Fenetyline as possible treatment in non-responder depressive patients

1990 ◽  
Vol 5 (1) ◽  
pp. 29-30
Author(s):  
F Lang ◽  
J Pellet ◽  
B Estour
Keyword(s):  
Major Depression ◽  
Sleep Deprivation ◽  
Therapeutic Response ◽  
Manic Episode ◽  
Endogenous Depression ◽  
Recurrent Depression ◽  
Different Types ◽  
Depressive Episodes ◽  
Depressive Patients

SummaryThe authors report the case of a 45-yr-old male who presented from 1979 to 1986 with several severe depressive episodes. The patient fulfilled Feighner criteria for major depression, Newcastle criteria for endogenous depression: the depressive episodes were all classified as severe recurrent depression without melancholia according to DSM III. The patient was resistant to different types of treatment (ECT, tricyclic and MAOI drugs, lithium, sleep deprivation). With a treatment of 10 cg/day of fenetyline, reduced to 5 cg/day after 6 months, (atypical manic episode), the patient improved considerably for 20 rnonths. The therapeutic response decreased after this period but after a month of withdrawal, the patient again responded. The authors cannot explain the duration of this therapeutic response.

scholarly journals Prophylactic effect of citalopram in unipolar, recurrent depression

2001 ◽  
Vol 178 (4) ◽  
pp. 304-310 ◽  
Author(s):  
B. Hochstrasser ◽  
P. M. Isaksen ◽  
H. Koponen ◽  
L. Lauritzen ◽  
F. A. Mahnert ◽  
...  
Keyword(s):  
Major Depression ◽  
Acute Treatment ◽  
Maintenance Treatment ◽  
Rating Scale ◽  
Treatment Time ◽  
Treatment Phase ◽  
Recurrent Depression ◽  
Double Blind ◽  
Patients At Risk ◽  
Depressive Episodes

BackgroundMajor depression is highly recurrent. Antidepressant maintenance treatment has proven efficacy against recurrent depression.AimsComparison of prophylactic efficacy of citalopram versus placebo in unipolar, recurrent depression.MethodsPatients 18–65 years of age with recurrent unipolar major depression (DSM–IV), a Montgomery–åsberg Depression Rating Scale score of ≥ 22 and two or more previous depressive episodes, one within the past 5 years, were treated openly with citalopram (20–60 mg) for 6–9 weeks and, if responding, continued for 16 weeks before being randomised to double-blind maintenance treatment with citalopram or placebo for 48–77 weeks.ResultsA total of 427 patients entered acute treatment and 269 were randomised to double-blind treatment. Time to recurrence was longer in patients taking citalopram than in patients taking placebo (P < 0.001). Prophylactic treatment was well tolerated.ConclusionsCitalopram (20, 40 and 60 mg) is effective in the prevention of depressive recurrences. Patients at risk should continue maintenance treatment at the dose necessary to resolve symptoms in the acute treatment phase.

Electroconvulsive Therapy and Depression with Psychotic Symptoms: a Case Report

2011 ◽  
Vol 26 (S2) ◽  
pp. 1136-1136
Author(s):  
A. Castillo ◽  
M. Lloret ◽  
M. Harto ◽  
A. Tatay ◽  
C. Almonacid ◽  
...  
Keyword(s):  
Major Depression ◽  
Electroconvulsive Therapy ◽  
Bipolar Affective Disorder ◽  
Manic Episode ◽  
Antipsychotic Agents ◽  
Pharmacological Therapy ◽  
Psychotic Symptoms ◽  
Antipsychotic Treatment ◽  
Psychotic Features ◽  
Depressive Episodes

