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Capuzzi E, Caldiroli A, Capellazzi M, Tagliabue I, Marcatili M, Colmegna F, Clerici M, Buoli M, Dakanalis A. Long-Term Efficacy of Intranasal Esketamine in Treatment-Resistant Major Depression: A Systematic Review. Int J Mol Sci 2021; 22:9338. [PMID: 34502248 PMCID: PMC8430977 DOI: 10.3390/ijms22179338] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/14/2021] [Accepted: 08/23/2021] [Indexed: 12/02/2022] Open
Abstract
Esketamine (ESK) has been approved as a rapid-acting intranasal treatment for treatment-resistant depression (TRD). Although existing studies have investigated the efficacy of ESK in the 4-week induction phase, our knowledge about long-term ESK efficacy remains poor. The aim of this systematic review was to summarize the available data on long-term ESK efficacy for TRD. A systematic search was performed including articles in English, up to 31 March 2021. The search found 7 relevant studies, involving 1024 adult TRD patients. Continuing treatment with ESK after the 4-week induction phase may be associated with stable efficacy in relapse prevention among TRD patients. Conversely, the long-term antidepressant effectiveness upon discontinuation of ESK might be limited, although data from three studies had a moderate to high risk of bias. Overall, the results on the effectiveness of this compound in the long term are mixed. According to our findings, ESK treatment should be continued following the induction phase to reach a stable efficacy in relapse prevention, while the long-term antidepressant and anti-suicidal effects of ESK after discontinuation are inconsistent. Currently, the level of proof of ESK efficacy in long-term TRD treatment remains low and more RCTs with larger sample sizes and active comparators are needed.
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Affiliation(s)
- Enrico Capuzzi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, via G.B. Pergolesi 33, 20900 Monza, Italy; (E.C.); (M.M.); (F.C.); (M.C.)
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, via G.B. Pergolesi 33, 20900 Monza, Italy; (E.C.); (M.M.); (F.C.); (M.C.)
| | - Martina Capellazzi
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900 Monza, Italy; (M.C.); (I.T.); (A.D.)
| | - Ilaria Tagliabue
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900 Monza, Italy; (M.C.); (I.T.); (A.D.)
| | - Matteo Marcatili
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, via G.B. Pergolesi 33, 20900 Monza, Italy; (E.C.); (M.M.); (F.C.); (M.C.)
| | - Fabrizia Colmegna
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, via G.B. Pergolesi 33, 20900 Monza, Italy; (E.C.); (M.M.); (F.C.); (M.C.)
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, via G.B. Pergolesi 33, 20900 Monza, Italy; (E.C.); (M.M.); (F.C.); (M.C.)
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900 Monza, Italy; (M.C.); (I.T.); (A.D.)
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, via Festa del Perdono 7, 20122 Milan, Italy;
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, via F. Sforza 35, 20122 Milan, Italy
| | - Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900 Monza, Italy; (M.C.); (I.T.); (A.D.)
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Nuggerud-Galeas S, Sáez-Benito Suescun L, Berenguer Torrijo N, Sáez-Benito Suescun A, Aguilar-Latorre A, Magallón Botaya R, Oliván Blázquez B. Analysis of depressive episodes, their recurrence and pharmacologic treatment in primary care patients: A retrospective descriptive study. PLoS One 2020; 15:e0233454. [PMID: 32437398 PMCID: PMC7241802 DOI: 10.1371/journal.pone.0233454] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 05/05/2020] [Indexed: 11/29/2022] Open
Abstract
Background Depression is one of the most prevalent health problems, frequently being a medium- and long-term condition, with a high comorbidity rate and with frequent relapses and recurrences. Although numerous studies have compared the effectiveness of specific antidepressant therapy drugs and have assessed relapses, scientific evidence on the relationship between pharmacologic treatments and recurrence is scarce. The objective of this study is to describe depressive episodes in a primary care patient cohort, the percentage of depression recurrences and the administered pharmacologic treatment, from a naturalistic perspective. Methods Retrospective descriptive study. 957 subjects were included. The dependent variable was a depression diagnosis and independent variables were: gender, age at time of data collection; age of onset, first-episode treatment, number of recurrences, age at recurrences, treatment prescribed for recurrences using therapeutic groups categorization. Results Recurrences are frequent, affecting more than 40% of the population. In the first episode, 13.69% of the patients were not prescribed pharmacological treatment, but this percentage decreased over the following depression episodes. 80.9% of the patients who did not receive drug treatment in the first depression episode did not experience subsequent episodes. Monotherapy, and specifically, SSRIs were the most frequently prescribed treatment option for all depressive episodes. Regards the combined pharmacologic treatment, the most frequent drug combinations were SSRIs and benzodiazepines. Limitations In order to increase the power of results, the statistical analysis was performed using therapeutic groups categorization, not individually analyzing each drug and dose. Conclusions Depressive episode recurrence is frequent in primary care patients. Further studies having a prospective design are needed in order to expand on this issue.
