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Kim TT, Xu C. Not all types of depressed patients who persist with their antidepressant treatment improve in side effect complaints: A comparison of treatment completers and dropouts in the STAR*D trial. Acta Psychiatr Scand 2024. [PMID: 39363550 DOI: 10.1111/acps.13764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 09/20/2024] [Accepted: 09/23/2024] [Indexed: 10/05/2024]
Abstract
INTRODUCTION There is a "traditional belief" that antidepressant side effect complaints improve with medication persistence; however, support for this theory has remained inconclusive. We aimed to examine if side effect complaints improved over time by modeling the relationship between side effect complaints and time at dropout for patients receiving citalopram during the first level of acute treatment in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial. METHODS We categorized the 2833 patients into five patterns by week of dropout. We used pattern-mixture modeling to model change in side effect complaints (frequency, intensity, and burden) over the 12-week course of treatment, while accounting for attrition and depressive severity. Using post-hoc linear contrasts, we compared the attrition patterns with the completers' pattern for severity of side effect complaints at each respective last visit prior to dropout as well as averaged side effect complaints across the duration of treatment. We also reported frequencies and tolerability of side effects for nine organ/function systems over the course of treatment. RESULTS Patients who dropped out early exhibited worsening side effect burden and patients who dropped out later showed improvements in side effect frequency and intensity. Treatment completers improved in all side effect complaints over the course of treatment. Early attrition patterns had more severe side effect complaints for both tests of post-hoc linear contrasts than later attrition patterns and completers. CONCLUSIONS Side effect complaints from antidepressant treatment improve over time, but only for some types of patients. As a precaution for early dropout, clinicians should monitor patients who exhibit worsening and more severe side effect complaints-especially in the first 6 weeks of antidepressant treatment. In addition, clinicians may want to consider changing the type of treatment early on for these patients, rather than encouraging them to persist with their current medication.
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Affiliation(s)
- Thomas T Kim
- Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
| | - Colin Xu
- Department of Psychology & Communication, University of Idaho, Moscow, Idaho, USA
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Singh P, Vasundhara B, Das N, Sharma R, Kumar A, Datusalia AK. Metabolomics in Depression: What We Learn from Preclinical and Clinical Evidences. Mol Neurobiol 2024:10.1007/s12035-024-04302-5. [PMID: 38898199 DOI: 10.1007/s12035-024-04302-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 06/11/2024] [Indexed: 06/21/2024]
Abstract
Depression is one of the predominant common mental illnesses that affects millions of people of all ages worldwide. Random mood changes, loss of interest in routine activities, and prevalent unpleasant senses often characterize this common depreciated mental illness. Subjects with depressive disorders have a likelihood of developing cardiovascular complications, diabesity, and stroke. The exact genesis and pathogenesis of this disease are still questionable. A significant proportion of subjects with clinical depression display inadequate response to antidepressant therapies. Hence, clinicians often face challenges in predicting the treatment response. Emerging reports have indicated the association of depression with metabolic alterations. Metabolomics is one of the promising approaches that can offer fresh perspectives into the diagnosis, treatment, and prognosis of depression at the metabolic level. Despite numerous studies exploring metabolite profiles post-pharmacological interventions, a quantitative understanding of consistently altered metabolites is not yet established. The article gives a brief discussion on different biomarkers in depression and the degree to which biomarkers can improve treatment outcomes. In this review article, we have systemically reviewed the role of metabolomics in depression along with current challenges and future perspectives.
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Affiliation(s)
- Pooja Singh
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Raebareli, 226002, India
| | - Boosani Vasundhara
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Raebareli, 226002, India
| | - Nabanita Das
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Raebareli, 226002, India
| | - Ruchika Sharma
- Centre for Precision Medicine and Centre, Delhi Pharmaceutical Sciences and Research University (DPSRU), New Delhi, 110017, India
| | - Anoop Kumar
- Department of Pharmacology, Delhi Pharmaceutical Sciences and Research University (DPSRU), New Delhi, 110017, India
| | - Ashok Kumar Datusalia
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Raebareli, 226002, India.
- Department of Regulatory Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Raebareli, 226002, India.
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Anwar MM, Laila IMI. The ameliorating effect of Rutin on hepatotoxicity and inflammation induced by the daily administration of vortioxetine in rats. BMC Complement Med Ther 2024; 24:153. [PMID: 38581023 PMCID: PMC10996088 DOI: 10.1186/s12906-024-04447-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 03/20/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Vortioxetine (VORTX) is a potent and selective type of selective serotonin reuptake inhibitor (SSRI) that is mainly prescribed for treating major depression along with mood disorders as the first drug of choice. Limited previous findings have indicated evidence of liver injury and hepatotoxicity associated with daily VORTX treatment. Rutin (RUT), which is known for its antioxidant properties, has demonstrated several beneficial health actions, including hepatoprotection. Therefore the current study aimed to evaluate and assess the ameliorative effect of RUT against the hepatotoxic actions of daily low and high-dose VORTX administration. METHODS The experimental design included six groups of rats, each divided equally. Control, rats exposed to RUT (25 mg/kg), rats exposed to VORTX (28 mg/kg), rats exposed to VORTX (28 mg/kg) + RUT (25 mg/kg), rats exposed to VORTX (80 mg/kg), and rats exposed to VORTX (80 mg/kg) + RUT (25 mg/kg). After 30 days from the daily exposure period, assessments were conducted for serum liver enzyme activities, hepatotoxicity biomarkers, liver antioxidant endogenous enzymes, DNA fragmentation, and histopathological studies of liver tissue. RESULTS Interestingly, the risk of liver damage and hepatotoxicity related to VORTX was attenuated by the daily co-administration of RUT. Significant improvements were observed among all detected liver functions, oxidative stress, and inflammatory biomarkers including aspartate aminotransferase (AST), alanine transaminase (ALT), lactate dehydrogenase (LDH), albumin, malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH), glutathione S-transferase (GST), total protein, acid phosphatase, N-Acetyl-/β-glucosaminidase (β-NAG), β-Galactosidase (β-Gal), alpha-fetoprotein (AFP), caspase 3, and cytochrom-C along with histopathological studies, compared to the control and sole RUT group. CONCLUSION Thus, RUT can be considered a potential and effective complementary therapy in preventing hepatotoxicity and liver injury induced by the daily or prolonged administration of VORTX.
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Affiliation(s)
- Mai M Anwar
- Department of Biochemistry, National Organization for Drug Control and Research (NODCAR)/Egyptian Drug Authority (EDA), Cairo, Egypt.
| | - Ibrahim M Ibrahim Laila
- Department of Biotechnology &Molecular drug evaluation, National Organization for Drug Control and Research (NODCAR)/Egyptian Drug Authority (EDA), Cairo, Egypt
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Smith S, Martin F, Rai D, Forbes H. Association between antidepressant use during pregnancy and miscarriage: a systematic review and meta-analysis. BMJ Open 2024; 14:e074600. [PMID: 38272551 PMCID: PMC10824002 DOI: 10.1136/bmjopen-2023-074600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 11/23/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Literature surrounding the association between antidepressant use during pregnancy and miscarriage is conflicting. We aimed to conduct a systematic review and meta-analysis of studies among pregnant women regarding the association between exposure to antidepressants during pregnancy and the risk of miscarriage, compared with pregnant women not exposed to antidepressants. DESIGN We conducted a systematic review and meta-analysis of non-randomised studies. DATA SOURCES We searched Medline, Embase and PsychINFO up to 6 August 2023. ELIGIBILITY CRITERIA AND OUTCOMES Case-control, cohort and cross-sectional study designs were selected if they compared individuals exposed to any antidepressant class during pregnancy to comparator groups of either no antidepressant use or an alternate antidepressant. DATA EXTRACTION AND SYNTHESIS Effect estimates were extracted from selected studies and pooled using a random-effects meta-analysis. Risk of bias (RoB) was assessed using the Risk of Bias in Non-Randomised Studies of Interventions (ROBINS-I) tool, and heterogeneity assessed using the I2 statistic. Subgroup analyses were used to explore antidepressant classes and the impact of confounding by indication. RESULTS 1800 records were identified from the search, of which 29 were included in the systematic review and meta-analysis. The total sample included 5 671 135 individuals. Antidepressant users initially appeared to have a higher risk of miscarriage compared with unexposed individuals from the general population (summary effect estimate: 1.24, 95% CI 1.18 to 1.31, I2=69.2%; number of studies (n)=29). However, the summary estimate decreased when comparing against unexposed individuals with maternal depression (1.16, 1.04 to 1.31; I2=58.6%; n=6), suggesting confounding by indication may be driving the association. 22 studies suffered from serious RoB, and only two of the 29 studies were deemed at moderate RoB. CONCLUSIONS After accounting for maternal depression, there is little evidence of any association between antidepressant use during pregnancy and miscarriage. Instead, the results indicate the biasing impact of confounding by indication.
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Affiliation(s)
- Sophie Smith
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol, UK
| | - Flo Martin
- MRC Integrative Epidemiology Unit, Population Health Sciences, University of Bristol, Bristol, UK
| | - Dheeraj Rai
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre, University of Bristol, Bristol, UK
- Bristol Autism Spectrum Service, Avon and Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
| | - Harriet Forbes
- London School of Hygiene and Tropical Medicine, London, UK
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Zheng M, Yang X, Yuan P, Wang F, Guo X, Li L, Wang J, Miao S, Shi X, Ma S. Investigating the mechanism of Sinisan formula in depression treatment: a comprehensive analysis using GEO datasets, network pharmacology, and molecular docking. J Biomol Struct Dyn 2024:1-15. [PMID: 38174416 DOI: 10.1080/07391102.2023.2297816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/14/2023] [Indexed: 01/05/2024]
Abstract
The herbal formula Sinisan (SNS) is a commonly used treatment for depression; however, its mechanism of action remains unclear. This article uses a combination of the GEO database, network pharmacology and molecular docking technologies to investigate the mechanism of action of SNS. The aim is to provide new insights and methods for future depression treatments. The study aims to extract effective compounds and targets for the treatment of depression from the T CMSP database. Relevant targets were searched using the GEO, Disgenet, Drugbank, PharmGKB and T T D databases, followed by screening of core targets. In addition, GO and KEGG pathway enrichment analyses were performed to explore potential pathways for the treatment of depression. Molecular docking was used to evaluate the potential targets and compounds and to identify the optimal core protein-compound complex. Molecular dynamics was used to further investigate the dynamic variability and stability of the complex. The study identified 118 active SNS components and 208 corresponding targets. Topological analysis of P P I networks identified 11 core targets. GO and KEGG pathway enrichment analyses revealed that the mechanism of action for depression involves genes associated with inflammation, apoptosis, oxidative stress, and the MAP K3 and P I3K-Akt signalling pathways. Molecular docking and dynamics simulations showed a strong binding affinity between these compounds and the screened targets, indicating promising biological activity. The present study investigated the active components, targets and pathways of SNS in the treatment of depression. Through a preliminary investigation, key signalling pathways and compounds were identified. These findings provide new directions and ideas for future research on the therapeutic mechanism of SNS and its clinical application in the treatment of depression.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Meiling Zheng
- Department of Pharmacy, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, P.R. China
- Department of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, P.R. China
| | - Xinxing Yang
- Department of Ultrasound, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, P.R. China
| | - Ping Yuan
- Northwestern Polytechnical University Hospital, Xi'an, Shaanxi, P.R. China
| | - Feiyan Wang
- Department of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, P.R. China
| | - Xiaodi Guo
- The College of Life Sciences, Northwest University, Xi'an, Shaanxi, P.R. China
| | - Long Li
- Department of Pharmacy, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, P.R. China
| | - Jin Wang
- Department of Pharmacy, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, P.R. China
| | - Shan Miao
- Department of Pharmacy, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, P.R. China
| | - Xiaopeng Shi
- Department of Pharmacy, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, P.R. China
| | - Shanbo Ma
- Department of Pharmacy, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, P.R. China
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Liu Y, Lin H, Zhang H, Zhang X, Yin S. Correlation analysis between physical activity and depressive tendencies among occupational groups: an isotemporal substitution approach. BMC Public Health 2023; 23:2241. [PMID: 37964346 PMCID: PMC10644550 DOI: 10.1186/s12889-023-17134-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 11/01/2023] [Indexed: 11/16/2023] Open
Abstract
OBJECTIVES Sedentary behaviour (SB) and physical activity (PA) have been shown to be associated with depression. However, behaviours, such as PA, occupy a portion of an individual's 24-h day. Thus, an increase in time for one behaviour takes away time from another. Previous evidence suggests that it would be more appropriate to shift the focus to the importance of reallocating time spent in sedentary behaviour to time spent in physical activity. The aim of this study was to analyse the mutual replacement effect of different health behaviours on depressive tendencies by isotemporal substitution modelling (ISM) under the objective condition of considering a limited 24-h day. Second, we aimed to further explore the potential association between excessive or insufficient sleep duration and depressive symptoms. METHODS A total of 10656 employees from 79 companies in four provinces of China participated in this survey. The Center for Epidemiological Studies Depression Scale (CES-D) was used to measure workers' depressive tendencies. The duration of various types of physical activity was self-reported by workers based on the International Physical Activity Questionnaire (IPAQ). ISM was used to assess the associations of time spent in different activities on displacement of equivalent time spent on other activities with depression risk. RESULTS A total of 10656 participants (89.5% of the sample) were included in the analysis. The ISM found that a 30-min unit of SB replaced with walking (OR, 95% CI: 0.83, 0.77-0.88), sleep (≤ 8 h) (OR, 95% CI: 0.77, 0.74-0.79), moderate physical activity (MPA) (OR, 95% CI: 0.87, 0.81-0.93) and vigorous physical activity (VPA) (OR, 95% CI: 0.91, 0.84-0.99) was significantly and negatively associated with the risk of depressive tendencies. When sleep duration was less than 8 h, each additional half hour of sleep time was significantly associated with a lower risk of depressive tendencies, and this association was no longer significant after 8 h. CONCLUSION Prolonged SB is common in the current workplace in China. Replacing an average of 30 min per day of SB with VPA and MPA, even walking is associated with less depression among workers. In addition, insufficient daily sleep is also an important risk factor for workers' depressive tendencies. These findings provide valuable evidence to promote mental health among occupational groups and support the development of healthy workplaces.
