Correlations Between Neuroendocrine Disorders and Biochemical Brain Metabolites Alterations in Antidepressant Treatment

2018 ◽  
Vol 69 (3) ◽  
pp. 621-626
Author(s):  
Luminita Ageu ◽  
Cristina Talpos ◽  
Ghizela Kanalas ◽  
Simina Crisan ◽  
Carmen Lacramioara Zamfir ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Mr Spectroscopy ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Antidepressant Treatment ◽  
Treatment Strategies ◽  
Antidepressant Medication ◽  
Brain Metabolites ◽  
Gamma Aminobutyric Acid ◽  
Pharmacogenetic Testing

We approach the theme of modern investigation and treatment strategies, based on biochemical, clinical-biological, metabolic, pharmacogenetic, neuro-imagistic, and neuroendocrine integrative correlations in the management of depressive disorders. Our main objective was to investigate: the biochemical brain metabolites [N-acetyl-aspartate (NAA), gamma-aminobutyric acid (GABA), aspartate (Asp), creatine (CR), glutamine (Gln), glicerophosphocholine (GPC), phosphocholine (PC), phosphocreatine (PCr), taurine (Tau), N-methyl-D-aspartate (N-MDA), serine, glycine, choline (Cho)]; the neuroimagistic and neurobiological markers and the metabolic abnormalities in correlation with the molecular pharmacogenetic testing in children and adolescents treated with antidepressant medication. Our research was conducted between 2009-2016 on 90 children and adolescents with depressive disorders -45 children-G1, who benefited of pharmacogenetic testing tailored pharmacotherapy, and 45 without pharmacogenetic testing-G2. The patients were also evaluated by MR spectroscopy at baseline and after pharmacotherapy. The efficacy of the chosen therapy in correlation with the pharmacogenetic testing was evaluated by the mean change in the CDRS (Child Depression Rating Scale) total scores, in the CGI-S/I (Clinical Global Impression Severity/Improvement), CGAS (Clinical Global Assessment of Functioning) and by the change of the relevant neurobiological markers and MR spectroscopy biochemical brain metabolites. Our results showed statistically significant differences in the clinical scores between the studied groups. Our research could represent a proof that the biochemical brain metabolites registered in depressive disorders modified values in the MR spectroscopy and the administration of antidepressants could determine metabolic and neuroendocrine abnormalities (changed lipid profiles, high insulin and plasma glucose levels, weight gain, obesity), especially when chosen without prior pharmacogenetic testing.

scholarly journals Decoding the Mechanism of Action of Rapid-Acting Antidepressant Treatment Strategies: Does Gender Matter?

2019 ◽  
Vol 20 (4) ◽  
pp. 949 ◽  
Author(s):  
David Herzog ◽  
Gregers Wegener ◽  
Klaus Lieb ◽  
Marianne Müller ◽  
Giulia Treccani
Keyword(s):  
Depressive Disorders ◽  
Treatment Guidelines ◽  
Antidepressant Treatment ◽  
Animal Experiments ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Specific Effects ◽  
Precise Understanding ◽  
Developed Nations ◽  
Gender Specific

Gender differences play a pivotal role in the pathophysiology and treatment of major depressive disorder. This is strongly supported by a mean 2:1 female-male ratio of depression consistently observed throughout studies in developed nations. Considering the urgent need to tailor individualized treatment strategies to fight depression more efficiently, a more precise understanding of gender-specific aspects in the pathophysiology and treatment of depressive disorders is fundamental. However, current treatment guidelines almost entirely neglect gender as a potentially relevant factor. Similarly, the vast majority of animal experiments analysing antidepressant treatment in rodent models exclusively uses male animals and does not consider gender-specific effects. Based on the growing interest in innovative and rapid-acting treatment approaches in depression, such as the administration of ketamine, its metabolites or electroconvulsive therapy, this review article summarizes the evidence supporting the importance of gender in modulating response to rapid acting antidepressant treatment. We provide an overview on the current state of knowledge and propose a framework for rodent experiments to ultimately decode gender-dependent differences in molecular and behavioural mechanisms involved in shaping treatment response.

