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Refractory major depression

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https://www.readbyqxmd.com/read/28687552/hyponatremia-induced-by-hyperinsulinemia-euglycemia-therapy
#1
Jennifer R Beavers, Joanna L Stollings, Todd W Rice
PURPOSE: A case of symptomatic hyponatremia induced by hyperinsulinemia-euglycemia (HIE) therapy is reported. SUMMARY: A 59-year-old, 81.65-kg woman with hypertension, major depressive disorder, and anxiety arrived at a tertiary medical center 1.5 hours after an intentional overdose of oral amlodipine 200 mg, metoprolol tartrate 2,000 mg, and isosorbide mononitrate 1,200 mg. Upon arrival, her pulse was 63 beats/min and blood pressure was 106/56 mm Hg. The patient's blood pressure was refractory to fluids, calcium gluconate, and norepinephrine, resulting in initiation of HIE therapy...
July 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28590988/seizures-after-pediatric-vilazodone-ingestion-a-case-series
#2
Jeannine Del Pizzo, Elon K Fernandez, Kathryn T Kopec, Jesse Wenger, Erin M Noyes, Matthew Salzman, Fred M Henretig
Vilazodone hydrochloride is the first member in a new class of antidepressants called indolealkylamines and was approved for use in the United States in 2011 for major depressive disorder. It has a combined mechanism of action of a selective serotonin reuptake inhibitor and a partial agonist of serotonin 5-HT1A receptors. It has not been approved for use in the pediatric population, and toxicity from exploratory vilazodone ingestion has been rarely described to date. We describe 2 children with laboratory-confirmed vilazodone ingestions that led to significant toxicity including refractory status epilepticus in 1 patient and likely transient seizure activity in the other...
June 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28579782/effect-of-aripiprazole-on-non-24-hour-sleep-wake-rhythm-disorder-comorbid-with-major-depressive-disorder-a-case-report
#3
Kentaro Matsui, Yoshikazu Takaesu, Takeshi Inoue, Ken Inada, Katsuji Nishimura
BACKGROUND: Patients with non-24-hour sleep-wake rhythm disorder (N24SWD) exhibit a sleep pattern that is asynchronous with the external light-dark cycle, typically involving a cycling, relapsing-remitting pattern of sleep disturbances, including nighttime insomnia and daytime sleepiness. Here, we report the case of a patient with N24SWD comorbid with major depressive disorder, who was successfully treated with a low dose of aripiprazole. CASE PRESENTATION: A 47-year-old female presented with an 8-year complaint of difficulty falling asleep and waking up in the morning...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28570803/ketamine-for-depression-2-diagnostic-and-contextual-indications
#4
REVIEW
Chittaranjan Andrade
There is a substantial body of literature comprising anecdotal material and descriptions of uncontrolled and randomized controlled trials addressing the use of subanesthetic doses of ketamine for the off-label treatment of major depressive episodes. This article examines diagnostic indications for the off-label use of ketamine as an antidepressant and possible contexts in which ketamine may be trialled. Ketamine is indicated in patients who are in a major depressive episode. Most of the research data have been collected from patients with major depressive disorder, but patients with bipolar depression have also been studied...
May 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28559069/the-potential-for-intrathecal-baclofen-in-the-treatment-of-essential-tremor
#5
REVIEW
Mousa Hamad, Ryan Holland, Naveed Kamal, Robert Luceri, Antonios Mammis
INTRODUCTION: Essential tremor (ET) is the most common movement disorder of adults, affecting an estimated 7 million Americans.[1] Symptoms of ET range from slightly noticeable to debilitating, with one cohort study finding 15% of patients were forced into early retirement.[2] Additionally, depression has also been correlated with the severity of disability of ET. [3] Treatment options include propranolol and primidone.[4] Current treatment options are not very effective, with over half (56...
