scholarly journals Relationship between dose and duration of treatment response in severely treatment-resistant depression patients treated with accelerated intermittent theta bust stimulation

2021 ◽  
Vol 14 (6) ◽  
pp. 1666-1667
Author(s):  
Ian Kratter ◽  
Andrew Geoly ◽  
Gregory Sahlem ◽  
Nolan Williams
Keyword(s):  
Treatment Response ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Duration Of Treatment ◽  
Resistant Depression

Baseline Working Memory Predicted Response to Low-Dose Ketamine Infusion in Patients with Treatment-Resistant Depression

2021 ◽  
Author(s):  
Mu-Hong Chen ◽  
Wei-Chen Lin ◽  
Cheng-Ta Li ◽  
Shih-Jen Tsai ◽  
Hui-Ju Wu ◽  
...  
Keyword(s):  
Working Memory ◽  
Depressive Symptoms ◽  
Treatment Response ◽  
Low Dose ◽  
Memory Function ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Ketamine Infusion ◽  
Treatment Groups ◽  
Resistant Depression

Abstract Introduction Pretreatment neurocognitive function may predict the treatment response to low-dose ketamine infusion in patients with treatment-resistant depression (TRD). However, the association between working memory function at baseline and the antidepressant efficacy of ketamine infusion remains unclear. Methods A total of 71 patients with TRD were randomized to one of three treatment groups: 0.5 mg/kg ketamine, 0.2 mg/kg ketamine, or normal saline. Depressive symptoms were measured using the 17-item Hamilton Depression Rating Scale (HDRS) at baseline and after treatment. Cognitive function was evaluated using working memory and go-no-go tasks at baseline. Results A generalized linear model with adjustments for demographic characteristics, treatment groups, and total HDRS scores at baseline revealed only a significant effect of working memory function (correct responses and omissions) on the changes in depressive symptoms measured by HDRS at baseline (F=12.862, p<0.05). Correlation analysis further showed a negative relationship (r=0.519, p=0.027) between pretreatment working memory function and changes in HDRS scores in the 0.5 mg/kg ketamine group. Discussion An inverse relationship between pretreatment working memory function and treatment response to ketamine infusion may confirm that low-dose ketamine infusion is beneficial and should be reserved for patients with TRD.

scholarly journals Resistant depression: criteria for determination, risk factors and therapeutic strategies

2017 ◽  
Vol 2 (3) ◽  
pp. 020338
Author(s):  
Olena Khaustova
Keyword(s):  
Risk Factors ◽  
Atypical Antipsychotics ◽  
Therapeutic Response ◽  
Therapeutic Strategies ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Duration Of Treatment ◽  
Resistance To Treatment ◽  
Step Model ◽  
Resistant Depression

Background Therapy of resistant depression raises a number of diagnostic and therapeutic problems, requires the solution of a number of methodological issues. A scientific discussion continues around the definition of depression resistance, assessment of the degree of reduction of depressive symptoms, the level of social and role functioning of patients; the improvement of models for determining the degree of resistance to various types of depression therapy continues; new methods of therapy and new algorithms of combined therapy are being developed. The ultimate goal of all these efforts should be practical recommendations for determining therapeutic options for the treatment of patients with resistant depression, which will help doctors make informed decisions on intervention strategies. Aim To analyze the therapeutic possibilities of treating depressive disorders that are resistant to therapy. Methods Publications from the Pubmed, MEDLINE, the Cochrane Library, Web of Science, Google Scholar databases were analyzed. Tags: depression, treatment, resistance, psevdoresistence, therapeutic response, resistance to treatment, strategies for treatment of resistant depression. Results The terminology related to resistant depression was defined: lack of a therapeutic response, adequate dose, adequate duration of treatment, antidepressant intolerance, pseudo-resistance, relative resistance to treatment, absolute resistance to treatment, treatment of resistant depression, remission, recovery. Models for determining the resistance of depression have been described: the Thase & Rush model; European stepped model; A step model of the Massachusetts hospital; Step model of Maudsley; Form of the history of treatment with antidepressants. Risk factors for treatment of resistant depression were identified, and the main therapeutic strategies were described: optimization, switching, augmentation, combination and non-drug therapy. Particular attention is paid to the use of atypical antipsychotics, in particular arapiprazole, as the augmentation strategy. A complex approach is described, which includes various combinations of the above strategies. Conclusion Each case of treatment-resistant depression has its own unique characteristics and requires careful evaluation to determine the correct diagnosis and the quality of the therapeutic response. Equally important for building an adequate treatment plan is evaluating risk factors for the treatment of resistant depression. There is a wide variety of options for the treatment of resistant depression, so each therapeutic strategy should be used to help patients with treatment-resistant depression. The combination of antidepressant therapy and atypical antipsychotics with antidepressant properties in combination with psychotherapeutic intervention and adherence to adequate doses and duration of treatment may be a choice strategy for patients with treatment-resistant depression.

scholarly journals The Impact of Childhood Maltreatment on Intravenous Ketamine Outcomes for Adult Patients with Treatment-Resistant Depression

