Therapeutic strategies used on treatment of depression. Dria study

2011 ◽  
Vol 26 (S2) ◽  
pp. 629-629
Author(s):  
R. Salvador ◽  
J. Galan ◽  
M. Garcia-Toro
Keyword(s):  
Real Life ◽  
Treatment Strategies ◽  
Therapeutic Strategies ◽  
Major Depressive ◽  
Multiple Strategies ◽  
The Past ◽  
Treatment Of Depression ◽  
Image Position ◽  
Antidepressant Combination

IntroductionThere are few clinical studies about strategies used in depression in clinical practice.ObjectivesDescribe therapeutic strategies used in psychiatric care in patients with depression who had a suboptimal response to standard antidepressants under real-life conditions.MethodsNon-interventional study that included a prospective cohort of outpatients diagnosed with Major Depressive Disorder (MDD) who needed a change on the treatment. Strategies were group as: switch of antidepressant, combination of antidepressants, augmentation or a combination of previous strategies. Follow-up period was 22-26 weeks.Results364 patients were included by 58 psychiatrists, 336 were analyzed (92.3%) and 315 (86.5%) completed the follow-up.[Strategies selected in each change][Relationship between no. changes and no. strategie]ConclusionsStrategies more used were: switch to another antidepressant, combination of antidepressant, augmentation and multiple strategies.Although a change of treatment was decided, frequently it was selected a strategy used in the past.This study has been sponsored by AstraZeneca Farmaceutica Spain, SA.

Impact of the number of changes of therapeutic strategy on improvement in depressed patients. dria study

2011 ◽  
Vol 26 (S2) ◽  
pp. 700-700
Author(s):  
M. Garcia-Toro ◽  
E. Valmisa ◽  
J. Galan ◽  
S. Ros
Keyword(s):  
Therapeutic Strategy ◽  
Clinical Symptoms ◽  
Remission Rate ◽  
Major Depressive ◽  
Pragmatic Clinical Trial ◽  
Remission Rates ◽  
Image Position ◽  
Antidepressant Combination ◽  
Strategy Switch

IntroductionThe STAR*D is a pragmatic clinical trial that showed lower remission rate and higher relapse rate when more strategies were used.[1]Objectives and aimsAssess clinical improvement in symptoms related to depression, anxiety and sleep, based on the number of strategies used.MethodsDescriptive, non-interventional, prospective study including outpatients diagnosed with Major Depressive Disorder (MDD) with sub-optimal response to standard antidepressants. In those patients a change on the therapeutic strategy (switch of antidepressant, combination of antidepressants, augmentation or a combination of previous strategies) had to be considered necessary. Follow-up period was 22–26 weeks.Results364 patients were included by 58 psychiatrists, 336 were analyzed (92.3%) and 315 (86.5%) completed the follow-up.[Difference last visit vs. basal]p < 0.0001 in all measuresConclusionsThe more changes on strategies used the less improvement on clinical symptoms and remission rates.This study has been sponsored by AstraZeneca Farmaceutica Spain, SA.

scholarly journals Assessment of therapeutic strategies for management of impulse control disorder in Parkinson’s disease

2021 ◽  
Vol 79 (11) ◽  
pp. 989-994
Author(s):  
Mayela Rodríguez-Violante ◽  
Yazmín Ríos-Solís ◽  
Oscar Esquivel-Zapata ◽  
Fanny Herrera ◽  
Susana López-Alamillo ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Impulse Control ◽  
Real Life ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Real Life Setting ◽  
Frequency Of Use ◽  
Baseline Evaluation

ABSTRACT Background: Impulse control disorders (ICD) occur frequently in individuals with Parkinson's disease. So far, prevention is the best treatment. Several strategies for its treatment have been suggested, but their frequency of use and benefit have scarcely been explored. Objective: To investigate which strategy is the most commonly used in a real-life setting and its rate of response. Methods: A longitudinal study was conducted. At the baseline evaluation, data on current treatment and ICD status according to QUIP-RS were collected. The treatment strategies were categorized as “no-change”, dopamine agonist (DA) dose lowering, DA removal, DA switch or add-on therapy. At the six-month follow-up visit, the same tools were applied. Results: A total of 132 individuals (58.3% men) were included; 18.2% had at least one ICD at baseline. The therapeutic strategy most used in the ICD group was no-change (37.5%), followed by DA removal (16.7%), DA switch (12.5%) and DA lowering (8.3%). Unexpectedly, in 20.8% of the ICD subjects the DA dose was increased. Overall, nearly 80% of the subjects showed remission of their ICD at follow-up. Conclusions: Regardless of the therapy used, most of the subjects presented remission of their ICD at follow-up Further research with a longer follow-up in a larger sample, with assessment of decision-making processes, is required in order to better understand the efficacy of strategies for ICD treatment.