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Affiliation(s)
- Yihua Liu
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Haoxiang Lin
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Hao Zhang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Xiaoyue Zhang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Shengli Yin
- DeZhou Center for Disease Control and Prevention, Dezhou, China.
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Blampied M, Tylianakis JM, Bell C, Gilbert C, Rucklidge JJ. Efficacy and safety of a vitamin-mineral intervention for symptoms of anxiety and depression in adults: A randomised placebo-controlled trial "NoMAD". J Affect Disord 2023; 339:954-964. [PMID: 37268087 DOI: 10.1016/j.jad.2023.05.077] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 05/18/2023] [Accepted: 05/21/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Anxiety and depression are increasingly burdening society. We investigated whether micronutrients (vitamins and minerals), improve anxiety and depression symptoms in an adult community setting. METHODS Participants (n = 150) describing functionally-impairing symptoms of anxiety/depression randomly received micronutrients or placebo for 10 weeks. Primary outcome measures were Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder Scale-7 (GAD-7), and Clinical Global Impression-Improvement scale (CGII). They were monitored online with regular phone contact with a clinical psychologist. RESULTS Linear mixed-effects modelling showed significant improvements in both groups, with the micronutrient group improving significantly more quickly on both the PHQ-9 (t = -2.17, p = 0.03) and the GAD-7 (t = -2.23, p = 0.03). Subsequent models with covariates showed that participant characteristics moderated time-by-group interactions; micronutrients provided fastest improvement relative to placebo for younger participants, those from lower socioeconomic groups and those who had previously tried psychiatric medication. On the CGII, there were no group differences at end-point ((F1,148) = 1.36, p = 0.25, d = 0.19, 95 % CI [-0.13 to 0.51]), with 49 % of the micronutrient and 44 % of the placebo groups being identified responders. Participants on micronutrients had significantly increased bowel motions compared with placebo. There was no increased suicidal ideation, no serious adverse events and the blind was adequately maintained. Drop out was low at 8.7 %. LIMITATIONS The improvement under placebo and lack of formal diagnoses limit generalizability. CONCLUSIONS Despite limited clinician contact, all participants improved significantly, though improvements were faster with micronutrients. Participants in some subgroups demonstrated a lower response to placebo, identifying where micronutrients may offer greatest potential as an intervention.
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Codella R, Chirico A. Physical Inactivity and Depression: The Gloomy Dual with Rising Costs in a Large-Scale Emergency. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1603. [PMID: 36674363 PMCID: PMC9862474 DOI: 10.3390/ijerph20021603] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
At the end of October of 2022, the World Health Organization (WHO) released "the Global status report on physical activity 2022" [...].
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Affiliation(s)
- Roberto Codella
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20138 Milan, Italy
| | - Andrea Chirico
- Department of Psychology of Development and Socialization Processes, “Sapienza”University of Rome, 00185 Rome, Italy
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Sun Y, Zhao J, Rong J. Dissecting the molecular mechanisms underlying the antidepressant activities of herbal medicines through the comprehensive review of the recent literatures. Front Psychiatry 2022; 13:1054726. [PMID: 36620687 PMCID: PMC9813794 DOI: 10.3389/fpsyt.2022.1054726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
Depression is clinically defined as a mood disorder with persistent feeling of sadness, despair, fatigue, and loss of interest. The pathophysiology of depression is tightly regulated by the biosynthesis, transport and signaling of neurotransmitters [e.g., serotonin, norepinephrine, dopamine, or γ-aminobutyric acid (GABA)] in the central nervous system. The existing antidepressant drugs mainly target the dysfunctions of various neurotransmitters, while the efficacy of antidepressant therapeutics is undermined by different adverse side-effects. The present review aimed to dissect the molecular mechanisms underlying the antidepressant activities of herbal medicines toward the development of effective and safe antidepressant drugs. Our strategy involved comprehensive review and network pharmacology analysis for the active compounds and associated target proteins. As results, 45 different antidepressant herbal medicines were identified from various in vivo and in vitro studies. The antidepressant mechanisms might involve multiple signaling pathways that regulate neurotransmitters, neurogenesis, anti-inflammation, antioxidation, endocrine, and microbiota. Importantly, herbal medicines could modulate broader spectrum of the cellular pathways and processes to attenuate depression and avoid the side-effects of synthetic antidepressant drugs. The present review not only recognized the antidepressant potential of herbal medicines but also provided molecular insights for the development of novel antidepressant drugs.
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Affiliation(s)
- Yilu Sun
- Department of Chinese Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- School of Chinese Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Jia Zhao
- Department of Chinese Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- School of Chinese Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Jianhui Rong
- School of Chinese Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Updates on the Role of Probiotics against Different Health Issues: Focus on Lactobacillus. Int J Mol Sci 2022; 24:ijms24010142. [PMID: 36613586 PMCID: PMC9820606 DOI: 10.3390/ijms24010142] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/14/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
This review article is built on the beneficial effects of Lactobacillus against different diseases, and a special focus has been made on its effects against neurological disorders, such as depression, multiple sclerosis, Alzheimer's, and Parkinson's disease. Probiotics are live microbes, which are found in fermented foods, beverages, and cultured milk and, when administered in an adequate dose, confer health benefits to the host. They are known as "health-friendly bacteria", normally residing in the human gut and involved in maintaining homeostatic conditions. Imbalance in gut microbiota results in the pathophysiology of several diseases entailing the GIT tract, skin, immune system, inflammation, and gut-brain axis. Recently, the use of probiotics has gained tremendous interest, because of their profound effects on the management of these disease conditions. Recent findings suggest that probiotics enrichment in different human and mouse disease models showed promising beneficial effects and results in the amelioration of disease symptoms. Thus, this review focuses on the current probiotics-based products, different disease models, variable markers measured during trials, and evidence obtained from past studies on the use of probiotics in the prevention and treatment of different diseases, covering the skin to the central nervous system diseases.
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Ramalho JB, Spiazzi CC, Bicca DF, Rodrigues JF, Sehn CP, da Silva WP, Cibin FWS. Beneficial effects of Lactococcus lactis subsp. cremoris LL95 treatment in an LPS-induced depression-like model in mice. Behav Brain Res 2022; 426:113847. [PMID: 35306095 DOI: 10.1016/j.bbr.2022.113847] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/05/2022] [Accepted: 03/14/2022] [Indexed: 12/12/2022]
Abstract
Clinical evidence suggests that neuroinflammation, activation of the immune system, and the composition of the intestinal microbiota are involved in the pathology of depression. This study evaluated the effectiveness of a probiotic intervention using Lactococcus lactis subsp. cremoris LL95 in ameliorating mood disorders in a lipopolysaccharide (LPS)-induced depression-like mouse model. C57BL/6 mice were randomly divided into four groups and treated with 5 mg/kg LPS via intraperitoneal injection to induce depression-like symptoms, followed by oral administration of LL95 for one week (1 × 109 CFU/mouse). The animals were then subjected to a series of behavioral assessments, including open field, sucrose preference, and forced swimming tests. In addition, we evaluated the levels of reactive oxygen species, tumor necrosis factor-α, and interleukin-1β in the hippocampal tissues of these animals, and also determined their fecal lactic acid bacteria (LAB) content. LL95 intervention improved LPS-induced depression-like behaviors in mice, including decreased sucrose preference and increased immobility time in the forced swim test. LL95 treatment reversed the LPS-induced increase in hippocampal levels of reactive oxygen species and tumor necrosis factor-α, and of interleukin-1β to a lesser extent. Furthermore, LL95 intervention increased the fecal LAB content in these animals, suggesting changes in the gut microbiota. These findings suggest that LL95 exerts antidepressant-like effects in LPS-induced depression, which may be attributed to modulation of the oxidative status and pro-inflammatory cytokine expression in the hippocampus and alteration in the LAB content of the gut microbiota.
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Affiliation(s)
- Juliana Bernera Ramalho
- Laboratório de Estresse Oxidativo, Universidade Federal do Pampa (UNIPAMPA), Campus Uruguaiana, 97500-970 Uruguaiana, RS, Brazil
| | - Cristiano Chiapinotto Spiazzi
- Laboratório de Estresse Oxidativo, Universidade Federal do Pampa (UNIPAMPA), Campus Uruguaiana, 97500-970 Uruguaiana, RS, Brazil
| | - Diogo Ferreira Bicca
- Laboratório de Estresse Oxidativo, Universidade Federal do Pampa (UNIPAMPA), Campus Uruguaiana, 97500-970 Uruguaiana, RS, Brazil
| | - Jéssica Ferreira Rodrigues
- Laboratório de Estresse Oxidativo, Universidade Federal do Pampa (UNIPAMPA), Campus Uruguaiana, 97500-970 Uruguaiana, RS, Brazil
| | - Carla Pohl Sehn
- Laboratório de Avaliações Farmacológicas e Toxicológicas Aplicadas às Moléculas Bioativas (LaftamBio), Universidade Federal do Pampa (UNIPAMPA), Campus Itaqui, 97650-000 Itaqui, RS, Brazil
| | - Wladimir Padilha da Silva
- Departamento de Ciência e Tecnologia Agroindustrial (DCTA), Universidade Federal de Pelotas (UFPel), 96010-900 Pelotas, RS, Brazil
| | - Francielli Weber Santos Cibin
- Laboratório de Estresse Oxidativo, Universidade Federal do Pampa (UNIPAMPA), Campus Uruguaiana, 97500-970 Uruguaiana, RS, Brazil.
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Espinola CW, Khoo Y, Parmar R, Demchenko I, Frey BN, Milev RV, Ravindran AV, Parikh SV, Ho K, Rotzinger S, Lou W, Lam RW, Kennedy SH, Bhat V. Pretreatment anxious depression as a predictor of side effect frequency and severity in escitalopram and aripiprazole adjunctive therapy. Brain Behav 2022; 12:e2555. [PMID: 35333448 PMCID: PMC9120722 DOI: 10.1002/brb3.2555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 01/02/2022] [Accepted: 03/01/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To report side effect frequency and severity in patients with major depressive disorder (MDD) receiving escitalopram and aripiprazole adjunctive therapy and to examine whether pretreatment anxious depression is associated with the number and presence of specific side effects. METHODS 188 of the 211 trial participants provided information on side effects during treatment with escitalopram (10-20 mg) for 8 weeks, and nonresponders received further augmentation on aripiprazole (2-10 mg) adjunctive therapy for another 8 weeks, whereas responders remained on escitalopram. Participants completed the Toronto Side Effects Scale at weeks 2, 4, 10, and 12. Covariate-adjusted negative binomial regression and Wilcoxon tests examined the association between anxious depression (GAD-7 ≥ 10) and number of side effects. Covariate-adjusted logistic regression and chi-square tests explored the association between anxious depression and specific side effects. RESULTS For both therapies, the most frequent side effects were also the most severe. They mostly related to the central nervous system (CNS) (i.e., drowsiness and nervousness). Between baseline and week 2, the number of side effects participants experienced (incidence rate ratio [IRR] = 1.38, p = .010) or had trouble with (IRR = 1.34, p = .026) was significantly higher among those with anxious depression for escitalopram but not adjunctive aripiprazole. Further, odds of experiencing and having trouble with nervousness and agitation were also significantly higher in anxious depression for escitalopram only (p < .05). CONCLUSION Patients on escitalopram and aripiprazole adjunctive therapy may experience and have trouble with CNS side effects. Pretreatment anxious depression may predispose escitalopram recipients with MDD to developing side effects, especially those related to anxiety.
