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Refractory major depression

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https://www.readbyqxmd.com/read/28396172/role-of-suppression-of-the-inward-rectifier-current-ik1-on-terminal-action-potential-repolarization-in-the-failing-heart
#1
Michael G Klein, Matie Shou, Jayna Stohlman, Soroosh Sohljoo, 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. 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: To define the effect of IK1 suppression on the cardiac AP and excitability in the normal and failing heart. METHODS: We used electrophysiological and pharmacological approaches to investigate IK1 function in a swine tachy-pacing model of heart failure...
April 7, 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
#2
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
#3
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
#4
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
#5
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...
February 22, 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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/27672487/a-case-of-treatment-resistant-depression-and-body-dysmorphic-disorder-the-role-of-electroconvulsive-therapy-revisited
#12
Ram S Mahato, Maria Chona P San Gabriel, Carrol T Longshore, David B Schnur
Body dysmorphic disorder is a common, often disabling condition, and is frequently comorbid with major depressive disorder. Selective serotonin reuptake inhibitors constitute first line set of somatic interventions but the management of refractory patients remains challenging. Electroconvulsive therapy, an often highly beneficial treatment for medication resistant-depression, is not considered an effective therapeutic alternative for treatment refractory body dysmorphic disorder. Here we present a 50-year-old woman with body dysmorphic disorder and comorbid major depressive disorder who remained incapacitated and suicidal despite several trials with selective serotonin reuptake inhibitors and antipsychotic medication...
July 2016: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/27648916/metabolomic-signatures-of-drug-response-phenotypes-for-ketamine-and-esketamine-in-subjects-with-refractory-major-depressive-disorder-new-mechanistic-insights-for-rapid-acting-antidepressants
#13
D M Rotroff, D G Corum, A Motsinger-Reif, O Fiehn, N Bottrel, W C Drevets, J Singh, G Salvadore, R Kaddurah-Daouk
Ketamine, at sub-anesthetic doses, is reported to rapidly decrease depression symptoms in patients with treatment-resistant major depressive disorder (MDD). Many patients do not respond to currently available antidepressants, (for example, serotonin reuptake inhibitors), making ketamine and its enantiomer, esketamine, potentially attractive options for treatment-resistant MDD. Although mechanisms by which ketamine/esketamine may produce antidepressant effects have been hypothesized on the basis of preclinical data, the neurobiological correlates of the rapid therapeutic response observed in patients receiving treatment have not been established...
September 20, 2016: Translational Psychiatry
https://www.readbyqxmd.com/read/27570392/does-antiepileptic-drug-withdrawal-predispose-patients-undergoing-temporal-lobe-epilepsy-surgery-to-late-onset-of-psychiatric-morbidity-a-report-of-three-cases
#14
Garima Shukla, Priya Agarwal, Rajesh Sagar, Mamta Sood, Aditya Gupta, Ashish Suri, Ajay Garg
Surgery is an established and increasingly utilized treatment option in medically refractory temporal lobe epilepsy. Many psychiatric problems are known to complicate in the postoperative period. Most studies have a follow-up period of less than 24 months. We report the cases of three patients who developed severe psychiatric problems in the late postoperative period after successful temporal lobectomy for refractory epilepsy - Psychosis, major depression with psychosis, and severe anxiety disorder, respectively...
July 2016: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/27523499/neurometabolic-disorders-potentially-treatable-abnormalities-in-patients-with-treatment-refractory-depression-and-suicidal-behavior
#15
Lisa A Pan, Petra Martin, Thomas Zimmer, Anna Maria Segreti, Sivan Kassiff, Brian W McKain, Cynthia A Baca, Manivel Rengasamy, Keith Hyland, Nicolette Walano, Robert Steinfeld, Marion Hughes, Steven K Dobrowolski, Michele Pasquino, Rasim Diler, James Perel, David N Finegold, David G Peters, Robert K Naviaux, David A Brent, Jerry Vockley
OBJECTIVE: Treatment-refractory depression is a devastating condition with significant morbidity, mortality, and societal cost. At least 15% of cases of major depressive disorder remain refractory to treatment. The authors previously identified a young adult with treatment-refractory depression and multiple suicide attempts with an associated severe deficiency of CSF tetrahydrobiopterin, a critical cofactor for monoamine neurotransmitter synthesis. Treatment with sapropterin, a tetrahydrobiopterin analogue, led to dramatic and long-lasting remission of depression...
