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Refractory major depression

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https://www.readbyqxmd.com/read/29101095/smartphone-cognitive-behavioral-therapy-as-an-adjunct-to-pharmacotherapy-for-refractory-depression-randomized-controlled-trial
#1
Akio Mantani, Tadashi Kato, Toshi A Furukawa, Masaru Horikoshi, Hissei Imai, Takahiro Hiroe, Bun Chino, Tadashi Funayama, Naohiro Yonemoto, Qi Zhou, Nao Kawanishi
BACKGROUND: In the treatment of major depression, antidepressants are effective but not curative. Cognitive behavioral therapy (CBT) is also effective, alone or in combination with pharmacotherapy, but accessibility is a problem. OBJECTIVE: The aim is to evaluate the effectiveness of a smartphone CBT app as adjunctive therapy among patients with antidepressant-resistant major depression. METHODS: A multisite, assessor-masked, parallel-group randomized controlled trial was conducted in 20 psychiatric clinics and hospitals in Japan...
November 3, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29018404/socioeconomic-outcome-and-quality-of-life-in-adults-after-status-epilepticus-a-multicenter-longitudinal-matched-case-control-analysis-from-germany
#2
Lena-Marie Kortland, Susanne Knake, Felix von Podewils, Felix Rosenow, Adam Strzelczyk
BACKGROUND: There is a lack of data concerning socioeconomic outcome and quality of life (QoL) in patients after status epilepticus (SE) in Germany. PATIENTS AND METHODS: Adult patients treated between 2011 and 2015 due to SE at the university hospitals in Frankfurt, Greifswald, and Marburg were asked to fill out a questionnaire regarding long-term outcome of at least 3 months after discharge. The SE cohort consisted of 25.9% patients with an acute symptomatic, 42% with a remote symptomatic and previous epilepsy, 22...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29016792/antidepressant-like-actions-of-inhibitors-of-poly-adp-ribose-polymerase-in-rodent-models
#3
Gregory A Ordway, Attila Szebeni, Liza J Hernandez, Jessica D Crawford, Katalin Szebeni, Michelle J Chandley, Katherine C Burgess, Corwin Miller, Erol Bakkalbasi, Russell W Brown
Background: Many patients suffering from depressive disorders are refractory to treatment with currently available antidepressant medications, while many more exhibit only a partial response. These factors drive research to discover new pharmacological approaches to treat depression. Numerous studies demonstrate evidence of inflammation and elevated oxidative stress in major depression. Recently, major depression has been shown to be associated with elevated levels of DNA oxidation in brain cells, accompanied by increased gene expression of the nuclear base excision repair enzyme, poly(ADP-ribose) polymerase-1...
August 3, 2017: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28926735/ketamine-metabolites-with-antidepressant-effects-fast-economical-and-eco-friendly-enantioselective-separation-based-on-supercritical-fluid-chromatography-sfc-and-single-quadrupole-ms-detection
#4
Georg M Fassauer, Robert Hofstetter, Mahmoud Hasan, Stefan Oswald, Christina Modeß, Werner Siegmund, Andreas Link
Increasing evidence accumulates that metabolites of the dissociative anesthetic ketamine contribute considerably to the biological effects of this drug and could be developed as next generation antidepressants, especially for acute treatment of patients with therapy-refractory major depression. Analytical methods for the simultaneous determination of the plethora of hydroxylated, dehydrogenated and/or demethylated compounds formed after administration of ketamine hydrochloride are a prerequisite for future clinical investigations and a deeper understanding of the individual role of the isomers of these metabolites...
September 8, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28926161/neural-basis-of-major-depressive-disorder-beyond-monoamine-hypothesis
#5
Shuken Boku, Shin Nakagawa, Hiroyuki Toda, Akitoyo Hishimoto
The monoamine hypothesis has been accepted as the most common hypothesis of major depressive disorder (MDD) for a long period because of its simplicity and understandability. Actually, most currently used antidepressants have been considered to act based on the monoamine hypothesis. However, an important problem of the monoamine hypothesis has been pointed out as follows: it fails to explain the latency of response to antidepressants. In addition, many patients with MDD have remained refractory to currently used antidepressants...
September 19, 2017: Psychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/28925030/drug-repurposing-may-generate-novel-approaches-to-treating-depression
#6
REVIEW
Mohamed Elsaed Ebada
OBJECTIVES: The breakthrough advancements in scientific medical research have greatly improved our understanding of the pathogenesis of depression, encouraging drug discoverers to take a shorter path than ever through drug repurposing to generate new antidepressant medications. In addition to reduced noradrenergic and serotonergic neurotransmission in the brain, other coincidence features such as glutamate neurotoxicity, inflammation and/or cerebrovascular insufficiency are implicated in the pathogenesis of major depressive disorder and late-life depression...