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Affiliation(s)
- Caroline W Espinola
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Yuelee Khoo
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Roohie Parmar
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Ilya Demchenko
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Roumen V Milev
- Departments of Psychiatry and Psychology, Queen's University, Providence Care, Kingston, Ontario, Canada
| | - Arun V Ravindran
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Sagar V Parikh
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Keith Ho
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Susan Rotzinger
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Wendy Lou
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sidney H Kennedy
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital & Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Venkat Bhat
- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital & Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
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- Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, Canada
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13
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Qi Y, Ni S, Heng X, Qu S, Ge P, Zhao X, Yao Z, Guo R, Yang N, Zhang Q, Zhu H. Uncovering the Potential Mechanisms of Coptis chinensis Franch. for Serious Mental Illness by Network Pharmacology and Pharmacology-Based Analysis. Drug Des Devel Ther 2022; 16:325-342. [PMID: 35173416 PMCID: PMC8841750 DOI: 10.2147/dddt.s342028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/21/2022] [Indexed: 11/23/2022] Open
Abstract
Background Serious mental illness is a disease with complex etiological factors that requires multiple interventions within a holistic disease system. With heat-clearing and detoxifying effects, Coptis chinensis Franch. is mainly used to treat serious mental illness. Aim of the Study To explore the underlying mechanisms and therapeutic effect by which Coptis chinensis Franch. treats serious mental illnesses at a holistic level. Methods A viable network pharmacology approach was adopted to obtain the potential active ingredients of Coptis chinensis Franch., and serious mental illnesses-related targets and signaling pathways. The interactions between crucial target HTR2A and constituents were verified by molecular docking, and the dynamic behaviors of binding were studied by molecular dynamics simulation. In addition, the anti-anxiety effect of Rhizoma Coptidis (the roots of Coptis chinensis Franch.) extract on lipopolysaccharide-stimulated mice was verified. The anxiety-like behavior was measured through the elevated plus-maze test, light–dark box test, and open field test. Radioimmunoassays detected the levels of interleukin-1β, tumor necrosis factor-α, interleukin-10, interleukin-4, 5-hydroxytryptamine, and dopamine in the serum, hippocampus, medial prefrontal cortex, and amygdala. Meanwhile, immunohistochemistry protocols for the assessment of neuronal loss (neuron-specific nuclear protein) and synaptic alterations (Synapsin I) were performed in the hippocampus. Results Based on scientific analysis of the established networks, serious mental illnesses-related targets mostly participated in the calcium signaling pathway, cyclic adenosine monophosphate signaling pathway, mitogen-activated protein kinase signaling pathway, serotonergic and dopaminergic synapse. Molecular docking and molecular dynamics simulation studies illustrated that berberine, epiberberine, palmatine, and coptisine presented favorable binding patterns with HTR2A. The in vivo experiments confirmed that Rhizoma Coptidis extract ameliorated anxiety-like behaviors by improving the survival of neurons, regulating synaptic plasticity, and inhibiting neuroinflammation. Conclusion These findings in the present study led to potential preventative and therapeutic strategies for serious mental illnesses with traditional Chinese medicine.
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Affiliation(s)
- Yiyu Qi
- Department of Traditional Chinese Medicine Processing and Preparation, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China
| | - Saijia Ni
- Department of Pharmacology, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China
| | - Xia Heng
- Department of Traditional Chinese Medicine Processing and Preparation, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China
| | - Shuyue Qu
- Department of Traditional Chinese Medicine Processing and Preparation, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China
| | - Pingyuan Ge
- Department of Traditional Chinese Medicine Processing and Preparation, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China
| | - Xin Zhao
- Department of Traditional Chinese Medicine Processing and Preparation, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China
| | - Zengying Yao
- Department of Pharmacology, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China
| | - Rui Guo
- Department of Physiological, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China
| | - Nianyun Yang
- Department of Traditional Chinese Medicine Processing and Preparation, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China
| | - Qichun Zhang
- Department of Pharmacology, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China
- Correspondence: Qichun Zhang; Huaxu Zhu, Email ;
| | - Huaxu Zhu
- Department of Traditional Chinese Medicine Processing and Preparation, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People’s Republic of China
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14
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Sun CW, Wang YJ, Fang YQ, He YQ, Wang X, So BCL, Shum DHK, Yan C. The effect of physical activity on anhedonia in individuals with depressive symptoms. Psych J 2021; 11:214-226. [PMID: 34530499 DOI: 10.1002/pchj.485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/04/2021] [Accepted: 08/04/2021] [Indexed: 12/28/2022]
Abstract
The therapeutic effect of antidepressants has been demonstrated for anhedonia in patients with depression. However, antidepressants may cause side-effects, such as cardiovascular dysfunction. Although physical activity has minor side-effects, it may serve as an alternative for improving anhedonia and depression. We sought to investigate whether physical activity reduces the level of anhedonia in individuals with depression. Fifty-six university students with moderate depressive symptoms (Beck Depression Inventory total score > 16) were divided into three training groups: the Running Group (RG, n = 19), the Stretching Group (SG, n = 19), and the Control Group (n = 18). We employed the Monetary Incentive Delay (MID) task and the Temporal Experience of Pleasure Scale (TEPS) to evaluate hedonic capacity. All participants in the RG and SG received 8 weeks of jogging and stretching training, respectively. The RG experienced an increase in the level of arousal during anticipation of a future reward and recalled less negativity towards the loss condition. The SG exhibited enhanced scores on the Anticipatory and Consummatory Pleasure subscales of the TEPS after training. Moreover, in the RG, greater improvements in anticipatory arousal ratings for pleasure and remembered valence ratings for negative affect were associated with longer training duration, lower maximum heart rate, and higher consumed calories during training. To conclude, physical activity is effective in improving anticipatory anhedonia in individuals with depressive symptoms.
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Affiliation(s)
- Ching-Wen Sun
- Key Laboratory of Brain Functional Genomics (MOE&STCSM), Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China.,Shanghai Changning Mental Health Center, Shanghai, China
| | - Ya-Jing Wang
- Department of Psychology, Navy Medical University, Shanghai, China
| | - Yu-Qi Fang
- Key Laboratory of Brain Functional Genomics (MOE&STCSM), Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Yu-Qian He
- Key Laboratory of Brain Functional Genomics (MOE&STCSM), Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Xuan Wang
- Key Laboratory of Brain Functional Genomics (MOE&STCSM), Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Billy C L So
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - David H K Shum
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.,Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,School of Applied Psychology, Griffith University, Gold Coast, Queensland, Australia
| | - Chao Yan
- Key Laboratory of Brain Functional Genomics (MOE&STCSM), Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China.,Shanghai Changning Mental Health Center, Shanghai, China
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15
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Shi Y, Wang Q, Song R, Kong Y, Zhang Z. Non-coding RNAs in depression: Promising diagnostic and therapeutic biomarkers. EBioMedicine 2021; 71:103569. [PMID: 34521053 PMCID: PMC8441067 DOI: 10.1016/j.ebiom.2021.103569] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 08/04/2021] [Accepted: 08/18/2021] [Indexed: 01/18/2023] Open
Abstract
Non-coding RNAs (ncRNAs), including microRNAs, circular RNAs, and long non-coding RNAs, are important regulators of normal biological processes and their abnormal expression may be involved in the pathogenesis of human diseases including depression. Multiple studies have demonstrated a significantly increased or reduced ncRNAs expression in depressed patients compared with healthy subjects and that antidepressant therapy can alter the aberrant expression of ncRNAs in depressed patients. Although the existing evidence is important, it is also mixed and a comprehensive review to guide an effective clinical translation is lacking. Focused on human research, this review summarizes clinical findings of ncRNAs in depression, including those in brain tissues and peripheral samples. We outlined the characteristics and functions of ncRNAs and highlighted their performance in the diagnosis and treatment of depression. Although their precise roles in depression remain uncertain, ncRNAs have shown potential value as biomarkers for diagnosis and therapy in depressed patients.
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Affiliation(s)
- Yachen Shi
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Institution of Neuropsychiatry, Southeast University, No. 87 Dingjiaqiao Road, Nanjing, Jiangsu 210009, China
| | - Qingyun Wang
- College of Agricultural and Environmental Sciences, University of California, Davis, California 95616, United States
| | - Ruize Song
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Institution of Neuropsychiatry, Southeast University, No. 87 Dingjiaqiao Road, Nanjing, Jiangsu 210009, China
| | - Yan Kong
- Department of Biochemistry and Molecular Biology, School of Medicine, Southeast University, No. 87 Dingjiaqiao Road, Nanjing, Jiangsu 210009, China.
| | - Zhijun Zhang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Institution of Neuropsychiatry, Southeast University, No. 87 Dingjiaqiao Road, Nanjing, Jiangsu 210009, China; School of Life Science and Technology, Key Laboratory of Developmental Genes and Human Disease, Southeast University, Nanjing, Jiangsu 210096, China; Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, China; Research Center for Brain Health, Pazhou Lab, Guangzhou, Guangdong 510330, China.
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16
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Martin EL, Strickland JC, Schlienz NJ, Munson J, Jackson H, Bonn-Miller MO, Vandrey R. Antidepressant and Anxiolytic Effects of Medicinal Cannabis Use in an Observational Trial. Front Psychiatry 2021; 12:729800. [PMID: 34566726 PMCID: PMC8458732 DOI: 10.3389/fpsyt.2021.729800] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/16/2021] [Indexed: 01/04/2023] Open
Abstract
Background: Anxiety and depressive disorders are highly prevalent. Patients are increasingly using medicinal cannabis products to treat these disorders, but little is known about the effects of medicinal cannabis use on symptoms of anxiety and depression. The aim of the present observational study was to assess general health in medicinal cannabis users and non-using controls with anxiety and/or depression. Methods: Participants (368 Cannabis Users; 170 Controls) completed an online survey assessing anxiety and depressive symptoms, cannabis product use, sleep, quality of life, and comorbid chronic pain. Participants that completed this baseline survey were then invited to complete additional follow-up surveys at 3-month intervals. Baseline differences between Cannabis Users and Controls were assessed using independent-samples t-tests and generalized linear mixed effects models were used to assess the impact of initiating cannabis product use, sustained use, or discontinuation of use on anxiety and depressive symptoms at follow-up. Results: Medicinal cannabis use was associated with lower self-reported depression, but not anxiety, at baseline. Medicinal cannabis users also reported superior sleep, quality of life, and less pain on average. Initiation of medicinal cannabis during the follow-up period was associated with significantly decreased anxiety and depressive symptoms, an effect that was not observed in Controls that never initiated cannabis use. Conclusions: Medicinal cannabis use may reduce anxiety and depressive symptoms in clinically anxious and depressed populations. Future placebo-controlled studies are necessary to replicate these findings and to determine the route of administration, dose, and product formulation characteristics to optimize clinical outcomes.
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Affiliation(s)
- Erin L. Martin
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
| | - Justin C. Strickland
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Nicolas J. Schlienz
- Department of Psychology, University at Buffalo, Buffalo, NY, United States
- Realm of Caring Foundation, Colorado Springs, CO, United States
| | - Joel Munson
- Realm of Caring Foundation, Colorado Springs, CO, United States
| | - Heather Jackson
- Realm of Caring Foundation, Colorado Springs, CO, United States
| | | | - Ryan Vandrey
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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17
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Murphy SE, Capitão LP, Giles SLC, Cowen PJ, Stringaris A, Harmer CJ. The knowns and unknowns of SSRI treatment in young people with depression and anxiety: efficacy, predictors, and mechanisms of action. Lancet Psychiatry 2021; 8:824-835. [PMID: 34419187 DOI: 10.1016/s2215-0366(21)00154-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 03/15/2021] [Accepted: 04/01/2021] [Indexed: 01/12/2023]
Abstract
The use of SSRIs for the treatment of depression and anxiety in young people is increasing. However, the effects of SSRIs in adolescence, a time when there are substantial changes in neural, cognitive, and social functioning, are not well understood. Here, we review evidence from clinical trials about the benefits and risks of SSRIs in young people and consider their mechanisms of action, as shown through human experimental work and animal models. We emphasise key outstanding questions about the effects of SSRIs in youth, identified through gaps in the literature and in consultation with young people with lived experience. It is crucial to characterise the mechanisms underpinning risks and benefits of SSRIs in this age group to progress the field, and to narrow the chasm between the widespread use of SSRIs in youth and the science on which this use is based.
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Affiliation(s)
- Susannah E Murphy
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK; Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Liliana P Capitão
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK; Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Sophie L C Giles
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Philip J Cowen
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK; Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Argyris Stringaris
- Section of Clinical and Computational Psychiatry, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Catherine J Harmer
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK; Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.
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18
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Breedvelt JJF, Warren FC, Segal Z, Kuyken W, Bockting CL. Continuation of Antidepressants vs Sequential Psychological Interventions to Prevent Relapse in Depression: An Individual Participant Data Meta-analysis. JAMA Psychiatry 2021; 78:868-875. [PMID: 34009273 PMCID: PMC8135055 DOI: 10.1001/jamapsychiatry.2021.0823] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE Depression frequently recurs. To prevent relapse, antidepressant medication is often taken in the long term. Sequentially delivering a psychological intervention while undergoing tapering of antidepressant medication might be an alternative to long-term antidepressant use. However, evidence is lacking on which patients may benefit from tapering antidepressant medication while receiving a psychological intervention and which should continue the antidepressant therapy. A meta-analysis of individual patient data with more power and precision than individual randomized clinical trials or a standard meta-analysis is warranted. OBJECTIVES To compare the associations between use of a psychological intervention during and/or after antidepressant tapering vs antidepressant use alone on the risk of relapse of depression and estimate associations of individual clinical factors with relapse. DATA SOURCES PubMed, the Cochrane Library, Embase, and PsycInfo were last searched on January 23, 2021. Requests for individual participant data from included randomized clinical trials (RCTs) were sent. STUDY SELECTION Randomized clinical trials that compared use of a psychological intervention while tapering antidepressant medication with antidepressant monotherapy were included. Patients had to be in full or partial remission from depression. Two independent assessors conducted screening and study selection. DATA EXTRACTION AND SYNTHESIS Of 15 792 screened studies, 236 full-text articles were retrieved, and 4 RCTs that provided individual participant data were included. MAIN OUTCOMES AND MEASURES Time to relapse and relapse status over 15 months measured via a blinded assessor using a diagnostic clinical interview. RESULTS Individual data from 714 participants (mean [SD] age, 49.2 [11.5] years; 522 [73.1%] female) from 4 RCTs that compared preventive cognitive therapy or mindfulness-based cognitive therapy during and/or after antidepressant tapering vs antidepressant monotherapy were available. Two-stage random-effects meta-analysis found no significant difference in time to depressive relapse between use of a psychological intervention during tapering of antidepressant medication vs antidepressant therapy alone (hazard ratio [HR], 0.86; 95% CI, 0.60-1.23). Younger age at onset (HR, 0.98; 95% CI, 0.97-0.99), shorter duration of remission (HR, 0.99; 95% CI, 0.98-1.00), and higher levels of residual depressive symptoms at baseline (HR, 1.07; 95% CI, 1.04-1.10) were associated with a higher overall risk of relapse. None of the included moderators were associated with risk of relapse. CONCLUSIONS AND RELEVANCE The findings of this individual participant data meta-analysis suggest that regardless of the clinical factors included in these studies, the sequential delivery of a psychological intervention during and/or after tapering may be an effective relapse prevention strategy instead of long-term use of antidepressants. These results could be used to inform shared decision-making in clinical practice.
