scholarly journals Sex differences in the psychopharmacological treatment of depression

2016 ◽  
Vol 18 (4) ◽  
pp. 447-457 ◽  
Keyword(s):  
Sex Differences ◽  
Antidepressant Treatment ◽  
Behavioral Differences ◽  
Sex Effects ◽  
Psychopharmacological Treatment ◽  
Treatment Of Depression ◽  
Antidepressant Efficacy ◽  
Physiological Differences

Although a number of studies have observed that females respond better to serotonergic antidepressants than males and that postmenopausal females have a diminished response to antidepressants compared with younger females, there are also studies that conflict with both of these findings, making any generalizations regarding sex differences difficult to make. Sex variance in antidepressant efficacy and pharmacokinetics profiles have been attributed to sex-based physiological differences, behavioral differences, related disorders, and sex-specific conditions, including pregnancy and menopause. This paper will review the history and current research on sex effects of antidepressant treatment.

SS05-02 - Management of depression with agomelatine: A different perception

2011 ◽  
Vol 26 (S2) ◽  
pp. 2178-2178
Author(s):  
G. Hajak
Keyword(s):  
Side Effects ◽  
Antidepressant Treatment ◽  
Real Life ◽  
Daily Practice ◽  
Early Improvement ◽  
Real Life Setting ◽  
Treatment Of Depression ◽  
Perceived Benefit ◽  
Antidepressant Efficacy ◽  
Clinical Benefits

Agomelatine is a completely new approach to the treatment of depression thanks to its innovative mode of action. Acting as melatonergic agonist and 5-HT2C antagonist, it provides depressed patients with a distinctive antidepressant efficacy that perfectly suits patients’ needs and addresses all symptoms at each step of depression. Two years after the first launch in Europe, now is the time for an update from doctors and patients alike.The patient/doctor relation is key when initiating depression treatment, because patients are reluctant to start, fearing withdrawal symptoms, serious unwanted side effects, and “addiction”. It is important therefore that they understand that agomelatine has none of these effects.The benefits perceived by patients right from the first days of treatment are influential, because patients are reluctant to continue with classic antidepressants (delayed onset of perceived benefit, early side effects). The early improvement reported by patients on agomelatine supplements data on clinical benefits seen in clinical trials from the first week versus venlafaxine (CGI-I, rate of response, daytime alertness, feeling good) and after two weeks versus sertraline (twice as many HAM-D responders to agomelatine as to sertraline).Finally, patients are reluctant to maintain antidepressant treatment because of later side effects (weight gain, sexual dysfunction, emotional blunting). Patients on agomelatine confirm the absence of the classic side effects of antidepressants and are more likely to continue treatment than they are with other drugs. Both the antidepressant efficacy and the tolerability were confirmed in a large non-interventional study in a real-life setting in daily practice.

scholarly journals Antidepressant Treatment of Depression in the Elderly: Efficacy and Safety Considerations

2021 ◽  
Vol 05 (04) ◽  
pp. 1-1
Author(s):  
Trevor R Norman ◽  
Keyword(s):  
Elderly Patients ◽  
Antidepressant Treatment ◽  
Clinical Problem ◽  
The Elderly ◽  
Term Treatment ◽  
Considerable Proportion ◽  
Treatment Of Depression ◽  
Long Term Treatment ◽  
Antidepressant Efficacy ◽  
Safety Considerations

Depression in the elderly is a significant clinical problem which is likely to endure as an ongoing issue as the cohort of individuals aged over 65years continues to increase as a proportion of the total population. While there are a multiplicity of approaches to the treatment of depression, the mainstay for moderate to severe cases is pharmacotherapy. The majority of extant antidepressants have demonstrated efficacy, at least in short term (6-12weeks) clinical evaluations. There is demonstrable efficacy over and above that of placebo in the majority of clinical trials for most agents. Within the classes of antidepressants there is no difference between individual agents, while between classes differences have not been demonstrated consistently. Thus, there appears to be little to choose between the various agents. However, considerations other than efficacy play a role in the choice of an antidepressant for an individual patient. A systematic review of the efficacy of antidepressant agents based on trials in elderly populations is presented. Factors influencing the choice of a medication over and above efficacy are presented along with a brief review of adverse events of particular concern in elderly patients. A considerable proportion of elderly patients have comorbid medical conditions, which may also influence the choice of agent due to drug-drug interaction considerations. A brief overview of interactions likely to influence medication selection is also canvassed. While there is every reason to be optimistic about outcomes in elderly patients, there are still unanswered questions about antidepressant efficacy in this population: effectiveness in long-term treatment and in the population of so-called ‘old-old’ elderly are principal among them.

