scholarly journals The Efficacy of Buprenorphine in Major Depression, Treatment-Resistant Depression and Suicidal Behavior: A Systematic Review

2018 ◽  
Vol 19 (8) ◽  
pp. 2410 ◽  
Author(s):  
Gianluca Serafini ◽  
Giulia Adavastro ◽  
Giovanna Canepa ◽  
Domenico De Berardis ◽  
Alessandro Valchera ◽  
...  
Keyword(s):  
Major Depression ◽  
Suicidal Behavior ◽  
Depression Treatment ◽  
Treatment Resistant Depression ◽  
Long Term Effects ◽  
Treatment Resistant ◽  
Refractory Depression ◽  
Research Findings ◽  
Resistant Depression

Although several pharmacological options to treat depression are currently available, approximately one third of patients who receive antidepressant medications do not respond adequately or achieve a complete remission. Thus, novel strategies are needed to successfully address those who did not respond, or partially respond, to available antidepressant pharmacotherapy. Research findings revealed that the opioid system is significantly involved in the regulation of mood and incentives salience and may be an appropriate target for novel therapeutic agents. The present study aimed to systematically review the current literature about the use of buprenorphine (BUP) for major depression, treatment-resistant depression (TRD), non-suicidal self-injury (NSSI) behavior, and suicidal behavior. We investigated Pubmed and Scopus databases using the following keywords: “buprenorphine AND depression”, “buprenorphine AND treatment resistant depression”, “buprenorphine AND suicid*”, “buprenorphine AND refractory depression”. Several evidence demonstrate that, at low doses, BUP is an efficacious, well-tolerated, and safe option in reducing depressive symptoms, serious suicidal ideation, and NSSI, even in patients with TRD. However, more studies are needed to evaluate the long-term effects, and relative efficacy of specific combinations (e.g., BUP + samidorphan (BUP/SAM), BUP + naloxone (BUP/NAL), BUP + naltrexone) over BUP monotherapy or adjunctive BUP treatment with standard antidepressants, as well as to obtain more uniform guidance about the optimal BUP dosing interval.

Treatment-resistant depression: therapeutic options when first-line treatments fail

2021 ◽  
Vol 28 (1) ◽  
pp. 4-8
Author(s):  
Chloe Wigg ◽  
Sara Costi
Keyword(s):  
Antidepressant Treatment ◽  
Small Body ◽  
Cochrane Review ◽  
Treatment Resistant Depression ◽  
Long Term Effects ◽  
Treatment Resistant ◽  
Short Term ◽  
Augmentation Strategies ◽  
Resistant Depression

SUMMARYThe Cochrane review by Davies et al aimed to address the lack of clarity on the risks and benefits of switching and augmentation strategies in the pharmacological treatment of treatment-resistant depression in adults who did not respond (or partially responded) to at least 4 weeks of antidepressant treatment at a recommended dose. This commentary assesses their review and their conclusion that augmenting the current antidepressant with mianserin or with an antipsychotic improves depressive symptoms over the short-term (8 to 12 weeks). Their results need to be treated with caution owing to the small body of evidence and individual comparisons supported by one, two or three studies, the limited evidence on long-term effects and the significant gaps in the literature (e.g. a lack of studies assessing dose increases).

Ketamine: Safe and Effective Treatment for Severe Depression

2021 ◽  
pp. 107839032110330
Author(s):  
Thomas Bradley Koss
Keyword(s):  
Low Dose ◽  
Alternative Therapy ◽  
Severe Depression ◽  
Infusion Therapy ◽  
Depression Treatment ◽  
Educational Video ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Safety And Efficacy ◽  
Resistant Depression

