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Refractory depression

Dennis D Spencer, Jason L Gerrard, Hitten P Zaveri
Intracranial electrophysiological recording in patients with refractory focal epilepsy is the gold standard for defining epileptogenic tissue. Although the concordance of intracranial electrophysiology, structural MRI, and pathology can identify brain regions for resection, complete seizure control after surgery is not achieved in all patients with focal epilepsy. Repetitive identical behavioural seizures suggest one onset area, but epileptogenesis might be distributed and connected by functional and structural brain networks outside the seizure onset area, which could explain poor postsurgical outcomes in some patients...
April 2018: Lancet Neurology
Hannah Maier, Saskia Helm, Sermin Toto, Nicole Moschny, Wolfgang Sperling, Thomas Hillemacher, Kai G Kahl, Ewgeni Jakubovski, Stefan Bleich, Helge Frieling, Alexandra Neyazi
Background: Electroconvulsive therapy (ECT) is one of the most effective treatment options for refractory depressed patients. To date, there are only a few predictors of response. Aim: The aim was to identify predictive biomarkers of remission to ECT on a molecular level. Methods: 11 patients suffering from a major depressive episode-according to the Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)-underwent 10 ECT sessions...
2018: Disease Markers
L N Melek, M Devine, T Renton
Trigeminal neuralgia (TN) is characterized by sharp, electric shock-like pain, which can be triggered by trivial stimuli. Although medical and surgical treatments are available for TN, some patients experience refractory pain, which has a significant impact on their quality of life. The aim of this systematic review was to determine the psychosocial impact of orofacial pain in patients with diagnosed TN. A search was initiated in three electronic databases (Embase, MEDLINE, PubMed) to identify potential studies for inclusion in the review...
March 8, 2018: International Journal of Oral and Maxillofacial Surgery
Jonaz Font, Mathilda Simeon, Christophe Simard, Stéphane Allouche, Anne-Flore Plane, Virginie Ferchaud, Marie Brionne, René Rouet, Marie Nowoczyn, Alain Manrique, Paolo Emilio Puddu, Paul Milliez, Joachim Alexandre
Whether oral anti-coagulants, vitamin K antagonists (VKAs) and non-vitamin K oral anticoagulant (NOACs) frequently prescribed to atrial fibrillation (AF) patients, do themselves have a pro- or anti-arrhythmic effect have never been addressed. Transmembrane action potentials were recorded in an acute rabbit model of superfused pulmonary veins (PVs) sleeves preparations using standard microelectrode technique. Fluindione 10 μmol/L (n = 6) increased the AP (action potential) duration (APD), induced a significantly Vmax depression (from 95±14 to 53±5 V/s, P < 0...
March 11, 2018: Fundamental & Clinical Pharmacology
David L Chan, Simron Singh
Carcinoid syndrome occurs in 20% of patients with neuroendocrine tumors, and serotonin is usually the main causative hormonal peptide. Carcinoid syndrome, and particularly diarrhea, can significantly impact patients' quality of life. Somatostatin analogs (SSAs) are the mainstay of treatment, but are unable to ameliorate symptoms in all patients due to dose-limiting side effects and tachyphylaxis. Telotristat is a novel oral inhibitor of tryptophan hydroxylase, which is the rate-limiting enzyme in serotonin synthesis...
2018: Therapeutics and Clinical Risk Management
Priyanka Thukral-Mahajan, Nilesh Shah, Gurvinder Kalra, Chittaranjan Andrade
Electroconvulsive therapy (ECT) is considered relatively contraindicated in patients with intracranial space-occupying lesions. A 53-year-old male presented with a 5-year history of medication-refractory major depressive disorder. Brain imaging findings suggested the presence of a ruptured dermoid cyst in the transverse sinus and a calcified meningioma in the temporal lobe sulcal space. There was no evidence of mass effect. Neurofibromatosis was the only other clinical condition present. The patient had no clinical neurological deficits...
October 2017: Indian Journal of Psychiatry
Anne Duffy, Paul Grof
INTRODUCTION: There is a resurgence of interest in lithium treatment of bipolar disorders in part related to its unique anti-suicidal and neuroprotective effects. METHODS: This is a narrative review of key studies pertaining to the effectiveness and tolerability of lithium treatment in pediatric populations. RESULTS: Evidence supports that lithium is an effective and generally well-tolerated acute treatment for pediatric mania compared to placebo...
