scholarly journals Combinatorial pharmacogenomic test for successful antidepressant treatment of a major depressive disorder

2021 ◽  
Vol 74 (3-4) ◽  
pp. 117-122
Author(s):  
Sladjana Vojvodic ◽  
Gabor Katona ◽  
Miroslav Sarac
Keyword(s):  
Major Depressive Disorder ◽  
Major Depression ◽  
Depressive Disorder ◽  
Antidepressant Treatment ◽  
Usher Syndrome ◽  
Antidepressant Therapy ◽  
Test Case ◽  
Major Depressive ◽  
Suicidal Thoughts ◽  
Type 3

Introduction. The combinatorial pharmacogenomic test has shown the potential to predict antidepressant response, tolerability, selection, and dosage in the treatment of a major depressive disorder. A case of successful management of antidepressant therapy adjustment is reported by using the combinatorial pharmacogenomic test. Case Report. A 53-year old man, severely disabled due to a rare genetic disease, Usher syndrome type 3, was treated with numerous antidepressants. However, episodes of major depression recurred, along with frequent suicidal thoughts. A combinatorial pharmacogenomic test was considered to design a potentially effective antidepressant therapy. Conclusion. According to the results of the combinatorial pharmacogenomic test, the patient constantly received inadequate antidepressant therapy, which did not lead to an improvement of depression due to moderate gene-drug interaction. The patient was prescribed nortriptyline, which proved to be one of the few most adequate according to the test. He showed improvement with subjectively more tolerable depression without suicidal thoughts and episodes of major depression. This case showed that the combinatorial pharmacogenomic testing may contribute to better selection of antidepressant therapy.

scholarly journals What combinations of agomelatine with other antidepressants could be successful during the treatment of major depressive disorder or anxiety disorders in clinical practice?

2019 ◽  
Vol 9 ◽  
pp. 204512531985520 ◽  
Author(s):  
Petr Potměšil
Keyword(s):  
Major Depressive Disorder ◽  
Major Depression ◽  
Depressive Disorder ◽  
Anxiety Disorders ◽  
Antidepressant Treatment ◽  
Case Reports ◽  
Melatonin Receptors ◽  
Major Depressive ◽  
Double Blind ◽  
Compulsive Disorder

Even with many antidepressant and anxiolytic drugs available on the market, there are still patients who do not respond well to the standard first or second line treatments for affective or anxiety disorders. The antidepressant agomelatine has been used in Europe for several years. Agomelatine, an agonist at melatonin receptors and an antagonist at serotonin receptors, can be particularly useful in patients suffering from a major depressive disorder associated with insomnia. Some clinical data have shown a limited effect for agomelatine in a subset of patients with major depression. A number of case reports published in 2011-2016 describe the effect of agomelatine in combination with an established antidepressant, such as escitalopram, venlafaxine, duloxetine, moclobemide or bupropion. A successful combination of agomelatine was reported after adjunctive use of agomelatine combined with clomipramine, escitalopram, and venlafaxine in patients with major depression or obsessive–compulsive disorder. Moreover, bupropion or moclobemide augmentation with agomelatine in patients with major depressive disorder led to a significant improvement. Other supportive data have been published, such as analysis of the VIVALDI study, although it should be noted that the study was supported by the manufacturer of agomelatine. In this study, agomelatine in combination with other antidepressants was shown to be effective and well tolerated in practice, although the most effective antidepressant treatment in the study consisted of agomelatine alone and not in combination with other antidepressants. There have also been two published case reports about the concomitant use of duloxetine and agomelatine which were not efficacious. The positive results of agomelatine augmentation with other antidepressants should be confirmed through randomized, double-blind clinical trials.

Relationship between fast-acting antidepressant properties of total sleep deprivation and serum BDNF levels

2011 ◽  
Vol 26 (S2) ◽  
pp. 2032-2032
Author(s):  
O. Caliyurt
Keyword(s):  
Major Depressive Disorder ◽  
Major Depression ◽  
Depressive Disorder ◽  
Sleep Deprivation ◽  
Treatment Response ◽  
Antidepressant Treatment ◽  
Major Depressive ◽  
Total Sleep Deprivation ◽  
Patient Groups ◽  
Depressive Patients

