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Antidepressant augmentation

Eva Ceskova, Petr Silhan
In spite of tremendous development in central nervous system research, current treatment is suboptimal, especially in severe mental disorders. In medicine, there are two main methods of improving the health care provided: seeking new treatment procedures and perfecting (optimizing) the existing ones. Optimization of treatment includes not only practical tools such as therapeutic drug monitoring but also implementation of general trends in the clinical practice. New pharmacological options include new more sophisticated forms of monoaminergic drugs, old drugs rediscovered on the base of a better understanding of pathophysiology of mental illnesses, and drugs aimed at new treatment targets...
2018: Neuropsychiatric Disease and Treatment
David Edberg, Debra Hoppensteadt, Amanda Walborn, Jawed Fareed, James Sinacore, Angelos Halaris
Immune system activation and neuroinflammation appear to play a key role in the pathophysiology and treatment of bipolar depression (BDD). This study is the first to analyze blood levels of the pro-inflammatory biomarker C-reactive protein (CRP) in bipolar disorder patients treated with the cyclooxygenase-2 inhibitor, celecoxib (CBX). In this double-blind study, 47 consenting patients with BDD were randomized to receive either escitalopram (10 mg twice/day) + CBX (200 mg twice/day), or escitalopram (10 mg twice/day) + placebo (twice/day)...
February 13, 2018: Journal of Psychiatric Research
Javier Trincado, Constanza Caneo
INTRODUCTION: Antidepressant treatment does not lead to a satisfactory response in a significant proportion of patients with depression. It has been postulated that co-administration of pharmacologically standardized nutrients (nutraceuticals), such as folate, would potentiate the effect of antidepressants. METHODS: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others...
February 25, 2018: Medwave
Yvette Low, Sajita Setia, Graca Lima
Psychiatric and physical conditions often coexist, and there is robust evidence that associates the frequency of depression with single and multiple physical conditions. More than half of patients with depression may have at least one chronic physical condition. Therefore, antidepressants are often used in cotherapy with other medications for the management of both psychiatric and chronic physical illnesses. The risk of drug-drug interactions (DDIs) is augmented by complex polypharmacy regimens and extended periods of treatment required, of which possible outcomes range from tolerability issues to lack of efficacy and serious adverse events...
2018: Neuropsychiatric Disease and Treatment
M Dold, L Bartova, J Mendlewicz, D Souery, A Serretti, S Porcelli, J Zohar, S Montgomery, S Kasper
OBJECTIVE: This multicenter, multinational, cross-sectional study aimed to investigate clinical characteristics and treatment outcomes associated with augmentation/combination treatment strategies in major depressive disorder (MDD). METHOD: Sociodemographic, clinical, and treatment features of 1410 adult MDD patients were compared between MDD patients treated with monotherapy and augmentation/combination medication using descriptive statistics, analyses of covariance (ancova), and Spearman's correlation analyses...
February 28, 2018: Acta Psychiatrica Scandinavica
I Antoniadou, M Kouskou, T Arsiwala, N Singh, S R Vasudevan, T Fowler, E Cadirci, G C Churchill, T Sharp
BACKGROUND AND PURPOSE: Lithium's antidepressant action may be mediated by inhibition of inositol monophosphatase (IMPase), a key enzyme in Gq protein coupled receptor signalling. Recently, the antioxidant agent ebselen was identified as an IMPase inhibitor. Here we investigated both ebselen and lithium in models of the 5-HT2A receptor, a Gq protein coupled receptor implicated in lithium's actions. EXPERIMENTAL APPROACH: 5-HT2A receptor function was modelled in mice by measuring the behavioural (head-twitches) and cortical immediate early gene (IEG; Arc, c-fos and Erg2 mRNA) responses to 5-HT2A receptor agonist administration...
February 27, 2018: British Journal of Pharmacology
Christian A Webb, Elizabeth A Olson, William D S Killgore, Diego A Pizzagalli, Scott L Rauch, Isabelle M Rosso
BACKGROUND: Rostral and subgenual anterior cingulate cortex (rACC and sgACC) activity and, to a lesser extent, volume have been shown to predict depressive symptom improvement across different antidepressant treatments. This study extends prior work by examining whether rACC and/or sgACC morphology predicts treatment response to Internet-based cognitive behavioral therapy (iCBT) for major depressive disorder. This is the first study to examine neural predictors of response to iCBT. METHODS: Hierarchical linear modeling tested whether pretreatment rACC and sgACC volumes predicted depressive symptom improvement during a six-session (10-week) randomized clinical trial of iCBT (n = 35) versus a monitored attention control condition (n = 38)...
