Antidepressant Medication May Moderate the Effect of Depression Duration on Hippocampus Volume

2016 ◽  
Vol 30 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Mark A. Rogers ◽  
Hidenori Yamasue ◽  
Kiyoto Kasai
Keyword(s):  
Major Depression ◽  
Antidepressant Treatment ◽  
Antidepressant Medication ◽  
Healthy Controls ◽  
Detailed History ◽  
Treatment History ◽  
Left Hippocampus ◽  
History Of ◽  
History Of Depression ◽  
Hippocampus Volume

Abstract. Hippocampus volume has been frequently, but not universally reported to be reduced in people with major depression relative to age-matched healthy controls. Among the potential reasons for this discrepancy in finding across studies is the effect of antidepressant medication. Hippocampus volume was determined by MRI (1.5 Tesla) for 10 people diagnosed with major depression for who detailed history of depression and antidepressant treatment history were known, and 10 age-matched healthy controls with no history of depression. Left, but not right, hippocampus volumes were significantly smaller in the patient group compared to the controls. Furthermore, there was a significant correlation such that left hippocampus volume was smaller with increasing lifetime duration of depression. However, this relationship was moderated by a significant correlation such that greater lifetime duration of antidepressant medication was associated with larger left hippocampus volume. The findings support the contention that antidepressant medication may act to normalize hippocampus volume.

scholarly journals Research on serotonin and suicidal behavior: neuroendocrine and molecular approaches

2002 ◽  
Vol 4 (4) ◽  
pp. 408-416
Keyword(s):  
Major Depression ◽  
Suicide Attempt ◽  
Gene Polymorphism ◽  
Psychiatric Disorder ◽  
Suicidal Behavior ◽  
Suicide Attempts ◽  
Healthy Controls ◽  
Molecular Approaches ◽  
History Of ◽  
Serotonergic Function

We carried out two studies to test the hypothesis that altered central serotonergic function, as assessed by lower prolactin (PRL) response to fenfluramine (D-FEN), is more closely associated with suicidal behavior than a particular psychiatric diagnosis. A D-FEN test was performed in 85 major depressed inpatients, 33 schizophrenic inpatients, and 18 healthy controls. We showed that PRL response to D-FEN is a marker of suicidality, regardless of psychiatric disorder. We then examined the association en the serotonin (5-hydroxytryptamine) receptor 5-HT(2A) gene polymorphism (T102C) and suicide in a sample of Brazilian psychiatric inpatients (95 with schizophrenia, 78 with major depression) and 52 healthy controls. No differences were found in genotypic frequencies across patients and controls. Overall, no differences were found between patients with (n=66) and without (n=107) a history of suicide attempt. We also compared patients with a history of severe suicide attempts (lethality>3; n=32) and patients without such a history (n=107), but they did not exhibit different genotypic frequencies either. These results show thai the 5-HT(2A) gene polymorphism (T102C) may not be involved in the genetic susceptibility to suicidal behavior.

scholarly journals Humoral and cellular responses to mRNA vaccines against SARS-CoV2 in patients with a history of CD20-B-cell depleting therapy

2021 ◽  
Author(s):  
Matthias B. Moor ◽  
Franziska Suter-Riniker ◽  
Michael P. Horn ◽  
Daniel Aeberli ◽  
Jennifer Amsler ◽  
...  
Keyword(s):  
Immune Responses ◽  
B Cell ◽  
Vaccine Dose ◽  
Lymphocyte Subpopulation ◽  
University Hospital ◽  
Healthy Controls ◽  
Vaccine Response ◽  
Treatment History ◽  
History Of ◽  
Anti Cd20

