scholarly journals Differentiated approach and indications for optimization of agomelatine therapy for endogenous depression

2019 ◽  
Vol 11 (2) ◽  
pp. 71-77
Author(s):  
L. I. Abramova ◽  
G. P. Panteleeva ◽  
I. Yu. Nikiforova ◽  
T. E. Novozhenova
Keyword(s):  
Depressive Disorders ◽  
Rating Scales ◽  
Rating Scale ◽  
Treatment Cycle ◽  
Endogenous Depression ◽  
Good Effect ◽  
Antidepressant Effect ◽  
Antidepressive Effect ◽  
Wide Range ◽  
Days Of Therapy

Objective: to develop and justify differentiated indications for the use of agomelatine (valdoxan) to treat the typological variants of endogenous depressions with varying severity on the basis of an analysis of its therapeutic efficacy.Patients and methods. An open prospective study was conducted using the clinical, psychopathological, and psychometric rating scales: the Hamilton Depression Rating Scale (HAMD-21); Udvalg for Kliniske Undersњgelser Scale (UKU); the Snaith-Hamilton Pleasure Scale (SHAPS) for assessing anhedonic disorders, and statistical methods. Examinations were made in 56 patients (mean age, 34.9 years) with moderate and severe endogenous depression within affective psychosis (n=42) and shift-like schizophrenia (n=14) (ICD-10 items F31.3–4; F32.1–2, and F33.1–2). The patients received a cycle treatment with agomelatine (valdoxan) 25–50 mg once a day in the evening for 4–8 weeks. The patients' status was evaluated over time on fixed days from a reduction in the mean total score (MTS) of the respective scales as insignificant (less than 19% reduction in disorders), moderate (20–49%), good (50–69%), and excellent (70% or more) effects. The effect of agomelatine was analyzed in two patient groups. The specific features of the antidepressive effect and its dynamics in the presence of endogenous depressions of different typologies (melancholic, anxious, and adynamic depressions) were studied in Group 1 (n=26); the effect of agomelatine on anhedonic endogenous depressions and manifestations of anhedonia in different mental activity areas (interests, social activity, emotional engagement and eating/drinking) was investigated in Group 2 (n=30).Results and discussion. There was a good tolerance and a high antidepressant activity of agomelatine during its treatment cycle for moderate and severe endogenous depressions. A significant improvement (an 84.4% reduction in HAMD-21 MTS) was noted in patients at 3 and 4 weeks of the treatment cycle and consistently persisted at a subsequent follow-up. Agomelatine showed a good effect (a 50% or more reduction in HAMD-21 MTS) just at 14 days of therapy. The drug was observed to have a balanced antidepressant effect, significant thymoleptic, stimulant, anxiolytic, and antianhedonic activities (reductions in the MTS of depressive disorders by 90.83, 84.9, 82.39, and 78.9%, respectively).Conclusion. The universal spectrum of the antidepressive effect of agomelatine, its good tolerability, high efficacy, and rapid improvement makes it the drug of choice in treating a wide range of psychopathological endogenous depressions: melancholic, apatho-adynamic, anxious, and anhedonic ones.

Biomarkers of depressive disorders: A multiplex analysis of blood serum

2017 ◽  
Vol 41 (S1) ◽  
pp. S524-S524 ◽  
Author(s):  
A.S. Boiko ◽  
I.S. Losenkov ◽  
L.A. Levchuk ◽  
G.G. Simutkin ◽  
N.A. Bokhan ◽  
...  
Keyword(s):  
Treatment Response ◽  
Depressive Disorders ◽  
Rating Scales ◽  
Rating Scale ◽  
Basic Research ◽  
Serum Markers ◽  
Control Group ◽  
Clinical Indicators ◽  
Feasible Option ◽  
Potential Biomarkers