scholarly journals The past, present, and future of humidifier disinfectant-associated interstitial lung diseases in children

2020 ◽  
Vol 63 (7) ◽  
pp. 251-258 ◽  
Author(s):  
Eun Lee ◽  
So-Yeon Lee ◽  
Soo-Jong Hong
Keyword(s):  
Health Effects ◽  
Lung Diseases ◽  
Therapeutic Strategies ◽  
Interstitial Lung Diseases ◽  
Toxic Chemicals ◽  
The Past ◽  
Radiologic Findings ◽  
Pathologic Findings

Exposure to environmental factors can cause interstitial lung diseases (ILDs); however, such types of ILDs are rare. From 2007 to 2011, an ILD epidemic occurred in South Korea owing to inhalational exposure to toxic chemicals in humidifier disinfectants (HDs). HD-associated ILDs (HD-ILDs) are characterized by rapidly progressing respiratory failure with pulmonary fibrosis and a high mortality rate of 43.8%−58.0%. Although 18.1%−31.1% of the general population used HDs, only a small proportion of HD users were diagnosed with HD-ILDs. This finding suggests that investigation of the pathophysiologies underlying HD-ILDs is needed in addition to the identification of susceptibility to HD-ILDs. Further, there have been several concerns regarding the diverse health effects of exposure to toxic chemicals in HDs, including those that have not been identified, and long-term prognoses in terms of pulmonary function and residual pulmonary lesions observed on follow-up chest images. In this review, we summarize the clinical features, pathologic findings, and changes in radiologic findings over time in patients with HD-ILDs and the results of previous experimental research on the mechanisms underlying the effects of toxic chemicals in HDs. Studies are currently underway to identify the pathophysiologies of HD-ILDs and possible health effects of exposure to HDs along with the development of targeted therapeutic strategies. The experience of identification of HD-ILDs has encouraged stricter control of safe chemicals in everyday life.

scholarly journals MTHFR GENE MUTATION AND ITS REPERCUSSION IN THE GENESIS AND TREATMENT OF DEPRESSION: CASE REPORT

2021 ◽  
Vol 9 (07) ◽  
pp. 415-421
Author(s):  
Alexandre Leal Laux ◽  
Alana Klochinski ◽  
Bruna Bobato ◽  
Evelyn Suquebski Dib ◽  
Harien Sprung ◽  
...  
Keyword(s):  
Case Report ◽  
Gene Mutation ◽  
Gene Mutations ◽  
Mthfr Gene ◽  
Major Depressive ◽  
Double Mutation ◽  
Residual Symptoms ◽  
Treatment Of Depression ◽  
Patient Reported

This study aims to report the correlation of MTHFR gene mutation with the genesis of depression and antidepressants non-response in a patient, highlighting the importance of genetic investigation and indicating the replacement of L-methylfolate as an effective treatment adjuvant. This is a case report of a patient diagnosed with major depressive disorder, refractory to pharmacological therapies, in monotherapy or combination therapy, and psychotherapy. After 1 year and 4 months of persistent residual symptoms, genetic testing of the MTHFR gene was requested with confirmation of a heterozygous double mutation of MTHFR. This gene polymorphism can result in deficiency of L-methylfolate, which is related to psychiatric diseases and refractoriness to antidepressant therapy. With the introduction of l-methylfolate 15mg, the patient reported remission of depressive symptoms in 4 months of follow-up. MTHFR gene mutations influence the action of folate, favoring depression and leading to refractory response to conventional treatment.

