxetine-for-neuropathic-cancer-pain-refractory-to-opioids-and-gabapentinoids-the-direct-study
#15
Hiromichi Matsuoka, Hiroto Ishiki, Satoru Iwase, Atsuko Koyama, Takashi Kawaguchi, Yoshiyuki Kizawa, Tatsuya Morita, Yoshinobu Matsuda, Tempei Miyaji, Keisuke Ariyoshi, Takuhiro Yamaguchi
INTRODUCTION: Management of patients with cancer suffering from neuropathic pain refractory to opioids and gabapentinoids remains an important challenge. Duloxetine is one of the choices after first-line treatment fails. The efficacy of duloxetine has been reported in patients with non-cancer disease and in chemotherapy-induced peripheral neuropathy, but no randomised clinical trials have examined its effects on neuropathic cancer pain refractory to first-line treatment. The objective of this study is to assess the analgesic efficacy of duloxetine in patients suffering from neuropathic cancer pain refractory to opioids and gabapentinoids...
August 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28844556/nocturnal-motor-activity-and-light-exposure-objective-actigraphy-based-marks-of-melancholic-and-non-melancholic-depressive-disorder-brief-report
#16
André Comiran Tonon, Daniel Fernando Paludo Fuchs, William Barbosa Gomes, Rosa Levandovski, Marcelo Pio de Almeida Fleck, Maria Paz Loayza Hidalgo, Luciano da Silva Alencastro
Differentiation of melancholic (MEL) and non-melancholic (N-MEL) depression results from subjective assessment of psychomotor disturbance, which obscures their accurate diagnosis. CORE instrument assigned participants with severe or refractory depression to MEL or N-MEL group. Participants underwent 7 days of actigraphy. Data was fitted to a cosinusoidal curve corresponding to a 24-h rhythm. Nocturnal activity was significantly higher in N-MEL. ROC curve shows that average night activity discriminate participants with 71% sensitivity and 100% specificity (area under the curve = 0...
August 19, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28843212/the-influence-of-endophenotypic-disease-specific-and-environmental-variables-on-the-expression-of-anxiety-in-pediatric-epilepsy
#17
William A Schraegle, Jeffrey B Titus
Children and adolescents with epilepsy often show higher rates of anxiety, which carries an increased risk for reduced health-related quality of life (HRQOL). The current study assessed the role of parental psychiatric history (i.e., anxiety, depression, and/or bipolar disorder) on the rate of anxiety features in youth seen in a tertiary epilepsy clinic. Data included parental ratings on the Behavior Assessment System for Children (BASC-2) and the Quality of Life in Childhood Epilepsy (QOLCE) questionnaire for 180 children and adolescents (mean age=11...
August 23, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28840189/refractoriness-accounts-for-variable-spike-burst-responses-in-somatosensory-cortex
#18
Bartosz Teleńczuk, Richard Kempter, Gabriel Curio, Alain Destexhe
Neurons in the primary somatosensory cortex (S1) respond to peripheral stimulation with synchronized bursts of spikes, which lock to the macroscopic 600-Hz EEG waves. The mechanism of burst generation and synchronization in S1 is not yet understood. Using models of single-neuron responses fitted to unit recordings from macaque monkeys, we show that these synchronized bursts are the consequence of correlated synaptic inputs combined with a refractory mechanism. In the presence of noise these models reproduce also the observed trial-to-trial response variability, where individual bursts represent one of many stereotypical temporal spike patterns...
July 2017: ENeuro
https://www.readbyqxmd.com/read/28838328/backing-into-the-future-pharmacological-approaches-to-the-management-of-resistant-depression
#19
P J Cowen
Pragmatic studies indicate that a substantial number of depressed patients do not remit with current first-line antidepressant treatments and after two failed treatment steps the chance of remission with subsequent therapies is around 15%. This paper focuses on current evidence for pharmacological treatments in resistant depression as well as possible future developments. For patients who have failed to respond to two antidepressant trials, augmentation with atypical antipsychotic drugs, specifically quetiapine and aripiprazole, has the best evidence for efficacy, though older treatments such as lithium and triiodothyronine still have utility...
August 25, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28832793/quality-of-life-depression-anxiety-and-coping-strategies-after-heart-transplantation
#20
Fulvio Bergamo Trevizan, Maria Cristina de Oliveira Santos Miyazaki, Yasmin Lima Witzel Silva, Christiane Maia Waetman Roque
Introduction: Heart transplantation is the therapeutic procedure indicated to increase the survival of patients with refractory heart failure. Improvement in overall functioning and quality of life are expected factors in the postoperative period. Objective: To identify and evaluate mental disorders and symptoms, such as depression and anxiety, quality of life and coping strategies in the post-surgical situation of heart transplantation. Methods: A cross-sectional, quantitative study with patients who have undergone heart transplantation...
May 2017: Brazilian Journal of Cardiovascular Surgery
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