March 2018: Biological Psychiatry: Cognitive Neuroscience and Neuroimaging
Mark Olfson, Tony B Amos, Carmela Benson, Jacquelyn McRae, Steven C Marcus
BACKGROUND: Although the clinical and health economic characteristics of commercially insured adults with treatment-resistant depression (TRD) have been well characterized, little is known about TRD in the Medicaid population. OBJECTIVE: To describe clinical and health economic characteristics of adult Medicaid beneficiaries with TRD. METHODS: Retrospective longitudinal cohort analyses were performed with Truven Health MarketScan Medicaid Database (2008-2014), focusing on adults with major depressive disorder (MDD) following an index antidepressant prescription...
March 2018: Journal of Managed Care & Specialty Pharmacy
Emmert Roberts, Ben Carter, Allan H Young
BACKGROUND: International guideline recommendations for the use of folate and its derivatives in the treatment of unipolar depressive disorders are confused and contradictory, perhaps reflecting wide variations in the underpinning evidence base. INTRODUCTION: We discuss differing methods of evidence synthesis in the formulation of international guideline recommendations. As an example we evaluated the efficacy of folate and its derivatives in unipolar depression via systematic review and meta-analysis...
February 1, 2018: Journal of Psychopharmacology
B Galling, J A Vernon, A K Pagsberg, A Wadhwa, E Grudnikoff, A J Seidman, M Tsoy-Podosenin, M Poyurovsky, J M Kane, C U Correll
OBJECTIVE: To evaluate the efficacy and safety of antidepressant augmentation of antipsychotics in schizophrenia. METHODS: Systematic literature search (PubMed/MEDLINE/PsycINFO/Cochrane Library) from database inception until 10/10/2017 for randomized, double-blind, efficacy-focused trials comparing adjunctive antidepressants vs. placebo in schizophrenia. RESULTS: In a random-effects meta-analysis (studies = 42, n = 1934, duration = 10...
March 2018: Acta Psychiatrica Scandinavica
Senthil Kumaran Satyanarayanan, Yin-Hwa Shih, Yu-Chuan Chien, Shih-Yi Huang, Piotr Gałecki, Siegfried Kasper, Jane Pei-Chen Chang, Kuan-Pin Su
Omega-3 polyunsaturated fatty acids (n-3 or omega-3 PUFAs) and melatonin receptor agonist ramelteon (RMT) both display antidepressant effects, while their cellular effects on anti-oxidative and neuroprotective mechanisms might be different. In this study, we aimed to decipher the individual and synergistic actions of n-3 PUFAs and RMT, as compared with the conventional antidepressant fluoxetine (FLX), in a cellular model of oxidative stress, which might play an important role in the pathophysiology of depression and associated disorders...
February 3, 2018: Molecular Neurobiology
Sylwia Wośko, Anna Serefko, Aleksandra Szopa, Piotr Wlaź, Andrzej Wróbel, Aleksandra Wlaź, Jolanta Górska, Ewa Poleszak
OBJECTIVE: During the last few decades, endocannabinoid system has emerged as a novel possible target for antidepressant treatment. Although the medical literature provides information on the mood-changing effects of CB1 ligands, little is known about the possible interaction between the simultaneous activation or inhibition of the CB1 receptor and administration of other agents that possess antidepressant potential. The main goal of our study was to evaluate the influence of the CB1 cannabinoid receptor ligands (oleamide - an endogenous agonist and AM251 - an inverse agonist/antagonist) on the antidepressant-like activity of biometals (i...
January 30, 2018: Journal of Pharmacy and Pharmacology
Baburajan Kandasamy, Navleen Kaur, Gulshan K Tomar, Atul Bharadwaj, Litto Manual, Meghna Chauhan
AIM: The purpose of this retrospective study is to assess implant success rates with various risk factors. MATERIALS AND METHODS: Two hundred patients with a total of 650 implants were selected. Risk factors, such as smoking, antidepressants, bruxism, diabetes, and bone augmentation procedures were considered, and patients were followed up for a period of 8 to 15 years. RESULTS: Of 650 implants placed, the success rate was 88%, i.e., a total of 572 implants were successful...
