scholarly journals Reducing the Global Burden of Depression

2014 ◽  
Vol 4 (1) ◽  
pp. 49
Author(s):  
Prabjyot Kaur Chahil
Keyword(s):  
Depressive Disorders ◽  
Cost Effective ◽  
Term Treatment ◽  
Alternative Methods ◽  
Global Burden ◽  
First Line ◽  
Depression Prevention ◽  
Long Term Treatment ◽  
Methods Of Treatment

<p>Depression is expected to be one of the leading causes of morbidity by 2020. Nonetheless, the current methods of treatment for depression may not be effective in reducing the global burden of this disease. Currently, pharmacotherapy represents the first line treatment for depressive disorders; however, many adverse effects of anti-depressants are often overlooked and their interference with body chemistry may not be ideal for long-term treatment.</p><p>In order to reduce the burden of disease of depression, methods of treatment such as counseling and therapy should be considered as alternatives to pharmacotherapy. Most importantly, these treatments reduce the occurrence of depression relapse, making them more effective in the long-term. In addition to alternative methods of treatment, depression prevention strategies should be prioritized. Not only is depression prevention the best solution therapeutically, but it is also the most cost-effective in reducing global morbidity. In order to implement these strategies, however, more evidence-based research on the prevention of depressive disorders is required.</p>

Will a once-weekly anticoagulant for the treatment and secondary prevention of thromboembolism improve adherence?

2009 ◽  
Vol 101 (03) ◽  
pp. 422-427 ◽  
Author(s):  
Louise Maillardet ◽  
Yshai Yavin ◽  
Alexander T. Cohen
Keyword(s):  
Secondary Prevention ◽  
Depressive Disorders ◽  
Term Treatment ◽  
Bisphosphonate Treatment ◽  
Weekly Administration ◽  
Once Daily ◽  
New Anticoagulants ◽  
Improved Outcomes ◽  
Long Term Treatment

SummaryOral anticoagulation, most commonly with warfarin once daily, has long been the main form of long-term treatment and secondary prevention of thromboembolism. The efficacy of warfarin has been established in clinical trials, but problems with unstable anticoagulation with international normalized ratios (INRs) outside the recommended range due to incorrect dosing, drug and food interactions, and with adherence and persistence have been reported in practice. Poor adherence and persistence are serious problems because they result in out-of-range INRs. Many new thromboembolic events, such as strokes, occur when INRs are out-of-range or after warfarin discontinuation. Among the new anticoagulants currently being investigated, some offer the possibility of more stable anticoagulation and weekly administration. Less frequent dosing schedules generally improve adherence. In many cases, such as bisphosphonate treatment for osteoporosis, and the long-term treatment of depressive disorders or multiple sclerosis, adherence to, and persistence with, weekly dosing is improved compared with daily dosing, and most patients prefer weekly dosing. The advent of novel anticoagulants such as idraparinux with its long half-life offers hope for improved adherence with anticoagulation, and ultimately improved outcomes.

First-line, long-term treatment of multiple myeloma with thalidomide, dexamethasone, and zoledronate in combination (TDZ)

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 6702-6702
Author(s):  
U. Klueppelberg ◽  
L. Chen ◽  
C. M. Aloba ◽  
J. Shapira ◽  
E. Smith ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Term Treatment ◽  
First Line ◽  
Long Term Treatment

Clinical and economic profile of entecavir in the treatment of chronic hepatitis b virus infection

2011 ◽  
Vol 12 (2) ◽  
pp. 61-76
Author(s):  
Mario Eandi
Keyword(s):  
Term Treatment ◽  
Hepatitis B Virus Infection ◽  
First Line ◽  
Genetic Barrier ◽  
Nucleotide Analogues ◽  
Chronic Hepatitis B Virus ◽  
Long Term Treatment ◽  
B Virus ◽  
Economic Profile

HBV infection in Italy is frequently underestimated, raising the risk of important complications, such as cirrhosis and hepatocellular carcinoma, and thus increasing mortality. In infections phases requiring treatment, it’s possible to choose among the currently available drugs: interferons, nucleoside and nucleotide analogues. Entecavir is a nucleoside analogue able to maintain a high genetic barrier, and to reduce the viral load < 300 copies/ml in 67% of HBeAg-positive patients and in 90% of HBeAg-negative patients after 48-weeks treatment, improving also necroinflammatory grade and fibrosis degree. In spite of the high cost of the confection, entecavir induces a saving in health costs because of the decrease in the disease progression. If compared, through pharmacoeconomic models and analysis, to tenofovir, a nucleotide acid considered equivalent in the first-line monotherapy of HBeAg-positive patients and in the long-term treatment of HBeAg-negative patients by the current international and Italian guidelines, it seems favourable in terms of safety and consequently in terms of costs of adverse events spared. However further studies are required: in particular direct comparative studies are still lacking.

scholarly journals Newer v. older antidepressants in long-term pharmacotherapy: Revisiting… Prevention of relapse and recurrence of depression

2005 ◽  
Vol 11 (3) ◽  
pp. 184-194 ◽  
Author(s):  
J. Guy Edwards
Keyword(s):  
Drug Acquisition ◽  
Term Treatment ◽  
First Line ◽  
Specific Effects ◽  
Drug Choice ◽  
Long Term Treatment ◽  
Acquisition Costs ◽  
Prevention Of Relapse ◽  
First Line Treatment

There is much evidence from clinical trials that antidepressants help prevent relapse and recurrence of major depression. However, this is unlikely to hold true for all patients with depression, particularly those treated in primary care. Individual antidepressants are equally efficacious, so choice (as first-line treatment in general or for individual patients) is largely determined by differences in side-effects, even though many of these disappear during long-term treatment, owing to adaptation. Specific effects that are considered in choosing a drug include those on cognition, psychomotor performance and sexual function; drug interactions, lethality in overdose and the potential for teratogenicity are also considered. There are insufficient entirely objective and generally accepted data on pharmaco-economics to allow for confident recommendations on drug choice for long-term treatment. Drug acquisition costs must be considered by those with restricted budgets, and especially patients in developing countries where difference in cost between newer and older drugs can be translated into more food for a hungry family.