January 1, 2017: American Journal of Psychiatry
https://www.readbyqxmd.com/read/27489070/new-use-for-an-old-drug-oral-ketamine-for-treatment-resistant-depression
#16
Kevin M Swiatek, Kim Jordan, Julie Coffman
Treatment-resistant depression (TRD) is a disabling disorder that can interfere with a patient's capacity to understand and participate in medical care and thus negatively impact individual morbidity and mortality. Hospitalised patients with TRD may require rapid alleviation of severe symptomatology, particularly when suicidal or if unable to participate in care decisions. Ketamine is well known for its anaesthetic effects and its use as a 'street' drug; however, its action as an N-methyl-D-aspartate receptor antagonist makes ketamine a potential therapy for TRD...
August 3, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27469513/effects-of-ketamine-and-ketamine-metabolites-on-evoked-striatal-dopamine-release-dopamine-receptors-and-monoamine-transporters
#17
Adem Can, Panos Zanos, Ruin Moaddel, Hye Jin Kang, Katinia S S Dossou, Irving W Wainer, Joseph F Cheer, Douglas O Frost, Xi-Ping Huang, Todd D Gould
Following administration at subanesthetic doses, (R,S)-ketamine (ketamine) induces rapid and robust relief from symptoms of depression in treatment-refractory depressed patients. Previous studies suggest that ketamine's antidepressant properties involve enhancement of dopamine (DA) neurotransmission. Ketamine is rapidly metabolized to (2S,6S)- and (2R,6R)-hydroxynorketamine (HNK), which have antidepressant actions independent of N-methyl-d-aspartate glutamate receptor inhibition. These antidepressant actions of (2S,6S;2R,6R)-HNK, or other metabolites, as well as ketamine's side effects, including abuse potential, may be related to direct effects on components of the dopaminergic (DAergic) system...
October 2016: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/27274384/pharmacotherapy-of-acute-bipolar-depression-in-adults-an-evidence-based-approach
#18
REVIEW
Ather Muneer
In the majority of cases of bipolar disorder, manic episodes are usually brief and typically responsive to currently available psychopharmacological agents. In contrast, depressive manifestations are more prevalent and persistent, and can present as major depressive/mixed episodes or residual interepisode symptoms. The depressive phase is often associated with other neuropsychiatric conditions, such as anxiety spectrum disorders, substance use disorders, stressor-related disorders, and eating disorders. It is viewed as a systemic disease with associated ailments such as metabolic syndrome, diabetes mellitus, and cardiovascular disease...
May 2016: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/27268576/the-medial-forebrain-bundle-as-a-target-for-deep-brain-stimulation-for-obsessive-compulsive-disorder
#19
Volker A Coenen, Thomas E Schlaepfer, Peter Goll, Peter C Reinacher, Ulrich Voderholzer, Ludger Tebartz van Elst, Horst Urbach, Tobias Freyer
Deep brain stimulation (DBS) is a promising putative modality for the treatment of refractory psychiatric disorders such as major depression and obsessive-compulsive disorder (OCD). Several targets have been posited; however, a clear consensus on differential efficacy and possible modes of action remain unclear. DBS to the supero-lateral branch of the medial forebrain bundle (slMFB) has recently been introduced for major depression (MD). Due to our experience with slMFB stimulation for MD, and because OCD might be related to similar dysfunctions of the reward system, treatment with slMFB DBS seams meaningful...
June 8, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27215046/deep-transcranial-magnetic-stimulation-a-promising-drug-free-treatment-modality-in-the-treatment-of-chronic-low-back-pain
#20
Erin Yates, Ganesh Balu
UNLABELLED: Deep Transcranial Magnetic Stimulation (dTMS) is the next generation of technology used to treat Major Depressive Disorder (MDD). dTMS has been proven to be a safe and effective treatment modality for MDD and may have secondary benefits in patients with chronic low back pain by reducing pain related morbidity. We are presenting two case studies with MDD and chronic low back pain to demonstrate the effectiveness of both the antidepressant and analgesic effects of dTMS. BACKGROUND: Transcranial Magnetic Stimulation (rTMS) utilizes MRI-strength magnetic pulses outside the cranium to stimulate the brain to a depth of approximately 1 cm...
March 2016: Delaware Medical Journal
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