1
|
Ip CT, de Bardeci M, Kronenberg G, Pinborg LH, Seifritz E, Brunovsky M, Olbrich S. EEG-vigilance regulation is associated with and predicts ketamine response in major depressive disorder. Transl Psychiatry 2024; 14:64. [PMID: 38272875 PMCID: PMC10810879 DOI: 10.1038/s41398-024-02761-x] [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: 05/04/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/27/2024] Open
Abstract
Ketamine offers promising new therapeutic options for difficult-to-treat depression. The efficacy of treatment response, including ketamine, has been intricately linked to EEG measures of vigilance. This research investigated the interplay between intravenous ketamine and alterations in brain arousal, quantified through EEG vigilance assessments in two distinct cohorts of depressed patients (original dataset: n = 24; testing dataset: n = 24). Clinical response was defined as a decrease from baseline of >33% on the Montgomery-Åsberg Depression Rating Scale (MADRS) 24 h after infusion. EEG recordings were obtained pre-, start-, end- and 24 h post- infusion, and the resting EEG was automatically scored using the Vigilance Algorithm Leipzig (VIGALL). Relative to placebo (sodium chloride 0.9%), ketamine increased the amount of low-vigilance stage B1 at end-infusion. This increase in B1 was positively related to serum concentrations of ketamine, but not to norketamine, and was independent of clinical response. In contrast, treatment responders showed a distinct EEG pattern characterized by a decrease in high-vigilance stage A1 and an increase in low-vigilance B2/3, regardless of whether placebo or ketamine had been given. Furthermore, pretreatment EEG differed between responders and non-responders with responders showing a higher percentage of stage A1 (53% vs. 21%). The logistic regression fitted on the percent of A1 stages was able to predict treatment outcomes in the testing dataset with an area under the ROC curve of 0.7. Ketamine affects EEG vigilance in a distinct pattern observed only in responders. Consequently, the percentage of pretreatment stage A1 shows significant potential as a predictive biomarker of treatment response.Clinical Trials Registration: https://www.clinicaltrialsregister.eu/ctr-search/trial/2013-000952-17/CZ Registration number: EudraCT Number: 2013-000952-17.
Collapse
Affiliation(s)
- Cheng-Teng Ip
- Center for Cognitive and Brain Sciences, University of Macau, Taipa, Macau SAR, China
- Neurobiology Research Unit, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Mateo de Bardeci
- Hospital for Psychiatry, Psychotherapy and Psychosomatic; University Zurich, Zurich, Switzerland
| | - Golo Kronenberg
- Hospital for Psychiatry, Psychotherapy and Psychosomatic; University Zurich, Zurich, Switzerland
| | - Lars Hageman Pinborg
- Neurobiology Research Unit, University Hospital Rigshospitalet, Copenhagen, Denmark
- Epilepsy Clinic, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Erich Seifritz
- Hospital for Psychiatry, Psychotherapy and Psychosomatic; University Zurich, Zurich, Switzerland
| | - Martin Brunovsky
- National Institute of Mental Health, Klecany, Czech Republic
- Charles University, Third Faculty of Medicine, Prague, Czech Republic
| | - Sebastian Olbrich
- Hospital for Psychiatry, Psychotherapy and Psychosomatic; University Zurich, Zurich, Switzerland.