Depressive disorders are a great burden for individual patients and society. Blood-based biomarkers are regarded as a feasible option for investigation of depressive disorders. Several potential biomarkers for depression were selected. We studied the following serum markers: cortisol, melatonin, brain-derived neurotrophic factor (BDNF), prolactin, insulin-like growth factor 1 (IGF-1), β-endorphin, orexin A. The patient sample consisted of 78 persons with depressive disorders. Patients were divided into two groups: 46 patients with a first depressive episode and 32 patients with recurrent depressive disorder. Control group consisted of 71 healthy individuals of corresponding age and sex. All markers were measured in serum using MILLIPLEX® MAP panels (Merck, Darmstadt, Germany) by analyzer MAGPIX (Luminex, USA). Statistical analyses were performed using SPSS software. Results were expressed as median and quartile intervals [Q1–Q3]. There was a significant increase of serum concentrations of cortisol (663.69 [467.5–959.49] nmol/L, Р < 0.001) and melatonin (66.31 [33.6–132.59] pg/mL, P = 0.029) in patients compared with the control group (526.1 [367,24–654,7] nmol/L and 45.11 [27.47–73.47] pg/mL). In addition, correlations were found between potential biomarkers, clinical indicators and treatment response measured by applying the Hamilton Depression rating scale and the Clinical Global Impression rating scales. A significant correlation was found between the concentration of prolactin and high response to pharmacotherapy (r = –0.267, P = 0.029). Identifying biomarkers that can be used as diagnostics or predictors of treatment response in people with depressive disorders will be an important step towards being able to provide personalized treatment.Disclosure of interestThe work is supported by the project of Russian Foundation of Basic Research No 14-04-01157a.

Anhedonia: a neglected symptom of psychopathology

1993 ◽  
Vol 23 (4) ◽  
pp. 957-966 ◽  
Author(s):  
Philip Snaith
Keyword(s):  
Depressive Disorders ◽  
Rating Scales ◽  
Antidepressant Drugs ◽  
Endogenous Depression ◽  
Depressive Illness ◽  
Point Of View ◽  
Psychiatric Research ◽  
Biological Research ◽  
The 1960S ◽  
Definition Of

SynopsisIn the last century psychopathologists attached importance to the concept of anhedonia, the loss of ability to experience pleasure. Its role in the diagnosis of melancholia was considered to be crucial. In the present century attention to anhedonia has faded, possibly because of the focus upon depressed mood as the pathognomonic feature of depressive disorders. Research on the symptomatology of endogenous depression did not include the concept; anhedonia was also lacking from the major instruments of psychiatric research, the depression rating scales,Attention was drawn to anhedonia by two authors: by Meehl in the 1960s and by Klein in the 1970s. Meehl considered anhedonia from the point of view of a personality defect predisposing to mental illness; and Klein regarded anhedonia to be a symptom of depressive illness and probably the best clinical marker predicting response to antidepressant drugs.In 1980 the revised DSM presented the concept of ‘loss of interest or pleasure’ as one of the two cardinal symptoms of major depression. Since then there has been a gradual recovery of emphasis although many systems confuse the two concepts of‘loss of interest’ and anhedonia. It is possible that anhedonia may provide the key to a more exact delineation of depressive disorders in biological research and in clinical practice. Further research will depend upon a more precise, cross-nationally agreed definition of the concept and the means of its assessment.

scholarly journals Echinacoside exhibits antidepressant-like effects through AMPAR–Akt/ERK–mTOR pathway stimulation and BDNF expression in mice

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Han-Wen Chuang ◽  
Tse-Yen Wang ◽  
Chih-Chia Huang ◽  
I-Hua Wei
Keyword(s):  
Depressive Disorders ◽  
Neuroprotective Effect ◽  
Underlying Mechanism ◽  
Mtor Pathway ◽  
Antidepressant Effect ◽  
Bdnf Expression ◽  
Echinacea Angustifolia ◽  
Extracellular Signal ◽  
Wide Range ◽  
Swimming Test

