scholarly journals Intranasal esketamine use in bipolar disorder: A case report

2021 ◽  
Vol 11 (4) ◽  
pp. 259-262
Author(s):  
Courtney Skriptshak ◽  
Ashley Reich
Keyword(s):  
Bipolar Disorder ◽  
Case Report ◽  
Mood Stabilizer ◽  
Rapid Cycling ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
The Past ◽  
Potential Safety ◽  
History Of ◽  
Resistant Depression

Abstract Over the past few years, intranasal esketamine has been FDA-approved for treatment-resistant depression as well as MDD with suicidal ideation. In the clinical trials leading to the recent FDA approvals, subjects with a diagnosis of bipolar disorder were excluded from participation in the trial. The manufacturer of intranasal esketamine states that it “has not been studied, and is not indicated, for patients with bipolar disorder.” Antidepressants are commonly associated with having the potential to induce rapid cycling in patients with bipolar disorder, though the mechanism is not fully understood. This case report demonstrates the potential safety of intranasal esketamine in combination with mood stabilizer therapy in a patient diagnosed with bipolar disorder without recent history of manic or hypomanic episodes.

scholarly journals Understanding Treatment-Resistant Depression: A Missionary’s Autobiographical Case Report

2019 ◽  
Vol 6 (1) ◽  
pp. 43-50
Author(s):  
Hunter York
Keyword(s):  
Case Report ◽  
Depression Symptoms ◽  
Primary Concern ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Spiritual Discipline ◽  
Convulsive Therapy ◽  
Service Oriented ◽  
Resistant Depression ◽  
Electro Convulsive Therapy

As a career cross-cultural missionary in Southeast Asia, the author has seen first-hand and has personally experienced the devastating effects of colleagues, families, leaders, clinicians, and the sufferers themselves misunderstanding the symptoms and the reality of major depressive disorder, an increasing global health problem.  This autobiographical case report reflects on twenty years of treatment-resistant depression and a journey through pharmacological approaches, psychotherapy treatment, Christian prayer counselling, and electro convulsive therapy without improvement in this condition.  The primary concern is how to remain faithful and effective with this condition in a service-oriented occupation that requires regular emotional expenditure.  In lieu of effective conventional and non-conventional therapies, the remaining option is to find a way to manage chronic depression; identify personal trends, weaknesses, and triggers; and find a personalized way to live that minimizes the effects of the condition.  In any chronic, incurable disorder, the sufferer must inevitably come to terms with his or her reality and find peace in the acceptance of that reality.  By expressing the journey through treatment-resistant depression, the author encourages readers to persevere in ministry and to respond more appropriately to the afflicted with clearer understanding and empathy.  A companion article on mitigating depression symptoms through the spiritual discipline of identifying with Christ and His experience of human emotional pain during His passion is available.  

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 Augmentation therapies for treatment-resistant depression: systematic review and meta-analysis

2018 ◽  
Vol 214 (1) ◽  
pp. 42-51 ◽  
Author(s):  
Rebecca Strawbridge ◽  
Ben Carter ◽  
Lindsey Marwood ◽  
Borwin Bandelow ◽  
Dimosthenis Tsapekos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Psychological Control ◽  
Meta Analysis ◽  
Treatment Modalities ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
The Past ◽  
Grant Support ◽  
Resistant Depression ◽  
Research Grant

BackgroundDepression is considered to have the highest disability burden of all conditions. Although treatment-resistant depression (TRD) is a key contributor to that burden, there is little understanding of the best treatment approaches for it and specifically the effectiveness of available augmentation approaches.AimsWe conducted a systematic review and meta-analysis to search and quantify the evidence of psychological and pharmacological augmentation interventions for TRD.MethodParticipants with TRD (defined as insufficient response to at least two antidepressants) were randomised to at least one augmentation treatment in the trial. Pre-post analysis assessed treatment effectiveness, providing an effect size (ES) independent of comparator interventions.ResultsOf 28 trials, 3 investigated psychological treatments and 25 examined pharmacological interventions. Pre-post analyses demonstrated N-methyl-d-aspartate-targeting drugs to have the highest ES (ES = 1.48, 95% CI 1.25–1.71). Other than aripiprazole (four studies, ES = 1.33, 95% CI 1.23–1.44) and lithium (three studies, ES = 1.00, 95% CI 0.81–1.20), treatments were each investigated in less than three studies. Overall, pharmacological (ES = 1.19, 95% CI 1.08–1.30) and psychological (ES = 1.43, 95% CI 0.50–2.36) therapies yielded higher ESs than pill placebo (ES = 0.78, 95% CI 0.66–0.91) and psychological control (ES = 0.94, 95% CI 0.36–1.52).ConclusionsDespite being used widely in clinical practice, the evidence for augmentation treatments in TRD is sparse. Although pre-post meta-analyses are limited by the absence of direct comparison, this work finds promising evidence across treatment modalities.Declaration of interestIn the past 3 years, A.H.Y. received honoraria for speaking from AstraZeneca, Lundbeck, Eli Lilly and Sunovion; honoraria for consulting from Allergan, Livanova and Lundbeck, Sunovion and Janssen; and research grant support from Janssen. In the past 3 years, A.J.C. received honoraria for speaking from AstraZeneca and Lundbeck; honoraria for consulting with Allergan, Janssen, Livanova, Lundbeck and Sandoz; support for conference attendance from Janssen; and research grant support from Lundbeck. B.B. has recently been (soon to be) on the speakers/advisory board for Hexal, Lilly, Lundbeck, Mundipharma, Pfizer, and Servier. No other conflicts of interest.

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