| |
Collapse
|
2
|
Zhou Y, Zhang Z, Wang C, Lan X, Li W, Zhang M, Lao G, Wu K, Chen J, Li G, Ning Y. Predictors of 4-week antidepressant outcome in patients with first-episode major depressive disorder: An ROC curve analysis. J Affect Disord 2022; 304:59-65. [PMID: 35172174 DOI: 10.1016/j.jad.2022.02.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 02/06/2022] [Accepted: 02/12/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND Pretreatment characteristics of patients, symptom and function could be associated with antidepressant treatment outcome, but its predictive ability is not adequate. Our study aimed to identify predictors of acute antidepressant efficacy in patients with first-episode Major Depressive Disorder (MDD). METHODS 187 patients with first-episode MDD were included and assessed clinical symptoms, cognitive function and global functioning using the 17-item Hamilton Depression Inventory (HAMD-17), MATRICS Consensus Cognitive Battery (MCCB) and Global Assessment of Functioning (GAF). Participants received treatment with a SSRI (escitalopram or venlafaxine) for 4 weeks. Logistic regression was used to analyze the association between patients' characteristics, symptom profiles, cognitive performance, and global functioning and the antidepressant outcome at the end of 4 weeks, and ROC curve analysis was performed for predictive accuracy with area under the receiver operating curve (AUC). RESULTS Antidepressant improvement, response and remission rate at week 4 was 87.7%, 64.7% and 42.8%, respectively. The combination of pretreatment clinical profiles, speed of processing and global functioning showed moderate discrimination of acute improvement, response and remission with AUCs of 0.863, 0.812 and 0.734, respectively. LIMITATIONS The major limitation of the present study is the study did not combine pharmacogenomics from the perspective of antidepressant drug metabolism. CONCLUSION Aside from the baseline clinical symptoms, cognitive function and global functioning could be predictors of acute treatment outcome in first episode MDD using escitalopram or venlafaxine. This relatively simple application based on clinical symptoms and function seems to be cost-effective method to identify individuals who are more likely to respond to antidepressant treatment.
Collapse
Affiliation(s)
- Yanling Zhou
- Department of Psychiatry, Department of Neurology, Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China
| | - Zhipei Zhang
- Department of Psychiatry, Department of Neurology, Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China; Southern Medical University, Guangzhou, China
| | - ChengYu Wang
- Department of Psychiatry, Department of Neurology, Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China
| | - Xiaofeng Lan
- Department of Psychiatry, Department of Neurology, Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China
| | - Weicheng Li
- Department of Psychiatry, Department of Neurology, Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China; Southern Medical University, Guangzhou, China
| | - Muqin Zhang
- Department of Psychiatry, Department of Neurology, Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China
| | - Guohui Lao
- Department of Psychiatry, Department of Neurology, Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China
| | - Kai Wu
- Department of Psychiatry, Department of Neurology, Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China; School of Biomedical Sciences and Engineering, South china University of Technology, Guangzhou, China
| | - Jun Chen
- Guangdong Institute of Medical Instruments, Guangzhou, China
| | - Guixiang Li
- Guangdong Institute of Medical Instruments, Guangzhou, China
| | - Yuping Ning
- Department of Psychiatry, Department of Neurology, Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, China; Southern Medical University, Guangzhou, China.
| |
Collapse
|
3
|
Romeo B, Hermand M, Pétillion A, Karila L, Benyamina A. Clinical and biological predictors of psychedelic response in the treatment of psychiatric and addictive disorders: A systematic review. J Psychiatr Res 2021; 137:273-282. [PMID: 33730602 DOI: 10.1016/j.jpsychires.2021.03.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/23/2021] [Accepted: 03/02/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND The use of psychedelic treatments has shown very promising results in some psychiatric and addictive disorders, but not all patients achieved a response. AIM The aim of this review is to explore the clinical and biological factors which could predict the response to psychedelics in psychiatric and addictive disorders. METHODS A systematic research was performed on MEDLINE, PsycInfo, Web of science, and Scopus databases from January 1990 to May 2020. All studies investigating the predictive factors of response to psychedelics regardless of psychiatric or addictive disorders, were included. RESULTS Twenty studies investigating addictive disorder, treatment-resistant depression, obsessive-compulsive disorder and depressive and anxiety symptoms in patients with life-threatening cancer were included in this review. We found that, in all indications, the main predictive factor of response to psychedelics is the intensity of the acute psychedelic experience. Indeed, we found this factor for alcohol and tobacco use disorders, treatment-resistant depression, and anxiety and depressive symptoms in patients with life-threatening cancer, but not for obsessive-compulsive disorder. CONCLUSION The intensity of the acute psychedelic experience was the main predicting factor of response. The action mechanism of this experience was not clear, but some hypotheses could be made, such as a modulation of serotoninergic system by 5-HT2A receptors agonism, a modulation of the default mode network (DMN) with an acute modular disintegration of the DMN followed by a re-integration of this network with a normal functioning, or an anti-inflammatory effect of this treatment.
