Dementia Improvement after Primary Hyperparathyroidism Surgery

This is the case of a 76-year-old man admitted to hospital in a delirium state, previously diagnosed with a major depressive disorder at an age of 50 years, treated for years for chronic tension headache. The computed tomography of the head resulted negative. Inpatient laboratory tests revealed a mild hypercalcemia. Due to the progression of the disease (delirium state, dementia, tension headache, and depression), he was again admitted to hospital. The patient showed dysarthria, postural tremors, mirror movements and palmar hyperhidrosis, mild ataxia when walking, and rigidity. Sleep disturbances were also observed. He underwent several clinical diagnostic tests, which resulted negative. After more than 2 years, the ultrasound of the neck identified enlarged parathyroid glands. The patient was surgically treated, and three parathyroid glands were removed. Parathyroidectomy and lithium treatment resulted in improvement of cognitive functions. In elderly patients, concomitant presence of cognitive dysfunction may mask the underlying primary hyperparathyroidism.

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Polygenic scores for major depressive disorder and depressive symptoms predict response to lithium in patients with bipolar disorder

10.1101/449363 ◽

2018 ◽

Cited By ~ 1

Author(s):

Azmeraw T. Amare ◽

Klaus Oliver Schubert ◽

Liping Hou ◽

Scott R. Clark ◽

Sergi Papiol ◽

...

Keyword(s):

Bipolar Disorder ◽

Major Depressive Disorder ◽

Depressive Symptoms ◽

Depressive Disorder ◽

Treatment Response ◽

Lithium Treatment ◽

Mapk Signaling ◽

Genome Wide Association Studies ◽

Major Depressive ◽

Polygenic Scores

AbstractBackgroundLithium is a first-line medication for bipolar disorder (BD), but only ~30% of patients respond optimally to the drug. Since genetic factors are known to mediate lithium treatment response, we hypothesized whether polygenic susceptibility to the spectrum of depression traits is associated with treatment outcomes in patients with BD. In addition, we explored the potential molecular underpinnings of this relationship.MethodsWeighted polygenic scores (PGSs) were computed for major depressive disorder (MDD) and depressive symptoms (DS) in BD patients from the Consortium on Lithium Genetics (ConLi+Gen; n=2,586) who received lithium treatment. Lithium treatment outcome was assessed using the ALDA scale. Summary statistics from genome-wide association studies (GWAS) in MDD (130,664 cases and 330,470 controls) and DS (n=161,460) were used for PGS weighting. Associations between PGSs of depression traits and lithium treatment response were assessed by binary logistic regression. We also performed a cross-trait meta-GWAS, followed by Ingenuity® Pathway Analysis.OutcomesBD patients with a low polygenic load for depressive traits were more likely to respond well to lithium, compared to patients with high polygenic load (MDD: OR =1.64 [95%CI: 1.26-2.15], lowest vs highest PGS quartiles; DS: OR=1.53 [95%CI: 1.18-2.00]). Associations were significant for type 1, but not type 2 BD. Cross-trait GWAS and functional characterization implicated voltage-gated potassium channels, insulin-related pathways, mitogen-activated protein-kinase (MAPK) signaling, and miRNA expression.InterpretationGenetic loading to depression traits in BD patients lower their odds of responding optimally to lithium. Our findings support the emerging concept of a lithium-responsive biotype in BD.FundingSee attached details

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Lithium Treatment Reduces Suicide Risk in Recurrent Major Depressive Disorder

The Journal of Clinical Psychiatry ◽

10.4088/jcp.v68n0304 ◽

2007 ◽

Vol 68 (03) ◽

pp. 380-383 ◽

Cited By ~ 122

Author(s):

Francesca Guzzetta ◽

Leonardo Tondo ◽

Franca Centorrino ◽

Ross J. Baldessarini

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Suicide Risk ◽

Lithium Treatment ◽

Major Depressive ◽

Recurrent Major Depressive Disorder

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P.238 Lithium treatment modulates the expression of inflammation involved genes in major depressive disorder

European Neuropsychopharmacology ◽

10.1016/j.euroneuro.2020.09.179 ◽

2020 ◽

Vol 40 ◽

pp. S136

Author(s):

K. Sakrajda ◽

D. Szczepankiewicz ◽

P. Celichowski ◽

E. Banach ◽

P. Zakowicz ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Lithium Treatment ◽

Major Depressive

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Escitalopram in Treatment of Sleep Disturbances in Major Depressive Disorder

European Psychiatry ◽

10.1016/s0924-9338(09)70865-x ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

N. Zivkovic ◽

G. Djokic ◽

D. Pavicevic ◽

V. Ilic

Keyword(s):

Major Depressive Disorder ◽

Adverse Effects ◽

Depressive Disorder ◽

Sleep Disturbances ◽

Rating Scale ◽

Statistical Significance ◽

Control Group ◽

Major Depressive ◽

High Statistical Significance ◽

Experimental Group

Major depressive disorder (MDD) is common and severe affective disorder with sleep disturbances and non-bizarre delusions which are organized in permanent and unshakeable delusional system. Neurobiological basis of MDD is still completely unknown, but significant role has serotoninergic and noradrenergic neuronal systems. Escitalopram is highly potent and highly selective serotonin re-uptake inhibitor.Purpose of this study was to estimate efficacy of the escitalopram in treatment of sleep disturbances in MDD.Methods:This prospective clinical study included 95 patients diagnosed by ICD-10 criteria for MDD, who are randomly divided into control (30 patients) and experimental group (65 patients). Patients were observed for 6 months in hospital and outpatients conditions, according to specially designed protocol, which included Hamilton Depression Rating Scale (HAMD) and Leeds Sleeping Evaluation Questionnaire (LSEQ). Control group was treated with maprotiline (75-150 mg/24h) and experimental group with escitalopram (10-20 mg/24h).Results:Escitalopram therapy influenced on HAMD score with high statistical significance vs. maprotiline, p=0.000. Escitalopram therapy improves LSEQ score after 6 months in comparison to maprotiline therapy with high statistical significance p=0.000. Percentage of adverse effects is significantly lower in escitalopram (10.76%) than in maprotiline (26.67%) group.Conclusion:Escitalopram has significantly better efficacy and lower adverse effects rate in treatment of depressive symptoms and sleep disturbances in MDD patients comparing to maprotiline.

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