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Refractory depression

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https://www.readbyqxmd.com/read/29763515/individualized-breathlessness-interventions-may-improve-outcomes-in-patients-with-advanced-copd
#1
Mary Y Y Qian, John Politis, Michelle Thompson, Darren Wong, Brian Le, Louis Irving, Natasha Smallwood
BACKGROUND AND OBJECTIVE: Many patients with advanced COPD experience refractory breathlessness and individualized breathlessness interventions may improve management of this complex symptom. The aims of this study were to develop, implement and assess the efficacy of a breathlessness intervention for patients with COPD and refractory breathlessness and to evaluate patient acceptability. METHODS: An individualized breathlessness plan, information leaflets, breathlessness education and a hand-held fan were offered to consecutive patients with severe COPD and refractory breathlessness attending a tertiary integrated respiratory and palliative care service...
May 15, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29756288/mixed-states-in-bipolar-and-major-depressive-disorders-systematic-review-and-quality-appraisal-of-guidelines
#2
REVIEW
N Verdolini, D Hidalgo-Mazzei, A Murru, I Pacchiarotti, L Samalin, A H Young, E Vieta, A F Carvalho
OBJECTIVE: This systematic review provided a critical synthesis and a comprehensive overview of guidelines on the treatment of mixed states. METHOD: The MEDLINE/PubMed and EMBASE databases were systematically searched from inception to March 21st, 2018. International guidelines covering the treatment of mixed episodes, manic/hypomanic, or depressive episodes with mixed features were considered for inclusion. A methodological quality assessment was conducted with the Appraisal of Guidelines for Research and Evaluation-AGREE II...
May 13, 2018: Acta Psychiatrica Scandinavica
https://www.readbyqxmd.com/read/29751598/informed-consent-decision-making-in-deep-brain-stimulation
#3
REVIEW
Gabriele Mandarelli, Germana Moretti, Massimo Pasquini, Giuseppe Nicolò, Stefano Ferracuti
Deep brain stimulation (DBS) has proved useful for several movement disorders (Parkinson’s disease, essential tremor, dystonia), in which first and/or second line pharmacological treatments were inefficacious. Initial evidence of DBS efficacy exists for refractory obsessive-compulsive disorder, treatment-resistant major depressive disorder, and impulse control disorders. Ethical concerns have been raised about the use of an invasive surgical approach involving the central nervous system in patients with possible impairment in cognitive functioning and decision-making capacity...
May 11, 2018: Brain Sciences
https://www.readbyqxmd.com/read/29748055/a-pilot-study-of-bed-nucleus-of-the-stria-terminalis-deep-brain-stimulation-in-treatment-resistant-depression
#4
Paul B Fitzgerald, Rebecca Segrave, Karyn E Richardson, Laura A Knox, Sally Herring, Zafiris J Daskalakis, Richard G Bittar
BACKGROUND: Studies are increasingly investigating the therapeutic effects of deep brain stimulation (DBS) applied to a variety of brain regions in the treatment of patients with highly treatment refractory depression. Limited research to date has investigated the therapeutic potential of DBS applied to the Bed Nucleus Of Stria Terminalis (BNST). OBJECTIVE: The aim of this study was to explore the therapeutic potential of DBS applied to the BNST. METHOD: Five patients with highly treatment resistant depression underwent DBS to the BNST in an open label case series design...
April 23, 2018: Brain Stimulation
https://www.readbyqxmd.com/read/29719351/senile-depression-with-somatization-symptoms-and-insomnia-is-diagnosed-as-multiple-system-atrophy-a-case-report
#5
Ling Yue, Hai Yu, Guanjun Li, Shifu Xiao
Patients who have senile depression with somatization symptoms are commonly encountered in clinical practice. The present case reports on a patient with senile depression who was repeatedly hospitalized and had somatic symptoms. Although the patient recovered after the first hospitalization, she suffered from a relapse one year later. As we followed up, due to the neurological findings and the response to treatment, we found that the patient is in line with the diagnoistic criteria for multiple system atrophy (MSA)...