Abstract Background Several natural products have been demonstrated to be effective in the treatment of depressive disorders. Echinacoside, a naturally occurring phenol extracted from Cistanche tubulosa, Echinacea angustifolia, and Cistanche spp, has a wide range of physiological effects, such as antioxidation, neuroprotection, anti-inflammatory, and immunoregulation, which are closely related to depression. In addition, echinacoside can activate protein kinase B (Akt), extracellular signal–regulated kinase (ERK), and brain-derived neurotrophic factor (BDNF) in the brain. A key downstream event of the Akt, ERK, and BDNF signaling pathways, namely mechanistic target of rapamycin (mTOR) signaling, plays a crucial role in generating an rapid antidepressant effect. Thus, echinacoside is a promising therapeutic agent for depression. However, research regarding the role of echinacoside in antidepressant effect and brain mTOR activation remains lacking. Materials and methods The forced swimming test and Western blot analysis in C57BL/6 mice was used to investigate the antidepressant-like activities of echinacoside and the underlying mechanism involved inα-amino3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR)–Akt/ERK–mTOR pathway. Results We confirmed the suggestions by previous reports that echinacoside activates Akt/ERK signaling and further demonstrated that echinacoside could provide antidepressant-like effects in mice via the activation of AMPAR–Akt/ERK–mTOR pathway in the hippocampus. Conclusions To the best of our knowledge, our study is the first to reveal that echinacoside is a potential treatment for depressive disorders. Moreover, the present study suggests a mechanism for the neuroprotective effect of echinacoside.

Repeated subcutaneous esketamine administration for depressive symptoms and pain relief in a terminally ill cancer patient: A case report

2020 ◽  
Vol 34 (6) ◽  
pp. 822-825
Author(s):  
Matheus Ghossain Barbosa ◽  
Rodrigo Simonini Delfino ◽  
Luciana Maria Sarin ◽  
Andrea Parolin Jackowski
Keyword(s):  
Pain Relief ◽  
Cancer Patients ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Vital Signs ◽  
Subcutaneous Administration ◽  
Antidepressant Effect ◽  
Abdominal Tumor ◽  
Case Presentation ◽  
Research Problems

Background: Depressive disorders are common among cancer patients. Ketamine can quickly relieve depression, and its subcutaneous administration appears to be as effective as and probably safer than its standard intravenous administration. Herein, we report a case verifying the antidepressant effect of a subcutaneous esketamine formulation. Case presentation: A 65-year-old male with metastatic abdominal tumor reported sadness, weight loss, fatigue, hopelessness, insomnia, inattention, and reduced motivation. His scores on the visual analogical scale for pain and Montgomery–Asberg depression rating scale were 8/10 and 30/60, respectively. Possible courses of action: Monoaminergic antidepressants are effective, but their response is slow for end-of-life care. Formulation of a plan: Esketamine was preferred because it possibly contributes to pain relief. It can repeatedly be infused intravenously, but was subcutaneously administered twice a week for safety reasons. Outcome: The patient showed continuous mood improvement, achieving depression remission on day 7. Pain relief was observed but without stability. His vital signs remained stable, and he remained calm, without major complaints. Lessons from the case: Repeated subcutaneous esketamine injections are possibly safe and effective in pain and depression relief in palliative care cancer patients. View on research problems, objectives, or questions generated by the case: Placebo-controlled studies with similar cases are needed to establish efficacy and safety.

scholarly journals Developing a Brief Behavior Rating Scale for Progress Monitoring of Depression in School Settings

2018 ◽  
Vol 45 (3) ◽  
pp. 163-172 ◽  
Author(s):  
Evan H. Dart ◽  
Prerna Arora ◽  
Tai Collins ◽  
Kevin Stark ◽  
Clayton R. Cook ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Depressive Disorders ◽  
Rating Scales ◽  
Progress Monitoring ◽  
Rating Scale ◽  
Response To Treatment ◽  
Behavior Rating ◽  
Behavior Rating Scale ◽  
Monitoring Tools ◽  
Data Driven Decisions

Frequent formative assessment of students’ functioning, or progress monitoring, is a critical component of multi-tiered systems of support as data inform data-driven decisions about response to treatment. Progress monitoring tools for students’ academic and behavioral functioning are readily available and widely researched; however, despite the documented prevalence of depressive disorders among youth and that schools have been put forth as an ideal location for the delivery of mental health services, there are currently no progress monitoring tools to examine students’ response to interventions that target depression. To address this gap, this study sought to develop a progress monitoring assessment of students’ depressive symptoms using an empirically informed model for creating Brief Behavior Rating Scales (BBRS). Using this model, a four-item BBRS of depressive symptoms (BBRS-D) was created from the item pools of the Beck Depression Inventory for Youth (BDI-Y) and Children’s Depression Inventory (CDI) administered during a treatment study of depression in female youth; the resulting short scale corresponds well to the full-length assessments (i.e., r = .65 and r = .59); however, the BBRS-D possessed lower than adequate internal consistency (α = .50) and test–retest reliability ( r = .56). Limitations and future directions are discussed.