scholarly journals Interaction Effect of Serum Serotonin Level and Age on the 12-Week Pharmacotherapeutic Response in Patients With Depressive Disorders

2021 ◽  
Author(s):  
Wonsuk Choi ◽  
Ju-Wan Kim ◽  
Hee-Ju Kang ◽  
Hee Kyung Kim ◽  
Ho-Cheol Kang ◽  
...  
Keyword(s):  
Depressive Disorders ◽  
Rating Scale ◽  
Antidepressant Treatment ◽  
Interaction Effects ◽  
Serotonin Level ◽  
Baseline Serum ◽  
Logistic Regression Models ◽  
Insufficient Response ◽  
The Individual ◽  
Serum Serotonin

Abstract Despite the recognized antidepressant role of serotonin (5-hydroxytryptamine [5-HT]) signaling pathways in the central nervous system, the association between baseline peripheral 5-HT level and the antidepressant treatment response in clinical studies remains debatable. We investigated the individual and interaction effects of baseline serum 5-HT level and age on 12-week remission in outpatients with depressive disorders who received stepwise antidepressant treatment. Baseline serum serotonin levels were measured and the age of 1,094 patients recorded. The patients received initial antidepressant monotherapy; then, patients with an insufficient response or who experienced uncomfortable side effects received alternative treatments every 3 weeks (3, 6, and 9 weeks). Subsequently, 12-week remission, defined as a Hamilton Depression Rating Scale (HAMD) score of ≤ 7, was evaluated. Individual and interaction effects of serum 5-HT level (lower vs. higher based on the median value of 72.6 ng/mL) and age (< 60 vs. ≥ 60 years) on 12-week remission were analyzed using logistic regression models after adjusting for relevant covariates. Significant individual effects of serum 5-HT level and age on 12-week remission were not observed. However, a higher 5-HT level and age ≥ 60 years were significantly associated with higher 12-week remission rates. Our study suggests that the combination of baseline serum 5-HT level and age can be a useful predictor of 12-week antidepressant treatment outcomes.

Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents

2017 ◽  
Author(s):  
Jill Ehrenreich-May ◽  
Sarah M. Kennedy ◽  
Jamie A. Sherman ◽  
Emily L. Bilek ◽  
Brian A. Buzzella ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Emotional Disorders ◽  
Depressive Disorders ◽  
Treatment Strategies ◽  
Tic Disorders ◽  
Evidence Based ◽  
Obsessive Compulsive ◽  
Evidence Based Treatment ◽  
Transdiagnostic Treatment ◽  
Obsessive Compulsive Disorders

The therapy manuals included in this volume—the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) and Adolescents (UP-A)—include evidence-based treatment strategies to assist child and adolescent clients to function better in their lives. The manuals include specific guidelines for treatment delivery, and they also contain information about how to introduce parent-directed strategies to help promote long-term uptake of youth-directed therapy skills. The evidence-based treatment skills presented may be applied by therapists to children and adolescents with a wide variety of emotional disorders. This treatment guide takes a transdiagnostic approach to the treatment of emotional disorders. Some of the disorders that may be targeted include anxiety disorders and depressive disorders. This treatment is flexible enough for use with some trauma and stress-related disorders (including adjustment disorders), somatic symptom disorders, tic disorders and obsessive-compulsive disorders. The transdiagnostic presentation of evidence-based intervention techniques within these treatments may be particularly useful for children and adolescents presenting with multiple emotional disorders or mixed/subclinical symptoms of several emotional disorders.