January 1, 2018: Journal of Contemporary Dental Practice
Kumud Madan, Sanju Nanda
Safranal, a monoterpene aldehyde, is present as one of the main volatile constituents of Crocus sativus Linn. (saffron flowers). This volatile constituent not only contributes to the aroma of saffron but has been reported to possess antidiabetic, antiulcer, antiasthamatic, anticonvulsant, antidepressant, cardioprotective, anticancer and UV protective properties. Most of these therapeutic actions are contributed by its potential to quench reactive oxygen species (ROS). Antioxidant properties of phytoconstituents are now being explored for developing photoprotective skin formulations...
January 4, 2018: Bioorganic Chemistry
Shoko Kagawa, Kazuo Mihara, Takeshi Suzuki, Goyo Nagai, Akifumi Nakamura, Kenji Nemoto, Tsuyoshi Kondo
BACKGROUND/AIMS: Serum levels of brain-derived neurotrophic factor (BDNF) and interleukin-6 (IL-6) were prospectively monitored in relation with therapeutic response to lamotrigine augmentation therapy in 46 (15 males and 31 females) inpatients with treatment-resistant depressive disorder during an 8-week treatment with lamotrigine using an open-study design. METHODS: The subjects were 46 depressed patients who had already shown insufficient response to at least 3 psychotropics including antidepressants, mood stabilizers, and atypical antipsychotics...
January 12, 2018: Neuropsychobiology
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
Wolfgang Rathmann, Oliver Kuß, Dörte Anderson, Stefan Busch, Michael Hahn, Johanna Engelhard, Ming Zou, Karel Kostev
The aim was to investigate the association between diabetes duration and depressive symptoms in type 2 diabetes. The DIAREG registry used data of a nationwide general medicine practice database (Disease Analyzer, Germany) augmented by prospective data from patient reported outcomes (PRO) including Center of Epidemiological Studies Depression Scale (CES-D: <16 vs. ≥16) and the SF-36. Multiple logistic regression models were used to investigate the association of diabetes duration with PROs. Overall, 1807 type 2 diabetes patients were registered in 108 practices...
January 3, 2018: Psychiatry Research
Douglas A Drossman, Jan Tack, Alexander C Ford, Eva Szigethy, Hans Törnblom, Lukas Van Oudenhove
BACKGROUND AND AIMS: Central neuromodulators (antidepressants, antipsychotics and other CNS targeted medications) are increasingly used for treatment of functional GI disorders (FGIDs), now recognized as disorders of gut-brain interaction. However, the available evidence and guidance for the use of central neuromodulators in these conditions is scanty and incomplete. In this Rome Foundation Working Team report, a multidisciplinary team summarized available research evidence and clinical experience to provide guidance and treatment recommendations...
December 21, 2017: Gastroenterology
Malek Bajbouj, Sabine Aust, Jan Spies, Ana-Lucia Herrera-Melendez, Sarah V Mayer, Maike Peters, Christian Plewnia, Andreas J Fallgatter, Lukas Frase, Claus Normann, Nora Behler, Linda Wulf, Eva-Lotta Brakemeier, Frank Padberg
Major Depressive Disorder (MDD) is one of the most prevalent psychiatric disorders worldwide. About 20-30% of patients do not respond to the standard psychopharmacological and/or psychotherapeutic interventions. Mounting evidence from neuroimaging studies in MDD patients reveal altered activation patterns in lateral prefrontal brain areas. Successful cognitive behavioral therapy (CBT) is associated with a recovery of these neural alterations. Moreover, it has been demonstrated that transcranial direct current stimulation (tDCS) is capable of influencing prefrontal cortex activity and cognitive functions such as working memory and emotion regulation...
December 6, 2017: European Archives of Psychiatry and Clinical Neuroscience
Wei-Hsi Chen, Yuan-Hsiang Chu, Kuo-Yen Chen
OBJECTIVES: Spontaneous orgasm is characterized by a spontaneous onset of orgasm without any preceding sexual or nonsexual trigger. It sheds insight on the mechanisms underlying orgasms and the sexual response cycle in humans. METHODS: We report a male patient of repetitive spontaneous orgasm under trazodone treatment and systematically review the literature on drug-associated spontaneous orgasm (DASO). RESULTS: A total of 25 patients (18 women and 7 men), including our reported case, experienced 27 DASO events...
January 2018: Clinical Neuropharmacology
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