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Corney KB, Stuart AL, Pasco JA, Mohebbi M, Kavanagh BE, Sui SX, Williams LJ. Psychiatric symptoms, associated pharmacological treatments and cognitive function: A population-based study of men. J Affect Disord 2024; 356:657-663. [PMID: 38657772 DOI: 10.1016/j.jad.2024.04.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 04/09/2024] [Accepted: 04/21/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Psychiatric symptomatology and medications used in their treatment may be modifiable risk factors associated with cognitive function, although findings from population-based studies spanning the full adult age range are lacking. This study aimed to investigate associations between psychiatric symptomatology, psychotropic medication use and cognitive function in a population-based sample of men. METHODS Data for 537 men were drawn from the Geelong Osteoporosis Study. Cognitive function (psychomotor function, attention, working memory and visual learning) was determined using the Cog-State Brief Battery. Current depressive and anxiety symptomatology was determined using the Hospital Anxiety and Depression Scale, and psychotropic medication use was self-reported. Linear regression models were developed to determine associations between psychiatric symptomatology and psychotropic medication use with each cognitive measure. RESULTS Depressive symptomatology was associated with lower overall cognitive function (b-0.037 ± 0.010, η2 = 0.025, p < 0.001), psychomotor function (b 0.006 ± 0.002, η2 = 0.028 p < 0.001) and attention (b 0.004 ± 0.001, η2 = 0.021, p < 0.001), whereas psychotropic use was associated with lower overall cognitive function (b - 0.174 ± 0.075, η2 = 0.010, p = 0.021), attention (b 0.017 ± 0.008, η2 = 0.008, p = 0.038 and working memory (b 0.031 ± 0.012, η2 = 0.010, p = 0.010). Anticonvulsant use was associated with lower overall cognitive function (b - 0.723 ± 0.172, η2 = 0.032, p < 0.001), attention (b 0.065 ± 0.018, η2 = 0.029, p < 0.001) and working memory (b 0.088 ± 0.026, η2 = 0.022, p < 0.001). All relationships were found to have a small effect. There were no significant associations between anxiety symptomatology and antidepressant and anxiolytic use with any of the cognitive domains. CONCLUSION Depressive symptomatology and anticonvulsant use were associated with lower cognitive function. Understanding the underlying mechanisms involved in these relationships can advance knowledge on the heterogeneity in cognitive ageing and aid in prevention initiatives.
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Affiliation(s)
- Kayla B Corney
- Deakin University, IMPACT - Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia.
| | - Amanda L Stuart
- Deakin University, IMPACT - Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia
| | - Julie A Pasco
- Deakin University, IMPACT - Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia; Barwon Health, Geelong, VIC, Australia; Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Mohammadreza Mohebbi
- Deakin University, IMPACT - Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia; Deakin University, Faculty of Health, Biostatistics Unit, Melbourne, VIC, Australia
| | - Bianca E Kavanagh
- Deakin University, IMPACT - Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia; Deakin University, Deakin Rural Health, School of Medicine, Warrnambool, VIC, Australia
| | - Sophia X Sui
- Deakin University, IMPACT - Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia
| | - Lana J Williams
- Deakin University, IMPACT - Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia; Barwon Health, Geelong, VIC, Australia
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Hori Y, Mimura K, Nagai Y, Hori Y, Kumata K, Zhang MR, Suhara T, Higuchi M, Minamimoto T. Reduced serotonergic transmission alters sensitivity to cost and reward via 5-HT1A and 5-HT1B receptors in monkeys. PLoS Biol 2024; 22:e3002445. [PMID: 38163325 PMCID: PMC10758260 DOI: 10.1371/journal.pbio.3002445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 11/22/2023] [Indexed: 01/03/2024] Open
Abstract
Serotonin (5-HT) deficiency is a core biological pathology underlying depression and other psychiatric disorders whose key symptoms include decreased motivation. However, the exact role of 5-HT in motivation remains controversial and elusive. Here, we pharmacologically manipulated the 5-HT system in macaque monkeys and quantified the effects on motivation for goal-directed actions in terms of incentives and costs. Reversible inhibition of 5-HT synthesis increased errors and reaction times on goal-directed tasks, indicating reduced motivation. Analysis found incentive-dependent and cost-dependent components of this reduction. To identify the receptor subtypes that mediate cost and incentive, we systemically administered antagonists specific to 4 major 5-HT receptor subtypes: 5-HT1A, 5-HT1B, 5-HT2A, and 5-HT4. Positron emission tomography (PET) visualized the unique distribution of each subtype in limbic brain regions and determined the systemic dosage for antagonists that would achieve approximately 30% occupancy. Only blockade of 5-HT1A decreased motivation through changes in both expected cost and incentive; sensitivity to future workload and time delay to reward increased (cost) and reward value decreased (incentive). Blocking the 5-HT1B receptor also reduced motivation through decreased incentive, although it did not affect expected cost. These results suggest that 5-HT deficiency disrupts 2 processes, the subjective valuation of costs and rewards, via 5-HT1A and 5-HT1B receptors, thus leading to reduced motivation.