The Carroll Rating Scale for Depression III. Comparison with Other Rating Instruments

1981 ◽  
Vol 138 (3) ◽  
pp. 205-209 ◽  
Author(s):  
Michael Feinberg ◽  
Bernard J. Carroll ◽  
Peter E. Smouse ◽  
Sarah G. Rawson
Keyword(s):  
Rating Scales ◽  
Rating Scale ◽  
Severe Depression ◽  
Endogenous Depression ◽  
The Self ◽  
Global Rating ◽  
Observer Ratings ◽  
Severity Of Depression ◽  
Bipolar Patients ◽  
The Cost

SummaryPatients in an affective disorders out-patient clinic were studied with four depression rating scales: the Hamilton rating scale (HRS) the Carroll rating scale (CRS) a clinical global rating of depression (CGRD) and the visual analogue scale (VAS). The overall correlations between the self ratings (CRS, VAS) and the observer ratings (HRS, CGRD) were highly significant. Both the HRS and the CRS distinguished mild from moderate, and moderate from severe depression. CRS scores increased more rapidly than HRS scores with increasing severity of depression. The concordance of self ratings and observer ratings was highest for the two structured instruments (HRS and CRS), and was lowest for the two global scales (CGRD and VAS). The global scales have the advantages of speed and simplicity, but at the cost of some reliability. Patients with non-endogenous depression had significantly increased self rating scores in comparison to patients with unipolar or bipolar endogenous depression. The correlations between the self ratings and the observer ratings were notably lower in patients with non-endogenous depression than in patients with endogenous depression. Euthymic bipolar patients rated themselves on the VAS as significantly less well than euthymic unipolar patients. The clinical and research implications of these findings are discussed.

Comorbidity of Headache and Depressive Disorders

Cephalalgia ◽  
1999 ◽  
Vol 19 (4) ◽  
pp. 211-217 ◽  
Author(s):  
DD Mitsikostas ◽  
AM Thomas
Keyword(s):  
Migraine With Aura ◽  
Depressive Disorders ◽  
Rating Scales ◽  
Rating Scale ◽  
Primary Headache ◽  
Anxiety And Depression ◽  
Psychiatric Evaluation ◽  
Drug Overuse ◽  
And Gender ◽  
Headache Patients

The goal of the present study was to investigate the clinical profile of patients with primary headache syndromes who also suffer from mood disorders. Four-hundred-and-seventy headache outpatients (170M, 300F) and 150 age- and sex-matched healthy subjects were screened using a specific questionnaire that included the Hamilton rating scales for anxiety and depression. The average scores of the Hamilton rating scales for anxiety and depression were significantly higher in headache sufferers (17.4 and 14.2, respectively) than in healthy people (6.8 and 5.7, respectively). The frequency of headache attacks, the history of headaches, and gender (women more than men) were correlated with the score of the Hamilton rating scale for both anxiety and depression. Sixteen headache patients (3.4%) achieved the DSM-IV criteria for major depression or dysthymia versus one among headache-free subjects (0.6%; OR 5.2). Patients suffering from drug-overuse and migraine with aura showed the higher odds ratios (35 and 17, respectively). These results suggest that those headache patients with long history and high frequency of headaches, or patients suffering from migraine with aura and drug-overuse might benefit from psychiatric evaluation.

scholarly journals Echinacoside Exhibits Antidepressant-like Effects Through AMPAR–Akt/ERK–mTOR Pathway Stimulation and BDNF Expression in Mice

2021 ◽  
Author(s):  
Han-Wen Chuang ◽  
Tse-Yen Wang ◽  
Chih-Chia Huang ◽  
I-Hua Wei
Keyword(s):  
Depressive Disorders ◽  
Neuroprotective Effect ◽  
Underlying Mechanism ◽  
Receptor Activation ◽  
Mtor Signaling ◽  
Erk Signaling ◽  
Antidepressant Effect ◽  
Bdnf Expression ◽  
Wide Range ◽  
Glutamatergic Signaling