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Affiliation(s)
- Josefien J. F. Breedvelt
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Fiona C. Warren
- Institute of Health Research, College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Zindel Segal
- Department of Clinical Psychological Science, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Willem Kuyken
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Claudi L. Bockting
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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19
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Zhang L, Chen B, Yao Q, Chen W, Yang W, Yang W, He L, Zhang Y. Comparison between acupuncture and antidepressant therapy for the treatment of poststroke depression: Systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25950. [PMID: 34087835 PMCID: PMC8183854 DOI: 10.1097/md.0000000000025950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 02/04/2021] [Accepted: 04/27/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND In this paper, a systematic review and meta-analysis of published randomized controlled trials (RCTs) was conducted to compare the efficacies of acupuncture and antidepressant therapy for the treatment of poststroke depression (PSD). METHODS The research team searched RCTs published on PubMed; Medline; Cochrane library; Chinese National Knowledge Infrastructure (CNKI); Wanfang; Embase; Scopus, and Sinomed from their respective establishments to January 2019. We evaluated the Hamilton Depression Rating Scale (HAMD) scores, Treatment Emergent Symptom Scale (TESS) scores, National Institute of Health Stroke Scale (NIHSS) scores, and total clinical efficacy using fixed effects models. RESULTS Fourteen RCTs, representing a total of 1124 patients, were studied. Results showed that acupuncture was more effective in improving HAMD scores at 3 weeks after administration (mean difference [MD] = -1.17, 95%CI = -2.18 to -0.16), at 4 weeks (MD = -4.44, 95% CI = -5.64 to -3.23), at 6 weeks (MD = -1.02, 95% CI = -1.68 to -0.36), and at 8 weeks (MD = -4.33, 95% CI = -4.96 to -3.70). Similarly, acupuncture more dramatically decreased NIHSS scores (MD = -2.31, 95% CI = -2.53 to -2.09), and TESS scores (MD = -4.70, 95% CI = -4.93 to -4.48) than conventional Western medicinal therapy. Further, the total clinical efficacy in the acupuncture group was significantly higher than in the antidepressants group (risk ratio [RR] = 1.15, 95% CI = 1.08-1.21). CONCLUSIONS The results of this study suggest that acupuncture not only can reduce the severity of PSD, but also has significant effects on decreasing the appearance of other adverse events.
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Affiliation(s)
| | - Bing Chen
- College of Life Sciences, Zhejiang Chinese Medical University, Zhejiang
| | - Qigu Yao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University
| | - Weiyan Chen
- College of Basic medical, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | | | - Weiji Yang
- College of Life Sciences, Zhejiang Chinese Medical University, Zhejiang
| | - Lan He
- Second Clinical Medical College
| | - Yuyan Zhang
- College of Life Sciences, Zhejiang Chinese Medical University, Zhejiang
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20
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Rezaei M, Shariat Bagheri MM, Ahmadi M. Clinical and demographic predictors of response to anodal tDCS treatment in major depression disorder (MDD). J Psychiatr Res 2021; 138:68-74. [PMID: 33831679 DOI: 10.1016/j.jpsychires.2021.03.047] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/17/2021] [Accepted: 03/24/2021] [Indexed: 11/18/2022]
Abstract
Transcranial direct current stimulation (tDCS) of the prefrontal cortex is known as a promising intervention in major depression disorder (MDD). However, limited information on predictors of therapeutic response to tDCS are available. This study aimed to investigate clinical and demographic predictors of therapeutic response in patients taking no medications. For this purpose, the required data were collected from 2 independent tDCS trials on 116 MDD patients. Accordingly, 84 patients underwent 10 sessions of 2 mA tDCS daily each one lasted for 20 min and 32 patients received 10 twice sessions of 2 mA tDCS daily each one lasted for 20 min. Anodal electrode was located over the left dorsolateral prefrontal cortex (DLPFC), and cathode was over the right supraorbital region. Depression symptoms and the underlying clinical dimensions were assessed using the Beck Depression Inventory (BDI-II) at baseline and after the tDCS treatment. Of the included 116 patients, 47.4% showed an antidepressant response. Results of logistic regression analysis showed that the reduction in BDI-II scores after tDCS was associated with the baseline values of cognitive-affective symptoms factor, loss of pleasure, loss of interest, and sleep problems. Pronounced sleep disturbances and cognitive-affective symptoms were identified as the potential clinical predictors of response to tDCS. However, more prospective tDCS studies are necessary to validate the predictive value of the derived model.
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Affiliation(s)
- Mehdi Rezaei
- Department of Psychology, Shahryar Branch, Islamic Azad University, Shahryar, Iran.
| | | | - Mehdi Ahmadi
- Department of Clinical Psychology, Shahed University, Tehran, Iran
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21
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Jalali A, Firouzabadi N, Zarshenas MM. Pharmacogenetic-based management of depression: Role of traditional Persian medicine. Phytother Res 2021; 35:5031-5052. [PMID: 34041799 DOI: 10.1002/ptr.7134] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/26/2021] [Accepted: 04/10/2021] [Indexed: 12/11/2022]
Abstract
Depression is one of the most common mental disorders worldwide. The genetic factors are linked to depression and anti-depressant outcomes. Traditional Persian medicine (TPM) manuscripts have provided various anti-depressant remedies, which may be useful in depression management. This review has studied the bioactive compounds, underlying mechanisms, and treatment outcomes of the medicinal plants traditionally mentioned effective for depression from "The storehouse of medicament" (a famous pharmacopeia of TPM) to merge those with the novel genetics science and serve new scope in depression prevention and management. This review paper has been conducted in two sections: (1) Collecting medicinal plants and their bioactive components from "The storehouse of medicament," "Physician's Desk Reference (PDR) for Herbal Medicines," and "Google scholar" database. (2) The critical key factors and genes in depression pathophysiology, prevention, and treatment were clarified. Subsequently, the association between bioactive components' underlying mechanism and depression treatment outcomes via considering polymorphisms in related genes was derived. Taken together, α-Mangostin, β-carotene, β-pinene, apigenin, caffeic acid, catechin, chlorogenic acid, citral, ellagic acid, esculetin, ferulic acid, gallic acid, gentiopicroside, hyperoside, kaempferol, limonene, linalool, lycopene, naringin, protocatechuic acid, quercetin, resveratrol, rosmarinic acid, and umbelliferone are suitable for future pharmacogenetics-based studies in the management of depression.
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Affiliation(s)
- Atefeh Jalali
- Medicinal Plants Processing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Negar Firouzabadi
- Department of Pharmacology & Toxicology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad M Zarshenas
- Medicinal Plants Processing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.,Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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22
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Griffiths C, Walker K, Reid I, da Silva KM, O'Neill-Kerr A. A qualitative study of patients' experience of ketamine treatment for depression: The ‘Ketamine and me’ project. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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23
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Alemi F, Aljuaid M, Durbha N, Yousefi M, Min H, Sylvia LG, Nierenberg AA. A surrogate measure for patient reported symptom remission in administrative data. BMC Psychiatry 2021; 21:121. [PMID: 33663440 PMCID: PMC7931356 DOI: 10.1186/s12888-021-03133-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 02/16/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND In real-world pragmatic administrative databases, patient reported remission is often missing. OBJECTIVE We evaluate if, in administrative data, five features of antidepressant use patterns can replace patient-reported symptom remission. METHOD We re-examined data from Sequence Treatment Alternatives to Relieve Depression (STAR*D) study. Remission was measured using 50% reduction in Hamilton index. Pattern of antidepressant use was examined through five variables: (a) number of prior ineffective antidepressants, (b) duration of taking current antidepressant, (c) receiving therapeutic dose of the medication, and (d) switching to another medication, or (e) augmenting with another antidepressant. The likelihood ratio (LR) associated with each of these predictors was assessed in 90% of data (3329 cases) and evaluated in 10% of data (350 cases) set-aside for evaluation. The accuracy of predictions was calculated using Area under the Receiver Operating Curve (AROC). RESULTS Patients who took antidepressants for 14 weeks (LR = 2.007) were more likely to have symptom remission. Prior use of 3 antidepressants reduced the odds of remission (LR = 0.771). Patients who received antidepressants below therapeutic dose were 5 times less likely to experience remission (LR = 0.204). Antidepressant that were augment or switched, almost never led to remission (LR = 0.008, LR = 0.002 respectively). Patterns of antidepressant use accurately (AROC = 0.93) predicted symptom remission. CONCLUSION Within the first 100 days, antidepressants use patterns could serve as a surrogate measure for patient-reported remission of symptoms.
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Affiliation(s)
- Farrokh Alemi
- Dept. of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, USA.
| | - Mai Aljuaid
- grid.22448.380000 0004 1936 8032Dept. of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, USA
| | - Naren Durbha
- grid.22448.380000 0004 1936 8032Dept. of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, USA
| | - Melanie Yousefi
- grid.22448.380000 0004 1936 8032School of Nursing, College of Health and Human Services, George Mason University, Fairfax, USA
| | - Hua Min
- grid.22448.380000 0004 1936 8032Dept. of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, USA
| | - Louisa G. Sylvia
- grid.32224.350000 0004 0386 9924Dauten Family Center for Bipolar Treatment Innovation, Department of Psychiatry, Massachusetts General Hospital, Boston, MA USA ,grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA
| | - Andrew A. Nierenberg
- grid.32224.350000 0004 0386 9924Dauten Family Center for Bipolar Treatment Innovation, Department of Psychiatry, Massachusetts General Hospital, Boston, MA USA ,grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA
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24
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Chen X, Ma Y, Mou X, Liu H, Ming H, Chen Y, Liu Y, Liu S. Synergistic Effect of Several Neurotransmitters in PFC-NAc-VTA Neural Circuit for the Anti-Depression Effect of Shuganheweitang in a Chronic Unpredictable Mild Stress Model. Nat Prod Commun 2021. [DOI: 10.1177/1934578x211002415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Depression, a major worldwide mental disorder, leads to massive disability and can result in death. The PFC-NAc-VTA neuro circuit is related to emotional, neurovegetative, and cognitive functions, which emerge as a circuit-level framework for understanding reward deficits in depression. Neurotransmitters, which are widely distributed in different brain regions, are important detected targets for the evaluation of depression. Shuganheweitang (SGHWT) is a popular prescription in clinical therapy for depression. In order to investigate its possible pharmacodynamics and anti-depressive mechanism, the complex plant material was separated into different fractions. These in low and high doses, along with low and high doses of SGHWT were tested in animal behavior tests. The low and high doses of SGHWT were more effective than the various fractions, which indicate the importance of synergistic function in traditional Chinese medicine. Furthermore, amino acid (GABA, Glu) and monoamine neurotransmitters (DA, 5-HT, NA, 5-HIAA) in the PFC-NAc-VTA neuro circuit were investigated by UPLC-MS/MS. The level trend of DA and 5-HT were consistent in the PFC-NAc-VTA neuro circuit, whereas 5-HIAA was decreased in the PFC, Glu was decreased in the PFC and VTA, and NA and GABA were decreased in the NAc. The results indicate that the pathogenesis of depression is associated with dysfunction of the PFC-NAc-VTA neural circuit, mainly through the neural projection effects of neurotransmitters associated with various brain regions in the neural circuit. PCA and OPLS-DA score plots demonstrated the similarities of individuals within each group and the differences among the groups. In this study, SGHWT could regulate the concentration level of different neurotransmitters in the PFC-NAc-VTA neuro circuit to improve the depression, which benefitted from the recognition of the brain reward circuitry in mood disorders.