Collapse
Affiliation(s)
- Bruno Romeo
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800, Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions- Unité de Recherche PSYCOMADD 4872 Université Paris Sud- APHP, Université Paris Saclay, Le Kremlin Bicêtre, France.
| | - Marianne Hermand
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800, Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions- Unité de Recherche PSYCOMADD 4872 Université Paris Sud- APHP, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Amélie Pétillion
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800, Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions- Unité de Recherche PSYCOMADD 4872 Université Paris Sud- APHP, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Laurent Karila
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800, Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions- Unité de Recherche PSYCOMADD 4872 Université Paris Sud- APHP, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Amine Benyamina
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800, Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions- Unité de Recherche PSYCOMADD 4872 Université Paris Sud- APHP, Université Paris Saclay, Le Kremlin Bicêtre, France
| |
Collapse
|
4
|
Magalhães EJM, Sarin LM, Del Sant LC, Lucchese AC, Nakahira C, Tuena MA, Puertas CB, Rodovalho Fava VA, Delfino RS, Surjan J, Steglich MS, Barbosa MG, Abdo G, Del Porto JA, Nemeroff CB, Cogo-Moreira H, Lacerda ALT, Mello AF. A Clinical Rationale for Assessing the Impact of Childhood Sexual Abuse on Adjunctive Subcutaneous Esketamine for Treatment-Resistant Depression. Front Psychiatry 2021; 12:608499. [PMID: 34483976 PMCID: PMC8415867 DOI: 10.3389/fpsyt.2021.608499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 07/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background: A history of child sexual abuse (CSA) is related to higher suicide rates and poor treatment outcomes in depressed adult patients. Twenty years after the first study investigating the effects of ketamine/esketamine on depression and suicide, there is a lack of data on the CSA effects on this emerging treatment. Here, we assess the impact of CSA on adjunctive subcutaneous (SC) esketamine for treatment-resistant depression (TRD). Methods: A directed acyclic graphic (DAG) was designed to identify clinical confounders between CSA and esketamine predictors of response. The confounders were applied in a statistical model to predict depression symptom trajectory in a sample of 67 TRD outpatients. Results: The patient sample had a relatively high prevalence rate of CSA (35.82%). Positive family history of first-degree relatives with alcohol use disorder and sex were clinical mediators of the effects of esketamine in a CSA adult population. Overall, the presence of at least one CSA event was unrelated to esketamine symptom reduction. Conclusions: Unlike responses to conventional antidepressants and psychotherapy, CSA does not appear to predict poor response to esketamine.