European Differences in Self-Perceived Multiple Intelligences

1999 ◽  
Vol 4 (3) ◽  
pp. 131-138 ◽  
Author(s):  
Adrian Furnham ◽  
Tim Rakow ◽  
Ivan Sarmany-Schuller ◽  
Filip De Fruyt
Keyword(s):  
Sex Differences ◽  
Multiple Intelligences ◽  
Factor Structure ◽  
Factor Analyses ◽  
Verbal Iq ◽  
Sex Effects ◽  
Iq Scores ◽  
Culture Differences ◽  
Three Factor

In this study, 140 Belgian, 227 British, and 177 Slovakian students estimated their own multiple IQ scores as well as that of their parents (mother and father) and siblings (first and second brother and sister). Various factor analyses yielded a clear three-factor structure replicating previous studies. A sex × culture ANOVA on self-ratings of three factors that underline the seven intelligences (verbal, numerical, cultural) showed culture and sex effects as well as interactions. As predicted, males rated their own overall IQ, though not that of their parents or siblings, higher than females did. Males also rated their numerical IQ, but not their verbal or cultural IQ, higher than females did. There were few culture differences but many interactions, nearly all caused by Slovakian females, who rated aspects of their own and their fathers' IQ higher than Slovakian males, while the pattern for the Belgians was precisely the opposite. Participants believed their verbal IQ was higher than their numerical IQ and their cultural IQ. Males believed their verbal and numerical IQ score to be fairly similar, though much higher than their cultural IQ, while females believed their verbal IQ the highest, followed by numerical and cultural IQ. Females also believed they were more intelligent than both parents. Overall results showed consistency in the sex differences in ratings across cultures but differences in level of estimated IQ possibly as a result of cultural demands for modesty.

Diagnosis, assessment, and treatment of depression in advanced disease

2018 ◽  
Author(s):  
Matthew Hotopf
Keyword(s):  
Palliative Care ◽  
Advanced Disease ◽  
Antidepressant Treatment ◽  
Population Level ◽  
Care Staff ◽  
Care Services ◽  
Treatment Of Depression ◽  
Assessment And Treatment ◽  
Palliative Care Services ◽  
Key Issues

Depression in palliative care is common, under-recognised and has significant impacts for sufferers. There are effective treatments but often a shortage of staff to provide them. This chapter sets out a number of key issues to consider when assessing and treating individual patients and considers the way in which palliative care services can innovate to provide a population level response to depression. Palliative care staff can be trained to deliver basic depression care and follow simple protocols to initiate, monitor and adjust antidepressant treatment. These approaches have been tested in trials in cancer care but the challenge is to take these approaches from research trials conducted in centres of excellence with good resources, to other settings.

scholarly journals Task-Modulated Brain Activity Predicts Antidepressant Responses of Prefrontal Repetitive Transcranial Magnetic Stimulation: A Randomized Sham-Control Study

2021 ◽  
Vol 5 ◽  
pp. 247054702110068
Author(s):  
Cheng-Ta Li ◽  
Chih-Ming Cheng ◽  
Chi-Hung Juan ◽  
Yi-Chun Tsai ◽  
Mu-Hong Chen ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Antidepressant Treatment ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Brain Activity ◽  
Characteristic Curve ◽  
Depression Score ◽  
Double Blind ◽  
Antidepressant Efficacy ◽  
Group B