OBJECTIVE Depression resistant to standard treatment is devastating to an individual’s quality of life. Ketamine offers a safe and effective alternative to standard depression treatment, but many patients and providers are often unaware of this option. The American Association of Nurse Anesthetists and the American Psychiatric Nurses Association partnered in developing a collaborative approach to providing ketamine infusion therapy for psychiatric disorders. The purpose of this project was to disseminate information through an educational video about the safety and efficacy of outpatient low-dose ketamine infusions as an alternative therapy for treatment-resistant depression. METHODS A thorough literature review was conducted in PubMed, PsychINFO, CINAHL, and Google Scholar for articles describing the safety and efficacy of ketamine use in treatment-resistant depression. Based on the current research, an educational video reporting the benefits and safety of ketamine was developed and launched on two social media platforms—YouTube and Facebook—for individuals to view. The effectiveness of the video was evaluated through the number of views, likes, shares, and comments recorded. RESULTS At 9 months, 156 views, 60 likes, 8 shares, and 4 comments were recorded in both platforms. Comments indicated that viewers found the video informative and encouraging. CONCLUSIONS A short evidence-based educational video provides individuals with information regarding the safety and efficacy of low-dose ketamine infusions as an option for depression treatment. Ketamine outpatient clinics support and treat depressed patients who do not benefit from conventional pharmacologic medications.

Toward Optimal Treatments for Major Depression

CNS Spectrums ◽  
2002 ◽  
Vol 7 (2) ◽  
pp. 148-154 ◽  
Author(s):  
Pierre Blier ◽  
Herbert Ward
Keyword(s):  
Major Depression ◽  
Therapeutic Response ◽  
Antidepressant Drug ◽  
Treatment Resistant Depression ◽  
Antidepressant Response ◽  
Controlled Clinical Trials ◽  
Treatment Resistant ◽  
Ongoing Research ◽  
Resistant Depression ◽  
First And Second Generation

ABSTRACTThe treatment of major depression remains problematic for several reasons. In particular, the therapeutic response to medications usually does not manifest itself until a week after administration has begun, and more than half the patients will not experience a full recovery with the first antidepressant drug administration. There are, however, some pharmacologic strategies that can accelerate antidepressant response. When facing a treatment-resistant depression, combination therapy offers a more time-efficient approach to achieve remission than drug substitution. These interventions have been devised on a better understanding of the basis for the therapeutic response obtained with the first- and second-generation antidepressants, and evidence derived from controlled clinical trials of their superior effectiveness is growing. The rationale for such approaches will be described in this article, as well as their advantages and potential inconveniences. Ongoing research in this field continues to fuel the development of novel, better-tolerated, and more effective pharmacotherapies for depression.

scholarly journals A Review of the Conceptualisation and Risk Factors Associated with Treatment-Resistant Depression

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Jenifer A. Murphy ◽  
Jerome Sarris ◽  
Gerard J. Byrne
Keyword(s):  
Major Depression ◽  
Poor Response ◽  
Clinical Problem ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Rank One ◽  
System Activation ◽  
Resistant Depression ◽  
Staging Model ◽  
Inflammatory System

Major depression does not always remit. Difficult-to-treat depression is thought to contribute to the large disease burden posed by depression. Treatment-resistant depression (TRD) is the conventional term for nonresponse to treatment in individuals with major depression. Indicators of the phenomenon are the poor response rates to antidepressants in clinical practice and the overestimation of the efficacy of antidepressants in medical scientific literature. Current TRD staging models are based on anecdotal evidence without an empirical rationale to rank one treatment strategy above another. Many factors have been associated with TRD such as inflammatory system activation, abnormal neural activity, neurotransmitter dysfunction, melancholic clinical features, bipolarity, and a higher traumatic load. This narrative review provides an overview of this complex clinical problem and discusses the reconceptualization of depression using an illness staging model in line with other medical fields such as oncology.

scholarly journals Long-Term Impact of Residual Symptoms in Treatment-Resistant Depression

2011 ◽  
Vol 56 (9) ◽  
pp. 549-557 ◽  
Author(s):  
Abebaw Fekadu ◽  
Sarah C Wooderson ◽  
Lena J Rane ◽  
Kalypso Markopoulou ◽  
Lucia Poon ◽  
...  
Keyword(s):  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Residual Symptoms ◽  
Resistant Depression ◽  
Long Term Impact
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