Collapse
Affiliation(s)
| | - Luciana Maria Sarin
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | | | | | - Carolina Nakahira
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Marco Aurélio Tuena
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | | | | | - Rodrigo Simonini Delfino
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.,Program for Care on Affective Disorders, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Juliana Surjan
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.,Program for Care on Affective Disorders, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Matheus Souza Steglich
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.,Program for Care on Affective Disorders, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | | | - Guilherme Abdo
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - José Alberto Del Porto
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.,Program for Care on Affective Disorders, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, Institute of Early Life Adversity Research, Dell Medical School, University of Texas at Austin, Austin, TX, United States
| | - Hugo Cogo-Moreira
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.,Department of Education, ICT and Learning, Faculty of Teacher Education and Languages, Østfold University College, Halden, Norway
| | - Acioly Luiz Tavares Lacerda
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.,Program for Care on Affective Disorders, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.,Laboratory of Integrative Neuroscience, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.,CNS Unit, BR Trials, São Paulo, Brazil
| | - Andrea Feijo Mello
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.,Program for Research and Care on Violence and Post-traumatic Stress Disorder, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| |
Collapse
|
5
|
Yin H, Guo J, Xin Q, Zheng S, Xue X, Li E, Liu T, Yan N, Keilp J, Mann JJ. Influence of the GABA Receptor Subunit Gene Polymorphism and Childhood Sexual Abuse on Processing Speed in Major Depression and Suicide Attempt. Front Psychiatry 2021; 12:712231. [PMID: 34733184 PMCID: PMC8558369 DOI: 10.3389/fpsyt.2021.712231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/13/2021] [Indexed: 01/07/2023] Open
Abstract
Background: Suicide is moderately heritable and also more common in those who report childhood abuse. Previously, it was found that allele A of GABRG2 (GABA A receptor subunit gamma2) polymorphism rs211034 was protective in a suicide attempt (SA). Hence, it was proposed that rs211034 may interact with childhood trauma to influence cognitive deficits related to SA or depression risk. Genetic variants may predict the benefits of certain cognitive treatments. Methods: A total of 52 individuals who had attempted suicide, 59 individuals with major depressive disorder (MDD) or bipolar depression who had not previously attempted suicide, and 90 healthy volunteers were subjected to the modified Suicide Stroop task and were clinically assessed using the Childhood Trauma Questionnaire (CTQ) and Hamilton Depression Scale-24 items (HAMD-24). rs211034 was genotyped using Sanger sequencing. Results: After correcting for covariates, depressed participants displayed longer reaction times for all emotional conditions, including suicide-related words, compared with healthy controls. Depressed suicide attempters displayed longer reaction times for negative words than depressed non-attempters. Depressed non-attempters displayed higher interference scores for negative words compared with healthy controls. There was an interaction between rs211034 risk allele and the effects of reported childhood sexual abuse (CSA) on reaction time for all emotional words and suicide-related words. Carriers of the rs211034 risk allele A exhibited shorter reaction times, but the protective effects of this allele were eliminated in those exposed to reported CSA. Conclusion: Only limited results were found regarding effects of a past suicide attempt on response times to emotional and suicide-related words, but there was an overall effect of major depression on slower response time. Protective genetic effects of the rs211034 A allele on this slowing were eliminated in those with a history of sexual abuse during childhood. Further research is needed to better characterize the mechanisms underlying the effects of childhood trauma on these genetic effects.
Collapse
Affiliation(s)
- Honglei Yin
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangdong, China
| | - Jia Guo
- Department of Biostatistics, Columbia University, New York, NY, United States
| | - Qianqian Xin
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangdong, China
| | - Shuqiong Zheng
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangdong, China
| | - Xiang Xue
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangdong, China
| | - Enze Li
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangdong, China
| | - Ting Liu
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangdong, China
| | - Na Yan
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangdong, China
| | - John Keilp
- Department of Psychiatry, Columbia University, New York, NY, United States.,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, United States
| | - J John Mann
- Department of Psychiatry, Columbia University, New York, NY, United States.,Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, United States
| |
Collapse
|
6
|
López-Solà C, Subirà M, Serra-Blasco M, Vicent-Gil M, Navarra-Ventura G, Aguilar E, Acebillo S, Palao DJ, Cardoner N. Is cognitive dysfunction involved in difficult-to-treat depression? Characterizing resistance from a cognitive perspective. Eur Psychiatry 2020; 63:e74. [PMID: 32571441 PMCID: PMC7443785 DOI: 10.1192/j.eurpsy.2020.65] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/11/2020] [Accepted: 06/08/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND This study aimed to identify clinical and cognitive factors associated with increased risk for difficult-to-treat depression (DTD) or treatment-resistant depression (TRD). METHODS A total of 229 adult outpatients with major depression were recruited from the mental health unit at a public hospital. Participants were subdivided into resistant and nonresistant groups according to their Maudsley Staging Model score. Sociodemographic, clinical, and cognitive (objective and subjective measures) variables were compared between groups, and a logistic regression model was used to identify the factors most associated with TRD risk. RESULTS TRD group patients present higher verbal memory impairment than the nonresistant group irrespective of pharmacological treatment or depressive symptom severity. Logistic regression analysis showed that low verbal memory scores (odds ratio [OR]: 2.02; 95% confidence interval [CI]: 1.38-2.95) together with high depressive symptom severity (OR: 1.29; CI95%: 1.01-1.65) were associated with TRD risk. CONCLUSIONS Our findings align with neuroprogression models of depression, in which more severe patients, defined by greater verbal memory impairment and depressive symptoms, develop a more resistant profile as a result of increasingly detrimental neuronal changes. Moreover, our results support a more comprehensive approach in the evaluation and treatment of DTD in order to improve illness course. Longitudinal studies are warranted to confirm the predictive value of verbal memory and depression severity in the development of TRD.