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Affiliation(s)
- Yukiko Hori
- Department of Functional Brain Imaging, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Koki Mimura
- Department of Functional Brain Imaging, National Institutes for Quantum Science and Technology, Chiba, Japan
- Research Center for Medical and Health Data Science, The Institute of Statistical Mathematics, Tokyo, Japan
| | - Yuji Nagai
- Department of Functional Brain Imaging, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Yuki Hori
- Department of Functional Brain Imaging, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Katsushi Kumata
- Department of Advanced Nuclear Medicine Sciences, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Ming-Rong Zhang
- Department of Advanced Nuclear Medicine Sciences, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Tetsuya Suhara
- Department of Functional Brain Imaging, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Makoto Higuchi
- Department of Functional Brain Imaging, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Takafumi Minamimoto
- Department of Functional Brain Imaging, National Institutes for Quantum Science and Technology, Chiba, Japan
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Reyna NC, Clark BJ, Hamilton DA, Pentkowski NS. Anxiety and Alzheimer's disease pathogenesis: focus on 5-HT and CRF systems in 3xTg-AD and TgF344-AD animal models. Front Aging Neurosci 2023; 15:1251075. [PMID: 38076543 PMCID: PMC10699143 DOI: 10.3389/fnagi.2023.1251075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/25/2023] [Indexed: 02/12/2024] Open
Abstract
Dementia remains one of the leading causes of morbidity and mortality in older adults. Alzheimer's disease (AD) is the most common type of dementia, affecting over 55 million people worldwide. AD is characterized by distinct neurobiological changes, including amyloid-beta protein deposits and tau neurofibrillary tangles, which cause cognitive decline and subsequent behavioral changes, such as distress, insomnia, depression, and anxiety. Recent literature suggests a strong connection between stress systems and AD progression. This presents a promising direction for future AD research. In this review, two systems involved in regulating stress and AD pathogenesis will be highlighted: serotonin (5-HT) and corticotropin releasing factor (CRF). Throughout the review, we summarize critical findings in the field while discussing common limitations with two animal models (3xTg-AD and TgF344-AD), novel pharmacotherapies, and potential early-intervention treatment options. We conclude by highlighting promising future pharmacotherapies and translational animal models of AD and anxiety.