2019 ◽  
Vol 12 (3) ◽  
pp. 133 ◽  
Author(s):  
O’Brien ◽  
Lijffijt ◽  
Wells ◽  
Swann ◽  
Mathew
Keyword(s):  
Treatment Response ◽  
Childhood Trauma ◽  
Childhood Maltreatment ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Increased Risk ◽  
Resistant Depression ◽  
Clinically Significant ◽  
The Impact ◽  
Intravenous Ketamine

Childhood maltreatment is associated with a poor treatment response to conventional antidepressants and increased risk for treatment-resistant depression (TRD). The N-methyl-D-aspartate receptor (NDMAR) antagonist ketamine has been shown to rapidly improve symptoms of depression in patients with TRD. It is unknown if childhood maltreatment could influence ketamine’s treatment response. We examined the relationship between childhood maltreatment using the Childhood Trauma Questionnaire (CTQ) and treatment response using the Quick Inventory of Depressive Symptoms–Self Report (QIDS-SR) in TRD patients receiving intravenous ketamine at a community outpatient clinic. We evaluated treatment response after a single infusion (n = 115) and a course of repeated infusions (n = 63). Repeated measures general linear models and Bayes factor (BF) showed significant decreases in QIDS-SR after the first and second infusions, which plateaued after the third infusion. Clinically significant childhood sexual abuse, physical abuse, and cumulative clinically significant maltreatment on multiple domains (maltreatment load) were associated with better treatment response to a single and repeated infusions. After repeated infusions, higher load was also associated with a higher remission rate. In contrast to conventional antidepressants, ketamine could be more effective in TRD patients with more childhood trauma burden, perhaps due to ketamine’s proposed ability to block trauma-associated behavioral sensitization.

scholarly journals Neuromodulation Intervention in Resistant Depression

2020 ◽  
Vol 8 (2) ◽  
pp. 39
Author(s):  
Era Catur Prasetya ◽  
Lestari Basoeki
Keyword(s):  
Functional Disability ◽  
Antidepressant Drugs ◽  
The United States ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Duration Of Treatment ◽  
Non Invasive ◽  
Disability Rate ◽  
Resistant Depression ◽  
Interventional Therapies

Treatment-resistant depression occurs in about 20% of all Major Deppresion Disorder patients. In addition to the high cost of treatment to be borne, the high functional disability rate, the suicide rate triggered by the disorder is also quite large. Various efforts were made to overcome this, including dose optimization and duration of treatment, substitution of drug selection, combination therapy and augmentation using non-antidepressant drugs and bilateral electroconvulsion therapy. Current pharmacological options according to some experts are no more efficacious than the 1950s. Clearly, a novel therapeutic approach to treatment - resistant depression disorders is urgently needed. Over the last few decades, there has been a renewed interest in focal neuromodulation as a treatment approach for neuropsychiatric conditions. The neuromodulation-based interventions discussed include Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS), which are non invasive intervention therapy and Vagus Nerve Stimulation (VNS) and Deep Brain Stimulation (DBS), which are invasive interventional therapies. This literature review proves that, although today only TMS and VNS have been approved for use by the Food and Drug Administration (FDA) in the United States, but neuromodilation-based intervention therapy has proven to be promising as a more effective and efficient resistant depression therapy in the future.

scholarly journals Copper Concentrations in Ketamine Therapy for Treatment-Resistant Depression

2020 ◽  
Vol 10 (12) ◽  
pp. 971
Author(s):  
Jakub Słupski ◽  
Wiesław Jerzy Cubała ◽  
Natalia Górska ◽  
Anita Słupska ◽  
Maria Gałuszko-Węgielnik
Keyword(s):  
Serum Concentration ◽  
Treatment Response ◽  
Copper Concentration ◽  
Rating Scale ◽  
Serum Copper ◽  
Copper Level ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Somatic Comorbidities ◽  
Resistant Depression

Changes in serum copper concentration are observed in patients with depressive symptoms. Unmet needs in contemporary antidepressant treatment have increased interest in non-monoaminergic antidepressants, such as ketamine, an anaesthetic drug that has demonstrated a rapid antidepressant effect in patients with treatment-resistant depression (TRD). The purpose of this study was to examine whether serum copper concentrations change during ketamine treatment and whether there is an association between the copper concentrations and treatment response measured using psychometric scale scores. Moreover, the interlink between somatic comorbidities and copper concentration was studied. Patients with major depressive disorder or bipolar disorder were rated weekly by a clinician using the Montgomery–Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS). Copper level assessments were carried out weekly before the start of ketamine treatment and then after every second infusion and one week after the last ketamine infusion. The serum concentration of copper before ketamine treatment was significantly higher than that after the fifth infusion (p = 0.016), and the serum concentration after the treatment was significantly higher than that after the fifth infusion (p = 0.048). No significant correlations between changes in the copper serum concentrations and MADRS or YMRS were found. The serum copper level was not associated with somatic comorbidities during the course of treatment. This study provides data on the role of copper in short-term intravenous ketamine treatment in TRD, although no clear evidence of a connection between the copper level and treatment response was found.

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