Abstract Background: Several natural products have been demonstrated to be effective in the treatment of depressive disorders. Echinacoside, a naturally occurring phenol extracted from Cistanche tubulosa, Echinacea angustifolia, and Cistanche spp, has a wide range of physiological effects, such as antioxidation, neuroprotection, anti-inflammatory, and immunoregulation, which are closely related to depression. In addition, echinacoside can activate protein kinase B (Akt), extracellular signal–regulated kinase (ERK), and brain-derived neurotrophic factor (BDNF) in the brain. A key downstream event of the Akt, ERK, and BDNF signaling pathways, namely mechanistic target of rapamycin (mTOR) signaling, plays a crucial role in generating an antidepressant effect. Thus, echinacoside is a promising therapeutic agent for depression. However, research regarding the role of echinacoside in brain mTOR activation and antidepressant effect remains lacking. Materials and methods: The forced swimming test in C57BL/6 mice was used to investigate the antidepressant-like activities of echinacoside and the underlying mechanism involved in glutamatergic signaling. Results: We confirmed the suggestions by previous reports that echinacoside activates Akt/ERK signaling and further demonstrated that echinacoside triggers mTOR signaling and α-amino3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor activation in the Akt/ERK signaling pathway downstream and upstream, respectively, and upregulates BDNF in the hippocampus of mice to exhibit antidepressant-like activities. Conclusion: To the best of our knowledge, our study is the first to reveal that echinacoside is a potential treatment for depressive disorders. Moreover, the present study suggests a mechanism for the neuroprotective effect of echinacoside.

AAC Collaboration Using the Self-Anchored Rating Scales (SARS): An Aphasia Case Study

2012 ◽  
Vol 21 (4) ◽  
pp. 136-143
Author(s):  
Lynn E. Fox
Keyword(s):  
Augmentative And Alternative Communication ◽  
Rating Scales ◽  
Rating Scale ◽  
Therapeutic Process ◽  
Family Counseling ◽  
The Self ◽  
Alternative Communication ◽  
Her Family ◽  
Solution Focused

Abstract The self-anchored rating scale (SARS) is a technique that augments collaboration between Augmentative and Alternative Communication (AAC) interventionists, their clients, and their clients' support networks. SARS is a technique used in Solution-Focused Brief Therapy, a branch of systemic family counseling. It has been applied to treating speech and language disorders across the life span, and recent case studies show it has promise for promoting adoption and long-term use of high and low tech AAC. I will describe 2 key principles of solution-focused therapy and present 7 steps in the SARS process that illustrate how clinicians can use the SARS to involve a person with aphasia and his or her family in all aspects of the therapeutic process. I will use a case study to illustrate the SARS process and present outcomes for one individual living with aphasia.

Childbirth and Posttraumatic Stress Responses

2006 ◽  
Vol 22 (4) ◽  
pp. 259-267 ◽  
Author(s):  
Eelco Olde ◽  
Rolf J. Kleber ◽  
Onno van der Hart ◽  
Victor J.M. Pop
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Responses ◽  
Rating Scales ◽  
Rating Scale ◽  
Stress Disorder ◽  
Traumatic Experience ◽  
Event Scale ◽  
Self Rating ◽  
The Impact

Childbirth has been identified as a possible traumatic experience, leading to traumatic stress responses and even to the development of posttraumatic stress disorder (PTSD). The current study investigated the psychometric properties of the Dutch version of the Impact of Event Scale-Revised (IES-R) in a group of women who recently gave birth (N = 435). In addition, a comparison was made between the original IES and the IES-R. The scale showed high internal consistency (α = 0.88). Using confirmatory factor analysis no support was found for a three-factor structure of an intrusion, an avoidance, and a hyperarousal factor. Goodness of fit was only reasonable, even after fitting one intrusion item on the hyperarousal scale. The IES-R correlated significantly with scores on depression and anxiety self-rating scales, as well as with scores on a self-rating scale of posttraumatic stress disorder. Although the IES-R can be used for studying posttraumatic stress reactions in women who recently gave birth, the original IES proved to be a better instrument compared to the IES-R. It is concluded that adding the hyperarousal scale to the IES-R did not make the scale stronger.

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