December 25, 2017: Shanghai Archives of Psychiatry
https://www.readbyqxmd.com/read/29718262/ketamine-effects-on-eeg-during-therapy-of-treatment-resistant-generalized-anxiety-and-social-anxiety
#6
Shabah Mohammad Shadli, Tame Kawe, Daniel Martin, Neil McNaughton, Shona Neehoff, Paul Glue
Background: Ketamine is swiftly effective in a range of neurotic disorders that are resistant to conventional antidepressant and anxiolytic drugs. The neural basis for its therapeutic action is unknown. Here we report the effects of ketamine on the EEG of patients with treatment-resistant generalized anxiety and social anxiety disorders. Methods: Twelve patients with refractory DSM-IV generalized anxiety disorder and/or social anxiety disorder provided EEG during 10 minutes of relaxation before and 2 hours after receiving double-blind drug administration...
April 24, 2018: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29717977/a-study-of-novel-bilateral-thermal-capsulotomy-with-focused-ultrasound-for-treatment-refractory-obsessive-compulsive-disorder-2-year-follow-up
#7
Se Joo Kim, Daeyoung Roh, Hyun Ho Jung, Won Seok Chang, Chan-Hyung Kim, Jin Woo Chang
BACKGROUND: Recently, a new thermal lesioning approach using magnetic-resonance-guided focused ultrasound (MRgFUS) was introduced for the treatment of neurologic disorders. However, only 2 studies have used this approach for treatment-refractory obsessive-compulsive disorder (OCD), and follow-up was short-term. We investigated the efficacy and safety of bilateral thermal lesioning of the anterior limb of the internal capsule using MRgFUS in patients with treatment-refractory OCD and followed them for 2 years...
May 2, 2018: Journal of Psychiatry & Neuroscience: JPN
https://www.readbyqxmd.com/read/29713292/avatar-therapy-for-persistent-auditory-verbal-hallucinations-in-an-ultra-resistant-schizophrenia-patient-a-case-report
#8
Laura Dellazizzo, Stéphane Potvin, Kingsada Phraxayavong, Pierre Lalonde, Alexandre Dumais
Effective treatment strategies for schizophrenia remain very challenging and many treatment-resistant patients will suffer from persistent auditory verbal hallucinations (AVH). While clozapine is the gold-standard medication for this complex population, many will not respond to this molecule. For these ultra-resistant patients, limited options are available. Cognitive-behavioral therapy (CBT) is the most widely used psychological intervention, though it offers modest effects. With the interpersonal dimension of AVH being recognized, Avatar Therapy (AT), a novel experiential treatment enabling patients to create an avatar of their persecutor and allowing them to gain control over their symptoms, was developed and tested...
2018: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29707426/is-electroconvulsive-therapy-a-treatment-for-depression-following-traumatic-brain-injury
#9
Anja Srienc, Puneet Narang, Simrat Sarai, Yee Xiong, Steven Lippmann
Traumatic brain injury (TBI) can be caused by blunt or penetrating injury to the head. The pathophysiological evolution of TBI involves complex biochemical and genetic changes. Common sequelae of TBI include seizures and psychiatric disorders, particularly depression. In considering pharmacologic interventions for treating post-TBI depression, it is important to remember that TBI patients have a higher risk of seizures; therefore, the benefits of prescribing medications that lower the seizure threshold need to be weighed against the risk of seizures...
April 1, 2018: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/29703415/electroconvulsive-therapy-for-depression-in-a-patient-with-an-inspire-hypoglossal-nerve-stimulator-device-for-obstructive-sleep-apnea-a-case-report
#10
Katie Mingo, Alan Kominsky
OUTCOME OBJECTIVES: METHODS: This is a case report of a patient who underwent placement and initiation of a hypoglossal nerve stimulator device in the context of receiving electroconvulsive therapy for bipolar depression between February and September 2016. To our knowledge, this has not yet been reported in the literature. Outcome measurements included successful device activation and successful device use throughout electroconvulsive therapy. RESULTS: The patient underwent successful device implantation, activation, and use without disruption throughout electroconvulsive therapy sessions...