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Affiliation(s)
- Xin Chen
- Key Laboratory of Hubei Province Resource and Chemistry of Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, P. R. China
| | - Yuanchun Ma
- Hubei University of Chinese Medicine, Wuhan, P. R. China
- Dr Ma’s Laboratories Inc., VancouverBC, Canada
| | - Xiongjun Mou
- Key Laboratory of Hubei Province Resource and Chemistry of Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, P. R. China
| | - Hao Liu
- Clinical College of Chinese Medicine, Hubei University of Chinese Medicine, Wuhan P. R. China
| | - Hao Ming
- Clinical College of Chinese Medicine, Hubei University of Chinese Medicine, Wuhan P. R. China
| | - Yu Chen
- Clinical College of Chinese Medicine, Hubei University of Chinese Medicine, Wuhan P. R. China
| | - Yanwen Liu
- Key Laboratory of Hubei Province Resource and Chemistry of Chinese Medicine, Hubei University of Chinese Medicine, Wuhan, P. R. China
| | - Songlin Liu
- Clinical College of Chinese Medicine, Hubei University of Chinese Medicine, Wuhan P. R. China
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25
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Malik S, Singh R, Arora G, Dangol A, Goyal S. Biomarkers of Major Depressive Disorder: Knowing is Half the Battle. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2021; 19:12-25. [PMID: 33508785 PMCID: PMC7851463 DOI: 10.9758/cpn.2021.19.1.12] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 07/02/2020] [Accepted: 09/15/2020] [Indexed: 12/18/2022]
Abstract
Major depressive disorder (MDD) is a heterogeneous disease which is why there are currently no specific methods to accurately test the severity, endophenotype or therapy response. This lack of progress is partly attributed to the com-plexity and variability of depression, in association with analytical variability of clinical literature and the wide number of theoretically complex biomarkers. The literature accessible, indicates that markers involved in inflammatory, neuro-trophic and metabolic processes and components of neurotransmitters and neuroendocrine systems are rather strong indicators to be considered clinically and can be measured through genetic and epigenetic, transcriptomic and proteomic, metabolomics and neuroimaging assessments. Promising biologic systems/markers found were i.e., growth biomarkers, endocrine markers, oxidant stress markers, proteomic and chronic inflammatory markers, are discussed in this review. Several lines of evidence suggest that a portion of MDD is a dopamine agonist-responsive subtype. This review analyzes concise reports on the pathophysiological biomarkers of MDD and therapeutic reactions via peripheral developmental factors, inflammative cytokines, endocrine factors and metabolic markers. Various literatures also support that endocrine and metabolism changes are associated with MDD. Accumulating evidence suggests that at least a portion of MDD patients show characteristics pathological changes regarding different clinical pathological biomarkers. By this review we sum up all the different biomarkers playing an important role in the detection or treatment of the different patients suffering from MDD. The review also gives an overview of different biomarker's playing a potential role in modulating effect of MDD.
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Affiliation(s)
- Sahil Malik
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India
| | - Ravinder Singh
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India
| | - Govind Arora
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India
| | - Akriti Dangol
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India
| | - Sanjay Goyal
- Department of Internal Medicine, Government Medical College, Patiala, India
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26
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Shanok NA, Meltzer K, Frank C, Lugo V, Jones NA. Computerized inhibitory control training reduces anxiety in preadolescent students. APPLIED NEUROPSYCHOLOGY-CHILD 2021; 11:455-470. [PMID: 33605177 DOI: 10.1080/21622965.2021.1884984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The study examined the relationship between anxiety, inhibitory control (IC), and resting-state electroencephalography (EEG) in a critical age-range for social and emotional development (8-12-year-olds). The participants were assigned to 4 weeks of either an emotional IC training program, a neutral IC training program, or a waitlisted control, and were tested using cognitive, emotional, and EEG measures. The training was computerized and completed remotely. At baseline, IC accuracy scores were negatively related to both anxiety and depression levels (N = 42). Additionally, increased right lateral frontal alpha asymmetry was predictive of increased anxiety/depression scores. A series of multivariate analyses of covariance and post-hoc tests were conducted to compare effects in the participants that completed the full 16 sessions of training (N = 32). Overall the emotional and neutral training conditions showed similar improvements in IC accuracy, as well as reductions in anxiety compared to the waitlist condition. Minimal neurophysiological changes occurred from pre-to-post; however, lateral frontal asymmetry shifted leftward in the emotional training group. These findings highlight the potential of computerized IC training for mitigating negative emotional functioning in preadolescents. Future research is necessary to determine the long-term effects of IC training and whether longer training intervals facilitate persisting impacts.
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Affiliation(s)
- Nathaniel A Shanok
- Behavioral Sciences Department, Florida Atlantic University, Boca Raton, Florida, USA
| | - Kelsey Meltzer
- Behavioral Sciences Department, Florida Atlantic University, Boca Raton, Florida, USA
| | - Colin Frank
- Behavioral Sciences Department, Florida Atlantic University, Boca Raton, Florida, USA
| | - Victoria Lugo
- Behavioral Sciences Department, Florida Atlantic University, Boca Raton, Florida, USA
| | - Nancy Aaron Jones
- Behavioral Sciences Department, Florida Atlantic University, Boca Raton, Florida, USA
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Larijani B, Parhizkar Roudsari P, Hadavandkhani M, Alavi-Moghadam S, Rezaei-Tavirani M, Goodarzi P, Sayahpour FA, Mohamadi-Jahani F, Arjmand B. Stem cell-based models and therapies: a key approach into schizophrenia treatment. Cell Tissue Bank 2021; 22:207-223. [PMID: 33387152 DOI: 10.1007/s10561-020-09888-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/04/2020] [Indexed: 12/26/2022]
Abstract
Psychiatric disorders such as schizophrenia can generate distress and disability along with heavy costs on individuals and health care systems. Different genetic and environmental factors play a pivotal role in the appearance of the mentioned disorders. Since the conventional treatment options for psychiatric disorders are suboptimal, investigators are trying to find novel strategies. Herein, stem cell therapies have been recommended as novel choices. In this context, the preclinical examination of stem cell-based therapies specifically using appropriate models can facilitate passing strong filters and serious examination to ensure proper quality and safety of them as a novel treatment approach. Animal models cannot be adequately helpful to follow pathophysiological features. Nowadays, stem cell-based models, particularly induced pluripotent stem cells reflected as suitable alternative models in this field. Accordingly, the importance of stem cell-based models, especially to experiment with the regenerative medicine outcomes for schizophrenia as one of the severe typing of psychiatric disorders, is addressed here.
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Affiliation(s)
- Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Peyvand Parhizkar Roudsari
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdieh Hadavandkhani
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepideh Alavi-Moghadam
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Parisa Goodarzi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Forough Azam Sayahpour
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Fereshteh Mohamadi-Jahani
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Arjmand
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. .,Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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28
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Al Zaabi MSR, Sridhar SB, Tadross TM. Assessment of incidence, causality, severity, and preventability of suspected adverse drug reactions to antidepressant medications in a psychiatry outpatient setting of a secondary care hospital. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2020; 12:131-138. [PMID: 32742111 PMCID: PMC7373102 DOI: 10.4103/jpbs.jpbs_196_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/15/2019] [Accepted: 01/05/2020] [Indexed: 11/09/2022] Open
Abstract
Background: Antidepressant medications are primarily used in the management of depression and various anxiety disorders. Antidepressant medications are known to cause adverse drug reactions (ADRs). Reporting ADRs can help in the rational use of medication and better patient drug management. Objective: The aim of this study was to monitor the incidence and nature of ADRs to antidepressant medications in a psychiatric outpatient setting of a secondary care hospital of the UAE. Materials and Methods: It was a cross-sectional study conducted in the psychiatric outpatient setting of a secondary care hospital. Patients attending psychiatry outpatient department and prescribed with antidepressant medications were included. All clinical side effects or ADRs noted by physician and reported by patients were documented and assessed according to causality, severity, and preventability scales. Results: A total of 131 patients were screened for the presence or occurrence of ADRs. During the study duration, an aggregate of 29 patients reported at least one ADR. Incidence of suspected ADR to antidepressant medications was found to be 22.1%. Most commonly documented suspected ADR was found to be weight gain in eight (18.1%) patients followed by somnolence in four (9.1%) patients. Escitalopram was the most common drug implicated with ADR in 13 (29.6%) patients followed by fluoxetine in 6 (13.6%) patients. According to World Health Organization-The Uppsala Monitoring Centre causality assessment, the predominance of the suspected ADRs was of “possible” type in 27 (61%) patients, and “mild” in severity in 40 (91%) patients, and “not preventable” in 37 (84%) patients. A statistically significant association (P = 0.019) was observed only between the presence of drug-interaction and the occurrence of ADR (relative risk: 0.429, confidence interval: 0.211–0.872). Conclusion: Most of the suspected ADRs related to antidepressants were “mild,” “predictable,” and “not preventable” in nature. Continuous monitoring may help in identifying, reducing, and preventing the risk of ADRs.
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Affiliation(s)
- Moza Salem Rashed Al Zaabi
- Department of Clinical Pharmacy and Pharmacology, RAK College of Pharmaceutical Sciences (RAKCOPS), RAK Medical & Health Sciences University (RAKMHSU), Ras Al Khaimah, UAE
| | - Sathvik B Sridhar
- Department of Clinical Pharmacy and Pharmacology, RAK College of Pharmaceutical Sciences (RAKCOPS), RAK Medical & Health Sciences University (RAKMHSU), Ras Al Khaimah, UAE
| | - Talaat Matar Tadross
- Department of Psychiatry, Ibrahim Bin Hamad Obaidallah Hospital, Ras Al Khaimah, UAE
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29
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Greenberg T, Fournier J, Stiffler R, Chase HW, Almeida JR, Aslam H, Deckersbach T, Cooper C, Toups M, Carmody T, Kurian B, Peltier S, Adams P, McInnis MG, Oquendo MA, Fava M, Parsey R, McGrath PJ, Weissman M, Trivedi M, Phillips ML. Reward related ventral striatal activity and differential response to sertraline versus placebo in depressed individuals. Mol Psychiatry 2020; 25:1526-1536. [PMID: 31462766 PMCID: PMC7047617 DOI: 10.1038/s41380-019-0490-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 04/16/2019] [Accepted: 05/31/2019] [Indexed: 12/22/2022]
Abstract
Medications to treat major depressive disorder (MDD) are not equally effective across patients. Given that neural response to rewards is altered in MDD and given that reward-related circuitry is modulated by dopamine and serotonin, we examined, for the first time, whether reward-related neural activity moderated response to sertraline, an antidepressant medication that targets these neurotransmitters. A total of 222 unmedicated adults with MDD randomized to receive sertraline (n = 110) or placebo (n = 112) in the Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study completed demographic and clinical assessments, and pretreatment functional magnetic resonance imaging while performing a reward task. We tested whether an index of reward system function in the ventral striatum (VS), a key reward circuitry region, moderated differential response to sertraline versus placebo, assessed with the Hamilton Rating Scale for Depression (HSRD) over 8 weeks. We observed a significant moderation effect of the reward index, reflecting the temporal dynamics of VS activity, on week-8 depression levels (Fs ≥ 9.67, ps ≤ 0.002). Specifically, VS responses that were abnormal with respect to predictions from reinforcement learning theory were associated with lower week-8 depression symptoms in the sertraline versus placebo arms. Thus, a more abnormal pattern of pretreatment VS dynamic response to reward expectancy (expected outcome value) and prediction error (difference between expected and actual outcome), likely reflecting serotonergic and dopaminergic deficits, was associated with better response to sertraline than placebo. Pretreatment measures of reward-related VS activity may serve as objective neural markers to advance efforts to personalize interventions by guiding individual-level choice of antidepressant treatment.
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Affiliation(s)
- Tsafrir Greenberg
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Jay Fournier
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Richelle Stiffler
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Henry W. Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Jorge R. Almeida
- Department of Psychiatry, University of Texas at Austin Dell Medical School
| | - Haris Aslam
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | | | - Crystal Cooper
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | - Marisa Toups
- Department of Psychiatry, University of Texas at Austin Dell Medical School
| | - Tom Carmody
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | - Benji Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | | | - Phillip Adams
- Department of Psychiatry, Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute
| | | | - Maria A. Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital
| | - Ramin Parsey
- Departments of Psychiatry and Behavioral Science & Radiology, Stony Brook University
| | - Patrick J. McGrath
- Department of Psychiatry, Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute
| | - Myrna Weissman
- Department of Psychiatry, Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute
| | - Madhukar Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center
| | - Mary L. Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine
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30
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Vaghef-Mehrabany E, Maleki V, Behrooz M, Ranjbar F, Ebrahimi-Mameghani M. Can psychobiotics “mood” ify gut? An update systematic review of randomized controlled trials in healthy and clinical subjects, on anti-depressant effects of probiotics, prebiotics, and synbiotics. Clin Nutr 2020; 39:1395-1410. [DOI: 10.1016/j.clnu.2019.06.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 05/30/2019] [Accepted: 06/07/2019] [Indexed: 02/07/2023]
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31
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Mavranezouli I, Megnin-Viggars O, Grey N, Bhutani G, Leach J, Daly C, Dias S, Welton NJ, Katona C, El-Leithy S, Greenberg N, Stockton S, Pilling S. Cost-effectiveness of psychological treatments for post-traumatic stress disorder in adults. PLoS One 2020; 15:e0232245. [PMID: 32353011 PMCID: PMC7192458 DOI: 10.1371/journal.pone.0232245] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 04/10/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is a severe and disabling condition that may lead to functional impairment and reduced productivity. Psychological interventions have been shown to be effective in its management. The objective of this study was to assess the cost-effectiveness of a range of interventions for adults with PTSD. METHODS A decision-analytic model was constructed to compare costs and quality-adjusted life-years (QALYs) of 10 interventions and no treatment for adults with PTSD, from the perspective of the National Health Service and personal social services in England. Effectiveness data were derived from a systematic review and network meta-analysis. Other model input parameters were based on published sources, supplemented by expert opinion. RESULTS Eye movement desensitisation and reprocessing (EMDR) appeared to be the most cost-effective intervention for adults with PTSD (with a probability of 0.34 amongst the 11 evaluated options at a cost-effectiveness threshold of £20,000/QALY), followed by combined somatic/cognitive therapies, self-help with support, psychoeducation, selective serotonin reuptake inhibitors (SSRIs), trauma-focused cognitive behavioural therapy (TF-CBT), self-help without support, non-TF-CBT and combined TF-CBT/SSRIs. Counselling appeared to be less cost-effective than no treatment. TF-CBT had the largest evidence base. CONCLUSIONS A number of interventions appear to be cost-effective for the management of PTSD in adults. EMDR appears to be the most cost-effective amongst them. TF-CBT has the largest evidence base. There remains a need for well-conducted studies that examine the long-term clinical and cost-effectiveness of a range of treatments for adults with PTSD.
