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Refractory major depression

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https://www.readbyqxmd.com/read/29756288/mixed-states-in-bipolar-and-major-depressive-disorders-systematic-review-and-quality-appraisal-of-guidelines
#1
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
#2
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/29685065/noninvasive-brain-stimulation-challenges-and-opportunities-for-a-new-clinical-specialty
#3
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
#4
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/29609146/effects-of-a-psychotherapeutic-group-intervention-in-patients-with-refractory-mesial-temporal-lobe-epilepsy-and-comorbid-psychogenic-nonepileptic-seizures-a-nonrandomized-controlled-study
#5
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/29601316/clinical-trial-of-the-potassium-channel-activator-diazoxide-for-major-depressive-disorder-halted-due-to-intolerability
#6
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
#7
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/29574297/gender-differences-in-prevalence-of-psychiatric-disorders-levels-of-alexithymia-and-coping-strategies-in-patients-with-refractory-mesial-temporal-epilepsy-and-comorbid-psychogenic-nonepileptic-seizures
#8
Amanda Cristian Serafim de Barros, Ana Eliza Romano Furlan, Lucia Helena Neves Marques, Gerardo Maria de Araújo Filho
OBJECTIVE: The objective of this study was to investigate the psychological aspects and psychiatric disorders (PDs) in patients dually diagnosed with refractory temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS) with psychogenic nonepileptic seizures (PNES) treated in a tertiary center in order to find any gender differences in psychiatric, clinical, and sociodemographic characteristics. METHOD: Psychiatric assessment was performed through the Diagnostic and Statistical Manual for Psychiatric Disorders - 5th edition (DSM-5)...
March 22, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29570971/phenotypic-assessment-of-drug-metabolic-pathways-and-p-glycoprotein-in-patients-treated-with-antidepressants-in-an-ambulatory-setting
#9
Célia Lloret-Linares, Marija Bosilkovska, Youssef Daali, Marianne Gex-Fabry, Kyle Heron, Victor Bancila, Giorgio Michalopoulos, Nader Perroud, Hélène Richard-Lepouriel, Jean-Michel Aubry, Jules Desmeules, Marie Besson
OBJECTIVE: Drug-metabolizing enzymes (DMEs), such as cytochrome P450 (CYP) enzymes, and transporters have emerged as major determinants of variability in drug metabolism and response. This study investigated the association between CYP and P-glycoprotein activities and plasma antidepressant concentration in an outpatient clinical setting. Secondary outcomes were antidepressant efficacy and tolerance. We also describe phenotypes in patients treated with antidepressants and evaluate the tolerance of a minimally invasive phenotyping approach...
March 20, 2018: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/29545905/s100b-homocysteine-vitamin-b12-folic-acid-and-procalcitonin-serum-levels-in-remitters-to-electroconvulsive-therapy-a-pilot-study
#10
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
https://www.readbyqxmd.com/read/29497194/electroconvulsive-therapy-for-medication-refractory-depression-in-a-patient-with-ruptured-intracranial-dermoid-cyst-meningioma-and-neurofibromatosis
#11
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
https://www.readbyqxmd.com/read/29490377/lithium-treatment-in-children-and-adolescents
#12
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
https://www.readbyqxmd.com/read/29490210/royal-australian-and-new-zealand-college-of-psychiatrists-clinical-practice-guidelines-for-mood-disorders-major-depression-summary
#13
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
https://www.readbyqxmd.com/read/29454551/rostral-anterior-cingulate-cortex-is-a-structural-correlate-of-repetitive-tms-treatment-response-in-depression
#14
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...
May 2018: Brain Stimulation
https://www.readbyqxmd.com/read/29452218/tnf%C3%AE-disrupts-blood-brain-barrier-integrity-to-maintain-prolonged-depressive-like-behavior-in-mice
#15
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...
March 2018: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/29429906/suicide-risk-temperament-traits-and-sleep-quality-in-patients-with-refractory-epilepsy
#16
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...
March 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29414551/oxidative-stress-in-patients-with-refractory-temporal-lobe-epilepsy-and-mesial-temporal-sclerosis-possible-association-with-major-depressive-disorder
#17
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...
March 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29406962/altered-spontaneous-brain-activity-in-mri-negative-refractory-temporal-lobe-epilepsy-patients-with-major-depressive-disorder-a-resting-state-fmri-study
#18
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
https://www.readbyqxmd.com/read/29389676/decreased-cognitive-functioning-after-electroconvulsive-therapy-is-related-to-increased-hippocampal-volume-exploring-the-role-of-brain-plasticity
#19
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
https://www.readbyqxmd.com/read/29371415/charting-the-road-forward-in-psychiatric-neurosurgery-proceedings-of-the-2016-american-society-for-stereotactic-and-functional-neurosurgery-workshop-on-neuromodulation-for-psychiatric-disorders
#20
Ausaf A Bari, Charles B Mikell, Aviva Abosch, Sharona Ben-Haim, Robert J Buchanan, Allen W Burton, Stephen Carcieri, G Rees Cosgrove, Pierre-Francois D'Haese, Zafiris Jeffrey Daskalakis, Emad N Eskandar, Jason L Gerrard, Wayne K Goodman, Benjamin David Greenberg, Robert E Gross, Clement Hamani, Zelma H T Kiss, Peter Konrad, Brian H Kopell, Lothar Krinke, Jean-Philippe Langevin, Andres M Lozano, Donald Malone, Helen S Mayberg, Jonathan P Miller, Parag G Patil, DeLea Peichel, Erika A Petersen, Ali R Rezai, R Mark Richardson, Patricio Riva-Posse, Tejas Sankar, Jason M Schwalb, Helen Blair Simpson, Konstantin Slavin, Paul H Stypulkowski, Tor Tosteson, Peter Warnke, Jon T Willie, Kareem A Zaghloul, Joseph S Neimat, Nader Pouratian, Sameer A Sheth
OBJECTIVE: Refractory psychiatric disease is a major cause of morbidity and mortality worldwide, and there is a great need for new treatments. In the last decade, investigators piloted novel deep brain stimulation (DBS)-based therapies for depression and obsessive-compulsive disorder (OCD). Results from recent pivotal trials of these therapies, however, did not demonstrate the degree of efficacy expected from previous smaller trials. To discuss next steps, neurosurgeons, neurologists, psychiatrists and representatives from industry convened a workshop sponsored by the American Society for Stereotactic and Functional Neurosurgery in Chicago, Illinois, in June of 2016...
January 25, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
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