Pharmacological Treatments for Unipolar Depression

2007 ◽  
pp. 271-288 ◽  
Author(s):  
Charles B. Nemeroff ◽  
Alan F. Schatzberg
Keyword(s):  
Major Depression ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Rating Scale ◽  
Antidepressant Treatment ◽  
Safety Margin ◽  
Antidepressant Medication ◽  
Unipolar Depression ◽  
Controlled Trials ◽  
Adverse Side Effect ◽  
Drug Induced

The treatment of unipolar major depression with antidepressant medication is well established on the basis of scores of randomized placebo-controlled trials involving thousands of patients. Tricyclic antidepressants (TCAs) were the first to be studied extensively; meta-analyses of placebo-controlled trials show them to be consistently and significantly more efficacious than a placebo. Because of a narrow safety margin and significant drug-induced adverse side effect problems, TCAs have now largely been replaced as the first-line treatment of depression by selective serotonin reuptake inhibitors (SSRIs)—fluoxetine, sertraline, paroxetine, citalopram, and escitalopram; serotonin norepinephrine reuptake inhibitors (SNRIs)—venlafaxine and duloxetine; as well as other compounds, including, for example, bupropion and mirtazapine. Each of these agents has been shown to be superior to a placebo and as effective as comparator TCAs or SSRIs in controlled trials. Clinical trials consistently show them to be better tolerated than TCAs, and they clearly have a wider margin of safety. However, there is a controversy concerning whether TCAs are more effective than SSRIs for the treatment of the most severely ill depressed patients. Monoamine oxidase inhibitors (MAOIs), while also more effective than placebo, have generally been reserved for treatment-refractory patients; however, a recently released transdermally delivered selegiline may be used in less refractory patients. It is now generally recognized that patients with recurrent major depression benefit from continued antidepressant treatment, and there is evidence that TCAs, SSRIs, SNRIs, and so forth are all effective for the long-term management of recurrent major depression. An important issue in evaluating the antidepressant literature is to distinguish between response rated as a reduction in the level of symptoms on a rating scale and response rated as true remission from illness.

scholarly journals The effect of aerobic exercise in the maintenance treatment of depression

2015 ◽  
Vol 12 (S1) ◽  
pp. S-3-S-6
Author(s):  
P. Majumder ◽  
I. Sharma ◽  
P. Vostanis ◽  
C. Bone
Keyword(s):  
Aerobic Exercise ◽  
Maintenance Treatment ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Antidepressant Medication ◽  
Evidence Base ◽  
Exercise Group ◽  
Treatment Of Depression ◽  
Further Development ◽  
Hamilton Rating Scale

We investigated the efficacy of aerobic exercise alongside antidepressant medication as an adjuvant maintenance treatment for depression. Fifty patients in remission were randomly assigned to either medication only or medication plus exercise. Assessment of psychopathology was made at 6-weekly intervals (for 24 weeks) using the Hamilton Rating Scale for Depression. The medication-plus-exercise group showed significantly more improvement at 12 and 24 weeks than the medication-only group. This study adds to a growing evidence base that suggests aerobic exercise is worthy of further development in the treatment of depressive disorders.

Treatment of Depressive Disorders

2021 ◽  
pp. 89-100
Author(s):  
Kirstin Painter ◽  
Maria Scannapieco
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Children And Adolescents ◽  
Case Studies ◽  
Depressive Disorders ◽  
Behavioral Therapy ◽  
Antidepressant Medication ◽  
Interpersonal Psychotherapy ◽  
Cognitive Behavioral ◽  
Treatment Interventions ◽  
The Brain

The two most common treatments for depression are antidepressant medication and psychotherapy, provided together or individually. This chapter provides an overview of the classes of antidepressant medications and addresses how they regulate neurotransmitters in the brain. The chapter addresses the use of antidepressants in children and adolescents and the risk of suicide related to antidepressants. Several models of psychotherapy treatments, including treatment interventions extensively tested and found effective in treating children and adolescents with depressive disorders (e.g., cognitive-behavioral therapy, interpersonal psychotherapy) are described. Links are provided to access further information on these interventions. This chapter returns to the two case studies from Chapter 5 and discloses the actual outcomes that occurred.

