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Liu Q, Li R, Qu W, Li B, Yang W, Cui R. Pharmacological and non-pharmacological interventions of depression after traumatic brain injury: A systematic review. Eur J Pharmacol 2019; 865:172775. [DOI: 10.1016/j.ejphar.2019.172775] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/26/2019] [Accepted: 11/01/2019] [Indexed: 12/27/2022]
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Hashimoto K. Rapid-acting antidepressant ketamine, its metabolites and other candidates: A historical overview and future perspective. Psychiatry Clin Neurosci 2019; 73:613-627. [PMID: 31215725 PMCID: PMC6851782 DOI: 10.1111/pcn.12902] [Citation(s) in RCA: 221] [Impact Index Per Article: 44.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/28/2019] [Accepted: 06/06/2019] [Indexed: 12/11/2022]
Abstract
Major depressive disorder (MDD) is one of the most disabling psychiatric disorders. Approximately one-third of the patients with MDD are treatment resistant to the current antidepressants. There is also a significant therapeutic time lag of weeks to months. Furthermore, depression in patients with bipolar disorder (BD) is typically poorly responsive to antidepressants. Therefore, there exists an unmet medical need for rapidly acting antidepressants with beneficial effects in treatment-resistant patients with MDD or BD. Accumulating evidence suggests that the N-methyl-D-aspartate receptor (NMDAR) antagonist ketamine produces rapid and sustained antidepressant effects in treatment-resistant patients with MDD or BD. Ketamine is a racemic mixture comprising equal parts of (R)-ketamine (or arketamine) and (S)-ketamine (or esketamine). Because (S)-ketamine has higher affinity for NMDAR than (R)-ketamine, esketamine was developed as an antidepressant. On 5 March 2019, esketamine nasal spray was approved by the US Food and Drug Administration. However, preclinical data suggest that (R)-ketamine exerts greater potency and longer-lasting antidepressant effects than (S)-ketamine in animal models of depression and that (R)-ketamine has less detrimental side-effects than (R,S)-ketamine or (S)-ketamine. In this article, the author reviews the historical overview of the antidepressant actions of enantiomers of ketamine and its major metabolites norketamine and hydroxynorketamine. Furthermore, the author discusses the other potential rapid-acting antidepressant candidates (i.e., NMDAR antagonists and modulators, low-voltage-sensitive T-type calcium channel inhibitor, potassium channel Kir4.1 inhibitor, negative modulators of γ-aminobutyric acid, and type A [GABAA ] receptors) to compare them with ketamine. Moreover, the molecular and cellular mechanisms of ketamine's antidepressant effects are discussed.
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Affiliation(s)
- Kenji Hashimoto
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan
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53
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Bhattacharyya S, Dunlop BW, Mahmoudiandehkordi S, Ahmed AT, Louie G, Frye MA, Weinshilboum RM, Krishnan RR, Rush AJ, Mayberg HS, Craighead WE, Kaddurah-Daouk R. Pilot Study of Metabolomic Clusters as State Markers of Major Depression and Outcomes to CBT Treatment. Front Neurosci 2019; 13:926. [PMID: 31572108 PMCID: PMC6751322 DOI: 10.3389/fnins.2019.00926] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 08/19/2019] [Indexed: 11/16/2022] Open
Abstract
Major depressive disorder (MDD) is a common and disabling syndrome with multiple etiologies that is defined by clinically elicited signs and symptoms. In hopes of developing a list of candidate biological measures that reflect and relate closely to the severity of depressive symptoms, so-called “state-dependent” biomarkers of depression, this pilot study explored the biochemical underpinnings of treatment response to cognitive behavior therapy (CBT) in medication-free MDD outpatients. Plasma samples were collected at baseline and week 12 from a subset of MDD patients (N = 26) who completed a course of CBT treatment as part of the Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) study. Targeted metabolomic profiling using the AbsoluteIDQ® p180 Kit and LC-MS identified eight “co-expressed” metabolomic modules. Of these eight, three were significantly associated with change in depressive symptoms over the course of the 12-weeks. Metabolites found to be most strongly correlated with change in depressive symptoms were branched chain amino acids, acylcarnitines, methionine sulfoxide, and α-aminoadipic acid (negative correlations with symptom change) as well as several lipids, particularly the phosphatidlylcholines (positive correlation). These results implicate disturbed bioenergetics as an important state marker in the pathobiology of MDD. Exploratory analyses contrasting remitters to CBT versus those who failed the treatment further suggest these metabolites may serve as mediators of recovery during CBT treatment. Larger studies examining metabolomic change patterns in patients treated with pharmacotherapy or psychotherapy will be necessary to elucidate the biological underpinnings of MDD and the -specific biologies of treatment response.
