Association between genetic polymorphism and antidepressants in major depression: a network meta-analysis

2020 ◽  
Vol 21 (13) ◽  
pp. 963-974
Author(s):  
Dan Du ◽  
Qiong Tang ◽  
Qiong Han ◽  
Jin Zhang ◽  
Xuemei Liang ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Genetic Polymorphism ◽  
Predictive Value ◽  
Meta Analysis ◽  
Response Ratio ◽  
Antidepressant Response ◽  
Major Depressive ◽  
Significant Difference ◽  
The Relationship ◽  
Bdnf Rs6265

This network meta-analysis was conducted to compare the predictive value of eight SNPs on the efficacy of antidepressants in major depressive disorder (MDD), including 5-HTTLPR, 5HTR2A (rs6311, rs6314, rs7997012 and rs6313), 5HTR2A (rs6295), BDNF (rs6265) and 5HTTSTin2. Databases were searched for related studies published up to December 2019. A total of 16 studies were included in this study. The predictive value were evaluated by the use of the odd ratios (OR) and drawing surface under the cumulative ranking curves (SUCRA). The pairwise meta-analysis indicated that in terms of overall response ratio, the SNPs were not associated with the efficacy of antidepressants in MDD. The result of this network meta-analysis suggested that there was no significant difference in predictive value of eight SNPs on the efficacy of antidepressants in MDD. More research is needed to explore the relationship between SNPs and antidepressant response.

scholarly journals THE RELATIONSHIP BETWEEN INTRUSIVE COGNITIONS AND DEFENSE MECHANISMS IN HEALTHY AND CLINICAL POPULATIONS

2020 ◽  
Vol 8 (1) ◽  
pp. 759-767
Author(s):  
Eid G. Abo Hamza ◽  
Ahmed Helal ◽  
Ahmed A. Moustafa ◽  
Mahmoud M. Emam
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Defense Mechanisms ◽  
Major Depressive ◽  
Healthy Group ◽  
Compulsive Disorder ◽  
Significant Difference ◽  
The Relationship ◽  
Intrusive Cognitions ◽  
Clinical Populations

Purpose: to examine the relationship between defense mechanisms and intrusive cognitions in normal healthy individuals and psychiatric patients. Methodology: The study sample consists of a healthy group (n=60; 30 males & 30 females), whereas the clinical group (n=66; 34 males, 32 females) includes patients with major depressive disorder (12 patients, 5 males, 7 females), schizophrenia (31 patients; 14 males, 17 females), obsessive-compulsive disorder (23 patients; 15 males, 8 females). We used several scales to measure the following variables: intrusive cognitions, intrusive memories, and defense mechanisms. Finding: The results show that there is a positive correlation between defense mechanisms and intrusive cognitions in healthy and clinical groups. Intrusive cognitions were more common in the patient than in a healthy group. Furthermore, there was no significant difference between males and females in measures of intrusive thoughts and memories in both groups. Implications: These findings have implications for behavioral treatment. Treatments used for managing posttraumatic stress disorder can also be used for the treatment of a major depressive disorder, OCD, and schizophrenia. Originality: This investigation the relationship between intrusive cognitions and defense mechanisms in healthy and clinical populations and its implication on the cue exposure therapy that can be the treatment of intrusive cognitions and thoughts in with major depressive disorder, OCD, and schizophrenia.

scholarly journals Efficacy of Treatments Targeting Hypothalamic-Pituitary-Adrenal Systems for Major Depressive Disorder: A Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Yudan Ding ◽  
Zirou Wei ◽  
Haohao Yan ◽  
Wenbin Guo
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Receptor Antagonist ◽  
Meta Analysis ◽  
Open Label ◽  
High Quality ◽  
Major Depressive ◽  
Hypothalamic Pituitary Adrenal ◽  
Significant Difference ◽  
Mean Differences

Abnormal hypothalamic-pituitary-adrenal (HPA) axis has been implicated in major depressive disorder (MDD). A number of studies have attempted to use HPA-modulating medications to treat depression. However, their results are inconsistent. The efficacy of these drugs for MDD remains uncertain. The aims of this meta-analysis were to determine the effect and safety profile of HPA-targeting medications for MDD. World of Science and PubMed databases were comprehensively searched up to March 2021. All randomized controlled trials (RCTs) and open-label trials exploring antiglucocorticoid and related medications in patients with depression were included. Standardized mean differences (SMDs) and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for continuous or dichotomous outcomes, respectively. In the meta-analysis, we identified 16 RCTs and seven open-label studies that included 2972 subjects. Pooling the change data that assessed the efficacy across all included HPA-targeting medications for depression showed a significant difference between interventions and controls with very small heterogeneity after influence analysis (SMD = 0.138, 95%CI = 0.052, 0.224, p = 0.002; I2 = 20.7%, p = 0.212). No obvious publication bias was observed (p = 0.127). Effectiveness remained significant in patients with MDD (SMD = 0.136, 95%CI = 0.049, 0.223, p = 0.002). Subgroup analysis showed a significant difference favoring mifepristone and vasopressin 1B (V1B) receptor antagonist treatment. Adverse events were reported by 14 studies and our analysis of high-quality studies showed a significant difference in favor of controls (RR = 1.283, 95%CI = 1.134, 1.452, p = 0). Our study suggested that patients with MDD may benefit from mifepristone and V1B receptor antagonist treatments that have tolerable side effects. HPA-based medications are promising for depression treatment. However, additional high-quality RCTs, including head-to-head trials, are needed.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, identifier registration number: CRD42021247279