April 19, 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29687182/prevalence-and-management-of-post-bppv-residual-symptoms
#11
Cristina Vaduva, Jonathan Estéban-Sánchez, Ricardo Sanz-Fernández, Eduardo Martín-Sanz
OBJECTIVES: To evaluate the prevalence and management of residual symptoms in recovered BPPV patients. METHODS: We performed a retrospective study on BPPV patients of any of the three semicircular canals. Exclusion criteria were multiple-canal BPPV, refractory BPPV, central nervous system pathologies or other vestibular diseases. Patients were treated with repositioning maneuvers until the vertigo disappeared and evaluated for symptoms of instability at 1 month after resolution...
April 23, 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29685065/noninvasive-brain-stimulation-challenges-and-opportunities-for-a-new-clinical-specialty
#12
Aaron D Boes, Michael S Kelly, Nicholas T Trapp, Adam P Stern, Daniel Z Press, Alvaro Pascual-Leone
Noninvasive brain stimulation refers to a set of technologies and techniques with which to modulate the excitability of the brain via transcranial stimulation. Two major modalities of noninvasive brain stimulation are transcranial magnetic stimulation (TMS) and transcranial current stimulation. Six TMS devices now have approved uses by the U.S. Food and Drug Administration and are used in clinical practice: five for treating medication refractory depression and the sixth for presurgical mapping of motor and speech areas...
April 24, 2018: Journal of Neuropsychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/29676713/-deep-brain-stimulation-for-psychiatric-disorders
#13
M Figee, P R Schuurman, D Denys
- Deep brain stimulation (DBS) corrects pathological activity of neuropsychiatric brain networks with high frequency current via implanted brain electrodes.- DBS is an effective and safe treatment for therapy-refractory obsessive-compulsive disorder and potentially also for therapy-refractory major depressive disorder.- Experimental psychiatric indications for DBS are Tourette syndrome, addiction, anorexia nervosa, post-traumatic stress disorder, autism and schizophrenia.- DBS influences brain networks that are relevant for a variety of psychiatric symptoms...
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29667860/educational-needs-in-the-diagnosis-and-management-of-pediatric-functional-constipation-a-us-survey-of-specialist-and-primary-care-clinicians
#14
Justin Barnes, Brandon Coleman, Sharon Hwang, Aleksandra Stolic, Athos Bousvaros, Samuel Nurko, Gregory D Salinas
OBJECTIVES: The goal of this study was to identify opportunities among gastroenterologists and gastroenterology nurse practitioners (NPs)/physician assistants (PAs) for continuing medical education (CME) related to functional constipation. METHODS: An online, case-vignette survey was designed to identify and quantify practice patterns of pediatric gastroenterology clinicians. Case vignettes are a validated method for assessing clinician practice patterns. The survey consisted of three patient cases: a 3-year-old female with a 6-month history of constipation; a 6-year-old male with a 1-year history of constipation refractory to treatment and a sacral dimple with nearby tuft of hair; and a 16-year-old male with a 10-year history of constipation, and a sullen, depressed mood...
April 27, 2018: Postgraduate Medicine
https://www.readbyqxmd.com/read/29659211/ketamine-for-depression-6-effects-on-suicidal-ideation-and-possible-use-as-crisis-intervention-in-patients-at-suicide-risk
#15
Chittaranjan Andrade
A growing body of literature suggests that ketamine, administered in subanesthetic doses, has early-onset antidepressant action in patients with severe and even treatment-refractory depression. Many case reports, open-label studies, and randomized controlled trials (RCTs) suggest that ketamine may have dramatic antisuicidal effects, as well. This article examines the benefits of ketamine in patients with suicidal ideation with particular focus on the findings of recent RCTs and meta-analyses. Important findings are that a single dose of ketamine is associated with antisuicidal benefits that emerge within an hour of administration and persist for up to a week...
March 2018: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/29609146/effects-of-a-psychotherapeutic-group-intervention-in-patients-with-refractory-mesial-temporal-lobe-epilepsy-and-comorbid-psychogenic-nonepileptic-seizures-a-nonrandomized-controlled-study
#16
Amanda Cristian Serafim de Barros, Ana Eliza Romano Furlan, Lucia Helena Neves Marques, Gerardo Maria de Araújo Filho
PURPOSE: Psychogenic nonepileptic seizures (PNES) are paroxysmal episodes superficially resembling epileptic seizures but are not associated with any electrical abnormalities. Despite the existence of recent evidence addressing psychological interventions on PNES, there is a scarcity of studies investigating such interventions on patients with dual diagnoses, such as in temporal lobe epilepsy/mesial temporal sclerosis (TLE-MTS) with comorbid PNES; TLE-MTS is a very frequent epilepsy syndrome found in tertiary centers...