Background B-cell depleting therapies increase COVID19 morbidity and mortality. For this specific population, evidence-based vaccination strategies are lacking. Here, we investigated humoral and cell mediated immune responses to SARS-CoV2 mRNA-based vaccines in patients receiving CD20-B-cell depleting agents for autoimmune disease, malignancy, or transplantation. Methods Patients at the Bern University Hospital with a treatment history of anti-CD20 depleting agents (rituximab or ocrelizumab) were enrolled for analysis of humoral and cell-mediated immune responses (by IFN-g release assay) after completing vaccination against SARS-CoV2. Primary outcome was the the anti-spike antibody response in anti-CD20-treated patients (n=96) in comparison to immunocompetent controls (n=29). Results Anti-spike IgG antibodies were detected in 49% of patients 1.79 months after the second vaccine dose (interquartile range, IQR: 1.16-2.48) compared to 100% of controls (p<0.001). SARS-CoV2 specific interferon-g; release was detected in 17% of patients and 86% of healthy controls (p<0.001). Only 5% of patients, but 86% of healthy controls showed positive reactions in both assays, respectively (p<0.001). Time since last anti-CD20 therapy (7.6 months), peripheral CD19+ (>27/ul), and CD4+ lymphocyte count (>653/ul) predicted humoral vaccine response (area under the curve [AUC]: 62% [CI 56-78], 67% [CI 58-80] and 67% [CI 54-79], (positive predictive value [PPV]: 0.76, 0.7 and 0.71). Conclusion This study provides evidence for blunted humoral and cell-mediated immune responses elicited by SARS-CoV2 mRNA vaccines in patients with CD20-depleting treatment history. Lymphocyte subpopulation counts are associated with vaccine response in this highly vulnerable population. (Funded by Bern University Hospital, ClinicalTrials.gov number, NCT04877496)

Prefrontal BOLD Responses Coupled to Changing Emotional Faces in Adolescents with and without a History of Suicide Attempt

2020 ◽  
Vol 1 (1) ◽  
pp. 43-52 ◽  
Author(s):  
Henry W. Chase ◽  
Anna Maria Segreti ◽  
Jay C. Fournier ◽  
Mary L. Phillips ◽  
David Brent ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Functional Neuroimaging ◽  
Emotion Processing ◽  
Blood Oxygenation ◽  
Neural Function ◽  
Healthy Controls ◽  
Emotional Faces ◽  
Bold Responses ◽  
History Of ◽  
History Of Depression

Background: Functional abnormalities in emotion processing neural circuitry in adolescents with a history of suicide attempt relative to depressed adolescents with no history of suicide and healthy controls have been identified, typically utilizing static face presentations. Objective: The objective of the present work was to characterize functional activations associated with emotional face processing in adolescents with and without a history of suicide attempt. Methods: 64 adolescents including 19 with a history of depression and suicide attempt (ATT), 22 with a history of depression but no suicide attempt (NAT) and 23 healthy controls (HC) performed an implicit emotional-faces task during functional neuroimaging, in which they identified a color label superimposed on neutral faces that dynamically morphed into one of four emotional faces (angry, fearful, sad, and happy). Results: HC showed greater Blood Oxygenation Level Dependent (BOLD) responses compared with ATT in the Right Dorsolateral Prefrontal Cortex (rDLPFC) to all emotional faces compared to shapes. A similar pattern of group differences was seen when both ATT and NAT groups were compared with HC. Across all participants, an association between child trauma and rDLPFC activation was seen, although this was not corrected for multiple comparisons. Conclusions: Together, the findings are consistent with prior observations of emotion-related alterations in neural function in suicide attempters. However, they also suggest that adequate control groups are necessary to dissociate specific correlates of suicide risk from depression or trauma severity, which may contribute to prefrontal alterations in emotion processing.

scholarly journals Determinants of Antidepressant Treatment and Outpatient Rehabilitation Within the First Year After Stroke

2020 ◽  
pp. 089198872097374
Author(s):  
Simon Ladwig ◽  
Katja Werheid
Keyword(s):  
Depressive Symptoms ◽  
Antidepressant Treatment ◽  
Antidepressant Medication ◽  
Inpatient Rehabilitation ◽  
Outpatient Rehabilitation ◽  
Prospective Longitudinal Study ◽  
Telephone Interviews ◽  
Individual Determinants ◽  
History Of ◽  
Prospective Longitudinal

