Multimodal Therapy of Treatment Resistant Depression: A Study and Analysis

2005 ◽  
Vol 35 (1) ◽  
pp. 27-39 ◽  
Author(s):  
Noreen Bannan
Keyword(s):  
Multimodal Therapy ◽  
Self Esteem ◽  
Treatment Resistant Depression ◽  
Pharmacological Treatments ◽  
Treatment Resistant ◽  
Psychological Therapies ◽  
Therapeutic Trials ◽  
History Of ◽  
Resistant Depression

Objective: To demonstrate through the use of a case study, the application of cognitive psychotherapy in the treatment of resistant depression. Method: The case of a woman with an 18-month history of resistant depression associated with low self-esteem, guilt and shame, who failed to respond to three therapeutic trials of antidepressants is described. A detailed description of a CBT intervention over 12 sessions is given. Result: Clear improvements on assessments of mood and hopelessness, along with overall improvements in social and occupational functioning were noted. Conclusion: These improvements were attributed to a combination of CBT and pharmacotherapy, where pharmacotherapy alone failed to alleviate symptoms. A concise literature review revealed relatively few published trials of psychological treatments, and a lack of clear guidelines on pharmacological treatments. More research is needed to explore the efficacy of psychological therapies for treatment resistant depression.

A pilot, open study of sertraline in outpatients with treatment-resistant depression (TRD) or with a history of TRD who responded but later relapsed

2003 ◽  
Vol 18 (5) ◽  
pp. 293-296
Author(s):  
George I. Papakostas ◽  
Timothy Petersen ◽  
John J. Worthington ◽  
Pamela A. Roffi ◽  
Jonathan E. Alpert ◽  
...  
Keyword(s):  
Open Study ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
History Of ◽  
Resistant Depression

scholarly journals Sevoflurane augmentation in treatment-resistant depression: a clinical case study

2020 ◽  
Vol 10 ◽  
pp. 204512532095712
Author(s):  
Shikai Wang ◽  
Shanfei Cheng ◽  
Min Feng ◽  
Ping Guo ◽  
Mincai Qian ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Clinical Case ◽  
Efficacy And Safety ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Clinical Case Study ◽  
Antidepressant Effects ◽  
Mucous Membranes ◽  
Resistant Depression

Compared with other inhaled anaesthetics, sevoflurane has a faster onset and offset, causes less irritation to the mucous membranes, and has a better safety profile. These characteristics warrant investigating the effect of sevoflurane in depression. In this Case Report, we describe that sevoflurane treatment was feasible and well tolerated by a patient with treatment-resistant depression (TRD). Sevoflurane had rapid and durable antidepressant effects, with few adverse effects. Moreover, the patient showed significant improvements in neurocognitive measurements. Our preliminary results suggest that further clinical trials are needed to determine the independent efficacy and safety of sevoflurane in patients with TRD.

A pilot, open study of sertraline in outpatients with treatment-resistant depression (TRD) or with a history of TRD who responded but later relapsed

2003 ◽  
Vol 18 (5) ◽  
pp. 293-296 ◽  
Author(s):  
George I. Papakostas ◽  
Timothy Petersen ◽  
John J. Worthington ◽  
Pamela A. Roffi ◽  
Jonathan E. Alpert ◽  
...  
Keyword(s):  
Open Study ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
History Of ◽  
Resistant Depression

scholarly journals Whole-body edema with olanzapine: A case report and literature review

2020 ◽  
Vol 10 (5) ◽  
pp. 291-295
Author(s):  
Elizabeth A. Cook ◽  
Denver Shipman ◽  
Tyler Gipson Fowler
Keyword(s):  
Weight Gain ◽  
Lower Limbs ◽  
Whole Body ◽  
White Female ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Symptomatic Management ◽  
Elevated Glucose ◽  
History Of ◽  
Resistant Depression

Abstract Olanzapine is a second-generation antipsychotic (SGA) that has been shown to promote disease remission in persons with treatment-resistant depression when used in combination with fluoxetine. However, tolerability of treatment augmentation with SGAs may be limited because of common adverse effects, such as weight gain, hypertriglyceridemia, and elevated glucose. Data exist pertaining to rare localized edematous reactions or angioedema with use of SGAs, but diffuse whole-body edema has yet to be documented. A 47-year-old white female with treatment-resistant depression presented with a 5-day history of weight gain and swelling of her torso and extremities. Five days prior, she had initiated olanzapine/fluoxetine 6/50 mg daily following failure of fluoxetine 40 mg daily monotherapy. The patient was noted to have gained 3.6 kg since her last appointment and exhibited profuse pitting edema on her forearms, lower limbs, hands, and chest. Olanzapine/fluoxetine was discontinued and the patient was prescribed a 3-day course of a loop diuretic for symptomatic management. A follow-up visit 5 days later noted complete resolution of symptoms. Because of the temporal relationship of symptoms with initiation of olanzapine, we recommend monitoring for edema with initiation and/or titration of therapy.

