Is There a Delay in the Onset of the Antidepressant Effect of Electroconvulsive Therapy?

1994 ◽  
Vol 164 (1) ◽  
pp. 106-109 ◽  
Author(s):  
Colin R. Rodger ◽  
Allan I. F. Scott ◽  
Lawrence J. Whalley
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Electroconvulsive Therapy ◽  
Rating Scale ◽  
Antidepressant Effect ◽  
Major Depressive ◽  
Depressed Patients ◽  
Severity Of Depression ◽  
Drug Free ◽  
Hamilton Rating Scale

The severity of depression in 11 drug-free unipolar patients diagnosed with definite major depressive disorder was assessed using the Hamilton Rating Scale for Depression during a course (5–10 treatments) of bilateral electroconvulsive therapy (ECT). The degree of improvement after three treatments of ECT was six times greater than the improvement that occurred over the remainder of the course. Although depressed patients who recover with ECT require repeated treatments, the treatments early in a course of ECT can have marked antidepressant effect.

scholarly journals Effects of Celecoxib on Electroconvulsive Therapy-Induced Cognitive Impairment in Patients With Major Depressive Disorder: A Pilot, Double-Blind, Placebo-Controlled Trial

2020 ◽  
Author(s):  
Nafiseh Banaha ◽  
Padideh Ghaeli ◽  
Abolghasem Yousefi ◽  
Valentin Artounian ◽  
Mohammad H. Afzali ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Cognitive Impairment ◽  
Depressive Disorder ◽  
Electroconvulsive Therapy ◽  
Rating Scale ◽  
Color Test ◽  
Major Depressive ◽  
Double Blind ◽  
Cox 2 ◽  
Hamilton Rating Scale

Cognitive impairment, an important side effect of electroconvulsive therapy (ECT), may be related to the release of prostaglandins in the brain. Cyclooxygenase-2 (COX-2), constitutively expressed in the CNS, has a functional role in glutamate-mediated learning and memory. The goal of this pilot, double-blind, placebocontrolled trial was to evaluate the effects of the selective COX-2 inhibitor celecoxib on the adverse cognitive effects of ECT. Twenty patients diagnosed with the major depressive disorder for which ECT was indicated as a treatment for their current episode randomly received either celecoxib (200 mg orally twice a day, a total dose of 400 mg/day) or placebo. All patients underwent the same protocol for anesthesia and ECT procedures. The patients received celecoxib or the placebo for the whole period of ECT treatment, starting the day before ECT and continuing until the sixth (last) session of ECT. The Wechsler Mental Scale-III (WMS-III), the Mini-Mental Scale Examination (MMSE), and Stroop Color test were used to assess cognition before the first session and after the first, third and sixth sessions of ECT. Hamilton rating scale for depression was also used for the assessment of depression before and after the trial. Our data showed that celecoxib group did not have significant improvement in cognition based on WMS-III or MMSE scores. There was an improvement in the Stroop Color test but not statistically significant. Our results demonstrated that although celecoxib was well tolerated in patients undergoing ECT, it did not improve related cognitive impairment. Clinical trial registration number: IRCT201201247202N2. CNS, central nervous system; COX-2, Cyclooxygenase-2; DSM-IV-TR, Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision; ECT, electroconvulsive therapy; ECS, electroconvulsive shocks; HAM-D, Hamilton rating scale for depression; LTP, long term potentiation; MDD, major depressive disorder; MMSE, Mini-Mental State Examination; NSAIDs, nonsteroidal anti-inflammatory drugs; WMS-III, Wechsler Memory Scale-III.

scholarly journals The Patient Health Questionnaire-9 vs. the Hamilton Rating Scale for Depression in Assessing Major Depressive Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Simeng Ma ◽  
Jun Yang ◽  
Bingxiang Yang ◽  
Lijun Kang ◽  
Peilin Wang ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Measurement Accuracy ◽  
Rating Scale ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Major Depressive ◽  
Patient Health ◽  
Severity Of Depression ◽  
Hamilton Rating Scale