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Affiliation(s)
| | | | | | | | | | - Rosa Magallón Botaya
- Institute for Health Research Aragón, Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
- * E-mail: ,
| | - Bárbara Oliván Blázquez
- Institute for Health Research Aragón, Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
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Rodrigues-Amorim D, Olivares JM, Spuch C, Rivera-Baltanás T. A Systematic Review of Efficacy, Safety, and Tolerability of Duloxetine. Front Psychiatry 2020; 11:554899. [PMID: 33192668 PMCID: PMC7644852 DOI: 10.3389/fpsyt.2020.554899] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 09/24/2020] [Indexed: 11/17/2022] Open
Abstract
Duloxetine is a serotonin-norepinephrine reuptake inhibitor approved for the treatment of patients affected by major depressive disorder (MDD), generalized anxiety disorder (GAD), neuropathic pain (NP), fibromyalgia (FMS), and stress incontinence urinary (SUI). These conditions share parallel pathophysiological pathways, and duloxetine treatment might be an effective and safe alternative. Thus, a systematic review was conducted following the 2009 Preferred Reporting Items (PRISMA) recommendations and Joanna Briggs Institute Critical (JBI) Appraisals guidelines. Eighty-five studies focused on efficacy, safety, and tolerability of duloxetine were included in our systematic review. Studies were subdivided by clinical condition and evaluated individually. Thus, 32 studies of MDD, 11 studies of GAD, 19 studies of NP, 9 studies of FMS, and 14 studies of SUI demonstrated that the measured outcomes indicate the suitability of duloxetine in the treatment of these clinical conditions. This systematic review confirms that the dual mechanism of duloxetine benefits the treatment of comorbid clinical conditions, and supports the efficacy, safety, and tolerability of duloxetine in short- and long-term treatments.
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Affiliation(s)
- Daniela Rodrigues-Amorim
- Translational Neuroscience Research Group, Galicia Sur Health Research Institute (IISGS), University of Vigo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Vigo, Spain
| | - José Manuel Olivares
- Translational Neuroscience Research Group, Galicia Sur Health Research Institute (IISGS), University of Vigo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Vigo, Spain.,Head of Department of Psychiatry, Health Area of Vigo, Servizo Galego de Saúde (SERGAS), Vigo, Spain.,Director Neuroscience Area, Galicia Sur Health Research Institute (IISGS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Vigo, Spain
| | - Carlos Spuch
- Translational Neuroscience Research Group, Galicia Sur Health Research Institute (IISGS), University of Vigo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Vigo, Spain
| | - Tania Rivera-Baltanás
- Translational Neuroscience Research Group, Galicia Sur Health Research Institute (IISGS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Vigo, Spain
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Is trazodone more effective than clomipramine in major depressed outpatients? A single-blind study with intravenous and oral administration. CNS Spectr 2019; 24:258-264. [PMID: 29081313 DOI: 10.1017/s1092852917000773] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Some antidepressants, such as trazodone or clomipramine, can be administered intravenously in patients with major depressive disorder (MDD), with potential benefits compared to the standard oral treatment, but available data about their efficacy are limited. The present study was aimed to compare the effectiveness of trazodone and clomipramine (intravenous [i.v.] followed by oral administration). METHODS Some 42 patients with a diagnosis of MDD according to the DSM-5 were selected and treated with i.v. trazodone or clomipramine according to clinical judgment. The Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, and the Montgomery-Åsberg Depression Rating Scale were administered at baseline, after 2 weeks, and after 6 weeks, as well as after 1 week of intravenous antidepressant administration. Raters were blinded to type of treatment. RESULTS No significant differences were found between treatment groups in terms of effectiveness at endpoint. Borderline statistical significance was found in terms of number of responders in favor of trazodone. In addition, patients treated with trazodone reported fewer total side effects than those treated with clomipramine. CONCLUSION Both i.v. trazodone and clomipramine are rapid and effective options for improving depressive symptoms, although trazodone appears to be tolerated better. Further studies with larger samples and double-blind conditions are warranted to confirm our results.
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Levy A, Daniels S, Hudson R, Horman T, Flynn A, Zhou Y, Leri F. Bupropion and naltrexone combination alters high fructose corn syrup self-administration and gene expression in rats. Neuropharmacology 2018; 135:547-554. [DOI: 10.1016/j.neuropharm.2018.01.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 01/18/2018] [Accepted: 01/24/2018] [Indexed: 12/22/2022]
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Dallé E, Mabandla MV. Early Life Stress, Depression And Parkinson's Disease: A New Approach. Mol Brain 2018; 11:18. [PMID: 29551090 PMCID: PMC5858138 DOI: 10.1186/s13041-018-0356-9] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 02/27/2018] [Indexed: 12/20/2022] Open
Abstract
This review aims to shed light on the relationship that involves exposure to early life stress, depression and Parkinson's disease (PD). A systematic literature search was conducted in Pubmed, MEDLINE, EBSCOHost and Google Scholar and relevant data were submitted to a meta-analysis . Early life stress may contribute to the development of depression and patients with depression are at risk of developing PD later in life. Depression is a common non-motor symptom preceding motor symptoms in PD. Stimulation of regions contiguous to the substantia nigra as well as dopamine (DA) agonists have been shown to be able to attenuate depression. Therefore, since PD causes depletion of dopaminergic neurons in the substantia nigra, depression, rather than being just a simple mood disorder, may be part of the pathophysiological process that leads to PD. It is plausible that the mesocortical and mesolimbic dopaminergic pathways that mediate mood, emotion, and/or cognitive function may also play a key role in depression associated with PD. Here, we propose that a medication designed to address a deficiency in serotonin is more likely to influence motor symptoms of PD associated with depression. This review highlights the effects of an antidepressant, Fluvoxamine maleate, in an animal model that combines depressive-like symptoms and Parkinsonism.