Sleep deprivation therapy is a treatment option for major depressive disorder. Total sleep deprivation for one night improves depressive symptoms in 40–60% of treatments. Recent reports have suggested that brain-derived neurotrophic factor (BDNF) levels are reduced in individuals suffering major depressive disorder and these levels normalize following antidepressant treatment.In a recent study we have shown that the effects of total sleep deprivation therapy on BDNF levels in major depression. Results were compared between depressive patients that were treated with sertraline and healthy volunteers who experienced single total sleep deprivation. The baseline BDNF levels were significantly lower in both patient groups than the controls. Single sleep deprivation therapy was shown to decrease HAM-D scores and increase BDNF levels significantly in depressive patients. Effects of single sleep deprivation therapy on HAM-D scores was correlated with changes in BDNF levels. A series of three sleep deprivation therapies in a week accelerated the treatment response and increased the BDNF levels rapidly compared to the patients treated with sertraline alone. Better treatment response in the TSD group was also correlated with the statistically significant increase of BDNF levels in the 7th day compared to the sertraline group.In conclusion, our results support the BDNF reduction in major depression. Rapid antidepressant effects of sleep deprivation therapy appear to relate to the rapid BDNF increase in major depressive patients. These results give an opportunity to explore the relationship between fast antidepressant response and BDNF changes in major depression.

The effect of antidepressant treatment on alpha2 adrenoceptor function in DSM 111 major depression

1989 ◽  
Vol 6 (2) ◽  
pp. 109-111 ◽  
Author(s):  
Siobhan Barry ◽  
Timothy G. Dinan
Keyword(s):  
Major Depressive Disorder ◽  
Major Depression ◽  
Depressive Disorder ◽  
Antidepressant Treatment ◽  
Challenge Test ◽  
Major Depressive ◽  
Alpha2 Adrenoceptor ◽  
Drug Free

AbstractTwenty-one drug free patients fulfilling the DSM-111-R criteria for major depressive disorder were administered an alpha2 adrenoceptor challenge test. They were then treated with an antidepressant or ECT. Six weeks later, alpha2 function was again tested and found to be universally downregulated in treatment responders. Those who failed to respond to treatment (33%) had evidence of continuing alpha2 adrenoceptor activity. These results suggest central noradrenergic overactivity as a possible mechanism for depression, which runs counter to the classic catecholamine hypothesis.

scholarly journals The Symptom Structure of Postdisaster Major Depression: Convergence of Evidence from 11 Disaster Studies Using Consistent Methods

2021 ◽  
Vol 11 (1) ◽  
pp. 8
Author(s):  
Carol S. North ◽  
David Baron
Keyword(s):  
Major Depressive Disorder ◽  
Major Depression ◽  
Depressive Disorder ◽  
Diagnostic Assessment ◽  
Self Report ◽  
Depression Symptoms ◽  
Symptom Scale ◽  
Major Depressive ◽  
Report Symptom ◽  
Symptom Patterns

Agreement has not been achieved across symptom factor studies of major depressive disorder, and no studies have identified characteristic postdisaster depressive symptom structures. This study examined the symptom structure of major depression across two databases of 1181 survivors of 11 disasters studied using consistent research methods and full diagnostic assessment, addressing limitations of prior self-report symptom-scale studies. The sample included 808 directly-exposed survivors of 10 disasters assessed 1–6 months post disaster and 373 employees of 8 organizations affected by the September 11, 2001 terrorist attacks assessed nearly 3 years after the attacks. Consistent symptom patterns identifying postdisaster major depression were not found across the 2 databases, and database factor analyses suggested a cohesive grouping of depression symptoms. In conclusion, this study did not find symptom clusters identifying postdisaster major depression to guide the construction and validation of screeners for this disorder. A full diagnostic assessment for identification of postdisaster major depressive disorder remains necessary.

scholarly journals Genetic contributions to suicidal thoughts and behaviors

2021 ◽  
pp. 1-8
Author(s):  
Emily DiBlasi ◽  
Jooeun Kang ◽  
Anna R. Docherty
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Molecular Genetic ◽  
Risk Scores ◽  
Major Depressive ◽  
Suicidal Thoughts ◽  
Genetic Covariance ◽  
Molecular Studies ◽  
And Behaviors ◽  
Suicidal Thoughts And Behaviors

Abstract Suicidal ideation, suicide attempt (SA) and suicide are significantly heritable phenotypes. However, the extent to which these phenotypes share genetic architecture is unclear. This question is of great relevance to determining key risk factors for suicide, and to alleviate the societal burden of suicidal thoughts and behaviors (STBs). To help address the question of heterogeneity, consortia efforts have recently shifted from a focus on suicide within the context of major psychopathology (e.g. major depressive disorder, schizophrenia) to suicide as an independent entity. Recent molecular studies of suicide risk by members of the Psychiatric Genomics Consortium and the International Suicide Genetics Consortium have identified genome-wide significant loci associated with SA and with suicide death, and have examined these phenotypes within and outside of the context of major psychopathology. This review summarizes important insights from epidemiological and biometrical research on suicide, and discusses key empirical findings from molecular genetic examinations of STBs. Polygenic risk scores for these phenotypes have been observed to be associated with case−control status and other risk phenotypes. In addition, estimated shared genetic covariance with other phenotypes suggests specific medical and psychiatric risks beyond major depressive disorder. Broadly, molecular studies suggest a complexity of suicide etiology that cannot simply be accounted for by depression. Discussion of the state of suicide genetics, a growing field, also includes important ethical and clinical implications of studying the genetic risk of suicide.