Background: The Hamilton Rating Scale for Depression (HAMD-17) has been used for several decades to assess the severity of depression. Multiple studies have documented defects in this scale and deemed it unsuitable for clinical evaluation. The HAMD-6, which is the abbreviated version of HAMD-17, has been shown to be effective in assessing the core symptoms of depression with greater sensitivity than HAMD-17. And the Patient Health Questionnaire-9 (PHQ-9) is suggested as an effective alternative to the HAMD-17 because of its simplicity and ease-of-use.Methods: Research was completed involving 1,741 participants having major depressive disorder. Cronbach's alpha, intraclass correlation coefficient (ICC) and weighted Kappa analysis was used to determine the reliability of the scales. Pearson correlation analysis and factor analysis were used to analyze validity. Item response theory (IRT) was used to analyze psychological characteristics of items in both the HAMD-17 and PHQ-9.Results: Reliability analysis showed that the Cronbach's alpha of the HAMD-17, HAMD-6 and PHQ-9 were 0.829, 0.764, and 0.893 respectively, and the ICC of the three scales ranged from 0.606 to 0.744. The Kappa score of the consistency of depression severity assessment was 0.248. Validity analysis showed that the PHQ-9 was a single factor structure, and the total score of the scale was strongly correlated with the HAMD-17 (r = 0.724, P < 0.001). The IRT analysis showed that the discrimination parameters of the PHQ-9 were higher than that of the HAMD-17 in all dimensions. The HAMD-6 had the lowest measurement accuracy in distinguishing the severity of depression, while the PHQ-9 had the highest measurement accuracy.Conclusion: Results showed that the PHQ-9 was satisfactory in terms of reliability, validity and distinguishing the severity of depression. It is a simple, rapid, effective and reliable tool which can be used as an alternative to the HAMD-17 to assess the severity of depression.

scholarly journals Predictors of Suicidal Ideation and Attempt among Patients with Major Depressive Disorder at a Tertiary Care Hospital, Puducherry

2021 ◽  
Vol 12 (01) ◽  
pp. 122-128
Author(s):  
Ralte Lalthankimi ◽  
Padmavathi Nagarajan ◽  
Vikas Menon ◽  
Jeby Jose Olickal
Keyword(s):  
Major Depressive Disorder ◽  
Suicidal Ideation ◽  
Depressive Disorder ◽  
Rating Scale ◽  
Tertiary Care ◽  
Severe Depression ◽  
Care Hospital ◽  
Suicidal Behaviors ◽  
Major Depressive ◽  
Severity Of Depression

Abstract Objectives Mental disorders have a large impact on death by suicide. Hence, this study aims to determine the prevalence of suicidal behaviors among major depressive disorder (MDD) patients and the associated factors. Materials and Methods This cross-sectional analytical study was conducted among individuals aged 18 to 65 years, diagnosed with MDD in the Psychiatry Outpatient Department of a Tertiary Care Center, Puducherry during March to October 2019. Severity of depression was assessed using Hamilton Depression Rating Scale and Columbia-Suicide Severity Rating Scale was used to find the suicidal behaviors. Results For 166 participants in the study, mean (standard deviation) age was 40 (11) years and majority were females (76%). More than one-third (37%) had severe or very severe depression, and the prevalence of suicidal ideation, plan, and attempts were 83, 24, and 35%, respectively. After adjusting the covariates, the severity of depression and unemployment were significantly associated with suicidal attempts (adjusted prevalence ratios [aPR] = 11.4 and 1.9), and very severe depression was associated with suicidal ideation (aPR = 1.6). Among 140 individuals with suicidal ideation, 45 (32%) had an ideation frequency of 2 to 3 times/week, 69 (50%) had ideation for 1 hour, 36 (26%) could control ideation with little difficulty, and 12% had suicidal ideation mostly to end or stop their pain. Conclusion Suicidal ideation and attempts were significantly high in MDD patients, and the severity of depression was significantly associated with it. Early identification of high-risk suicidal behavior and implementation of effective preventive interventions are necessary to reduce death by suicide in these groups.