Low-Dose Lithium for Long-Term Treatment of Clozapine- Induced Neutropenia: A Case Series

2019 ◽  
Vol 8 (2) ◽  
pp. 155-158 ◽  
Author(s):  
Muhammad R. Baig
Keyword(s):  
Mental Health ◽  
Effective Treatment ◽  
Low Dose ◽  
Lithium Treatment ◽  
Case Series ◽  
Cost Effective ◽  
Term Treatment ◽  
Treatment Resistant ◽  
Long Term Treatment

Background: Treatment-resistant psychosis makes schizophrenia a disabling and costly illness. Clozapine is an effective treatment for treatment-resistant psychosis, though it is underutilized mainly due to prescribing providers’ fear of a serious yet uncommon complication, clozapine-induced neutropenia. Clozapine-induced neutropenia predisposes patients to potentially life-threatening infections leading prescribers to stop use when blood counts start to drop even well above the recommended cut-off point. Colonystimulating factors are effective options for reducing risk and duration of neutropeniarelated events though they add a significant cost burden to the patient and healthcare system. There is a great need for feasible and cost-effective pharmacotherapies in the mental health care setting for the management of clozapine-induced neutropenia. Objective: We evaluated adjunctive use of lithium when prescribed at a low-dose to stabilize dropping blood count in patients receiving clozapine for treatment-resistant psychosis. Methods & Results: A case series analysis of three patients who were followed in a mental health outpatient clinic for the management of schizophrenia. Blood counts of all the patients were stabilized by low-dose lithium treatment and continued to receive long term treatment of clozapine. Conclusion: Results suggest low-dose lithium as a feasible and cost-effective pharmacotherapeutic option enabling the continuation of clozapine, an effective treatment for treatment-resistant psychosis.

Bariatric Surgery as a Long-Term Treatment for Type 2 Diabetes/Metabolic Syndrome

2020 ◽  
Vol 71 (1) ◽  
pp. 1-15
Author(s):  
Zubaidah Nor Hanipah ◽  
Philip R. Schauer
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Surgery ◽  
Lifestyle Modification ◽  
Cost Effective ◽  
Term Treatment ◽  
Sustained Weight Loss ◽  
Long Term Treatment ◽  
Perioperative Risks

Metabolic surgery is increasingly becoming recognized as a more effective treatment for patients with type 2 diabetes (T2D) and obesity as compared to lifestyle modification and medical management alone. Both observational studies and clinical trials have shown metabolic surgery to result in sustained weight loss (20–30%), T2D remission rates ranging from 23% to 60%, and improvement in cardiovascular risk factors such as hypertension and dyslipidemia. Metabolic surgery is cost-effective and relatively safe, with perioperative risks and mortality comparable to low-risk procedures such as cholecystectomy, hysterectomy, and appendectomy. International diabetes and medical organizations have endorsed metabolic surgery as a standard treatment for T2D with obesity.

scholarly journals Clinical case of long-term pemetrexed-based chemotherapy treatment for pulmonary adenocarcinoma (ALA +)

2018 ◽  
pp. 68-72
Author(s):  
A. M. Lozhkina ◽  
M. A. Sviridenko ◽  
A. O. Cheremnykh ◽  
E. A. Filippova ◽  
M. A. Urtenova ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Clinical Case ◽  
Term Treatment ◽  
Small Cell ◽  
Chemotherapy Treatment ◽  
Small Cell Lung ◽  
First Line ◽  
Long Term Treatment ◽  
Alk Positive

The article describes a clinical case of ALK-positive non-small cell lung cancer and its long-term treatment with a chemotherapy drug pemetrexed as first-line regimen followed by pemetrexed maintenance therapy.

scholarly journals What do we know about long-term treatment outcomes for severe depressive disorders?

BJPsych Open ◽  
2020 ◽  
Vol 6 (2) ◽  
Author(s):  
Rebecca Strawbridge ◽  
Tanja Jaeckle ◽  
Anthony J. Cleare
Keyword(s):  
Treatment Outcomes ◽  
Depressive Disorders ◽  
Term Treatment ◽  
Routine Practice ◽  
Long Term Outcomes ◽  
Patient Response ◽  
Psychological Therapies ◽  
Long Term Treatment ◽  
Improve Patient

Summary In a recent issue of BJPsych Open, McPherson & Hengartner (see https://doi.org/10.1192/bjo.2019.65) reviewed 11 trials examining psychological and pharmacological treatment outcomes for chronic or treatment-resistant depression. They concluded that when assessed in the long term, antidepressants become less effective whereas psychological therapies become more effective. We argue that the evidence does not support this; indeed, most of the studies reviewed do not directly compare antidepressant with psychological therapy treatments and there is little consistency between them in terms of populations and interventions examined. The issue of long-term outcomes is key for optimising clinical guidelines and deserves more intensive research and scrutiny to improve patient response in routine practice.

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