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Affiliation(s)
- Ifigeneia Mavranezouli
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational & Health Psychology, University College London, London, United Kingdom
- National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, London, United Kingdom
| | - Odette Megnin-Viggars
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational & Health Psychology, University College London, London, United Kingdom
- National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, London, United Kingdom
| | - Nick Grey
- Sussex Partnership NHS Foundation Trust, Hove, United Kingdom
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Gita Bhutani
- Lancashire & South Cumbria NHS Foundation Trust, Preston, United Kingdom
- University of Liverpool, Liverpool, United Kingdom
| | | | - Caitlin Daly
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Sofia Dias
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Nicky J. Welton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Cornelius Katona
- Helen Bamber Foundation, London, United Kingdom
- Division of Psychiatry, University College London, London, United Kingdom
| | - Sharif El-Leithy
- Traumatic Stress Service, Springfield Hospital, London, United Kingdom
| | - Neil Greenberg
- King’s Centre for Military Health Research, King’s College London, London, United Kingdom
| | - Sarah Stockton
- National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, London, United Kingdom
| | - Stephen Pilling
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational & Health Psychology, University College London, London, United Kingdom
- National Guideline Alliance, Royal College of Obstetricians and Gynaecologists, London, United Kingdom
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, London, United Kingdom
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32
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Abstract
Major depressive disorder (MDD) is a serious public health problem that has, at best, modest treatment response—potentially due to its heterogeneous clinical presentation. One way to parse the heterogeneity is to investigate the role of particular features of MDD, an endeavor that can also help identify novel and focal targets for treatment and prevention efforts. Our R01 focuses on the feature of psychomotor disturbance (e.g., psychomotor agitation (PmA) and retardation (PmR)), a particularly pernicious feature of MDD, that has not been examined extensively in MDD. Aim 1 is comparing three groups of individuals—those with current MDD (n = 100), remitted MDD (n = 100), and controls (n = 50)—on multiple measures of PmR and PmA (assessed both in the lab and in the subjects’ natural environment). Aim 2 is examining the structural (diffusion MRI) and functional (resting state fMRI) connectivity of motor circuitry of the three groups as well as the relation between motor circuitry and the proposed indicators of PmR and PmA. Aim 3 is following up with subjects three times over 18 months to evaluate whether motor symptoms change in tandem with overall depressive symptoms and functioning over time and/or whether baseline PmR/PmA predicts course of depression and functioning. Aim 3 is particularly clinically significant. Finding that motor functioning and overall depression severity co-vary over time, or that motor variables predict subsequent change in overall depression severity, would support the potential clinical utility of these novel, reliable, and easily administered motor assessments.
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Grubor M, Zivkovic M, Sagud M, Nikolac Perkovic M, Mihaljevic-Peles A, Pivac N, Muck-Seler D, Svob Strac D. HTR1A, HTR1B, HTR2A, HTR2C and HTR6 Gene Polymorphisms and Extrapyramidal Side Effects in Haloperidol-Treated Patients with Schizophrenia. Int J Mol Sci 2020; 21:ijms21072345. [PMID: 32231051 PMCID: PMC7178229 DOI: 10.3390/ijms21072345] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/20/2020] [Accepted: 03/27/2020] [Indexed: 12/14/2022] Open
Abstract
Schizophrenia is a serious, chronic psychiatric disorder requiring lifelong treatment. Extrapyramidal side effects (EPS) are common adverse reactions to antipsychotic medications. In addition to the dopaminergic system, serotonergic mechanisms, including serotonin (5-HT) receptors, might be involved in EPS development. This study aimed to examine molecular associations of HTR1A, HTR1B, HTR2A, HTR2C and HTR6 gene polymorphisms with acute EPS in 229 male schizophrenia patients, following two weeks of haloperidol monotherapy. The Simpson-Angus Rating Scale for Extrapyramidal Side Effects (SAS), Barnes Akathisia Rating Scale (BARS) and Extrapyramidal Symptom Rating Scale (ESRS) were used to evaluate EPS severity. Genotyping was performed using real-time PCR, following extraction of blood DNA. Significant acute EPS appeared in 48.03% of schizophrenia patients. For the rs13212041 HTR1B gene polymorphism, affecting microRNA regulation of HTR1B gene expression, a higher frequency of TT carriers was found among haloperidol-treated patients with akathisia when compared to the group without akathisia symptoms. In comparison to C-allele carriers, patients carrying the TT genotype had higher akathisia severity, as determined by the SAS, BARS and ESRS scales. These molecular findings suggest potential involvement of 5-HT1B receptors in akathisia development following haloperidol treatment, as well as possible epigenetic mechanisms of serotonergic modulation associated with antipsychotic-induced EPS.
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MESH Headings
- Adult
- Antipsychotic Agents/adverse effects
- Antipsychotic Agents/therapeutic use
- Haloperidol/adverse effects
- Haloperidol/therapeutic use
- Humans
- Male
- Middle Aged
- Polymorphism, Genetic
- Receptor, Serotonin, 5-HT1A/genetics
- Receptor, Serotonin, 5-HT1B/genetics
- Receptor, Serotonin, 5-HT2A/genetics
- Receptor, Serotonin, 5-HT2C/genetics
- Receptors, Serotonin/genetics
- Schizophrenia/drug therapy
- Schizophrenia/genetics
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Affiliation(s)
- Mirko Grubor
- Faculty of Pharmacy and Biochemistry, University of Zagreb, 10 000 Zagreb, Croatia;
| | - Maja Zivkovic
- Department of Psychiatry, University Hospital Centre Zagreb, 10 000 Zagreb, Croatia; (M.Z.); (M.S.); (A.M.-P.)
| | - Marina Sagud
- Department of Psychiatry, University Hospital Centre Zagreb, 10 000 Zagreb, Croatia; (M.Z.); (M.S.); (A.M.-P.)
- School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia
| | - Matea Nikolac Perkovic
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Rudjer Boskovic Institute, 10 000 Zagreb, Croatia; (M.N.P.); (N.P.); (D.M.-S.)
| | - Alma Mihaljevic-Peles
- Department of Psychiatry, University Hospital Centre Zagreb, 10 000 Zagreb, Croatia; (M.Z.); (M.S.); (A.M.-P.)
- School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia
| | - Nela Pivac
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Rudjer Boskovic Institute, 10 000 Zagreb, Croatia; (M.N.P.); (N.P.); (D.M.-S.)
| | - Dorotea Muck-Seler
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Rudjer Boskovic Institute, 10 000 Zagreb, Croatia; (M.N.P.); (N.P.); (D.M.-S.)
| | - Dubravka Svob Strac
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Rudjer Boskovic Institute, 10 000 Zagreb, Croatia; (M.N.P.); (N.P.); (D.M.-S.)
- Correspondence: ; Tel.: +385-1-457-1207
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Kandola A, Ashdown-Franks G, Hendrikse J, Sabiston CM, Stubbs B. Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity. Neurosci Biobehav Rev 2019; 107:525-539. [PMID: 31586447 DOI: 10.1016/j.neubiorev.2019.09.040] [Citation(s) in RCA: 477] [Impact Index Per Article: 95.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/27/2019] [Accepted: 09/29/2019] [Indexed: 12/13/2022]
Abstract
Physical activity can treat and prevent depressive symptoms, but its antidepressant mechanisms are yet to be established. In this review, we comprehensively assess key biological and psychosocial mechanisms through which physical activity exerts antidepressant effects, with a particular focus on exercise. Exercise, a subset of physical activity, influences a range of biological and psychosocial processes also implicated in the pathophysiology of depression. We focus on the capacity for exercise to elicit changes in neuroplasticity, inflammation, oxidative stress, the endocrine system, self-esteem, social support and self-efficacy. We also discuss how a better understanding of these mechanisms can inform the way we design and implement exercise-based interventions to maximise their antidepressant effects on an individual basis. We conclude by presenting a conceptual framework of the key biological and psychosocial mechanisms underlying the relationship between physical activity and depressive symptoms, and the moderators and confounders that may influence it.
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Affiliation(s)
- Aaron Kandola
- Division of Psychiatry, University College London, London, UK.
| | - Garcia Ashdown-Franks
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; Department of Exercise Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Joshua Hendrikse
- Brain, Mind and Society Research Hub, School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | | | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; Physiotherapy Department, South London and Maudsley National Health Services Foundation Trust, London, UK
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A Retrospective Examination of Symptom Improvements in Primary Care Patients Receiving Behavior Therapy With and Without Concurrent Pharmacotherapy. J Clin Psychol Med Settings 2019; 27:582-592. [DOI: 10.1007/s10880-019-09642-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Lesnewich LM, Conway FN, Buckman JF, Brush CJ, Ehmann PJ, Eddie D, Olson RL, Alderman BL, Bates ME. Associations of depression severity with heart rate and heart rate variability in young adults across normative and clinical populations. Int J Psychophysiol 2019; 142:57-65. [PMID: 31195066 DOI: 10.1016/j.ijpsycho.2019.06.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 06/05/2019] [Accepted: 06/07/2019] [Indexed: 12/19/2022]
Abstract
Limitations of current depression treatments may arise from a lack of knowledge about unique psychophysiological processes that contribute to depression across the full range of presentations. This study examined how individual variations in heart rate (HR) and heart rate variability (HRV) are related to depressive symptoms across normative and clinical populations in 152 young adults (aged 18-35 years). Moderating effects of sex and antidepressant medication status were considered. Electrocardiogram data were collected during "vanilla" baseline and in response to positive and negative emotional cues. Linear regressions and repeated-measures mixed models were used to assess the relationships between Beck Depression Inventory-II (BDI-II) scores, sex, antidepressant use, and cardiovascular outcomes. Baseline models yielded significant main effects of BDI-II and sex on HR and significant interactions between antidepressant medication status and BDI-II on HRV outcomes. The main effects of BDI-II and sex on HR were no longer significant after controlling for cardiorespiratory fitness. Participants who denied current antidepressant use (n = 137) exhibited a negative association and participants who endorsed current antidepressant (n = 15) use exhibited a positive association between BDI-II scores and HRV. Emotional reactivity models were largely non-significant with the exception of a significant main effect of antidepressant medication status on high-frequency HRV reactivity. Results indicated antidepressant medication use may moderate the relationship between depression severity and cardiovascular functioning, but this requires replication given the modest proportion of medicated individuals in this study. Overall, findings suggest cardiovascular processes and cardiorespiratory fitness are linked to depression symptomatology and may be important to consider in depression treatment.
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Affiliation(s)
- Laura M Lesnewich
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, 607 Allison Road, Piscataway, NJ 08854, USA.
| | - Fiona N Conway
- Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto Boulevard, Austin, TX 78712, USA.
| | - Jennifer F Buckman
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, 607 Allison Road, Piscataway, NJ 08854, USA; Department of Kinesiology and Health, Rutgers, The State University of New Jersey, 70 Lipman Drive, New Brunswick, NJ 08901, USA.
| | - Christopher J Brush
- Department of Kinesiology and Health, Rutgers, The State University of New Jersey, 70 Lipman Drive, New Brunswick, NJ 08901, USA.
| | - Peter J Ehmann
- Department of Kinesiology and Health, Rutgers, The State University of New Jersey, 70 Lipman Drive, New Brunswick, NJ 08901, USA.
| | - David Eddie
- Recovery Research Institute, Center for Addiction Medicine, Massachusetts General Hospital, Harvard Medical School, 151 Merrimac Street, Boston, MA 02114, USA.
| | - Ryan L Olson
- Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, 1921 Chestnut Street, Denton, TX 76203, USA.
| | - Brandon L Alderman
- Department of Kinesiology and Health, Rutgers, The State University of New Jersey, 70 Lipman Drive, New Brunswick, NJ 08901, USA.
| | - Marsha E Bates
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, 607 Allison Road, Piscataway, NJ 08854, USA; Department of Kinesiology and Health, Rutgers, The State University of New Jersey, 70 Lipman Drive, New Brunswick, NJ 08901, USA.