Propofol Anaesthesia in Electroconvulsive Therapy

1994 ◽  
Vol 165 (4) ◽  
pp. 506-509 ◽  
Author(s):  
Christopher F. Fear ◽  
Carl S. Littlejohns ◽  
Eryl Rouse ◽  
Paul McQuail
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Electroconvulsive Therapy ◽  
Rating Scale ◽  
Induction Agent ◽  
Double Blind Study ◽  
Major Depressive ◽  
Seizure Duration ◽  
Double Blind ◽  
Induction Agents

BackgroundThe induction agent propofol is known to reduce electroconvulsive therapy (ECT) seizure duration. It is assumed that outcome from depression is adversely affected by this agent. This study compares propofol and methohexitone as induction agents for ECT.MethodIn a prospective, randomised, double-blind study 20 subjects with major depressive disorder (DSM-III-R criteria) received propofol or methohexitone anaesthesia. The Hamilton Depression Rating Scale and Beck Depression Inventory were used to assess depression before therapy, at every third treatment, and at the end of therapy. Seizure duration was measured using the cuff technique.ResultsMean seizure durations (P < 0.01) and mean total seizure duration (P < 0.01) were shorter in the propofol group. There was no difference in outcome.ConclusionsUse of propofol may not adversely affect outcome from depression and it is not necessarily contraindicated as an induction agent for ECT. Our results should be interpreted cautiously, and larger studies are needed.

scholarly journals Crocus sativus L. versus Citalopram in the Treatment of Major Depressive Disorder with Anxious Distress: A Double-Blind, Controlled Clinical Trial

2016 ◽  
Vol 50 (04) ◽  
pp. 152-160 ◽  
Author(s):  
A. Ghajar ◽  
S. Neishabouri ◽  
N. Velayati ◽  
L. Jahangard ◽  
N. Matinnia ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Rating Scale ◽  
Crocus Sativus ◽  
Controlled Clinical Trial ◽  
P Value ◽  
Major Depressive ◽  
Significant Difference ◽  
Hamilton Rating Scale ◽  
Crocus Sativus L

Abstract Introduction: Saffron (Crocus sativus L.) has demonstrated antidepressant effects in clinical studies and extensive anxiolytic effects in experimental animal models. Methods: 66 patients with major depressive disorder accompanied by anxious distress were randomly assigned to receive either saffron (30 mg/day) or citalopram (40 mg/day) for 6 weeks. Hamilton Rating Scale for Depression (HAM-D) and Hamilton Rating Scale for Anxiety (HAM-A) were used to assess treatment effect during the trial. Results: 60 participants finished the study. Patients who received either saffron or citalopram showed significant improvement in scores of the Hamilton Rating Scale for Depression (P-value<0.001 in both groups) and Hamilton Rating Scale for Anxiety (P-value<0.001 in both groups). Comparison of score changes between the 2 trial arms showed no significant difference (P-value=0.984). Frequency of side effects was not significantly different between the 2 groups. Discussion: The present study indicates saffron as a potential efficacious and tolerable treatment for major depressive disorder with anxious distress.

scholarly journals A prospective study to compare the efficacy of vilazodone and escitalopram tablets in the treatment of patients with newly diagnosed major depressive disorder

2020 ◽  
Vol 9 (5) ◽  
pp. 757
Author(s):  
Arjun Adiyodi ◽  
C. V. Singh ◽  
A. K. Mishra ◽  
Alok Dixit ◽  
Virendra Singh
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Rating Scale ◽  
Therapy Group ◽  
Age Group ◽  
Newly Diagnosed ◽  
Major Depressive ◽  
Treatment Groups ◽  
Severity Of Depression ◽  
A Prospective Study

Background: With the availability of large number of anti-depressant drugs, a thorough knowledge of comparative efficacy of the commonly used antidepressants is necessary to prescribe best drug molecule to the patient. This improves the compliance and therapeutic outcome. The aim of the study is to compare the efficacy of vilazodone and escitalopram in the treatment of patients with newly diagnosed major depressive disorder in a prospective study.Methods: 200 patients attending the psychiatry out-patient department diagnosed with major depressive disorder were assessed and enrolled into vilazodone 40 mg and escitalopram 20 mg treatment groups. Hamilton depression rating scale score (HDRS) was used to assess the severity of depression disorder at regular intervals.Results: Maximum cases were in the 21-30 age group and minimum cases in above 60 years age group. Males contributed maximum to number of depression cases with respect to females in both the treatment groups. Both escitalopram and vilazodone therapy group showed onset of improvement   at the end of 1st week. The efficacy of both treatment arms in reducing HDRS is comparable till 2nd week of treatment, but at 6th month vilazodone was more efficacious than escitalopram therapy. Conclusions: Escitalopram tablet given once/twice daily is significantly effective in reducing HDRS score as early as 2nd week. At 6th month vilazodone tablet was more efficacious than escitalopram therapy. Vilazodone is safe with fewer adverse effects as compared to escitalopram. 