Association of CD20 positivity (+) with event free survival (EFS) in children with post-transplant lymphoproliferative disease (PTLD) following solid organ transplantation (SOT)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 8070-8070
Author(s):  
M. Orjuela ◽  
B. Alobeid ◽  
E. R. Kott ◽  
L. J. Addonizio ◽  
S. J. Lobritto ◽  
...  
Keyword(s):  
Solid Organ Transplantation ◽  
Treatment Strategies ◽  
Lymphoproliferative Disease ◽  
Solid Organ ◽  
Free Survival ◽  
Prognostic Features ◽  
The Past ◽  
Kaplan Meier ◽  
Time To Onset

8070 Background: The roles of CD20 and EBV as prognostic features for development and survival of pediatric PTLD after SOT are poorly understood. We previously demonstrated the safety and efficacy of cyclophosphamide, prednisone and rituximab (CPR) in CD20+ PTLD (Orjuela/Cairo, CCR 2005) Methods: All patients (pts), =25 yrs with PTLD in the past 15 yrs were analyzed and classified according to presence of detectable EBV or CD20 by IHC or ISH. Overall survival (OS) and EFS were estimated using Kaplan-Meier, significance was assessed by t-test comparison and Mantel-Cox. Results: 41 SOT pts (28 heart, 8 liver, 4 kidney) had PTLD (53.6% female) at a median of 38.8 months (mo) post SOT (4–43); Age 14–263 mo. Of 35 evaluable tumors, 29 (82.9%) had detectable EBV, while 22 (62.9%) expressed CD20 antigen. All pts had immunosuppression reduced, followed by chemo- and immunotherapy as needed. In pts with =9 mo follow-up after PTLD (n = 38) (median 49 mo, 10–184) OS is 73.2% and PTLD related EFS is 63%. Pts with EBV+ tumors had a shorter time to onset than those with EBV- tumors (median 18 vs 44 mo, p = 0.002). Pts with CD20+ PTLD were diagnosed earlier than those with CD20- PTLD (median 19 vs 62 mo, p= 0.006). PTLD-related 5 yr EFS showed significantly increased survival for CD20+ over CD20- pts (90 ± 6.5% vs 25 ± 11.2%, respectively [95% CI], p = 0.001). EBV status did not have a significant effect on OS (p=0.7) or EFS (p=0.7). Conclusions: CD20 and EBV are important predictors of time to PTLD development and presence of CD20 predicts for significantly improved EFS for SOT PTLD. CD20- PTLD pts appear to have lower EFS suggesting a need for alternative treatment strategies. No significant financial relationships to disclose.

scholarly journals Endovascular treatment of posterior communicating artery aneurysms in the presence of the fetal variant of posterior cerebral artery

2015 ◽  
Vol 21 (4) ◽  
pp. 456-461 ◽  
Author(s):  
Zhi Chen ◽  
Yin Niu ◽  
Jun Tang ◽  
Lin Li ◽  
Zhou Feng ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Cerebral Artery ◽  
Clinical Evidence ◽  
Posterior Cerebral Artery ◽  
Therapeutic Strategies ◽  
Posterior Communicating Artery ◽  
Hemorrhagic Complication ◽  
Multiple Strategies ◽  
Angiographic Findings

Posterior communicating artery (PcomA) aneurysms in the presence of the fetal variant of posterior cerebral artery (PCA) often pose technical challenges for endovascular treatment because of a greater potential for ischemic injury with the fetal PCA compromise. The purpose of this study was to assess the feasibility and results of endovascular treatment for these lesions. We retrospectively reviewed our experience and results of endovascular treatments for a series of nine consecutive patients with PcomA aneurysms occurring at the origin of fetal PCAs at the Department of Neurosurgery of Southwest Hospital, Chongqing, China, between June 2011 and June 2014. Depending on the angiographic findings, location and shape of the aneurysms, various therapeutic strategies were used including coiling by single or double microcatheter, balloon remodeling technique, and single or Y-stenting technique. Overall, fetal PCA was preserved patent in all cases, and complete or near complete occlusion was achieved in 8/9 cases. There was no procedure-related morbidity or mortality. With the exception of one patient who died of pneumonia 6 weeks after treatment, no clinical evidence of neurologic deterioration and hemorrhagic complication was seen during the follow-up period in the remaining 8 patients. Our experience suggests that endovascular treatment is relatively safe and technically feasible in most patients with PcomA aneurysms in the presence of fetal PCA using multiple strategies.

scholarly journals Major Depressive Symptoms Increase 3-Year Mortality Rate in Patients with Mild Dementia

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Jindong Ding Petersen ◽  
Frans Boch Waldorff ◽  
Volkert Dirk Siersma ◽  
Thien Kieu Thi Phung ◽  
Anna Carina Klara Magdalena Bebe ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Excess Mortality ◽  
Smoking Status ◽  
Multivariable Analysis ◽  
Major Depressive ◽  
Mild Dementia ◽  
Treatment Of Depression ◽  
Post Hoc ◽  
Major Depressive Symptoms