March 27, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29604484/psychiatric-and-cognitive-adverse-events-a-pooled-analysis-of-three-phase-iii-trials-of-adjunctive-eslicarbazepine-acetate-for-partial-onset-seizures
#17
Eva Andermann, Victor Biton, Selim R Benbadis, Bassel Shneker, Aashit K Shah, Mar Carreño, Eugen Trinka, Elinor Ben-Menachem, Arnaud Biraben, Francisco Rocha, Helena Gama, Hailong Cheng, David Blum
OBJECTIVE: To evaluate the nature and incidence of psychiatric and cognitive adverse events (AEs) reported with eslicarbazepine acetate (ESL) used as adjunctive treatment for refractory partial-onset seizures (POS) in adults. METHODS: This was a post-hoc analysis of data pooled from three randomized double-blind, placebo-controlled trials (BIA-2093-301, -302, -304). After an 8-week baseline period, patients received placebo or adjunctive ESL 400mg (studies 301 and 302 only), 800mg, or 1200mg once daily (QD) for 14weeks (2-week titration period, 12-week maintenance period)...
March 28, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29601316/clinical-trial-of-the-potassium-channel-activator-diazoxide-for-major-depressive-disorder-halted-due-to-intolerability
#18
Bashkim Kadriu, Shiwen Yuan, Cristan Farmer, Allison C Nugent, Marc S Lener, Mark J Niciu, Minkyung Park, Aaron Yazdian, Elizabeth D Ballard, Fritz A Henn, Ioline D Henter, Lawrence T Park, Carlos A Zarate
BACKGROUND: Some glutamatergic modulators have demonstrated rapid and relatively sustained antidepressant properties in patients with major depressive disorder. Because the potassium channel activator diazoxide increases glutamate uptake via potassium channel activation, we hypothesized that it might exert antidepressant effects by increasing the removal of glutamate from the synaptic cleft, thereby reducing excessive glutamate transmission. METHODS: This randomized, double-blind, placebo-controlled, crossover, single-site inpatient clinical study was conducted at the National Institute of Mental Health to assess the efficacy and safety of a 3-week course of diazoxide (200-400 mg daily, twice a day) versus a 3-week course of placebo in 6 participants with treatment-refractory major depressive disorder...
March 29, 2018: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29593576/vagus-nerve-as-modulator-of-the-brain-gut-axis-in-psychiatric-and-inflammatory-disorders
#19
REVIEW
Sigrid Breit, Aleksandra Kupferberg, Gerhard Rogler, Gregor Hasler
The vagus nerve represents the main component of the parasympathetic nervous system, which oversees a vast array of crucial bodily functions, including control of mood, immune response, digestion, and heart rate. It establishes one of the connections between the brain and the gastrointestinal tract and sends information about the state of the inner organs to the brain via afferent fibers. In this review article, we discuss various functions of the vagus nerve which make it an attractive target in treating psychiatric and gastrointestinal disorders...
2018: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29588852/treating-refractory-depression-in-parkinson-s-disease-a-meta-analysis-of-transcranial-magnetic-stimulation
#20
REVIEW
Alexandra M Lesenskyj, Megan P Samples, Jill M Farmer, Christina R Maxwell
Background: Parkinson's disease (PD) is often accompanied by clinically identified depression. Providing effective pharmacotherapies that concomitantly treat both motor and psychological symptoms can pose a challenge to physicians. For this reason, alternatives to standard anti-depressant treatments, such as repetitive transcranial magnetic stimulation (rTMS), have been evaluated within the Parkinson's population. Methods: A literature search was conducted on the PubMed database for all studies that evaluated rTMS as a treatment in patients with both depression and PD...
2018: Translational Neurodegeneration
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