IntroductionPsychotic symptoms in depression are indicators of severity and poor prognosis. It usually requires psychopharmacotherapy with antidepressants and antipsychotic agents and it may even require electroconvulsive therapy (ECT).Aims, methodologyTo review the indications of ECT in major depression through the study of a clinical case of a patient admitted in an indoor psychiatric unit.ResultsA 64-year-old woman diagnosed as bipolar affective disorder 20 years ago. Her first manic episode required hospitalization. Afterwards, she remained clinically stable for 18 years with pharmacotherapy with lithium. Lately she was admitted due to a major depressive episode with psychotic features (injury delusions, ruin and catastrophe). Antidepressant and antipsychotic treatment was added, improving her symptoms. However, she had to be readmitted two months later with severe psychotic symptoms that did not improve with pharmacological treatment. ECT was added to her treatment. She improved after a few sessions. During the last years, she has presented depressive episodes with psychotic symptoms at least once a year, and all of them have required ECT.ConclusionsECT is an alternative to pharmacological therapy in depression with psychotic symptoms in patients with no response to drugs. According to studies and clinical practice, ETC has been effective as we see in this case. Therefore, ECT is a technique to consider in major depression, not only in patients who do not respond to drug therapy but also in those who do not tolerate psychopharmacological, who suffer from severe or psychotic symptoms, suicide thoughts or those, psychomotor agitation or stupor.

Relationship between fast-acting antidepressant properties of total sleep deprivation and serum BDNF levels

2011 ◽  
Vol 26 (S2) ◽  
pp. 2032-2032
Author(s):  
O. Caliyurt
Keyword(s):  
Major Depressive Disorder ◽  
Major Depression ◽  
Depressive Disorder ◽  
Sleep Deprivation ◽  
Treatment Response ◽  
Antidepressant Treatment ◽  
Major Depressive ◽  
Total Sleep Deprivation ◽  
Patient Groups ◽  
Depressive Patients

Sleep deprivation therapy is a treatment option for major depressive disorder. Total sleep deprivation for one night improves depressive symptoms in 40–60% of treatments. Recent reports have suggested that brain-derived neurotrophic factor (BDNF) levels are reduced in individuals suffering major depressive disorder and these levels normalize following antidepressant treatment.In a recent study we have shown that the effects of total sleep deprivation therapy on BDNF levels in major depression. Results were compared between depressive patients that were treated with sertraline and healthy volunteers who experienced single total sleep deprivation. The baseline BDNF levels were significantly lower in both patient groups than the controls. Single sleep deprivation therapy was shown to decrease HAM-D scores and increase BDNF levels significantly in depressive patients. Effects of single sleep deprivation therapy on HAM-D scores was correlated with changes in BDNF levels. A series of three sleep deprivation therapies in a week accelerated the treatment response and increased the BDNF levels rapidly compared to the patients treated with sertraline alone. Better treatment response in the TSD group was also correlated with the statistically significant increase of BDNF levels in the 7th day compared to the sertraline group.In conclusion, our results support the BDNF reduction in major depression. Rapid antidepressant effects of sleep deprivation therapy appear to relate to the rapid BDNF increase in major depressive patients. These results give an opportunity to explore the relationship between fast antidepressant response and BDNF changes in major depression.

Clinical presentation of postnatal and non-postnatal depressive episodes

2007 ◽  
Vol 37 (9) ◽  
pp. 1273-1280 ◽  
Author(s):  
CARLY COOPER ◽  
LISA JONES ◽  
EMMA DUNN ◽  
LIZ FORTY ◽  
SAYEED HAQUE ◽  
...  
Keyword(s):  
Major Depression ◽  
Clinical Presentation ◽  
Early Morning ◽  
Recurrent Depression ◽  
Icd 10 ◽  
Dsm Iv ◽  
Relationship Of ◽  
Recurrent Major Depressive Disorder ◽  
Depressive Episodes ◽  
The Relationship