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Affiliation(s)
- Sudeepa Bhattacharyya
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Siamak Mahmoudiandehkordi
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Ahmed T Ahmed
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Gregory Louie
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States.,Department of Medicine, Duke University, Durham, NC, United States.,Duke Institute for Brain Sciences, Duke University, Durham, NC, United States
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Richard M Weinshilboum
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, United States
| | - Ranga R Krishnan
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, United States
| | - A John Rush
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States.,Department of Psychiatry, Texas Tech University, Health Sciences Center, Permian Basin, TX, United States.,Duke-NUS Medical School, Singapore, Singapore
| | - Helen S Mayberg
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States.,Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - W Edward Craighead
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Rima Kaddurah-Daouk
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States.,Department of Medicine, Duke University, Durham, NC, United States.,Duke Institute for Brain Sciences, Duke University, Durham, NC, United States
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54
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Ma JH, Wang SY, Yu HY, Li DY, Luo SC, Zheng SS, Wan LF, Duan KM. Prophylactic use of ketamine reduces postpartum depression in Chinese women undergoing cesarean section ✰. Psychiatry Res 2019; 279:252-258. [PMID: 31147085 DOI: 10.1016/j.psychres.2019.03.026] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 03/15/2019] [Accepted: 03/15/2019] [Indexed: 01/02/2023]
Abstract
This study aimed to explore the effect of prophylactic ketamine administration on postpartum depression in Chinese woman undergoing cesarean section. This randomized controlled study included 654 Chinese women undergoing cesarean section. At 10 min after child birth, patients in the ketamine group were given 0.5 mg/kg ketamine, whereas patients in the control group received standard postpartum care. At the end of operation, all patients were armed with a patient-controlled intravenous analgesia device. The primary outcome was the prevalence of postpartum depression (PPD), as assessed by the Edinburgh Postnatal Depression Scale (EPDS), and the secondary outcomes included the safety assessment and the Numerical Rating Scale (NRS) of postoperative pain. The prevalence of postpartum blues and postpartum depression were significantly lower in the ketamine group than in the control group. Logistic analysis showed that ketamine administration protected against postpartum depression, and PPD-associated risk factors included stress during pregnancy, antenatal depressive symptom and antenatal suicidal ideation. In addition, the antidepressive effect of prophylactic ketamine was stronger in mothers with a history of moderate stress during pregnancy, antenatal depressive symptom and antenatal suicidal ideation. Our findings suggest that ketamine functions as a prophylactic agent against PPD.
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Affiliation(s)
- Jia-Hui Ma
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, PR China
| | - Sai-Ying Wang
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, PR China; Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, Changsha 410078, PR China
| | - He-Ya Yu
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, PR China
| | - Dan-Yang Li
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, PR China
| | - Shi-Chao Luo
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, PR China
| | - Shan-Shan Zheng
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, PR China
| | - Li-Fei Wan
- People's Hospital of Ningxiang City, Ningxiang 410600, PR China
| | - Kai-Ming Duan
- Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha 410013, PR China.