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Affiliation(s)
- Ernest Dallé
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, 4000 South Africa
| | - Musa V. Mabandla
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, 4000 South Africa
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Aftab A, Gao K. The preclinical discovery and development of brexpiprazole for the treatment of major depressive disorder. Expert Opin Drug Discov 2017; 12:1067-1081. [DOI: 10.1080/17460441.2017.1354849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Awais Aftab
- Department of Psychiatry, Residency Training Program, University Hospitals Cleveland Medical Center/Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Keming Gao
- Mood and Anxiety Clinic in the Mood Disorders Program, Department of Psychiatry, University Hospitals Cleveland Medical Center/Case Western Reserve University School of Medicine, Cleveland, OH, USA
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Dallé E, Daniels WMU, Mabandla MV. Fluvoxamine maleate effects on dopamine signaling in the prefrontal cortex of stressed Parkinsonian rats: Implications for learning and memory. Brain Res Bull 2017; 132:75-81. [PMID: 28549887 DOI: 10.1016/j.brainresbull.2017.05.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/09/2017] [Accepted: 05/22/2017] [Indexed: 10/19/2022]
Abstract
Parkinson's disease (PD) is also associated with cognitive impairment and reduced extrinsic supply of dopamine (DA) to the prefrontal cortex (PFC). In the present study, we looked at whether exposure to early life stress reduces DA and serotonin (5-HT) concentration in the PFC thus leading to enhanced cognitive impairment in a Parkinsonian rat model. Maternal separation was the stressor used to develop an animal model for early life stress that has chronic effects on brain and behavior. Sprague-Dawley rats were treated with the antidepressant Fluvoxamine maleate (FM) prior to a unilateral 6-hydroxydopamine (6-OHDA) lesion to model motor deficits in rats. The Morris water maze (MWM) and the forelimb use asymmetry (cylinder) tests were used to assess learning and memory impairment and motor deficits respectively. Blood plasma was used to measure corticosterone concentration and prefrontal tissue was collected for lipid peroxidation, DA, and 5-HT analysis. Our results show that animals exposed to early life stress displayed learning and memory impairment as well as elevated basal plasma corticosterone concentration which were attenuated by treatment with FM. A 6-OHDA lesion effect was evidenced by impairment in the cylinder test as well as decreased DA and 5-HT concentration in the PFC. These effects were attenuated by FM treatment resulting in higher DA concentration in the PFC of treated animals than in non-treated animals. This study suggests that DA and 5-HT signaling in the PFC are responsive to FM and may reduce stress-induced cognitive impairment in PD.
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Affiliation(s)
- Ernest Dallé
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
| | - Willie M U Daniels
- School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Musa V Mabandla
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa.
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Anti-parkinsonian effects of fluvoxamine maleate in maternally separated rats. Int J Dev Neurosci 2016; 53:26-34. [PMID: 27338206 DOI: 10.1016/j.ijdevneu.2016.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/15/2016] [Accepted: 06/16/2016] [Indexed: 11/21/2022] Open
Abstract
Exposure to early life stress has been shown to result in anxiety-like symptoms and exacerbates degeneration of dopaminergic neurons in a rat model of Parkinson's disease (PD). First line treatment for anxiety disorders includes the use of Fluvoxamine maleate (FM). In this study, we investigated whether treating anxiety-like symptoms with FM has an effect in alleviating the neurotoxic effects of 6-OHDA in a parkinsonian rat model. Early maternal separation was used to create a rat model that depicts anxiety-like symptoms. Maternally separated adult Sprague-Dawley rats were treated with FM prior to and following lesion with 6-hydroxydopamine (6-OHDA). The elevated plus-maze (EPM) and the forelimb akinesia tests were used to evaluate anxiety-like symptoms and motor impairment respectively. Blood plasma was used to measure corticosterone concentration, and striatal tissue was collected for dopamine (DA) and serotonin (5-HT) analysis. Our results show that animals exposed to early life stress displayed increased anxiety-like symptoms and elevated basal plasma corticosterone concentration which were attenuated by treatment with FM. A 6-OHDA lesion effect was evidenced by impairment in the forelimb akinesia test as well as decreased DA and 5-HT concentrations in the lesioned striatum. These effects were attenuated on DA neurons by FM treatment in the pre-lesion treated as opposed to the post-lesion treated rats. This study suggests that early treatment of anxiety-like behavior decreases the vulnerability of DA neurons to neurotoxic insults later in life thus slowing down DA degeneration in PD.
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