This study aims to identify individual determinants of antidepressant treatment and outpatient rehabilitation after stroke. People with ischemic stroke ( N = 303) recruited at 2 inpatient rehabilitation clinics were included into a prospective longitudinal study with follow-up telephone interviews 6 and 12 months later. Participants reported on their use of antidepressant medication and psychotherapy as well as physical, occupational, speech, and neuropsychological therapy. The use of antidepressants at discharge ( n = 65, 23.8%) was predicted by the severity of depressive symptoms, severity of stroke, history of depression, and use of antidepressants at admission (all p < .05, R 2= .55). The number of outpatient rehabilitation services used at follow-ups was predicted by higher functional and cognitive impairment, higher education, younger age, severity of depressive symptoms, and lower self-efficacy (all p < .05; R 2 6M = .24, R 2 12M = .49). The relevance of identified determinants for the improvement of treatment rates after stroke is discussed.

Pharmacological Treatments for Unipolar Depression

2007 ◽  
pp. 271-288 ◽  
Author(s):  
Charles B. Nemeroff ◽  
Alan F. Schatzberg
Keyword(s):  
Major Depression ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Rating Scale ◽  
Antidepressant Treatment ◽  
Safety Margin ◽  
Antidepressant Medication ◽  
Unipolar Depression ◽  
Controlled Trials ◽  
Adverse Side Effect ◽  
Drug Induced

The treatment of unipolar major depression with antidepressant medication is well established on the basis of scores of randomized placebo-controlled trials involving thousands of patients. Tricyclic antidepressants (TCAs) were the first to be studied extensively; meta-analyses of placebo-controlled trials show them to be consistently and significantly more efficacious than a placebo. Because of a narrow safety margin and significant drug-induced adverse side effect problems, TCAs have now largely been replaced as the first-line treatment of depression by selective serotonin reuptake inhibitors (SSRIs)—fluoxetine, sertraline, paroxetine, citalopram, and escitalopram; serotonin norepinephrine reuptake inhibitors (SNRIs)—venlafaxine and duloxetine; as well as other compounds, including, for example, bupropion and mirtazapine. Each of these agents has been shown to be superior to a placebo and as effective as comparator TCAs or SSRIs in controlled trials. Clinical trials consistently show them to be better tolerated than TCAs, and they clearly have a wider margin of safety. However, there is a controversy concerning whether TCAs are more effective than SSRIs for the treatment of the most severely ill depressed patients. Monoamine oxidase inhibitors (MAOIs), while also more effective than placebo, have generally been reserved for treatment-refractory patients; however, a recently released transdermally delivered selegiline may be used in less refractory patients. It is now generally recognized that patients with recurrent major depression benefit from continued antidepressant treatment, and there is evidence that TCAs, SSRIs, SNRIs, and so forth are all effective for the long-term management of recurrent major depression. An important issue in evaluating the antidepressant literature is to distinguish between response rated as a reduction in the level of symptoms on a rating scale and response rated as true remission from illness.

scholarly journals Autism risk following antidepressant medication during pregnancy

2017 ◽  
Vol 47 (16) ◽  
pp. 2787-2796 ◽  
Author(s):  
A. Viktorin ◽  
R. Uher ◽  
A. Reichenberg ◽  
S. Z. Levine ◽  
S. Sandin
Keyword(s):  
Cox Regression ◽  
Population Sample ◽  
Antidepressant Drugs ◽  
Antidepressant Medication ◽  
Population Based ◽  
Autism Spectrum ◽  
Relative Risks ◽  
Increased Risk ◽  
History Of ◽  
History Of Depression

