scholarly journals Occurrence of Side Effects in Treatment-Resistant Depression: Role of Clinical, Socio-Demographic and Environmental Characteristics

2021 ◽  
Vol 12 ◽  
Author(s):  
Anna Levy ◽  
Wissam El-Hage ◽  
Djamila Bennabi ◽  
Etienne Allauze ◽  
Alexandra Bouvard ◽  
...  
Keyword(s):  
Side Effects ◽  
Emotional Abuse ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Cross Sectional ◽  
Pharmacological Management ◽  
History Of ◽  
Resistant Depression ◽  
Main Determinants ◽  
Using Data

Introduction: Treatment-resistant depression (TRD) is a disabling psychiatric condition characterized by the failure of two antidepressants (ADs). Since the occurrence of side effects (SEs) appears to be one of the main determinants of early discontinuation of pharmacological treatments contributing to a pseudo-resistance, the purpose of this study was to determine the parameters associated with the occurrence of SEs under ADs in a cohort of patients with TRD.Methods: An observational, cross-sectional, multicentre study was carried out using data from the French network of Expert Centers for TRD. For the 108 patients enrolled in the study, the statistical analyses focused on the overall occurrence and on the profile of the SEs (9 categories, 32 items).Results: SEs were influenced by age and sex and were positively associated with the intensity of anxious, depressive and suicidal symptoms, a history of childhood trauma (sexual abuse, emotional abuse and neglect), and negatively associated with self-esteem, and assessment of overall functioning.Conclusion: Using variables accessible in common practice, these results fall within the dynamic of a more tailored approach to medicine that could allow, through integrated pharmacological management, the continuation of antidepressant treatments, and therefore limit the risk of therapeutic failure.

scholarly journals Comprehensive assessment of side effects associated with a single dose of ketamine in treatment-resistant depression

2020 ◽  
Vol 263 ◽  
pp. 568-575 ◽  
Author(s):  
Elia E. Acevedo-Diaz ◽  
Grace W. Cavanaugh ◽  
Dede Greenstein ◽  
Christoph Kraus ◽  
Bashkim Kadriu ◽  
...  
Keyword(s):  
Single Dose ◽  
Side Effects ◽  
Comprehensive Assessment ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Resistant Depression

scholarly journals Using Oral and Intranasal Dosage Forms of Ketamine for Managing Treatment-Resistant Depression: A Review of the Literature

2016 ◽  
Vol 4 (2) ◽  
pp. 64-71 ◽  
Author(s):  
Patrick Arthur Twohig ◽  
Vaughn Huckfeldt
Keyword(s):  
Health Care ◽  
Side Effects ◽  
Care Setting ◽  
Dosage Forms ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Similar Reduction ◽  
Aspartate Receptor ◽  
Pubmed Database ◽  
Resistant Depression

A lack of effective treatment for patients with treatment-resistant depression (TRD) has led to the evaluation of ketamine, an N-methyl- D-aspartate receptor antagonist. Despite the demonstrated short-term benefits of using intravenous (IV) ketamine, side effects and the difficulty in administering ketamine outside the health-care setting has raised interest in alternative dosage forms. Research articles evaluating oral or intranasal (IN) ketamine were retrieved from the PubMed database. Patients who received oral or IN ketamine experienced a similar reduction in depressive symptoms within 24 hours of treatment and fewer side effects compared to patients who received IV ketamine. Novel administration forms of ketamine provide an opportunity for patients with TRD to achieve remission with fewer adverse side effects. Future studies should continue to evaluate these administration strategies in the hope of promoting ketamine’s use outside health-care settings and for longer time periods.

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 Prevalence of common mental disorder and associated factors among pregnant women in South-East Ethiopia, 2017: a community based cross-sectional study

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Ashenafi Mekonnen Woldetsadik ◽  
Abebaw Nigussie Ayele ◽  
Adem Esmael Roba ◽  
Genet Fikadu Haile ◽  
Khan Mubashir
Keyword(s):  
Mental Disorder ◽  
Pregnant Women ◽  
Emotional Abuse ◽  
Common Mental Disorder ◽  
Obstetric Care ◽  
Cross Sectional Study ◽  
Medical Illness ◽  
Cross Sectional ◽  
History Of ◽  
Main Determinants

Abstract Background Mothers suffering from common mental disorder (CMD), such as anxiety and depression may not be able to function properly, which could adversely affect the mother-infant bond and even result in increased infant morbidity and mortality. The purpose of this study was to assess the prevalence of CMD and its determinants among pregnant women in Southeast Ethiopia. Methods Data was collected from 743 pregnant women via interview-administered, standardised questionnaires during Dec–Jan 2017. The WHO Self-Reported Questionnaire (SRQ) was used to screen CMD. Multivariate logistic regression was conducted and ORs and 95% confidence intervals were calculated. Results The prevalence of CMD during pregnancy was 35.8% (95% CI: 34–38%) and the main determinants of CMD were: illiteracy, presence of health risk, financial instability, physical or emotional abuse, having sexual intercourse without her willingness, family history of psychiatric illness and history of chronic medical illness. Conclusion CMD prevalence during pregnancy was high, indicating a need to regularly screen pregnant women for CMD and its determinants as part of routine obstetric care.