ABSTRACTBackgroundThe relationship of postnatal (postpartum) depression (PND) to episodes of depression occurring at other times is not well understood. Despite a number of studies of clinical presentation, there is little consistency in the literature. We have undertaken within- and between-individual comparisons of the clinical presentation of postnatal (PN) and non-postnatal (NPN) depressive episodes in women with recurrent depression.MethodIn a sample of well-characterized, parous women meeting DSM-IV and ICD-10 criteria for recurrent major depressive disorder, the clinical presentation of episodes of major depression with onset within 4 weeks of giving birth (PND group, n=50) were compared with (i) the non-postnatal episodes of women with PND, and (ii) episodes of major depression in parous women who had not experienced episodes of mood disorder in relation to childbirth (NPND group, n=132). In addition, the non-postnatal episodes of the PND group of women were compared with the depressive episodes of the NPND group.ResultsThe small number of differences found between PN and NPN depressive episodes, such as reduced early morning wakening in postnatal episodes, are likely to be explicable by the context of having a new baby rather than by any difference in the nature of the underlying depression.ConclusionsThe results do not point to substantial differences in clinical presentation between episodes of major depression occurring in relation to childbirth and at other times. Other avenues of research are therefore required to demonstrate a specific relationship between childbirth and depression.

Three- to 5-year prospective follow-up of outcome in major depression

1998 ◽  
Vol 28 (3) ◽  
pp. 731-735 ◽  
Author(s):  
L. VAN LONDEN ◽  
R. P. G. MOLENAAR ◽  
J. G. GOEKOOP ◽  
A. H. ZWINDERMAN ◽  
H. G. M. ROOIJMANS
Keyword(s):  
Major Depression ◽  
Partial Remission ◽  
Psychomotor Retardation ◽  
Major Depressive ◽  
Residual Symptoms ◽  
Full Remission ◽  
Depressive Episodes ◽  
Depressive Patients ◽  
Dutch Cohort

Background. A Dutch cohort of predominantly out-patient DSM-III-R major depressive patients was followed for 3 to 5 years after start of treatment in a psycho-neuro-endocrinological prediction study. The study design permitted description of the course of remissions, relapses and recurrences.Methods. Pharmacological treatment was standardized, psychotherapy was tailored to the needs of the patient, follow-ups were done monthly until 3 years or more after the initial recruitment.Results. After 9 months 49% of the patients had reached full remission and 45% were in partial remission. During the following 3 to 5 years 82% of the patients had reached a period of full remission. Sixteen per cent of the patients needed 2 years or more before full remission. A relapse or recurrence rate of 41% within 5 years was found. Patients with residual symptoms relapsed particularly in the first 4 months after remission, while patients without residual symptoms recurred mainly after 12 months after remission. Previous depressive episodes and psychoticism predicted relapse. Psychomotor retardation at inception predicted a longer time to partial remission.Conclusion. In most cases, major depression is a seriously impairing episodic disease. This is also true for a sample of predominantly out-patients treated at a university clinic.

Measures of anhedonia and hedonic responses to sucrose in depressive and schizophrenic patients in comparison with healthy subjects

1998 ◽  
Vol 13 (6) ◽  
pp. 303-309 ◽  
Author(s):  
I Berlin ◽  
L Givry-Steiner ◽  
Y Lecrubier ◽  
AJ Puech
Keyword(s):  
Major Depression ◽  
Healthy Subjects ◽  
Sweet Taste ◽  
Taste Perception ◽  
Social Anhedonia ◽  
Perception Threshold ◽  
Sucrose Solutions ◽  
Scale Scores ◽  
Schizophrenic Patients ◽  
Depressive Patients

SummaryAnhedonia may be considered as a transnosological feature of depression and schizophrenia. The aim of the present study was to assess hedonic responses to sucrose solutions and sweet taste perception threshold in patients with major depression and in schizophrenic patients in comparison with healthy subjects (matched for age and gender with depressive patients), and to compare these responses to evaluations by the Physical and Social Anhedonia scale of Chapman and the Pleasure Scale of Fawcett, generally used to quantify anhedonia. Hedonic responses to sucrose solutions were similar in patients with major depression (n = 20), schizophrenia (n = 20), and healthy controls (n = 20). Sweet taste perception threshold was significantly higher in depressive patients than in controls. Hedonic response to sucrose was inversely correlated with physical Anhedonia Scores and sweet taste perception threshold with Pleasure Scale scores. Measures of hedonia/anhedonia were not related with the intensity of depression or anxiety as measured by the Montgomery-Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Scale, respectively. In 11 depressed patients hospitalised for 17 to 33 days, neither hedonic ratings to sucrose solutions, sweet taste perception threshold, Physical, Social Anhedonia scores nor Pleasure Scale scores were modified in spite of substantial decrease in MADRS or Hamilton Anxiety scores. Hedonic responses to sucrose solutions and sweet taste perception threshold may be used as complementary evaluation to quantify anhedonia.