Background Prolonged intermittent theta-burst stimulation (piTBS) and repetitive transcranial magnetic stimulation (rTMS) are effective antidepressant interventions for major depressive disorder (MDD). Cognition-modulated frontal theta (frontalθ) activity had been identified to predict the antidepressant response to 10-Hz left prefrontal rTMS. However, whether this marker also predicts that of piTBS needs further investigation. Methods The present double-blind randomized trial recruited 105 patients with MDD who showed no response to at least one adequate antidepressant treatment in the current episode. The recruited patients were randomly assigned to one of three groups: group A received piTBS monotherapy; group B received rTMS monotherapy; and group C received sham stimulation. Before a 2-week acute treatment period, electroencephalopgraphy (EEG) and cognition-modulated frontal theta changes (Δfrontalθ) were measured. Depression scores were evaluated at baseline, 1 week, and 2 weeks after the initiation of treatment. Results The Δfrontalθ at baseline was significantly correlated with depression score changes at week 1 (r = −0.383, p = 0.025) and at week 2 for rTMS group (r = −0.419, p = 0.014), but not for the piTBS and sham groups. The area under the receiver operating characteristic curve for Δfrontalθ was 0.800 for the rTMS group (p = 0.003) and was 0.549 for the piTBS group (p = 0.619). Conclusion The predictive value of higher baseline Δfrontalθ for antidepressant efficacy for rTMS not only replicates previous results but also implies that the antidepressant responses to rTMS could be predicted reliably at baseline and both piTBS and rTMS could be effective through different neurobiological mechanisms.

scholarly journals Biomarkers of ketamine’s antidepressant effect: a clinical review of genetics, functional connectivity, and neurophysiology

2021 ◽  
Vol 5 ◽  
pp. 247054702110142
Author(s):  
Alexandra A. Alario ◽  
Mark J. Niciu
Keyword(s):  
Treatment Response ◽  
Antidepressant Treatment ◽  
A Priori ◽  
Antidepressant Effect ◽  
Aspartate Receptor ◽  
Neurophysiological Studies ◽  
All Cause Mortality ◽  
Antidepressant Efficacy ◽  
Glutamate Modulators ◽  
Response Biomarkers

Major depressive disorder (MDD) is one of the leading causes of morbidity and all-cause mortality (including suicide) worldwide, and, unfortunately, first-line monoaminergic antidepressants and evidence-based psychotherapies are not effective for all patients. Subanesthetic doses of the N-methyl-D-aspartate receptor antagonists and glutamate modulators ketamine and S-ketamine have rapid and robust antidepressant efficacy in such treatment-resistant depressed patients (TRD). Yet, as with all antidepressant treatments including electroconvulsive therapy (ECT), not all TRD patients adequately respond, and we are presently unable to a priori predict who will respond or not respond to ketamine. Therefore, antidepressant treatment response biomarkers to ketamine have been a major focus of research for over a decade. In this article, we review the evidence in support of treatment response biomarkers, with a particular focus on genetics, functional magnetic resonance imaging, and neurophysiological studies, i.e. electroencephalography and magnetoencephalography. The studies outlined here lay the groundwork for replication and dissemination.

scholarly journals BREED AND SEX EFFECTS ON THE RELATIONSHIP BETWEEN WEIGHT AND FATNESS IN LACOMBE AND YORKSHIRE SWINE AND THEIR RECIPROCAL CROSSES

1965 ◽  
Vol 45 (1) ◽  
pp. 33-36
Author(s):  
G. W. Rahnefeld
Keyword(s):  
Body Weight ◽  
Sex Differences ◽  
Regression Coefficients ◽  
Average Depth ◽  
Constant Weight ◽  
Reciprocal Crosses ◽  
Sex Effects ◽  
Female Mating ◽  
The Mean ◽  
The Relationship

The relationship between thickness of fat measured at the shoulder, last rib, and loin of live pigs and market weight (86.2 to 95.2 kg) was studied in 1596 pigs from the Lacombe and Yorkshire breeds and their reciprocal crosses. No significant breed or sex differences were found in the proportion of fat at the three sites. Breed and sex differences were evident in the average depth of fat. The regression coefficients for the mean of three fat measurements on market weight were.016 ±.003,.019 ±.007, and.017 ±.004 for Lacombe males, barrows, and females respectively;.039 ±.002,.036 ±.005, and.041 ±.001 for Yorkshire males, barrows and females respectively;.027 ±.005 and.029 ±.004 for barrows and females from the Lacombe male × Yorkshire female mating; and.023 ±.007 and.021 ±.009 for barrows and females from the Yorkshire male × Lacombe female mating. Comparisons between animals measured at a relatively constant weight should be made after the fat measurement is adjusted for variations in body weight. The results of this study indicate that separate corrections should be applied for each breed. Separate corrections for sexes within breeds do not appear warranted.