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 Stanford Accelerated Intelligent Neuromodulation Therapy for Treatment-Resistant Depression (SAINT-TRD)

2019 ◽  
Author(s):  
Eleanor J. Cole ◽  
Katy H. Stimpson ◽  
Brandon S. Bentzley ◽  
Merve Gulser ◽  
Kirsten Cherian ◽  
...  
Keyword(s):  
Side Effects ◽  
Rating Scale ◽  
Neuropsychological Testing ◽  
Anterior Cingulate ◽  
High Dose ◽  
Delayed Response ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Resting Motor Threshold ◽  
Resistant Depression

AbstractBackgroundCurrent treatments for depression are limited by suboptimal efficacy, delayed response, and frequent side effects. Intermittent theta-burst stimulation (iTBS) is a non-invasive brain stimulation treatment that is FDA-approved for treatment-resistant depression (TRD). Recent methodological advancements suggest iTBS could be improved through 1) treating with multiple sessions per day at optimally-spaced intervals, 2) applying a higher overall pulse-dose of stimulation and 3) precision targeting of the left dorsolateral prefrontal cortex (L-DLPFC) to subgenual anterior cingulate cortex (sgACC) circuit. We examined the feasibility, tolerability, and preliminary efficacy of an accelerated, high-dose, resting-state functional connectivity MRI (fcMRI)-guided iTBS protocol for TRD termed ‘Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT)’.MethodsTwenty-one participants with TRD received open-label SAINT. FcMRI was used to individually target the region of L-DLPFC most anticorrelated with sgACC. Fifty iTBS sessions (1800 pulses per session, 50-minute inter-session interval) were delivered as 10 daily sessions over 5 consecutive days at 90% resting motor threshold (adjusted for cortical depth). Neuropsychological testing was conducted before and after SAINT.ResultsNineteen of 21 participants (90.48%) met criteria for remission (≤10 on the Montgomery-Åsberg Depression Rating Scale) immediately after SAINT. Neuropsychological testing demonstrated no negative cognitive side-effects. There were no seizures or other severe adverse events.DiscussionOur accelerated, high-dose, iTBS protocol with fcMRI-guided targeting (SAINT) was well tolerated and safe. Efficacy was strikingly high, especially for this treatment-resistant population. Double-blinded sham-controlled trials are required to confirm the high remission rate found in this initial study.Trial registrationClinicalTrials.gov NCT03240692

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 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.

scholarly journals Clinical characteristics of treatment-resistant depression in adults in Hungary: Real-world evidence from a 7-year-long retrospective data analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245510
Author(s):  
Péter Döme ◽  
Péter Kunovszki ◽  
Péter Takács ◽  
László Fehér ◽  
Tamás Balázs ◽  
...  
Keyword(s):  
Cerebrovascular Diseases ◽  
Poor Quality ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Retrospective Data Analysis ◽  
Real World Evidence ◽  
Increased Risk ◽  
Autoimmune Conditions ◽  
Resistant Depression ◽  
Using Data

Purpose Treatment-resistant depression (TRD) is associated with a poor quality of life and high economic burden. This observational retrospective epidemiological study aimed to estimate the proportion of patients with TRD within a cohort of patients with major depressive disorder (MDD) in Hungary and examine the mortality and comorbidities of patients with and without TRD. Patients and methods This study included patients with MDD who experienced onset of a new depressive episode between 01 January 2009 and 31 August 2015, using data from a nationwide, longitudinal database. Results Overall, 99,531 patients were included in the MDD cohort, of which 8,268 (8.3%) also met the criteria for TRD. The overall survival of non-TRD patients was longer than in TRD patients; the risk of mortality for TRD patients was significantly higher than of non-TRD patients (HR [CI] 1.381 [1.212–1.571]; p<0.001). Patients with TRD had a significantly higher probability of having “Neurotic, stress-related and somatoform disordersˮ, autoimmune conditions, cardio- or cerebrovascular diseases, thyroid gland diseases and self-harming behaviour not resulting in death than non-TRD patients (for all comparisons, p values were less than 0.005). Discussion To our best knowledge, this is the first study to assess the frequency of TRD in Hungary. In a cohort of Hungarian MDD patients, we have found that the proportion of TRD (~8.3%) is comparable to those reported in previous studies with similar methodology from other countries. The majority of our other main findings (e.g. more frequent self-harming behaviour, increased risk of “Neurotic, stress-related and somatoform disordersˮ and higher overall mortality in TRD subjects) are also in line with previous results from other countries. Taking the substantial proportion of patients with TRD into consideration, a more comprehensive and targeted treatment strategy would be required for these individuals.

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