Reduced latency to first antidepressant treatment in Italian patients with a more recent onset of major depressive disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S529-S529
Author(s):  
B. Grancini ◽  
B. Dell’Osso ◽  
L. Cremaschi ◽  
F. De Cagna ◽  
B. Benatti ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Antidepressant Treatment ◽  
Stressful Events ◽  
Major Depressive ◽  
Recent Onset ◽  
Valid Predictor ◽  
Before And After ◽  
Competing Interest ◽  
Year 2000

IntroductionMajor depressive disorder (MDD) is a prevalent burdensome disease, which frequently remains untreated. The duration of untreated illness (DUI) is modifiable parameter and a valid predictor of outcome. Previous investigation in patients with MDD revealed a DUI of different years, while recent reports have documented a reduction of DUI across time, in patients with different psychiatric disorders.Objectives/aimsThe present study was aimed to investigate potential differences in terms of DUI and related variables in patients with MDD across time.MethodsAn overall sample of 188 patients with MDD was divided in two subgroups on the basis of their epoch of onset (onset before and after year 2000). DUI and other onset-related variables were assessed through a specific questionnaire and compared between the two subgroups.ResultsThe whole sample showed a mean DUI of approximately 4.5 years, with a lower value in patients with more recent onset compared to the other subgroup (27.1 ± 42.6 vs. 75.8 ± 105.2 months, P < .05). Moreover, patients with onset after 2000 reported higher rates of onset-related stressful events and lower ones for benzodiazepines prescription (65% vs. 81%; P = 0.02; 47% vs. 30%; P = 0.02).ConclusionsThe comparison of groups with different epochs of onset showed a significant reduction in terms of DUI and benzodiazepines prescription, and a higher rate of onset-related stressful events in patients with a more recent onset. Reported findings are of epidemiologic and clinical relevance in order to evaluate progress and developments in the diagnostic and therapeutic pathways of MDD in Italian and other countries.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Emotional availability in women with bipolar disorder and major depression: A longitudinal pregnancy cohort study

2021 ◽  
pp. 000486742199879
Author(s):  
Pavitra Aran ◽  
Andrew J Lewis ◽  
Stuart J Watson ◽  
Thinh Nguyen ◽  
Megan Galbally
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Major Depression ◽  
Depressive Disorder ◽  
Emotional Availability ◽  
Major Depressive ◽  
Interaction Quality ◽  
Pregnancy Cohort ◽  
The Impact

Objective: Poorer mother–infant interaction quality has been identified among women with major depression; however, there is a dearth of research examining the impact of bipolar disorder. This study sought to compare mother–infant emotional availability at 6 months postpartum among women with perinatal major depressive disorder, bipolar disorder and no disorder (control). Methods: Data were obtained for 127 mother–infant dyads from an Australian pregnancy cohort. The Structured Clinical Interview for the DSM-5 was used to diagnose major depressive disorder ( n = 60) and bipolar disorder ( n = 12) in early pregnancy (less than 20 weeks) and review diagnosis at 6 months postpartum. Prenatal and postnatal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, along with self-report psychotropic medication use. Mother and infant’s interaction quality was measured using the Emotional Availability Scales when infants reached 6 months of age. Multivariate analyses of covariance examining the effects of major depressive disorder and bipolar disorder on maternal emotional availability (sensitivity, structuring, non-intrusiveness, non-hostility) and child emotional availability (responsiveness, involvement) were conducted. Results: After controlling for maternal age and postpartum depressive symptoms, perinatal disorder (major depressive disorder, bipolar disorder) accounted for 17% of the variance in maternal and child emotional availability combined. Compared to women with major depressive disorder and their infants, women with bipolar disorder and their infants displayed lower ratings across all maternal and child emotional availability qualities, with the greatest mean difference seen in non-intrusiveness scores. Conclusions: Findings suggest that perinatal bipolar disorder may be associated with additional risk, beyond major depressive disorder alone, to a mother and her offspring’s emotional availability at 6 months postpartum, particularly in maternal intrusiveness.

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