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Zhao X, Niu L, Clerici C, Russo R, Byrd M, Setchell KD. Data analysis of MS-based clinical lipidomics studies with crossover design: A tutorial mini-review of statistical methods. CLINICAL MASS SPECTROMETRY (DEL MAR, CALIF.) 2019; 13:5-17. [PMID: 34841080 PMCID: PMC8620525 DOI: 10.1016/j.clinms.2019.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 05/15/2019] [Accepted: 05/15/2019] [Indexed: 11/28/2022]
Abstract
Clinical lipidomics using mass spectrometry (MS) is important to support discovery of biomarkers for diagnosis and understanding the pathophysiology of diseases. Frequently, lipidomics data from clinical studies have large variations among individuals because the human metabolome/lipidome is strongly influenced by genotype, daily activity, diet and gut flora. This inter-personal variability makes data analysis more complex and normally requires a large cohort for robust statistical analysis. Crossover designed experiments treat each subject as his or her own control, thereby reducing the between-subject variability, such that the effects of exposure/treatment are more likely to be identified when using a relatively small number of subjects. This design repeatedly samples an individual when crossing over from one treatment/exposure to another during the course of the study. The acquired datasets have a distinct data structure resulting from repeated longitudinal measurements. A variety of statistical methods are used in published crossover studies, but many appear to ignore the data structure inherent in the experimental design. An appropriate data analysis approach is critical to discovering robust clinical biomarkers. Hereby, we summarize the statistical methodologies suitable for clinical lipidomics studies using crossover design. To help understand and apply these methods to practical cases, we focused on the general concepts of statistical models in the context of analysis of metabolomics data without spending too much effort on mathematical details. Importantly, we aim to evaluate these methods and provide suggestions for data analysis and biomarker discovery. We applied the discussed methods on a MS-based lipidomics dataset from a double-blind random crossover designed clinical dietary intervention study. The strength and potential pitfalls of each method are briefly discussed and a suggestion for analytic workflow proposed.
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Affiliation(s)
- Xueheng Zhao
- Division of Pathology and Laboratory Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Liang Niu
- Division of Biostatistics and Bioinformatics, Department of Environmental Health, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
| | - Carlo Clerici
- Clinica Di Gastroenterologia – Endoscopia – Epatologia, Policlinico, S. Maria Della Misericordia Azienda Ospedaliera Di Perugia, Italy
| | - Roberta Russo
- Clinica Di Gastroenterologia – Endoscopia – Epatologia, Policlinico, S. Maria Della Misericordia Azienda Ospedaliera Di Perugia, Italy
| | - Melissa Byrd
- Division of Pathology and Laboratory Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Kenneth D.R. Setchell
- Division of Pathology and Laboratory Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
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Advances and challenges in development of precision psychiatry through clinical metabolomics on mood and psychotic disorders. Prog Neuropsychopharmacol Biol Psychiatry 2019; 93:182-188. [PMID: 30904564 DOI: 10.1016/j.pnpbp.2019.03.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 02/21/2019] [Accepted: 03/20/2019] [Indexed: 01/14/2023]
Abstract
Metabolomics is defined as the study of the global metabolite profile in a system under a given set of conditions. The objective of this review is to comprehensively assess the literature on metabolomics in mood disorders and schizophrenia and provide data for mental health researchers about the challenges and potentials of metabolomics. The majority of studies in metabolomics in Psychiatry uses peripheral blood or urine. The most widely used analytical techniques in metabolomics research are nuclear magnetic resonance (NMR) and mass spectrometry (MS). They are multiparametric and provide extensive structural and conformational information on multiple chemical classes. NMR is useful in untargeted analysis, which focuses on biosignatures or 'metabolic fingerprints' of illnesses. MS targeted metabolomics approach focuses on the identification and quantification of selected metabolites known to be involved in a particular metabolic pathway. The available studies of metabolomics in Schizophrenia, Bipolar Disorder and Major Depressive Disorder suggest a potential in investigating metabolic pathways involved in these diseases' pathophysiology and response to treatment, as well as its potential in biomarkers identification.