BackgroundPrevious studies have examined if maternal antidepressant medication during pregnancy increase the risk of autism spectrum disorder (ASD) in the offspring, but the results have been conflicting.MethodsIn a population-based cohort of 179 007 children born in 2006 and 2007 and followed through 2014 when aged 7 and 8, we estimated relative risks (RRs) of ASD and 95% confidence intervals (CIs) from Cox regression in children exposed to any antidepressant medication during pregnancy, and nine specific antidepressant drugs. Analyses were adjusted for potential confounders and were conducted in the full population sample, and in a clinically relevant sub-sample of mothers with at least one diagnosis of depression or anxiety during life.ResultsThe adjusted RR of ASD in children of mothers who used antidepressant medication during pregnancy was estimated at 1.23 (95% CI 0.96–1.57), and at 1.07 (95% CI 0.80–1.43) in women with a history of depression or anxiety. Analyses of specific antidepressants initially revealed increased RRs of offspring ASD confined to citalopram and escitalopram (RR: 1.47; 95% CI 0.92–2.35) and clomipramine (RR: 2.86; 95% CI 1.04–7.82).ConclusionMedication with antidepressants during pregnancy does not appear to be causally associated with an increased risk of ASD in the offspring. Instead, the results suggest that the association is explained by factors related to the underlying susceptibility to psychiatric disorders. Based on these findings, the risk of ASD in the offspring should not be a consideration to withhold treatment with commonly used antidepressant drugs from pregnant women.

scholarly journals Altered Levels of Neurotrophic Factors in Alzheimer's Disease Patients with a Lifetimne History of Depression

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M.A. Rapp ◽  
V. Haroutunian ◽  
A. Heinz
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Major Depression ◽  
Neurotrophic Factors ◽  
Major Depressive ◽  
Neurotrophin 3 ◽  
Co Morbidity ◽  
History Of ◽  
Underlying Mechanisms ◽  
History Of Depression

Aims:We have recently shown both increases in the number of neuropathological changes in Alzheimer's disease patients with a history of recurrent major depression, and evidence for Alzheimer's disease-related neuropathological changes in patients with geriatric major depression. However, the correlates and possible underlying mechanisms for these neuropathological changes in Alzheimer's disease patients as a function of depression remains to be studied.Method:Levels of several neurotrophic factors, including nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and neurotrophin-3 (NT-3) were measured in a sample of Alzheimer's disease patients with and without a lifetime history of major depressive disorder.Results:Alzheimer's disease patients with co-morbid depression showed lower levels BDNF (P < .001) and NGF (P < .001) than Alzheimer's disease patients without co-morbid depression. Results remained stable when controlling for age, gender, level of education, and other medical co-morbidities.Conclusion:In Alzheimer's disease, the presence of depression co-morbidity corresponds to decreases in neurotrophic factors beyond effects of age, education, and medical co-morbidities, suggesting that the previously described link between major depression and the neuropathological processes in Alzheimer's disease may be related to changes in neuronal survival mediated by neurotrophic factors.Funded by the National Institute on Aging (U01 AG016976 and NIA P01-AG05138) and NARSAD.

An Empirical Study of Object Relations in Adult Children of Depressed Elderly Mothers

1998 ◽  
Vol 46 (2) ◽  
pp. 143-156 ◽  
Author(s):  
Nancy A. Hernandez ◽  
Gregory A. Hinrichsen ◽  
Leah Blumberg Lapidus
Keyword(s):  
Major Depression ◽  
Object Relations ◽  
Emotional Distress ◽  
Psychological Functioning ◽  
Adaptive Coping ◽  
Partial Support ◽  
Late Life Depression ◽  
Family Issues ◽  
History Of ◽  
History Of Depression

This study used a psychodynamic perspective on psychological functioning, object relations, for understanding coping and emotional distress in ( N = 50) sons and daughters providing assistance to an elderly mother hospitalized for major depression. Hypotheses that better maternal object relations would be related to more adaptive coping and less emotional distress received partial support. The hypothesis that an elderly mother's history of depression when a son or daughter was a child would be associated with adult children's poorer object relations received support. Results indicate that object relations may be a useful framework for studying family issues in late life depression.

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