Biochemical Modifications Study of Cerebral Metabolites by Spectroscopy in Epilepsy Treatment

2018 ◽  
Vol 69 (4) ◽  
pp. 965-970
Author(s):  
Laura Alexandra Nussbaum ◽  
Lavinia Maria Hogea ◽  
Roxana Folescu ◽  
Mirela Loredana Grigoras ◽  
Carmen Lacramioara Zamfir ◽  
...  
Keyword(s):  
Early Detection ◽  
Children And Adolescents ◽  
Mr Spectroscopy ◽  
Epileptic Seizures ◽  
Brain Metabolites ◽  
Antiepileptic Medication ◽  
Before And After ◽  
Cerebral Metabolites ◽  
Key Aspects ◽  
The Brain

Through this research, our main focus was: to investigate the biochemical brain metabolites (NAA-N-acetylaspartate, GABA-Gama-Aminobutyric Acid, Asp-Aspartate, CR-Creatine, Gln-Glutamine, GPC-Glicerophosphocholine, PC-Phosphocholine, PCr-Phosphocreatine, Tau-Taurine, N-MDA-N-Metyl-D-Aspartate, Serine, Glicine, Cho-Choline); the neuroimagistic, the brain biochemical and metabolic abnormalities in children and adolescents with epilepsy before and after treatment; to review the main antiepileptic medication administered to these patients; and to make some correlations with the results obtained through Magnetic Resonance (MR) Spectroscopy, for further proper early detection and intervention in children and adolescents with epilepsy. Our research was performed between 2010-2017, involving 45 children and adolescents with epilepsy. Also, the patients were evaluated through MR Spectroscopy at baseline and after pharmacotherapy. Through the MR Spectroscopy, we investigated key aspects of the brain function and metabolism. The antiepileptic medication was chosen according to the guides and the type of epileptic seizures. The efficacy of the chosen therapy was evaluated through the change of the relevant MR spectroscopy biochemical brain metabolites. Our results, showed statistically significant modified values and concentrations of the biochemical cerebral metabolites. Our research was a proof, which the evaluation of the biochemical brain metabolites through MR Spectroscopy is of high clinical utility in prevention, early detection and intervention in epilepsy in children and adolescents.

Adherence to antidepressant treatment in depressive patients with comorbid psychiatric disorders

2011 ◽  
Vol 26 (S2) ◽  
pp. 1277-1277
Author(s):  
M. Roca ◽  
S. Armengol ◽  
M. García-García ◽  
J. Salva ◽  
S. Monzón ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Psychiatric Comorbidity ◽  
Rating Scale ◽  
Antidepressant Treatment ◽  
Antidepressant Medication ◽  
Pharmacological Treatments ◽  
Chi Square ◽  
Cross Sectional ◽  
Comorbid Psychiatric Disorders ◽  
Depressive Patients

BackgroundDepression is associated with high rates of comorbidity with other psychiatric disorders. Adherence to antidepressant medication regimens has been associated to different factors. Few studies have analyzed the influence of comorbid psychiatric disorders and adjunctive pharmacological treatments on antidepressant adherence.AimThe study evaluates the association of comorbid psychiatric disorder and pharmacological treatments with adherence rates to antidepressants in a large sample of depressive outpatients.Method3606 depressive patients were included in a cross-sectional epidemiological study, involving a stratified sample of 750 psychiatrists selected to participate. Patients were included if they met DSM-IV criteria for current single or recurrent non-psychotic major depressive disorder. Simplified Medication Adherence Questionnaire (SMAQ) and Hamilton Depression Rating Scale (HDRS) were used to assess adherence and depression severity.ResultsAdherence rates are lower in depressive patients with psychiatric comorbidity (62.8%) than in patients without comorbidity (69.1%) (Chi-square = 15.9, p < 0.001, OR = 1.6, 1.2–1.8). There are no significant differences in adherence rates between those patients taking or not benzodiacepines.ConclusionsPsychiatric comorbidity plays a negative role in adherence to antidepressant treatment. Benzodiazepine use has no influence on adherence rates. Special attention should be paid to the symptom overlapping between anxiety and depression and to the benzodiazepine prescription in comorbid depressive patients.