Depression and dementia are commonly concurrent and are both associated with increased mortality among older people. However, little is known about whether home-dwelling patients newly diagnosed with mild dementia coexisting with depressive symptoms have excess mortality. We conducted a post hoc analysis based on data from the Danish Alzheimer’s Intervention Study of 330 individuals who were diagnosed with mild dementia within the past 12 months. Thirty-four patients were identified with major depressive symptoms (MD-S) at baseline. During the 3-year follow-up period, 56 patients died, and, among them, 12 were with MD-S at baseline. Multivariable analysis adjusting for the potential confounders (age, sex, smoking status, alcohol consumption, education, BMI, household status, MMSE, CCI, QoL-AD, NPIQ, ADSC-ADL, medication, and RCT allocation) showed that patients with MD-S had a 2.5-fold higher mortality as compared to the patients without or with only few depressive symptoms. Our result revealed that depression is possibly associated with increased mortality in patients with mild dementia. Given that depression is treatable, screening for depression and treatment of depression can be important already in the earliest stage of dementia to reduce mortality.

scholarly journals TA Treatment of Depression: A Hermeneutic Single-Case Efficacy Design Study - ‘Caterina’

2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Enrico Benelli ◽  
Sara Filanti ◽  
Roberta Musso ◽  
Vincenzo Calvo ◽  
Stefania Mannarini ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Anxiety Disorder ◽  
Depressive Disorder ◽  
Single Case ◽  
Transactional Analysis ◽  
Major Depressive ◽  
Italian Woman ◽  
Treatment Of Depression

This study is the second of a series of seven, and belongs to the second Italian systematic replication of findings from two previous series (Widdowson 2012a, 2012b, 2012c, 2013; Benelli, 2016a, 2016b, 2016c) that investigated the effectiveness of a manualised transactional analysis treatment for depression through Hermeneutic Single-Case Efficacy Design. The therapist was a white Italian woman with 10 years of clinical experience and the client, Caterina, was a 28-year old white Italian woman who attended 16 sessions of transactional analysis psychotherapy. Caterina satisfied DSM-5 criteria for major depressive disorder with generalized anxiety disorder. The conclusion of the judges was that this was an outstanding good-outcome case: the depressive symptoms showed an early clinical and reliable improvement, maintained till the 6 months follow-up, accompanied by reductions in anxiety symptoms, global distress and severity of personal problems. Adherence to the manualised treatment for depression appears good to excellent. In this case study, transactional analysis treatment for depression has proven its efficacy in treating major depressive disorder in comorbidity with anxiety disorder.

Treatment of Depression in Patients with Alcohol or Drug Dependence

2018 ◽  
Author(s):  
J. Corey Williams ◽  
Gustavo A. Angarita Africano
Keyword(s):  
Substance Use ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Substance Use Disorders ◽  
Main Study ◽  
Major Depressive ◽  
Treatment Of Depression ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study on the treatment of major depressive disorder and co-morbid substance use disorders. Are antidepressants efficacious in treatment of combined depression and substance use disorders? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The main study findings suggest that Major Depressive Disorder can be effectively treated with antidepressant medications in patients with co-morbid substance use disorders. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

A Review of the STAR*D Trial

2006 ◽  
Vol 19 (6) ◽  
pp. 353-360
Author(s):  
Megan J. Ehret ◽  
Benjamin Chavez
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Treatment Resistant ◽  
First Line ◽  
Major Depressive ◽  
Treatment Of Depression ◽  
Clinical Strategies ◽  
Resistant Depression

Major depressive disorder is a common disorder that affects 5% to 13% of medical outpatients. The treatment of depression can be challenging, with many first-line options and even more second-line or next-step options. The STAR*D trial was the first of its kind developed to evaluate clinical strategies to improve outcomes for patients with treatment-resistant depression and determining the best next-step treatment option for patients who did not respond adequately to earlier treatment attempts. The trial included a widely representative group of outpatients so as to be applicable to the current practice in the treatment of depression. The trial consisted of 4 different treatment strategies with both switching and augmentation options. Patients were permitted to select treatment options at each of the levels that they themselves selected, creating a “realworld” setting in the trial. Patients were recommended to continue through each level until remission was reached. The study, though limited in size at each level, has provided much-needed information for the continued treatment of major depressive disorder.

Sign in / Sign up

Export Citation Format

Share Document