May 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28505499/clinical-predictors-of-acute-response-to-transcranial-direct-current-stimulation-tdcs-in-major-depression
#6
Giordano D'Urso, Bernardo Dell'Osso, Rodolfo Rossi, Andre Russowsky Brunoni, Marco Bortolomasi, Roberta Ferrucci, Alberto Priori, Andrea de Bartolomeis, Alfredo Carlo Altamura
BACKGROUND: Transcranial direct current stimulation (tDCS) is a promising neuromodulation intervention for poor-responding or refractory depressed patients. However, little is known about predictors of response to this therapy. The present study aimed to analyze clinical predictors of response to tDCS in depressed patients. METHODS: Clinical data from 3 independent tDCS trials on 171 depressed patients (including unipolar and bipolar depression), were pooled and analyzed to assess predictors of response...
May 8, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28492363/vagus-nerve-stimulation-improves-working-memory-performance
#7
Lihua Sun, Jari Peräkylä, Katri Holm, Joonas Haapasalo, Kai Lehtimäki, Keith H Ogawa, Jukka Peltola, Kaisa M Hartikainen
Vagus nerve stimulation (VNS) is used for treating refractory epilepsy and major depression. While the impact of this treatment on seizures has been established, its impact on human cognition remains equivocal. The goal of this study is to elucidate the immediate effects of vagus nerve stimulation on attention, cognition, and emotional reactivity in patients with epilepsy. Twenty patients (12 male and 8 female; 45 ± 13 years old) treated with VNS due to refractory epilepsy participated in the study. Subjects performed a computer-based test of executive functions embedded with emotional distractors while their brain activity was recorded with electroencephalography...
February 19, 2017: Journal of Clinical and Experimental Neuropsychology
https://www.readbyqxmd.com/read/28483102/use-of-buprenorphine-in-treatment-of-refractory-depression-a-review-of-current-literature
#8
REVIEW
Cornel N Stanciu, Oliver M Glass, Thomas M Penders
OBJECTIVE: Current treatment strategies for depressive disorders have limited efficacy, leaving many patients unimproved or with significant residual symptoms. The development of additional treatments represent a significant unmet need for providers. Several lines of evidence suggest that the opioid system may be involved in regulation of mood and incentives salience. Intervention based on modifying central opioid receptors may represent a novel approach to treatment of depressive disorders among those unresponsive to accepted treatments...
April 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/28469875/deep-brain-stimulation-in-the-bed-nucleus-of-the-stria-terminalis-and-medial-forebrain-bundle-in-a-patient-with-major-depressive-disorder-and-anorexia-nervosa
#9
Patric Blomstedt, Matilda Naesström, Owe Bodlund
Deep brain stimulation (DBS) may be considered in severe cases of therapy-refractory major depressive disorder (MDD). However, DBS for MDD is still an experimental therapy. Therefore, it should only be administered in clinical studies driven by multidisciplinary teams, including surgeons with substantial experience of DBS in the treatment of other conditions.
May 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28396172/role-of-suppression-of-the-inward-rectifier-current-in-terminal-action-potential-repolarization-in-the-failing-heart
#10
Michael G Klein, Matie Shou, Jayna Stohlman, Soroosh Solhjoo, Myles Haigney, Richard R Tidwell, Robert E Goldstein, Thomas P Flagg, Mark C Haigney
BACKGROUND: The failing heart exhibits an increased arrhythmia susceptibility that is often attributed to action potential (AP) prolongation due to significant ion channel remodeling. The inwardly rectifying K(+) current (IK1) has been reported to be reduced, but its contribution to shaping the AP waveform and cell excitability in the failing heart remains unclear. OBJECTIVE: The purpose of this study was to define the effect of IK1 suppression on the cardiac AP and excitability in the normal and failing hearts...