Collapse
Affiliation(s)
- Clara López-Solà
- Mental Health Department, Parc Taulí Hospital Universitari, Neuroscience and Mental Health Research Area, Institut d’Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Carlos III Health Institute, Madrid, Spain
| | - Marta Subirà
- Mental Health Department, Parc Taulí Hospital Universitari, Neuroscience and Mental Health Research Area, Institut d’Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Carlos III Health Institute, Madrid, Spain
| | - Maria Serra-Blasco
- Mental Health Department, Parc Taulí Hospital Universitari, Neuroscience and Mental Health Research Area, Institut d’Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
| | - Muriel Vicent-Gil
- Mental Health Department, Parc Taulí Hospital Universitari, Neuroscience and Mental Health Research Area, Institut d’Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
- Department of Psychiatry, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | - Guillem Navarra-Ventura
- Mental Health Department, Parc Taulí Hospital Universitari, Neuroscience and Mental Health Research Area, Institut d’Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eva Aguilar
- Mental Health Department, Parc Taulí Hospital Universitari, Neuroscience and Mental Health Research Area, Institut d’Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
| | - Siddarta Acebillo
- Mental Health Department, Parc Taulí Hospital Universitari, Neuroscience and Mental Health Research Area, Institut d’Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
| | - Diego J. Palao
- Mental Health Department, Parc Taulí Hospital Universitari, Neuroscience and Mental Health Research Area, Institut d’Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Carlos III Health Institute, Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Narcís Cardoner
- Mental Health Department, Parc Taulí Hospital Universitari, Neuroscience and Mental Health Research Area, Institut d’Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
- CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Carlos III Health Institute, Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| |
Collapse
|
7
|
Pham TH, Gardier AM. Fast-acting antidepressant activity of ketamine: highlights on brain serotonin, glutamate, and GABA neurotransmission in preclinical studies. Pharmacol Ther 2019; 199:58-90. [DOI: 10.1016/j.pharmthera.2019.02.017] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 02/25/2019] [Indexed: 12/13/2022]
|
8
|
Raison CL, Pikalov A, Siu C, Tsai J, Koblan K, Loebel A. C-reactive protein and response to lurasidone in patients with bipolar depression. Brain Behav Immun 2018; 73:717-724. [PMID: 30102967 DOI: 10.1016/j.bbi.2018.08.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 08/01/2018] [Accepted: 08/09/2018] [Indexed: 01/03/2023] Open
Abstract
Prior studies suggest that the inflammatory biomarker c-reactive protein (CRP) holds promise for predicting antidepressant response in patients with major depressive disorder. The objective of this study was to evaluate whether CRP might similarly predict antidepressant responses to lurasidone in patients with bipolar I depression. Serum CRP concentration was measured prior to, and following, 6 weeks of treatment in 485 outpatients with bipolar I depression. Patients were randomized to receive monotherapy with lurasidone 20-60 mg/day (N = 161), lurasidone 80-120 mg/day (N = 162) or placebo (N = 162). CRP was assessed using the