scholarly journals Relationship between Childhood Physical Abuse and Clinical Severity of Treatment-Resistant Depression in a Geriatric Population

2020 ◽  
Author(s):  
Antoine Yrondi ◽  
Christophe Arbus ◽  
Djamila Bennabi ◽  
Thierry D'Amato ◽  
Frank Bellivier ◽  
...  
Keyword(s):  
Depressive Symptom ◽  
Physical Abuse ◽  
Symptom Severity ◽  
Self Esteem ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
High Severity ◽  
Depressive Symptom Severity ◽  
Resistant Depression ◽  
Score Range

Abstract Background: We assessed the correlation between childhood maltreatment (CM) and severity of depression in an elderly unipolar Treatment-Resistant Depression (TRD) sample. Methods: Patients were enrolled from a longitudinal cohort (FACE-DR) of the French Network of Expert TRD Centres. Results: Our sample included 96 patients (33% of the overall cohort) aged 60 years or above, with a mean age of 67.2 (SD = 5.7). Most of the patients were female (62.5%). The Montgomery and Asberg Depression Rating Scale (MADRS) and Quick Inventory Depression Scale-Self Report (QIDS-SR) mean scores were high, 28.2 (SD = 7.49) [MADRS score range: 0-60; moderate severity≥20, high severity≥35] and 16.5 (SD=4.94) [IDS-SR score range: 0-27; moderate severity≥11, high severity≥16], respectively. Mean self-esteem scores were 22.47 (SD=6.26) [range 0-30]. In an age and sex-adjusted model, we found a positive correlation between childhood trauma (CTQ scores) and depressive symptom severity [MADRS (β=0.274; p=0.07) and QIDS-SR (β=0.302; p=0.005) scores]. We detected a statistically significant correlation between physical abuse and depressive symptom severity [MADRS (β=0.304; p=0.03) and QIDS-SR (β=0.362; p=0.005) scores]. We did not observe any significant correlation between other types of trauma and depressive symptom severity. We showed that self-esteem (Rosenberg scale) mediated the effect of physical abuse (PA) on the intensity of depressive symptoms [MADRS: b=0.318, 95% BCa C.I. [0.07, 0.62]; QIDS-SR: b=0.177, 95% BCa C.I. [0.04, 0.37]]. Preacher & Kelly’s Kappa Squared values of 19.1% (k2=0.191) and 16% (k2=0.16), respectively, indicate a moderate effect. Conclusion: To our knowledge, this is the first study conducted in a geriatric TRD population documenting an association between childhood trauma (mainly relating to PA) and the intensity of depressive symptoms.

scholarly journals A Clinical Rationale for Assessing the Impact of Childhood Sexual Abuse on Adjunctive Subcutaneous Esketamine for Treatment-Resistant Depression

2021 ◽  
Vol 12 ◽  
Author(s):  
Eduardo Jorge Muniz Magalhães ◽  
Luciana Maria Sarin ◽  
Lorena Catarina Del Sant ◽  
Ana Cecília Lucchese ◽  
Carolina Nakahira ◽  
...  
Keyword(s):  
Sexual Abuse ◽  
Adult Population ◽  
Positive Family History ◽  
Poor Response ◽  
Depression Symptom ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
History Of ◽  
Resistant Depression ◽  
The Impact

Background: A history of child sexual abuse (CSA) is related to higher suicide rates and poor treatment outcomes in depressed adult patients. Twenty years after the first study investigating the effects of ketamine/esketamine on depression and suicide, there is a lack of data on the CSA effects on this emerging treatment. Here, we assess the impact of CSA on adjunctive subcutaneous (SC) esketamine for treatment-resistant depression (TRD).Methods: A directed acyclic graphic (DAG) was designed to identify clinical confounders between CSA and esketamine predictors of response. The confounders were applied in a statistical model to predict depression symptom trajectory in a sample of 67 TRD outpatients.Results: The patient sample had a relatively high prevalence rate of CSA (35.82%). Positive family history of first-degree relatives with alcohol use disorder and sex were clinical mediators of the effects of esketamine in a CSA adult population. Overall, the presence of at least one CSA event was unrelated to esketamine symptom reduction.Conclusions: Unlike responses to conventional antidepressants and psychotherapy, CSA does not appear to predict poor response to esketamine.

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