scholarly journals Altered serum interleukin-7 and interleukin-10 are associated with drug-free major depressive disorder

2020 ◽  
Vol 10 ◽  
pp. 204512532091665 ◽  
Author(s):  
Sadia Anjum ◽  
M. M. A. Shalahuddin Qusar ◽  
Mohammad Shahriar ◽  
Sardar Mohammad Ashraful Islam ◽  
Mohiuddin Ahmed Bhuiyan ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Inflammatory Process ◽  
Rating Scale ◽  
Interleukin 10 ◽  
Enzyme Linked Immunosorbent Assay ◽  
Major Depressive ◽  
Interleukin 7 ◽  
Cytokine Levels ◽  
Severity Of Depression

Background: Abnormal expression of inflammatory cytokines in major depressive disorder (MDD) suggests the activation of an inflammatory process. The pattern of alterations in cytokine levels is still ambiguous. The present study aimed to evaluate interleukin-7 (IL-7) and interleukin-10 (IL-10) for their involvement in the pathophysiology of MDD and determine their relationships with depression risk. Methods: The study included 166 medication-free subjects: 84 MDD patients and 82 sex- and age-matched healthy controls (HCs). A qualified psychiatrist diagnosed patients and evaluated controls based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Hamilton depression rating scale (Ham-D) was used to measure the severity of depression in MDD patients. Serum IL-7 and IL-10 levels were measured using enzyme-linked immunosorbent assay (ELISA) kits. Results: Compared with HCs, the serum levels of IL-7 were significantly decreased, whereas that of IL-10 increased in MDD patients. Moreover, the severity of depression is correlated with the altered levels of IL-7 and IL-10 in MDD patients. We found a negative correlation between IL-7 and Hamilton depression rating (Ham-D) scores ( r = –0.580, p < 0.05), whereas there was a positive correlation between IL-10 and Ham-D scores ( r = 0.555, p < 0.05). Conclusions: The altered levels of serum IL-7 and IL-10 in MDD patients may represent a homeostatic mechanism that enhances the inflammatory process during depression. The alterations of these cytokine levels in MDD and their association with the severity of depression support them as promising, but there may still be controversial factors for understanding the pathophysiology of depression.

scholarly journals Association between suicide risk severity and sarcopenia in non-elderly Chinese inpatients with major depressive disorder

2020 ◽  
Author(s):  
Xinxin Fan ◽  
Jing Yuan ◽  
Yujun Wei ◽  
Fang Zhou ◽  
Li Xu ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Suicide Risk ◽  
Rating Scale ◽  
Risk Groups ◽  
First Episode ◽  
Depression Severity ◽  
Major Depressive ◽  
Elderly Chinese ◽  
Hamilton Rating Scale

Abstract Background: Sarcopenia is a skeletal muscle disorder. Recent studies showed high rates of suicide in non-elderly adults and the association between muscle health and suicide. But there have been no previous studies on the relationship between suicide risk severity and sarcopenia in major depressive disorder (MDD). This study aimed to explore the association between suicide risk severity and sarcopenia in non-elderly Chinese inpatients with MDD. Methods: The first-episode drug-naïve MDD inpatients aged 20-59 years with the 24-item Hamilton Rating Scale for Depression (HAMD-24) scores of ＞20 were included, who were then classified into low, intermediate, high and very high suicide risk groups according to the Nurses' Global Assessment of Suicide Risk (NGASR). The HAMD-24, the Hamilton Rating Scale for Anxiety (HAMA) and the SARC-F questionnaire were used to assess depression severity, anxiety severity and sarcopenia, respectively. The plasma levels of cortisol and adrenocorticotropic hormone (ACTH) were measured. Results: A total of 192 MDD inpatients (122 females, 70 males; aged 39.3 ± 11.7 years) were included, with 12.5% of sarcopenia. There were significant differences in gender, HAMD score and prevalence of sarcopenia among the suicide risk groups. Adjusted ordinal regression analysis showed that sarcopenia was significantly associated with severer suicide risk (OR=2.39, 95%CI 1.02-5.58, p=.044). Conclusions: This study revealed that sarcopenia was significantly associated with higher suicide risk in non-elderly Chinese MDD inpatients after adjustment for depression severity. Intervention of sarcopenia might be effective to reduce the risk of suicide in non-elderly MDD patients.

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