April 8, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28386401/the-efficacy-and-safety-of-intravenous-lidocaine-for-analgesia-in-the-older-adult-a-literature-review
#11
REVIEW
Harriet Daykin
Opioids remain the mainstay of analgesia for the treatment of moderate to severe acute pain. Even in the young, the use of opioids can be associated with an increased incidence of post-operative complications such as respiratory depression, vomiting, pruritus, excessive sedation, slowing of gastrointestinal function, and urinary retention. The need to manage acute pain in the older patient is becoming more common as the population ages, and increasingly older patients are undergoing more major surgery. Medical conditions are more common in older people and can result in the requirement of systemic analgesia for fractures, malignancy, nociceptive or neuropathic pain and peripheral vascular disease...
February 2017: British Journal of Pain
https://www.readbyqxmd.com/read/28373849/deep-brain-stimulation-in-anorexia-nervosa-hope-for-the-hopeless-or-exploitation-of-the-vulnerable-the-oxford-neuroethics-gold-standard-framework
#12
Rebecca J Park, Ilina Singh, Alexandra C Pike, Jacinta O A Tan
Neurosurgical interventions for psychiatric disorders have a long and troubled history (1, 2) but have become much more refined in the last few decades due to the rapid development of neuroimaging and robotic technologies (2). These advances have enabled the design of less invasive techniques, which are more focused, such as deep brain stimulation (DBS) (3). DBS involves electrode insertion into specific neural targets implicated in pathological behavior, which are then repeatedly stimulated at adjustable frequencies...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28367707/pharmacological-treatment-of-unipolar-depressive-disorders-summary-of-wfsbp-guidelines
#13
Michael Bauer, Emanuel Severus, Hans-Jürgen Möller, Allan H Young
OBJECTIVE: Major depressive disorder (MDD) is a severe mood disorder affecting individuals of all ages and is characterised by single or recurrent major depressive episodes. Key elements of acute and maintenance treatment of MDD include pharmacotherapy, and psychological approaches such as psychoeducation and adherence monitoring. METHODS: This summary of the 'Practice guidelines for the biological treatment of unipolar depressive disorders' comprises acute, continuation and maintenance treatment developed by an international Task Force of the World Federation of Societies of Biological Psychiatry (WFSBP), and focuses on pharmacological treatment options...
April 3, 2017: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/28236724/clinical-and-sociodemographic-variables-associated-with-interictal-dysphoric-disorder-and-interictal-personality-in-patients-with-drug-resistant-temporal-lobe-epilepsy-a-controlled-study
#14
Gerardo Maria de Araújo Filho, Bruna Tarifa, Raquel Espagnolla Santos, Ana Laura de Oliveira Dias, Júlia Rodrigues Leandro Ulliano, Lucia Helena Neves Marques
Psychiatric disorders (PD) have an elevated prevalence and an important negative impact on patients with epilepsy (PWE) since they are associated with lower quality of life and clinical refractoriness. However, it is also necessary to identify behavioral conditions possibly associated with epilepsy that are not part of the standard psychiatric classifications, such as Interictal Dysphoric Disorder (IDD) and Interictal Personality (IP). The frequency of IDD and IP in patients with drug-resistant temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS) was assessed...
April 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28138119/the-normalization-of-brain-%C3%A2-%C3%A2-f-fluorodeoxy-d-glucose-positron-emission-tomography-hypometabolism-following-electroconvulsive-therapy-in-a-55-year-old-woman-with-treatment-resistant-late-onset-depression-a-case-report
#15
Jeongjae Bak, Sang Mi Lee, Young-Joon Kwon, Se-Hoon Shim, Joong Il Kim
Major depressive disorder, especially in later life, has heterogeneous clinical characteristics and treatment responses. Symptomatically, psychomotor retardation, lack of energy, and apathy tends to be more common in people with late-onset depression (LOD). Despite recent advances in psychopharmacologic treatments, 20% to 30% of patients with mood disorders experience inadequate responses to medication, often resulting in a trial of electroconvulsive therapy (ECT). However, the therapeutic mechanism of ECT is still unclear...