February 28, 2018: Pharmacopsychiatry
Gin S Malhi, Tim Outhred, Amber Hamilton, Philip M Boyce, Richard Bryant, Paul B Fitzgerald, Bill Lyndon, Roger Mulder, Greg Murray, Richard J Porter, Ajeet B Singh, Kristina Fritz
In December 2015, the Royal Australian and New Zealand College of Psychiatrists published a comprehensive set of mood disorder clinical practice guidelines for psychiatrists, psychologists and mental health professionals. This guideline summary, directed broadly at primary care physicians, is an abridged version that focuses on major depression. It emphasises the importance of shared decision making, tailoring personalised care to the individual, and delivering care in the context of a therapeutic relationship...
March 5, 2018: Medical Journal of Australia
Olivier Percie du Sert, Stéphane Potvin, Olivier Lipp, Laura Dellazizzo, Mélanie Laurelli, Richard Breton, Pierre Lalonde, Kingsada Phraxayavong, Kieron O'Connor, Jean-François Pelletier, Tarik Boukhalfi, Patrice Renaud, Alexandre Dumais
Schizophrenia is a chronic and severe mental illness that poses significant challenges. While many pharmacological and psychosocial interventions are available, many treatment-resistant schizophrenia patients continue to suffer from persistent psychotic symptoms, notably auditory verbal hallucinations (AVH), which are highly disabling. This unmet clinical need requires new innovative treatment options. Recently, a psychological therapy using computerized technology has shown large therapeutic effects on AVH severity by enabling patients to engage in a dialogue with a computerized representation of their voices...
February 24, 2018: Schizophrenia Research
Sean J Belouin, Jack E Henningfield
The purpose of this commentary is to provide an introduction to this special issue of Neuropharmacology with a historical perspective of psychedelic drug research, their use in psychiatric disorders, research-restricting regulatory controls, and their recent emergence as potential breakthrough therapies for several brain-related disorders. It begins with the discovery of lysergic acid diethylamide (LSD) and its promising development as a treatment for several types of mental illnesses during the 1940s. This was followed by its abuse and stigmatization in the 1960s that ultimately led to the placement of LSD and other psychedelic drugs into the most restrictively regulated drug schedule of the United States Controlled Substances Act (Schedule I) in 1970 and its international counterparts...
February 21, 2018: Neuropharmacology
Aaron D Boes, Brandt D Uitermarkt, Fatimah M Albazron, Martin J Lan, Conor Liston, Alvaro Pascual-Leone, Marc J Dubin, Michael D Fox
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for medication-refractory major depression, yet the mechanisms of action for this intervention are poorly understood. Here we investigate cerebral cortex thickness as a possible biomarker of rTMS treatment response. METHODS: Longitudinal change in cortical thickness is evaluated relative to clinical outcomes across 48 participants in 2 cohorts undergoing left dorsolateral prefrontal cortex rTMS as a treatment for depression...
January 31, 2018: Brain Stimulation
Yuyan Cheng, Sachi Desse, Ana Martinez, Ryan J Worthen, Richard S Jope, Eleonore Beurel
Recovery from major depressive disorder is difficult, particularly in patients who are refractory to antidepressant treatments. To examine factors that regulate recovery, we developed a prolonged learned helplessness depression model in mice. After the induction of learned helplessness, mice were separated into groups that recovered or did not recover within 4 weeks. Comparisons were made between groups in hippocampal proteins, inflammatory cytokines, and blood brain barrier (BBB) permeability. Compared with mice that recovered and control mice, non-recovered mice displaying prolonged learned helplessness had greater hippocampal activation of glycogen synthase kinase-3 (GSK3), higher levels of tumor necrosis factor-α (TNFα), interleukin-17A, and interleukin-23, increased permeability of the blood brain barrier (BBB), and lower levels of the BBB tight junction proteins occludin, ZO1, and claudin-5...
February 13, 2018: Brain, Behavior, and Immunity
Gopinath Niraj
Background: Chronic abdominal wall pain arising from the myofascial structures is termed abdominal myofascial pain syndrome and is an important cause of refractory abdominal pain that utilizes significant health care costs. The current literature is vague on its management. Design: The author presents a prospective audit of a structured management pathway and discusses the pathophysiology of abdominal myofascial pain syndrome. The objective was to identify an effective and durable treatment for the individual patient and evaluate patient satisfaction with the management pathway...