wide-range CRP assay (wr-CRP). The primary efficacy endpoint was change from baseline to week 6 in Montgomery-Åsberg Depression Rating Scale (MADRS) score. Mixed models and statistical interaction tests were applied to investigate the moderating effects of pre-treatment wr-CRP on clinical endpoints. CRP was evaluated as a log-transformed continuous variable and by clinically-relevant cut-points. Increasing pre-treatment wr-CRP level predicted a larger overall antidepressant response to lurasidone, as well as an increased response for a number of individual depressive symptoms. These moderating effects of pre-treatment wr-CRP remained significant after adjustment for potential confounds (e.g. baseline BMI and weight change). Treatment with lurasidone did not affect serum concentrations of CRP compared to placebo during the study. Elevated CRP level prior to treatment was associated with an enhanced clinical response to lurasidone in patients with bipolar I depression. If confirmed in future studies, CRP may represent a clinically useful diagnostic and predictive biomarker supporting a precision medicine approach to the treatment of bipolar depression.
Collapse
Affiliation(s)
- Charles L Raison
- School of Human Ecology, University of Wisconsin-Madison, 1300 Linden Drive, Madison, WI 53706, USA; Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, 6001 Research Park Blvd, Madison, WI 53719, USA.
| | - Andrei Pikalov
- Sunovion Pharmaceuticals Inc., 1 Bridge Plaza North, Suite 510, Fort Lee, NJ, USA; Sunovion Pharmaceuticals Inc., Marlborough, MA, USA
| | - Cynthia Siu
- COS & Associates Ltd., 20/F Central Tower, 28 Queen's Rd, Central District, Hong Kong
| | - Joyce Tsai
- Sunovion Pharmaceuticals Inc., 1 Bridge Plaza North, Suite 510, Fort Lee, NJ, USA; Sunovion Pharmaceuticals Inc., Marlborough, MA, USA
| | - Kenneth Koblan
- Sunovion Pharmaceuticals Inc., 1 Bridge Plaza North, Suite 510, Fort Lee, NJ, USA; Sunovion Pharmaceuticals Inc., Marlborough, MA, USA
| | - Antony Loebel
- Sunovion Pharmaceuticals Inc., 1 Bridge Plaza North, Suite 510, Fort Lee, NJ, USA; Sunovion Pharmaceuticals Inc., Marlborough, MA, USA
| |
Collapse
|
9
|
Wang S, Qian M, Li L, Yang Q. A Case Report of A Patient with Treatment-Resistant Depression Successfully Treated with Repeated Intravenous Injections of A Low Dosage of Ketamine. SHANGHAI ARCHIVES OF PSYCHIATRY 2017; 29:376-379. [PMID: 29719350 PMCID: PMC5925590 DOI: 10.11919/j.issn.1002-0829.217036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Depression is a highly prevalent and severely disabling disease. The treatment effects, intensity and onset time of antidepressants have been highlighted in many studies. Recent studies on the rapid-onset of antidepressant response focused on the effect of a single low dose of intravenous ketamine. However, there are still some problems with treatment, including safety, efficacy, ethics, dose, frequency of administration and their effect in treatment-resistant depression. In the present study, we treated one case of treatment resistant depression with repeated intravenous injections with a low dosage of ketamine.
Collapse
Affiliation(s)
- Shikai Wang
- Third People's Hospital, Huzhou, Zhejiang Province, China
| | - Mincai Qian
- Third People's Hospital, Huzhou, Zhejiang Province, China
| | - Liang Li
- Third People's Hospital, Huzhou, Zhejiang Province, China
| | - Qi Yang
- Third People's Hospital, Huzhou, Zhejiang Province, China
| |
Collapse
|