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In Vitro Probiotic and Antioxidant Potential of Lactococcus lactis subsp. cremoris LL95 and Its Effect in Mice Behaviour. Nutrients 2019; 11:nu11040901. [PMID: 31013601 PMCID: PMC6521076 DOI: 10.3390/nu11040901] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 04/01/2019] [Accepted: 04/03/2019] [Indexed: 12/19/2022] Open
Abstract
The composition of intestinal microbiota is widely believed to not only affect gut health but also influence behaviour. This study aimed to evaluate the probiotic characteristics, antioxidant activity, and antidepressant- and anxiolytic-like activities of Lactococcus lactis subsp. cremoris LL95. This strain showed probiotic properties such as resistance in a simulated gastric tract model and survival at different concentrations of NaCl and bile salts. Moreover, antioxidant activity of LL95 was demonstrated through DPPH radical scavenging activity, scavenging of ABTS•+ radical and ferric ion reducing antioxidant power (FRAP) assays. Female C57BL/6 mice received LL95 orally at a dose of 109 UFC/day for 28 days. LL95 improved depressive- and anxiety-like behaviour, demonstrated by decreased immobility time in the tail suspension test and forced swim test and increased per cent of time spent in the open arms on the elevated plus maze. These findings indicate the potential antioxidant activity of LL95 and its role in behaviour, suggesting that probiotic may have therapeutic applications.
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38
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Abstract
Depression is a common and heterogeneous condition with a chronic and recurrent natural course that is frequently seen in the primary care setting. Primary care providers play a central role in managing depression and concurrent physical comorbidities, and they face challenges in diagnosing and treating the condition. In this two part series, we review the evidence available to help to guide primary care providers and practices to recognize and manage depression. The first review outlined an approach to screening and diagnosing depression in primary care. This second review presents an evidence based approach to the treatment of depression in primary care, detailing the recommended lifestyle, drug, and psychological interventions at the individual level. It also highlights strategies that are being adopted at an organizational level to manage depression more effectively in primary care.
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Affiliation(s)
- Parashar Ramanuj
- Center for Family and Community Medicine, Columbia University Medical Center, New York, NY, USA
- Royal National Orthopaedic Hospital
| | | | - Harold Alan Pincus
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, USA
- Irving Institute for Clinical and Translational Research, Columbia University, New York, NY, USA
- RAND Corporation, Pittsburgh, PA, USA
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39
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Schlicker S, Weisel KK, Buntrock C, Berking M, Nobis S, Lehr D, Baumeister H, Snoek FJ, Riper H, Ebert DD. Do Nonsuicidal Severely Depressed Individuals with Diabetes Profit from Internet-Based Guided Self-Help? Secondary Analyses of a Pragmatic Randomized Trial. J Diabetes Res 2019; 2019:2634094. [PMID: 31218230 PMCID: PMC6536948 DOI: 10.1155/2019/2634094] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 04/11/2019] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Diabetes mellitus type 1 and type 2 are linked to higher prevalence and occurrences of depression. Internet-based depression- and diabetes-specific cognitive behavioral therapies (CBT) can be effective in reducing depressive symptom severity and diabetes-related emotional distress. The aim of the study was to test whether disease-specific severity indicators moderate the treatment outcome in a 6-week minimally guided web-based self-help intervention on depression and diabetes (GET.ON Mood Enhancer Diabetes (GET.ON M.E.D.)) and to determine its effectiveness in a nonsuicidal severely depressed subgroup. METHODS Randomized controlled trial- (RCT-) based data (N = 253) comparing GET.ON M.E.D. to an online psychoeducation control group was used to test disease-specific severity indicators as predictors/moderators of a treatment outcome. Changes in depressive symptom severity and treatment response were examined in a nonsuicidal severely depressed subgroup (CES - D > 40; N = 40). RESULTS Major depressive disorder diagnosis at the baseline (p prf6 = 0.01), higher levels of depression (Beck Depression Inventory II; p prpo = 0.00; p prf6 = 0.00), and lower HbA1c (p prpo = 0.04) predicted changes in depressive symptoms. No severity indicator moderated the treatment outcome. Severely depressed participants in the intervention group showed a significantly greater reduction in depressive symptom severity (d prpo = 2.17, 95% Confidence Interval (CI): 1.39-2.96) than the control condition (d prpo = 0.92; 95% CI: 0.001-1.83), with a between-group effect size of d prpo = 1.05 (95% CI: 0.11-1.98). Treatment response was seen in significantly more participants in the intervention (4/20; 20%) compared to the control group (0/20, 0%; χ 2 (2)(N = 40) = 4.44; p < 0.02). At the 6-month follow-up, effects were maintained for depressive symptom reduction (d pr6f = 0.71; 95% CI: 0.19-1.61) but not treatment response. CONCLUSION Disease-specific severity indicators were not related to a differential effectiveness of guided self-help for depression and diabetes. Clinical meaningful effects were observed in nonsuicidal severely depressed individuals, who do not need to be excluded from web-based guided self-help. However, participants should be closely monitored and referred to other treatment modalities in case of nonresponse.
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Affiliation(s)
- Sandra Schlicker
- Friedrich-Alexander University Erlangen-Nürnberg, Germany
- Philipps-University Marburg, Germany
| | | | | | | | | | - Dirk Lehr
- Leuphana University Lüneburg, Germany
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40
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Dodd S, Mitchell PB, Bauer M, Yatham L, Young AH, Kennedy SH, Williams L, Suppes T, Lopez Jaramillo C, Trivedi MH, Fava M, Rush AJ, McIntyre RS, Thase ME, Lam RW, Severus E, Kasper S, Berk M. Monitoring for antidepressant-associated adverse events in the treatment of patients with major depressive disorder: An international consensus statement. World J Biol Psychiatry 2018; 19:330-348. [PMID: 28984491 DOI: 10.1080/15622975.2017.1379609] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES These recommendations were designed to ensure safety for patients with major depressive disorder (MDD) and to aid monitoring and management of adverse effects during treatment with approved antidepressant medications. The recommendations aim to inform prescribers about both the risks associated with these treatments and approaches for mitigating such risks. METHODS Expert contributors were sought internationally by contacting representatives of key stakeholder professional societies in the treatment of MDD (ASBDD, CANMAT, WFSBP and ISAD). The manuscript was drafted through iterative editing to ensure consensus. RESULTS Adequate risk assessment prior to commencing pharmacotherapy, and safety monitoring during pharmacotherapy are essential to mitigate adverse events, optimise the benefits of treatment, and detect and assess adverse events when they occur. Risk factors for pharmacotherapy vary with individual patient characteristics and medication regimens. Risk factors for each patient need to be carefully assessed prior to initiating pharmacotherapy, and appropriate individualised treatment choices need to be selected. Some antidepressants are associated with specific safety concerns which were addressed. CONCLUSIONS Risks of adverse outcomes with antidepressant treatment can be managed through appropriate assessment and monitoring to improve the risk benefit ratio and improve clinical outcomes.
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Affiliation(s)
- Seetal Dodd
- a School of Medicine, Barwon Health , Deakin University, IMPACT SRC (Innovation in Mental and Physical Health and Clinical Treatment - Strategic Research Centre) , Geelong , Australia.,b Department of Psychiatry , University of Melbourne , Melbourne , Australia.,c Mental Health Drug and Alcohol Services , University Hospital Geelong, Barwon Health , Geelong , Australia.,d Orygen The National Centre of Excellence in Youth Mental Health , Parkville , Australia
| | - Philip B Mitchell
- f School of Psychiatry , University of New South Wales, and Black Dog Institute , Sydney , Australia
| | - Michael Bauer
- g Department of Psychiatry and Psychotherapy , University Hospital Carl Gustav Carus, Technische, Universität Dresden , Dresden , Germany
| | - Lakshmi Yatham
- h Department of Psychiatry , University of British Columbia , British Columbia , BC , Canada
| | - Allan H Young
- i Department of Psychological Medicine , Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK & South London and Maudsley NHS Foundation Trust , London , UK
| | - Sidney H Kennedy
- j Department of Psychiatry , University of Toronto , Toronto , ON , Canada
| | - Lana Williams
- a School of Medicine, Barwon Health , Deakin University, IMPACT SRC (Innovation in Mental and Physical Health and Clinical Treatment - Strategic Research Centre) , Geelong , Australia
| | - Trisha Suppes
- k Department of Psychiatry & Behavioral Sciences , School of Medicine, Stanford University , Stanford , CA , USA
| | | | - Madhukar H Trivedi
- m Department of Psychiatry , University of Texas Southwestern Medical Center , Dallas , TX , USA
| | - Maurizio Fava
- n Division of Clinical Research , Massachusetts General Hospital and Harvard Medical School , Boston , MA , USA
| | - A John Rush
- o Duke-National University of Singapore Medical School , Singapore , Singapore
| | - Roger S McIntyre
- j Department of Psychiatry , University of Toronto , Toronto , ON , Canada.,p Mood Disorders Psychopharmacology Unit, University of Toronto , Toronto , ON , Canada.,q Brain and Cognition Discovery Foundation , Toronto , ON , Canada
| | - Michael E Thase
- r Department of Psychiatry, Perelman School of Medicine , University of Pennsylvania , Pennsylvania , PA , USA
| | - Raymond W Lam
- h Department of Psychiatry , University of British Columbia , British Columbia , BC , Canada
| | - Emanuel Severus
- g Department of Psychiatry and Psychotherapy , University Hospital Carl Gustav Carus, Technische, Universität Dresden , Dresden , Germany
| | - Siegfried Kasper
- s Department of Psychiatry and Psychotherapy , Medical University of Vienna , Wien , Austria
| | - Michael Berk
- a School of Medicine, Barwon Health , Deakin University, IMPACT SRC (Innovation in Mental and Physical Health and Clinical Treatment - Strategic Research Centre) , Geelong , Australia.,b Department of Psychiatry , University of Melbourne , Melbourne , Australia.,c Mental Health Drug and Alcohol Services , University Hospital Geelong, Barwon Health , Geelong , Australia.,d Orygen The National Centre of Excellence in Youth Mental Health , Parkville , Australia.,e The Florey Institute of Neuroscience and Mental Health , Parkville , Australia
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Zhang S, Liu X, Sun M, Zhang Q, Li T, Li X, Xu J, Zhao X, Chen D, Feng X. Reversal of reserpine-induced depression and cognitive disorder in zebrafish by sertraline and Traditional Chinese Medicine (TCM). Behav Brain Funct 2018; 14:13. [PMID: 29898741 PMCID: PMC6001006 DOI: 10.1186/s12993-018-0145-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 06/01/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND With increased social pressure, individuals face a high risk of depression. Subsequently, depression affects cognitive behaviour and negatively impacts daily life. Fortunately, the Traditional Chinese Medicine Jia Wei Xiao Yao (JWXY) capsule is effective in reducing depression and improving cognitive behaviour. METHODS The constituents of JWXY capsule were identified by ultra-performance liquid chromatography and quadrupole time-of-flight mass spectrometry analyses. We analysed behaviours of depression-like zebrafish in the novel tank with an automatic 3D video-tracking system and conducted the colour preference test, as well detected physiological changes after sertraline and JWXY capsule treatments. RESULTS Both sertraline and JWXY capsule rescued the decreased locomotive behaviour and depression phenotype of zebrafish caused by reserpine. JWXY capsule especially improved the inhibited exploratory behaviour caused by reserpine. In addition, with the onset of depressive behaviour, zebrafish exhibited alterations in cognitive behaviour as indicated by colour preference changes. However, compared with sertraline, JWXY capsule was more efficaciously in rescuing this change in the colour preference pattern. Moreover, an increased level of cortisol, increased expression of tyrosine hydroxylase (TH) and decreased monoamine neurotransmitters, including serotonin (5-HT) and noradrenaline, were involved in the depressive behaviours. In addition, sertraline and JWXY capsule rescued the depressive phenotype and cognitive behaviour of zebrafish by altering the levels of endogenous cortisol and monoamine neurotransmitters. CONCLUSIONS JWXY capsule was more effectively than sertraline in rescuing reserpine-induced depression and cognitive disorder in zebrafish. Potentially, our study can provide new insights into the clinical treatment of depression and the mechanism of action of JWXY capsule.
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Affiliation(s)
- Shuhui Zhang
- State Key Laboratory of Medicinal Chemical Biology, The Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Science, Nankai University, Tianjin, 300071, China
| | - Xiaodong Liu
- State Key Laboratory of Medicinal Chemical Biology, The Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Science, Nankai University, Tianjin, 300071, China
| | - Mingzhu Sun
- The Institute of Robotics and Automatic Information Systems, Nankai University, Tianjin, 300071, China
| | - Qiuping Zhang
- Tianjin Key Laboratory of Tumor Microenvironment and Neurovascular Regulation, Department of Histology and Embryology, School of Medicine, Nankai University, Tianjin, 300071, China
| | - Teng Li
- The Institute of Robotics and Automatic Information Systems, Nankai University, Tianjin, 300071, China
| | - Xiang Li
- State Key Laboratory of Medicinal Chemical Biology, The Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Science, Nankai University, Tianjin, 300071, China
| | - Jia Xu
- Tianjin Key Laboratory of Tumor Microenvironment and Neurovascular Regulation, Department of Histology and Embryology, School of Medicine, Nankai University, Tianjin, 300071, China
| | - Xin Zhao
- The Institute of Robotics and Automatic Information Systems, Nankai University, Tianjin, 300071, China.
| | - Dongyan Chen
- Tianjin Key Laboratory of Tumor Microenvironment and Neurovascular Regulation, Department of Histology and Embryology, School of Medicine, Nankai University, Tianjin, 300071, China.
| | - Xizeng Feng
- State Key Laboratory of Medicinal Chemical Biology, The Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Science, Nankai University, Tianjin, 300071, China.