scholarly journals Changes in brain arousal (EEG-vigilance) after therapeutic sleep deprivation in depressive patients and healthy controls

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Christian Sander ◽  
Jonathan M. Schmidt ◽  
Roland Mergl ◽  
Frank M. Schmidt ◽  
Ulrich Hegerl
Keyword(s):  
Sleep Deprivation ◽  
Healthy Controls ◽  
Depressive Patients ◽  
Brain Arousal

The Efficacy and Tolerability of Combined Antidepressant Treatment in Different Depressive Subgroups

1993 ◽  
Vol 162 (3) ◽  
pp. 363-368 ◽  
Author(s):  
Sinead O'brien ◽  
Patrick McKeon ◽  
Myra O'regan
Keyword(s):  
Treatment Group ◽  
Side Effects ◽  
Major Depression ◽  
Orthostatic Hypotension ◽  
Antidepressant Treatment ◽  
Combined Treatment ◽  
Endogenous Depression ◽  
Double Blind Study ◽  
Double Blind ◽  
Global Improvement

Eighty patients admitted to hospital with major depression were randomly allocated to six weeks of treatment with tranylcypromine, amitriptyline, or tranylcypromine and amitriptyline in combination, in a double-blind study. Scores on the HRSD improved significantly in all three groups, but there were no differences between the three groups. Patients on tranylcypromine and amitriptyline combined improved more according to their self-ratings after six weeks, and response was earlier as measured by a clinical global improvement scale. Those with endogenous depression improved more than those with neurotic depression, irrespective of treatment group. Combined treatment was less well tolerated than single treatments and gave rise to more side-effects, although there was no serious toxicity. Orthostatic hypotension was observed more frequently in patients on combined treatment. This group also experienced a significant increase in weight and prolongation of the P-R interval on ECG.

scholarly journals Psychotherapy for subclinical depression: meta-analysis

2014 ◽  
Vol 205 (4) ◽  
pp. 268-274 ◽  
Author(s):  
Pim Cuijpers ◽  
Sander L. Koole ◽  
Annemiek van Dijke ◽  
Miquel Roca ◽  
Juan Li ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Major Depression ◽  
Depressive Disorder ◽  
Psychological Treatment ◽  
Meta Analysis ◽  
Major Depressive ◽  
Major Depressive Episodes ◽  
Depressive Episodes ◽  
Subclinical Depression

BackgroundThere is controversy about whether psychotherapies are effective in the treatment of subclinical depression, defined by clinically relevant depressive symptoms in the absence of a major depressive disorder.AimsTo examine whether psychotherapies are effective in reducing depressive symptoms, reduce the risk of developing major depressive disorder and have comparable effects to psychological treatment of major depression.MethodWe conducted a meta-analysis of 18 studies comparing a psychological treatment of subclinical depression with a control group.ResultsThe target groups, therapies and characteristics of the included studies differed considerably from each other, and the quality of many studies was not optimal. Psychotherapies did have a small to moderate effect on depressive symptoms against care as usual at the post-test assessment (g = 0.35, 95% CI 0.23–0.47; NNT = 5, 95% CI 4–8) and significantly reduced the incidence of major depressive episodes at 6 months (RR = 0.61) and possibly at 12 months (RR = 0.74). The effects were significantly smaller than those of psychotherapy for major depressive disorder and could be accounted for by non-specific effects of treatment.ConclusionsPsychotherapy may be effective in the treatment of subclinical depression and reduce the incidence of major depression, but more high-quality research is needed.

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