Frailty and Depression in Late Life: A High-Risk Comorbidity with Distinctive Clinical Presentation and Poor Antidepressant Response

2021 ◽  
Author(s):  
Patrick J Brown ◽  
Adam Ciarleglio ◽  
Steven P Roose ◽  
Carolina Montes Garcia ◽  
Sarah Chung ◽  
...  
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Depressive Disorders ◽  
Latent Class ◽  
Rating Scale ◽  
Controlled Trial ◽  
Antidepressant Medication ◽  
Biological Aging ◽  
Antidepressant Response ◽  
Previous Response

Abstract Background Investigate the longitudinal relationship between physical frailty, the clinical representation of accelerated biological aging, and antidepressant medication response in older adults with depressive illness. Methods An 8-week randomized placebo-controlled trial (escitalopram or duloxetine) followed by 10-months of open antidepressant medication treatment (augmentation, switch strategies) was conducted in an outpatient research clinic. 121 adults age &gt; 60 years with Major Depressive (MDD) or Persistent Depressive Disorders and a 24-item Hamilton Rating Scale for Depression (HRSD) &gt; 16 were enrolled. Primary measures assessed serially over 12-months include response (50% reduction from baseline HRSD score), remission (HRSD score &lt; 10), and frailty (non/intermediate frail [0-2 deficits] vs frail [&gt; 3 deficits]); latent class analysis was used to classify longitudinal frailty trajectories. Results A 2-class model best fit the data, identifying a consistently-low frailty-risk (63% of the sample) and consistently-high frailty-risk (37% of the sample) trajectory. Response and remission rates (P’s&lt;.002) for adults in the high-risk frailty class were at least 21 percentage-points worse than those in the low-risk class over 12-months. Furthermore, subsequent frailty was associated with previous frailty (P’s &lt; .01) but not previous response or remission (P’s &gt; .10). Conclusions Antidepressant medication is poorly effective for MDD occurring in the context of frailty in older adults. Furthermore, even when an antidepressant response is achieved, this response does little to improve their frailty. These data suggest that standard psychiatric assessment of depressed older adults should include frailty measures and that novel therapeutic strategies to address comorbid frailty and depression are needed.

scholarly journals Interaction effect of serum serotonin level and age on the 12-week pharmacotherapeutic response in patients with depressive disorders

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wonsuk Choi ◽  
Ju-Wan Kim ◽  
Hee-Ju Kang ◽  
Hee Kyung Kim ◽  
Ho-Cheol Kang ◽  
...  
Keyword(s):  
Interaction Effect ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Remission Rate ◽  
Antidepressant Treatment ◽  
Interaction Effects ◽  
Continuous Variable ◽  
Serotonin Level ◽  
Baseline Serum ◽  
Serum Serotonin

AbstractDespite the recognized antidepressant role of serotonin (5-hydroxytryptamine [5-HT]) signaling pathways in the central nervous system, the association between baseline peripheral 5-HT level and the antidepressant treatment response in clinical studies remains debatable. We investigated the interaction effects of baseline serum 5-HT level and age on the 12-week remission in outpatients with depressive disorders who received stepwise antidepressant treatment. Baseline serum serotonin levels were measured and the age of 1094 patients recorded. The patients received initial antidepressant monotherapy; then, patients with an insufficient response or who experienced uncomfortable side effects received alternative treatments every 3 weeks (3, 6, and 9 weeks). Subsequently, 12-week remission, defined as a Hamilton Depression Rating Scale (HAMD) score of ≤ 7, was evaluated. Individual and interaction effects of serum 5-HT level (as a binary [low vs. high, based on the median value of 72.6 ng/mL] or continuous variable) and age (as a binary [< 60 vs. ≥ 60 years] or continuous variable) on the 12-week remission rate were analyzed using logistic regression models after adjusting for relevant covariates. High 5-HT (≥ 72.6 ng/mL) and age ≥ 60 years were associated with the highest 12-week remission rates and a significant multiplicative interaction effect. The interaction effect of the two variables on the 12-week remission rate was significant even when analyzed as a continuous variable. Our study suggests that the association between baseline serum 5-HT level and 12-week antidepressant treatment outcomes differs according to patient age.

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