February 9, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Sayra Catalina Coral Castro, Gislaine Verginia Baroni, William Alves Martins, André Luis Fernandes Palmini, Luísa Weber Bisol
OBJECTIVES: The objective of the study was to access the suicide risk (SR) in patients with refractory epilepsy and its association with temperament and sleep quality. METHODS: A total of 50 consecutive patients referred for epilepsy surgery evaluation in the Porto Alegre Epilepsy Surgery Program were included. All patients had a detailed neurologic and psychiatric evaluation, including video-electroencephalogram (VEEG), high-resolution magnetic ressonance imaging (MRI), and neuropsychologic assessment...
February 8, 2018: Epilepsy & Behavior: E&B
Ana María Ramírez-Giraldo, Diana Restrepo
INTRODUCTION: Bipolar disorder is a chronic and recurrent mood disease that includes symptoms that fluctuate from euphoria to depression. As a mood disorder, itis one of the main contraindications for transplantation procedures. The case is presented of a patient with bipolar disorder who had a heart transplant after a cardiac arrest. Heart transplantation is the treatment of choice in patients with heart failure and arrhythmias that do not respond to conventional treatment. METHODS: Case report and narrative review of literature...
January 2018: Revista Colombiana de Psiquiatría
Nolan R Williams, Keith D Sudheimer, Brandon S Bentzley, Jaspreet Pannu, Katy H Stimpson, Dalton Duvio, Kirsten Cherian, Jessica Hawkins, Kristen H Scherrer, Benjamin Vyssoki, Danielle DeSouza, Kristin S Raj, Jennifer Keller, Alan F Schatzberg
No abstract text is available yet for this article.
February 5, 2018: Brain: a Journal of Neurology
Cheng-Ta Li, Tung-Ping Su
No abstract text is available yet for this article.
February 5, 2018: Brain: a Journal of Neurology
Gerardo Maria de Araújo Filho, Denise Poltronieri Martins, Angélica Marta Lopes, Beatriz de Jesus Brait, Ana Eliza Romano Furlan, Camila Ive Ferreira Oliveira, Lucia Helena Neves Marques, Dorotéia Rossi Silva Souza, Eduardo Alves de Almeida
OBJECTIVE: The objective was to evaluate the genetic and biochemical profiles associated with oxidative stress (OS) in patients with temporal lobe epilepsy with mesial temporal sclerosis (TLE-MTS) and a healthy control group, and also to verify the possible existence of association between OS markers and psychiatric disorders (PD) in group with TLE-MTS. METHODS: Forty-six patients with refractory TLE-MTS and 112 healthy controls were included. Psychiatric evaluation occurred through Diagnostical and Statistical Manual of Mental Disorders (DSM-5) criteria...
January 26, 2018: Epilepsy & Behavior: E&B
Xi Zhu, Zhongqiong He, Cheng Luo, Xiangmiao Qiu, Shixu He, Anjiao Peng, Lin Zhang, Lei Chen
OBJECTIVE: To investigate alterations in spontaneous brain activity in MRI-negative refractory temporal lobe epilepsy patients with major depressive disorder using resting-state functional magnetic resonance imaging (RS-fMRI). METHODS: Eighteen MRI-negative refractory temporal lobe epilepsy patients with major depressive disorder (PDD), 17 MRI-negative refractory temporal lobe epilepsy patients without major depressive disorder (nPDD), and 21 matched healthy controls (HC) were recruited from West China Hospital of SiChuan University from April 2016 to June 2017...
March 15, 2018: Journal of the Neurological Sciences
Iris van Oostrom, Philip van Eijndhoven, Elke Butterbrod, Maria H van Beek, Joost Janzing, Rogier Donders, Aart Schene, Indira Tendolkar
OBJECTIVE: Electroconvulsive therapy (ECT) is still the most effective treatment of severe and therapy-refractory major depressive disorder. Cognitive side effects are the major disadvantage of ECT. Cognitive deficits are generally temporary in nature and may be mediated by the hippocampus. Recent studies have shown a temporary increase in hippocampal volume and a temporary decrease in cognitive functioning post-ECT compared with pre-ECT. This study investigates whether these volumetric changes are related to changes in cognitive functioning after ECT...
January 31, 2018: Journal of ECT
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