scholarly journals 6-Sulfatoxymelatonin predicts treatment response to fluoxetine in major depressive disorder

2019 ◽  
Vol 9 ◽  
pp. 204512531988192
Author(s):  
Juliana Jury Freitas ◽  
Nicóli Bertuol Xavier ◽  
André Comiran Tonon ◽  
Alicia Carissimi ◽  
Leandro Timm Pizutti ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Serotonin Uptake ◽  
Antidepressant Response ◽  
Major Depressive ◽  
Illness Burden ◽  
Nocturnal Increase ◽  
Dsm Iv ◽  
The Relationship ◽  
Care Costs

Background: To date, no biomarker has been able to predict antidepressant response at an early blockade of norepinephrine or serotonin uptake. The transient nocturnal increase in plasma melatonin levels is upregulated by blocking these uptakes. The aim of this study was to test whether fluoxetine increase in urinary 6-sulfatoxymelatonin (aMT6s) is an indicator of serotonin uptake blockade. Methods: A total of 20 women (35–45 years of age) recruited from the community had a diagnosis of major depressive disorder confirmed by the Structured Clinical Interview for DSM-IV. Depressive symptoms were evaluated by the Beck Depression Inventory (BDI). Participants were instructed to take 20 mg of fluoxetine every morning. Every 4 weeks, the dose could be increased by 20 mg until symptom remission. The concentration of aMT6s was evaluated in overnight urine samples collected 1 day before and 1 day after the first fluoxetine dose. Results: An increase in aMT6s correlated to a decrease in BDI score evaluated on day 45 (ρ = −0.67, p = 0.024) was observed. Conclusions: Nocturnal increase in urinary aMT6s after the first day of medication use links the early mechanism of action of fluoxetine to its clinical output 45 days later. Thus, the relationship between urinary aMT6s excretion 1 day before/1 day after is a biomarker for predicting clinical output earlier, reducing illness burden and health care costs.

scholarly journals Polygenic risk scores for major depressive disorder and neuroticism as predictors of antidepressant response: meta-analysis of three treatment cohorts

2018 ◽  
Author(s):  
Joey Ward ◽  
Nicholas Graham ◽  
Rona Strawbridge ◽  
Amy Ferguson ◽  
Gregory Jenkins ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Meta Analysis ◽  
Antidepressant Medication ◽  
Research Network ◽  
Risk Scores ◽  
Antidepressant Response ◽  
Major Depressive ◽  
Polygenic Risk ◽  
Therapeutic Drugs

AbstractThere are currently no reliable approaches for correctly identifying which patients with major depressive disorder (MDD) will respond well to antidepressant therapy. However, recent genetic advances suggest that Polygenic Risk Scores (PRS) could allow MDD patients to be stratified for antidepressant response. We used PRS for MDD and PRS for neuroticism as putative predictors of antidepressant response within three treatment cohorts: The Genome-based Therapeutic Drugs for Depression (GENDEP) cohort, and 2 sub-cohorts from the Pharmacogenomics Research Network Antidepressant Medication Pharmacogenomics Study PRGN-AMPS (total patient number = 783). Results across cohorts were combined via meta-analysis within a random effects model. Overall, PRS for MDD and neuroticism did not significantly predict antidepressant response but there was a consistent direction of effect, whereby greater genetic loading for both MDD (best MDD result, p < 5*10-5 MDD-PRS at 4 weeks, β = -0.019, S.E = 0.008, p = 0.01) and neuroticism (best neuroticism result, p < 0.1 neuroticism-PRS at 8 weeks, β = -0.017, S.E = 0.008, p = 0.03) were associated with less favourable response. We conclude that the PRS approach may offer some promise for treatment stratification in MDD and should now be assessed within larger clinical cohorts.

scholarly journals Restless legs syndrome is a risk factor for major depressive disorder: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Haiwang Zhang ◽  
Changxi Zhou ◽  
Shuai Jin ◽  
Xingde Liu ◽  
Song Li ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Restless Legs Syndrome ◽  
Meta Analysis ◽  
Case Control Studies ◽  
Major Depressive ◽  
Restless Legs ◽  
Knowledge Infrastructure ◽  
Significant Difference