scholarly journals Clinical trials of antidepressant medications are producing meaningless results

2003 ◽  
Vol 183 (2) ◽  
pp. 102-104 ◽  
Author(s):  
Gordon Parker ◽  
Ian M. Anderson ◽  
Peter Haddad
Keyword(s):  
Clinical Trials ◽  
Antidepressant Treatment ◽  
Meta Analysis ◽  
Antidepressant Medication ◽  
Unipolar Depression ◽  
Controlled Trials ◽  
Antidepressant Medications ◽  
Treatment Of Depression ◽  
Randomised Controlled ◽  
The Uk

A recent alert from the UK Committee on Safety of Medicines stated that the dangers of treatment of depression with paroxetine outweigh the benefits in those under 18. Such a warning should focus our minds on the evidence on which clinical practice is based. Antidepressant treatment of depression in the under-18s has been thought to be justified because clinical trials show that it works so well in over-18s. But is that a reasonable assessment of the evidence? Kirsch et al (2002) use the analogy of ‘The Emperor's New Clothes' to describe the findings from their meta-analysis of randomised placebo-controlled trials of antidepressants. They conclude that antidepressant medication appears to have only a small effect on outcome over and above placebo. In this analogy psychiatry is the emperor, drug trials are the fraudsters and the deception is being revealed by a growing body of critical opinion proposing that, once methodological problems with clinical trials are taken into account, antidepressants either do not work at all or have an effect that is so small as to be clinically unimportant (Andrews, 2001; Moncrieff, 2002). A large number of randomised placebo-controlled trials of antidepressants have been carried out over the past decades, mostly funded by the pharmaceutical industry, and it is now recognised that about 50% of negative trials go unpublished (Thase, 1999). Meanwhile, unipolar depression has jumped into the top five of the world's total burden of disease, and there is an imperative need for effective and safe treatments. Do we need more randomised controlled trials (RCTs) of antidepressant medications, or has that research paradigm outlived its usefulness? In this month's debate, Professor Gordon Parker, University of New South Wales and Black Dog Institute, Australia, and Drs Ian Anderson and Peter Haddad from the University of Manchester discuss whether clinical trials for antidepressant medication produce meaningless results.

Male-Female Differences in Variables Affecting Performance

1978 ◽  
Vol 22 (1) ◽  
pp. 416-420 ◽  
Author(s):  
Connie Grasley ◽  
M. M. Ayoub ◽  
Nancy J. Bethea
Keyword(s):  
Sex Differences ◽  
Cold Stress ◽  
Body Dimensions ◽  
Performance Levels ◽  
Physiological Variables ◽  
Performance Matrix ◽  
Males And Females ◽  
Physiological Differences ◽  
And Control ◽  
Sensory Process

Literature concerning variables affecting performance levels of males and females was reviewed. Emphasis was placed on literature using both males and females as subjects in the areas of anthropometric, biomechanical, and physiological variables. When literature using both sexes as subjects was not available, comparable studies were considered for possible use. The results of this review indicate that there are sex differences in anthropometry with regard to body dimensions. In biomechanics, sex differences were noted in reach envelopes strength and flexibility in particular. Physiological differences were noted in responses to heat/cold stress and altitude. These differences were then applied to a performance matrix under the categories of sensory, process and control. Differences noted were either very specific or did not exist at all. This is due in part to a lack of research involving variables as they actually affect performance levels between males and females.

scholarly journals A common clinical conundrum: Antidepressant treatment of depression in pregnant women

2020 ◽  
Vol 44 (3) ◽  
pp. 151229 ◽  
Author(s):  
Gabrielle A. Mesches ◽  
Katherine L. Wisner ◽  
Hannah K. Betcher
Keyword(s):  
Pregnant Women ◽  
Antidepressant Treatment ◽  
Treatment Of Depression
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