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Witkin JM, Martin AE, Golani LK, Xu NZ, Smith JL. Rapid-acting antidepressants. ADVANCES IN PHARMACOLOGY 2019; 86:47-96. [DOI: 10.1016/bs.apha.2019.03.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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58
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Rockel JS, Kapoor M. The Metabolome and Osteoarthritis: Possible Contributions to Symptoms and Pathology. Metabolites 2018; 8:metabo8040092. [PMID: 30551581 PMCID: PMC6315757 DOI: 10.3390/metabo8040092] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 12/22/2022] Open
Abstract
Osteoarthritis (OA) is a progressive, deteriorative disease of articular joints. Although traditionally viewed as a local pathology, biomarker exploration has shown that systemic changes can be observed. These include changes to cytokines, microRNAs, and more recently, metabolites. The metabolome is the set of metabolites within a biological sample and includes circulating amino acids, lipids, and sugar moieties. Recent studies suggest that metabolites in the synovial fluid and blood could be used as biomarkers for OA incidence, prognosis, and response to therapy. However, based on clinical, demographic, and anthropometric factors, the local synovial joint and circulating metabolomes may be patient specific, with select subsets of metabolites contributing to OA disease. This review explores the contribution of the local and systemic metabolite changes to OA, and their potential impact on OA symptoms and disease pathogenesis.
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Affiliation(s)
- Jason S Rockel
- Arthritis Program, University Health Network, Toronto, ON M5T 2S8, Canada.
- Division of Genetics and Development, Krembil Research Institute, University Health Network, Toronto, ON M5T 2S8, Canada.
| | - Mohit Kapoor
- Arthritis Program, University Health Network, Toronto, ON M5T 2S8, Canada.
- Division of Genetics and Development, Krembil Research Institute, University Health Network, Toronto, ON M5T 2S8, Canada.
- Department of Surgery, University of Toronto, Toronto, ON M1C 1A4, Canada.
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M1C 1A4, Canada.
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59
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Zhang K, Hashimoto K. An update on ketamine and its two enantiomers as rapid-acting antidepressants. Expert Rev Neurother 2018; 19:83-92. [PMID: 30513009 DOI: 10.1080/14737175.2019.1554434] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Introduction: Depression is one of the most disabling diseases worldwide. Approximately one-third of depressed patients are treatment-resistant to the currently available antidepressants and there is a significant therapeutic time lag of weeks to months. There is a clear unmet need for rapid-acting and more efficacious treatments. (R,S)-ketamine, an old anesthetic drug, appears now to be going through a renaissance. Areas covered: This paper reviews recent literature describing the antidepressant effects of ketamine and its enantiomer (S)-ketamine in patients with major depressive disorder (MDD) and bipolar disorder (BD). Furthermore, the authors discuss the therapeutic potential of (R)-ketamine, another enantiomer of (R,S)-ketamine, and (S)-norketamine. Expert commentary: A number of clinical studies have demonstrated that (R,S)-ketamine has rapid-acting and sustained antidepressant activity in treatment-resistant patients with MDD, BD, and other psychiatric disorders. Off-label use of ketamine for mood disorders is proving popular in the United States. Meanwhile, preclinical data suggests that (R)-ketamine can exert longer-lasting antidepressant effects than (S)-ketamine in animal models of depression, and (R)-ketamine may have less detrimental side effects than (R,S)-ketamine and (S)-ketamine. Additionally, (S)-norketamine exhibits rapid and sustained antidepressant effects, with a potency similar to that of (S)-ketamine. Unlike (S)-ketamine, (S)-norketamine does not cause behavioral and biochemical abnormalities and could be a safer than (S)-ketamine too.
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Affiliation(s)
- Kai Zhang
- a Division of Clinical Neuroscience , Chiba University Center for Forensic Mental Health , Chiba , Japan.,b Wuxi Mental Health Center , Nanjing Medical University , Wuxi , China
| | - Kenji Hashimoto
- a Division of Clinical Neuroscience , Chiba University Center for Forensic Mental Health , Chiba , Japan
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