Abstract A significant association between major depressive disorder (MDD) and restless legs syndrome (RLS), but RLS prevalence is dramatically different among MDD individuals across studies. Our present work aimed to comprehensively evaluate available evidences to determine the role of RLS in MDD. PubMed, Web of Science, Embase, Science Online, Wip Chinese Biomedical Journal, Wanfang and Chinese National Knowledge Infrastructure were searched to identify observational and case-control studies relevant to RLS and MDD. Stata 12.0 software was used for meta-analysis. RLS individuals exhibited a higher risk of MDD than non-RLS controls (OR 2.05, 95%CI 1.80–2.33; p<0.05). No significant differences were found in MDD prevalence between young RLS patients (OR 2.10, 95%CI 1.72–2.56) and older RLS patients (OR 2.02, 95%CI 1.70–2.39). In addition, no significant difference in MDD prevalence was evident between between Asian (OR 1.98, 95%CI 1.66–2.37) and European or American (OR 1.76, 95%CI 1.54–2.01) RLS patients. Our meta-analysis provides evidence that the risk for MDD is higher among RLS patients compared to non-RLS individuals suggesting that RLS may play an important role in MDD patheogenesis.

Psychotherapy, Pharmacotherapy, and Their Combination for Adolescents with Major Depressive Disorder: A Meta-Analysis

2013 ◽  
Vol 31 (1) ◽  
pp. 47-65 ◽  
Author(s):  
Nikita Singh ◽  
John Reece
Keyword(s):  
Major Depressive Disorder ◽  
Treatment Outcome ◽  
Combination Therapy ◽  
Depressive Disorder ◽  
Meta Analysis ◽  
Treatment Strategies ◽  
Inclusion Criteria ◽  
Major Depressive ◽  
Treatment Type ◽  
Significant Difference

This meta-analysis aims to inform clinical practice of treatment strategies for adolescents with major depressive disorder (MDD). The efficacy of three empirically validated treatments was compared to determine the most effective treatment. These were: cognitive-behavioural therapy (CBT), selective serotonin reuptake inhibitor (SSRI) pharmacotherapy, and combination CBT and SSRI therapy. Inclusion criteria required studies to report a reliable and valid pre- and post-treatment measure and adequate data for Hedge's g effect size to be calculated. Forty-nine studies meeting the above inclusion criteria were found and included in the analysis. Although all three treatment strategies were found to be effective, analysis revealed no significant difference in treatment outcome among CBT, SSRI, and combination therapy. An investigation of moderator variables revealed months to follow-up to significantly influence the relationship between treatment type and treatment outcome. Given that CBT has no side effects, is more cost effective, and is equally as effective as SSRI therapy and combination therapy, the current study makes a strong case for CBT as a first-line treatment strategy for adolescents with MDD.

scholarly journals Falls in older adults with major depressive disorder (MDD): a systematic review and exploratory meta-analysis of prospective studies

2015 ◽  
Vol 28 (1) ◽  
pp. 23-29 ◽  
Author(s):  
Brendon Stubbs ◽  
Jean Stubbs ◽  
Solomon Donald Gnanaraj ◽  
Andrew Soundy
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Major Depressive Disorder ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Major Depressive ◽  
Depressive Symptomology ◽  
Falls In Older Adults ◽  
The Relationship

ABSTRACTBackground:Depressive symptomology is now widely recognized as a key risk factor for falls. The evidence regarding the impact of major depressive disorder (MDD) on falls is unclear. A systematic review and exploratory meta-analysis was undertaken to explore the relationship between MDD and falls.Methods:Major electronic database were searched from inception till April 2015. Studies that defined MDD and measured falls prospectively in older adults (≥60 years) were included. Studies relying on depressive symptomology alone were excluded. The methodological quality of included articles was assessed and study findings were synthesized using an exploratory meta-analysis.Results:From a potential of 415 articles, only three studies met the inclusion criteria. This included 976 unique older adults with a range of mean age from ≥65 to 83 years. The methodological quality of included studies was satisfactory. None of the included studies’ primary aim was to investigate the relationship between MDD and falls. The exploratory meta-analysis demonstrated older adults with MDD are at increased risk of falling compared to non-depressed older adults (odds ratio (OR) 4.0, 95% CI 2.0–8.1, I2 = 60%, n = 976).Conclusion:There is a paucity of research considering falls in older adults with MDD. Our results demonstrate that the odds of falling appear to be greater among people with MDD (OR 4.0) than in previous meta-analyses that have only considered subthreshold depressive symptoms. Given the distinct nature and challenges with MDD, more research is required to better understand the falls risk in this group.

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