November 2017: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/28918253/deep-brain-stimulation-of-the-medial-forebrain-bundle-elevates-striatal-dopamine-concentration-without-affecting-spontaneous-or-reward-induced-phasic-release
#7
Marianne Klanker, Matthijs Feenstra, Ingo Willuhn, Damiaan Denys
Deep brain stimulation (DBS) of the medial forebrain bundle (MFB) induces rapid improvement of depressive symptoms in patients suffering from treatment-refractory major depressive disorder (MDD). It has been hypothesized that activation of the dopamine (DA) system contributes to this effect. To investigate whether DBS in the MFB affects DA release in the striatum, we combined DBS with fast-scan cyclic voltammetry (FSCV) in freely moving rats. Animals were implanted with a stimulating electrode at the border of the MFB and the ventral tegmental area, and a FSCV microelectrode in the ventromedial striatum to monitor extracellular DA during the acute onset of DBS and subsequent continued stimulation...
November 19, 2017: Neuroscience
https://www.readbyqxmd.com/read/28860968/differential-peripheral-proteomic-biosignature-of-fluoxetine-response-in-a-mouse-model-of-anxiety-depression
#8
Indira Mendez-David, Céline Boursier, Valérie Domergue, Romain Colle, Bruno Falissard, Emmanuelle Corruble, Alain M Gardier, Jean-Philippe Guilloux, Denis J David
The incorporation of peripheral biomarkers in the treatment of major depressive disorders (MDD) could improve the efficiency of treatments and increase remission rate. Peripheral blood mononuclear cells (PBMCs) represent an attractive biological substrate allowing the identification of a drug response signature. Using a proteomic approach with high-resolution mass spectrometry, the present study aimed to identify a biosignature of antidepressant response (fluoxetine, a Selective Serotonin Reuptake Inhibitor) in PBMCs in a mouse model of anxiety/depression...
2017: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/28832793/quality-of-life-depression-anxiety-and-coping-strategies-after-heart-transplantation
#9
Fulvio Bergamo Trevizan, Maria Cristina de Oliveira Santos Miyazaki, Yasmin Lima Witzel Silva, Christiane Maia Waetman Roque
Introduction: Heart transplantation is the therapeutic procedure indicated to increase the survival of patients with refractory heart failure. Improvement in overall functioning and quality of life are expected factors in the postoperative period. Objective: To identify and evaluate mental disorders and symptoms, such as depression and anxiety, quality of life and coping strategies in the post-surgical situation of heart transplantation. Methods: A cross-sectional, quantitative study with patients who have undergone heart transplantation...
May 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28762544/coexisting-depressive-symptoms-do-not-limit-the-benefits-of-chronic-neuromodulation-a-study-of-over-200-patients
#10
Kim A Killinger, Jonathan Fergus, Luke Edwards, Judith A Boura, Jamie Bartley, Priyanka Gupta, Janice Tomakowsky, Jason Gilleran, Kenneth M Peters
AIMS: To examine the relationship between coexisting depressive symptoms and outcomes after staged neuromodulation procedures for refractory urological symptoms. METHODS: Adults who enrolled in a prospective database and completed a Personal Health Questionnaire Depression Scale (PHQ-8) at baseline were reviewed. The PHQ-8 and Generalized Anxiety Disorder (GAD-7) assessed depressive/anxiety symptoms pre and 6 months post device implant. Urological symptoms were assessed with The Interstitial Cystitis Symptom Index/Problem Index (ICSI-PI) and Overactive Bladder Questionnaire (OAB-q) at baseline, 3 and 6 months, and Global Response Assessments (GRA) post implant...
August 1, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28687552/hyponatremia-induced-by-hyperinsulinemia-euglycemia-therapy
#11
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
#12
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
#13
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
#14
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/potential-for-intrathecal-baclofen-in-treatment-of-essential-tremor
#15
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. Symptoms of ET range from slightly noticeable to debilitating, with 1 cohort study finding 15% of patients were forced into early retirement. Additionally, depression has also been correlated with the severity of disability of ET. Treatment options include propranolol and primidone. Current treatment options are not very effective, with more than half (56.3%) of patients discontinuing medications because of no changes in symptoms...
September 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28505499/clinical-predictors-of-acute-response-to-transcranial-direct-current-stimulation-tdcs-in-major-depression
#16
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
#17
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
#18
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
#19
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
#20
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
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