February 28, 2017: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28137432/higher-than-recommended-dosages-of-antipsychotics-in-male-patients-with-schizophrenia-are-associated-with-increased-depression-but-no-major-neurocognitive-side-effects-results-of-a-cross-sectional-pilot-naturalistic-study
#16
Konstantinos N Fountoulakis, Xenia Gonda, Melina Siamouli, Katerina Moutou, Zoe Nitsa, Brian E Leonard, Siegfried Kasper
INTRODUCTION: The current small pilot naturalistic cross-sectional study assesses whether higher dosages of antipsychotics are related to a satisfactory outcome concerning symptoms of schizophrenia but also to a worse outcome in terms of adverse events and neurocognitive function. MATERIAL AND METHODS: 41 male stabilized hospitalized schizophrenic patients were assessed by PANSS, Calgary Depression Rating Scale, UKU and Simpson-Angus Scale and a battery of neurocognitive tests...
April 3, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28098427/emergence-of-mania-in-two-middle-aged-patients-with-a-history-of-unipolar-treatment-refractory-depression-receiving-vagus-nerve-stimulation
#17
Naji C Salloum, Marie C Walker, Sunil Gangwani, Charles R Conway
OBJECTIVES: We report on two patients who experienced emergence of full manic symptoms while receiving vagal nerve stimulation (VNS). METHODS: Two patients, both with a well-documented and verified history of longstanding unipolar depression, were initiated on VNS for treatment of their severe major depressive episodes. RESULTS: The two patients had emergence of full manic symptoms after 8 and 9 months of VNS, respectively. Manic symptoms were adequately managed with standard treatments (mood stabilizer and electroconvulsive therapy) and VNS was continued in the two subjects for up to 5 years without any further occurrences of manic/hypomanic episodes...
February 2017: Bipolar Disorders
https://www.readbyqxmd.com/read/27887679/-mindfulness-based-interventions-in-obsessive-compulsive-disorder-mechanisms-of-action-and-presentation-of-a-pilot-study
#18
M Gasnier, A Pelissolo, G Bondolfi, S Pelissolo, M Tomba, L Mallet, K N'diaye
Obsessive-compulsive disorder (OCD) is a frequent and severe disease, potentially inducing a major impairment for the patient and burden for their family. Recent research in psychiatry and neuroscience have led to better comprehension of the disease's mechanisms and helped to improve its treatment. However, a large proportion of patients have refractory symptoms, including for traditional cognitive and behavioral therapy by exposure and response prevention (ERP), leading clinicians to look for new treatments...
November 22, 2016: L'Encéphale
https://www.readbyqxmd.com/read/27848034/vagus-nerve-stimulation-in-psychiatry-a-systematic-review-of-the-available-evidence
#19
REVIEW
Camelia-Lucia Cimpianu, Wolfgang Strube, Peter Falkai, Ulrich Palm, Alkomiet Hasan
Invasive and non-invasive vagus nerve stimulation (VNS) is a promising add-on treatment for treatment-refractory depression, but is also increasingly evaluated for its application in other psychiatric disorders, such as dementia, schizophrenia, somatoform disorder, and others. We performed a systematic review aiming to give a detailed overview of the available evidence of the efficacy of VNS for the treatment of psychiatric disorders. Data derived from animal models, experimental trials without health-related outcomes, case reports, single-session studies, and reviews were excluded...
January 2017: Journal of Neural Transmission
https://www.readbyqxmd.com/read/27723668/vagus-nerve-stimulation-an-evolving-adjunctive-treatment-for-cardiac-disease
#20
Barış Akdemir, David G Benditt
The vagus nerve is a major component of the autonomic nervous system and plays a critical role in many body functions including for example, speech, swallowing, heart rate and respiratory control, gastric secretion, and intestinal motility. Vagus nerve stimulation (VNS) refers to any technique that stimulates the vagus nerve, with electrical stimulation being the most important. Implantable devices for VNS are approved therapy for refractory epilepsy and for treatment-resistant depression. In the case of heart disease applications, implantable VNS has been shown to be beneficial for treating heart failure in both preclinical and clinical studies...
October 2016: Anatolian Journal of Cardiology
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