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Busch Y, Menke A. Blood-based biomarkers predicting response to antidepressants. J Neural Transm (Vienna) 2018; 126:47-63. [PMID: 29374800 DOI: 10.1007/s00702-018-1844-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 01/11/2018] [Indexed: 01/04/2023]
Abstract
Major depressive disorder is a common, serious and in some cases, life-threatening condition and affects approximately 350 million people globally. Although there is effective treatment available for it, more than 50% of the patients fail to respond to the first antidepressant they receive. The selection of a distinct treatment is still exclusively based on clinical judgment without incorporating lab-derived objective measures. However, there is growing evidence of biomarkers that it helps to improve diagnostic processes and treatment algorithms. Here genetic markers and blood-based biomarkers of the monoamine pathways, inflammatory pathways and the hypothalamic-pituitary-adrenal (HPA) axis are reviewed. Promising findings arise from studies investigating inflammatory pathways and immune markers that may identify patients suitable for anti-inflammatory based treatment regimes. Next, an early normalization of a disturbed HPA axis or depleted neurotrophic factors may predict stable treatment response. Genetic markers within the serotonergic system may identify patients who are vulnerable because of stressful life events, but evidence for guiding treatment regimes still is inconsistent. Therefore, there is still a great need for studies investigating and validating biomarkers for the prediction of treatment response to facilitate the treatment selection and shorten the time to remission and thus provide personalized medicine in psychiatry.
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Affiliation(s)
- Yasmin Busch
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, 97080, Würzburg, Germany
| | - Andreas Menke
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, 97080, Würzburg, Germany. .,Comprehensive Heart Failure Center, University Hospital of Wuerzburg, Am Schwarzenberg 15, 97080, Würzburg, Germany.
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Kim EJ, Felsovalyi K, Young LM, Shmelkov SV, Grunebaum MF, Cardozo T. Molecular basis of atypicality of bupropion inferred from its receptor engagement in nervous system tissues. Psychopharmacology (Berl) 2018; 235:2643-2650. [PMID: 29961917 PMCID: PMC6132670 DOI: 10.1007/s00213-018-4958-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/20/2018] [Indexed: 11/28/2022]
Abstract
Despite decades of clinical use and research, the mechanism of action (MOA) of antidepressant medications remains poorly understood. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are the most commonly prescribed antidepressants-atypical antidepressants such as bupropion have also proven effective, while exhibiting a divergent clinical phenotype. The difference in phenotypic profiles presumably lies in the differences among the MOAs of SSRIs/SNRIs and bupropion. We integrated the ensemble of bupropion's affinities for all its receptors with the expression levels of those targets in nervous system tissues. This "combined target tissue" profile of bupropion was compared to those of duloxetine, fluoxetine, and venlafaxine to isolate the unique target tissue effects of bupropion. Our results suggest that the three monoamines-serotonin, norepinephrine, and dopamine-all contribute to the common antidepressant effects of SSRIs, SNRIs, and bupropion. At the same time, bupropion is unique in its action on 5-HT3AR in the dorsal root ganglion and nicotinic acetylcholine receptors in the pineal gland. These unique tissue-specific activities may explain unique therapeutic effects of bupropion, such as pain management and smoking cessation, and, given melatonin's association with nicotinic acetylcholine receptors and depression, highlight the underappreciated role of the melatonergic system in bupropion's MOA.
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Affiliation(s)
- Eric J. Kim
- Amherst College, Amherst, MA USA ,Department of Biochemistry and Molecular Pharmacology, NYU School of Medicine, New York, NY USA
| | | | - Lauren M. Young
- Department of Biochemistry and Molecular Pharmacology, NYU School of Medicine, New York, NY USA ,Department of Pathology, NYU School of Medicine, New York, NY USA
| | - Sergey V. Shmelkov
- Department of Neuroscience and Physiology, NYU School of Medicine, New York, NY USA ,Department of Psychiatry, NYU School of Medicine, New York, NY USA
| | - Michael F. Grunebaum
- Department of Psychiatry, Columbia University Medical Center, New York, NY USA ,New York State Psychiatric Institute, New York, NY USA
| | - Timothy Cardozo
- Department of Biochemistry and Molecular Pharmacology, NYU School of Medicine, New York, NY, USA.
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Vancampfort D, Stubbs B. Physical activity and metabolic disease among people with affective disorders: Prevention, management and implementation. J Affect Disord 2017; 224:87-94. [PMID: 27519365 DOI: 10.1016/j.jad.2016.07.042] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 06/24/2016] [Accepted: 07/10/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND One in ten and one in three of people with affective disorders experience diabetes and metabolic syndrome respectively. Physical activity (PA) and sedentary behaviour (SB) are key risk factors that can ameliorate the risk of metabolic disease among this population. However, PA is often seen as luxury and/or a secondary component within the management of people with affective disorders. METHODS The current article provides a non-systematic best-evidence synthesis of the available literature, detailing a number of suggestions for the implementation of PA into clinical practice. RESULTS Whilst the evidence is unequivocal for the efficacy of PA to prevent and manage metabolic disease in the general population, it is in its infancy in this patient group. Nonetheless, action must be taken now to ensure that PA and reducing SB are given a priority to prevent and manage metabolic diseases and improve wider health outcomes. PA should be treated as a vital sign and all people with affective disorders asked about their activity levels and if appropriate advised to increase this. There is a need for investment in qualified exercise specialists in clinical practice such as physiotherapists to undertake and oversee PA in practice. Behavioural strategies such as the self-determined theory should be employed to encourage adherence. Funding is required to develop the evidence base and elucidate the optimal intervention characteristics. CONCLUSION PA interventions should form an integral part of the multidisciplinary management of people with affective disorders and our article outlines the evidence and strategies to implement this in practice.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven - University of Leuven, University Psychiatric Center KU Leuven, Campus Kortenberg, Belgium
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, UK.
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Combining aerobic exercise and repetitive transcranial magnetic stimulation to improve brain function in health and disease. Neurosci Biobehav Rev 2017; 83:11-20. [PMID: 28951250 DOI: 10.1016/j.neubiorev.2017.09.023] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 08/02/2017] [Accepted: 09/21/2017] [Indexed: 12/22/2022]
Abstract
The aetiology of various psychiatric and neurological disorders may be partially attributable to impairments in neuroplasticity. Developing novel methods of stimulating neuroplasticity is a promising treatment approach to counterbalance these maladaptive influences and alleviate symptomologies. Two non-pharmacological approaches with significant and direct impacts on neuroplasticity are aerobic exercise and repetitive transcranial magnetic stimulation. Aerobic exercise is associated with the promotion of numerous neurotrophic mechanisms at a molecular and cellular level, which have a broad influence on neuroplasticity. Transcranial magnetic stimulation is a form of non-invasive brain stimulation with the capacity to modulate the synaptic efficacy and connectivity of particular brain networks. This review synthesises extant literature to explore the complementary physiological mechanisms targeted by aerobic exercise and repetitive transcranial magnetic stimulation, and to substantiate the hypothesis that the use of these techniques in tandem may result in synergistic impact on neural mechanisms to achieve a more efficacious therapeutic approach for mental disorders.
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Wang J, Liu Y, Li L, Qi Y, Zhang Y, Li L, Teng L, Wang D. Dopamine and serotonin contribute to Paecilomyces hepiali against chronic unpredictable mild stress induced depressive behavior in Sprague Dawley rats. Mol Med Rep 2017; 16:5675-5682. [DOI: 10.3892/mmr.2017.7261] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 06/21/2017] [Indexed: 11/06/2022] Open
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Carvalho AF, Sharma MS, Brunoni AR, Vieta E, Fava GA. The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature. PSYCHOTHERAPY AND PSYCHOSOMATICS 2017; 85:270-88. [PMID: 27508501 DOI: 10.1159/000447034] [Citation(s) in RCA: 365] [Impact Index Per Article: 52.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 05/24/2016] [Indexed: 11/19/2022]
Abstract
Newer generation antidepressant drugs (ADs) are widely used as the first line of treatment for major depressive disorders and are considered to be safer than tricyclic agents. In this critical review, we evaluated the literature on adverse events, tolerability and safety of selective serotonin reuptake inhibitors, serotonin noradrenaline reuptake inhibitors, bupropion, mirtazapine, trazodone, agomelatine, vilazodone, levomilnacipran and vortioxetine. Several side effects are transient and may disappear after a few weeks following treatment initiation, but potentially serious adverse events may persist or ensue later. They encompass gastrointestinal symptoms (nausea, diarrhea, gastric bleeding, dyspepsia), hepatotoxicity, weight gain and metabolic abnormalities, cardiovascular disturbances (heart rate, QT interval prolongation, hypertension, orthostatic hypotension), genitourinary symptoms (urinary retention, incontinence), sexual dysfunction, hyponatremia, osteoporosis and risk of fractures, bleeding, central nervous system disturbances (lowering of seizure threshold, extrapyramidal side effects, cognitive disturbances), sweating, sleep disturbances, affective disturbances (apathy, switches, paradoxical effects), ophthalmic manifestations (glaucoma, cataract) and hyperprolactinemia. At times, such adverse events may persist after drug discontinuation, yielding iatrogenic comorbidity. Other areas of concern involve suicidality, safety in overdose, discontinuation syndromes, risks during pregnancy and breast feeding, as well as risk of malignancies. Thus, the rational selection of ADs should consider the potential benefits and risks, likelihood of responsiveness to the treatment option and vulnerability to adverse events. The findings of this review should alert the physician to carefully review the appropriateness of AD prescription on an individual basis and to consider alternative treatments if available.
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Affiliation(s)
- André F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
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A study of time- and sex-dependent effects of vortioxetine on rat sexual behavior: Possible roles of direct receptor modulation. Neuropharmacology 2017; 121:89-99. [DOI: 10.1016/j.neuropharm.2017.04.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 04/07/2017] [Accepted: 04/12/2017] [Indexed: 12/19/2022]
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Rohden AI, Benchaya MC, Camargo RS, Moreira TDC, Barros HM, Ferigolo M. Dropout Prevalence and Associated Factors in Randomized Clinical Trials of Adolescents Treated for Depression: Systematic Review and Meta-analysis. Clin Ther 2017; 39:971-992.e4. [DOI: 10.1016/j.clinthera.2017.03.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 03/02/2017] [Accepted: 03/13/2017] [Indexed: 12/29/2022]
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Schütter AF, Tünsmeyer J, Kästner SBR. Influence of tramadol on acute thermal and mechanical cutaneous nociception in dogs. Vet Anaesth Analg 2017; 44:309-316. [PMID: 28215815 DOI: 10.1016/j.vaa.2016.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/19/2015] [Accepted: 02/02/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the influence of tramadol on acute nociception in dogs. STUDY DESIGN Experimental, blinded, randomized, crossover study. ANIMALS Six healthy laboratory Beagle dogs. METHODS Dogs received three treatments intravenously (IV): isotonic saline placebo (P), tramadol 1 mg kg-1 (T1) and tramadol 4 mg kg-1 (T4). Thermal thresholds were determined by ramped contact heat stimulation (0.6 °C second-1) at the lateral thoracic wall. Mechanical thresholds (MT) were measured using a probe containing three blunted pins which were constantly advanced over the radial bone, using a rate of force increase of 0.8 N second-1. Stimulation end points were defined responses (e.g. skin twitch, head turn, repositioning, vocalization) or pre-set cut-out values (55 °C, 20 N). Thresholds were determined before treatment and at predetermined time points up to 24 hours after treatment. At each measurement point, blood was collected for determination of O-desmethyltramadol concentrations. The degree of sedation and behavioural side effects were recorded. Data were analysed by one-way anova and two-way anova for repeated measurements. RESULTS Thermal nociception was not influenced by drug treatment. Mechanical nociception was significantly increased between P and T1 at 120 and 240 minutes, and between P and T4 at 30, 60, 240 and 420 minutes. T1 and T4 did not differ. O-desmethyltramadol (M1) maximum plasma concentrations (Cmax) were 4.2±0.8 ng mL-1 and 14.3±2.8 ng mL-1 for T1 and T4, respectively. Times to reach maximum plasma concentrations (Tmax) were 27.6±6.3 minutes for T1 and 32.1±7.8 minutes for T4. No sedation occurred. There were signs of nausea and mild to moderate salivation in both groups. CONCLUSION AND CLINICAL RELEVANCE Tramadol was metabolized marginally to O-desmethyltramadol and failed to produce clinically relevant acute antinociception. Therefore, the use of tramadol for acute nociceptive pain is questionable in dogs.
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Affiliation(s)
- Alexandra F Schütter
- Clinic for Small Animals, University of Veterinary Medicine, Hannover Foundation, Germany.
| | - Julia Tünsmeyer
- Clinic for Small Animals, University of Veterinary Medicine, Hannover Foundation, Germany
| | - Sabine B R Kästner
- Clinic for Small Animals, University of Veterinary Medicine, Hannover Foundation, Germany
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