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Affiliation(s)
- Nicole C. Reyna
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
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El-Khoury BB, Ray KL, Altchuler SI, Reichard JF, Dukes CH. Selective Serotonin Reuptake Inhibitors and Other Treatment Modalities for Deep Space Missions. Aerosp Med Hum Perform 2023; 94:843-851. [PMID: 37853590 DOI: 10.3357/amhp.6272.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
INTRODUCTION: As humankind ventures further into the depths of space, planning is already underway for long-duration exploration missions that will test the bounds of human performance. Deep space travel will include added risk related to stressors from the isolated, confined, and extreme environment that lies outside the boundaries of low Earth orbit. Currently, selective serotonin reuptake inhibitors (SSRIs) are considered the standard of care for many mental health diagnoses, including anxiety and depression; however, SSRIs are also associated with several undesired side effects. The utility of nonpharmacological therapies for the management of behavioral health conditions has not yet been fully explored.METHODS: A comprehensive literature search was performed using PubMed. Relevant articles pertaining to the psychological impacts of isolated, confined, and extreme environments, use of SSRIs in spaceflight, side effects associated with SSRIs, and nonpharmacological treatments for anxiety and depression were reviewed. Over 70 studies were reviewed in total.RESULTS: Reduced bone mineral density, impaired hemostatic function, significant individual variability resulting from gene polymorphisms, and drug-drug interactions are well described adverse effects of SSRIs that may complicate their operational use in the deep space environment. Four alternative therapies for the treatment of anxiety and depression may show promise for long duration missions.DISCUSSION: Although SSRIs have long been considered standard of care treatment for many behavioral health conditions, we cannot trivialize the risk that prolonged pharmacological therapy may pose. The need to mitigate these risks by exploring alternative therapies has never been more relevant.El-Khoury BB, Ray KL, Altchuler SI, Reichard JF, Dukes CH. Selective serotonin reuptake inhibitors and other treatment modalities for deep space missions. Aerosp Med Hum Perform. 2023; 94(11):843-851.
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Barlet BD, Hauson AO, Pollard AA, Zhang EZ, Nemanim NM, Sarkissians S, Lackey NS, Stelmach NP, Walker AD, Carson BT, Flora-Tostado C, Reszegi K, Allen KE, Viglione DJ. Neuropsychological Performance in Alzheimer's Disease versus Late-Life Depression: A Systematic Review and Meta-Analysis. Arch Clin Neuropsychol 2023; 38:991-1016. [PMID: 37332152 DOI: 10.1093/arclin/acad036] [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] [Accepted: 04/14/2023] [Indexed: 06/20/2023] Open
Abstract
OBJECTIVE Despite decades of research, neuropsychological tests (NPTs) that clearly differentiate between Alzheimer's disease (AD) and late-life depression (LLD) have yet to be agreed upon. Given this gap in knowledge and the rapid deployment of disease-modifying drugs for the two disorders, accurate clinical diagnosis using evidence-based assessment is essential. This study aims to systematically examine the literature to identify NPTs that would be able to differentiate AD and LLD. METHOD Databases and bibliographies were searched to identify articles for analysis. Two major inclusion criteria were that the studies compared neuropsychological functioning of AD versus LLD using normed NPTs and provided data for effect size calculation. Risk of bias was minimized by having independent coders for all steps in the review. RESULTS Forty-one studies met inclusion criteria (N = 2,797) and provided effect sizes for tests that were classified as belonging to 15 domains of functioning. The two groups were well differentiated by tasks of delayed contextual verbal memory as compared to immediate or non-contextual memory, recognition cueing, confrontation naming, visuospatial construction, and conceptualization. Specific NPTs that appear to be useful for differential diagnosis include the Rey Auditory Verbal Learning Test-Delayed Recognition; Boston Naming Test; the Dementia Rating Scale's memory, conceptualization, and construction subscales; and the CERAD Constructional Praxis. CONCLUSIONS The NPTs highlighted in this systematic review could be used as a relatively simple and cost-effective method to differentiate between patients with cognitive dysfunction due to AD versus LLD.
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Affiliation(s)
- Brianna D Barlet
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Alexander O Hauson
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Anna A Pollard
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Emily Z Zhang
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Natasha M Nemanim
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Sharis Sarkissians
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Nick S Lackey
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Nicholas P Stelmach
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Alyssa D Walker
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Bryce T Carson
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Christopher Flora-Tostado
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Katalin Reszegi
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Kenneth E Allen
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Donald J Viglione
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
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Masdrakis VG, Markianos M, Baldwin DS. Apathy associated with antidepressant drugs: a systematic review. Acta Neuropsychiatr 2023; 35:189-204. [PMID: 36644883 DOI: 10.1017/neu.2023.6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Administration of antidepressant drugs - principally selective serotonin reuptake inhibitors (SSRIs) - may induce clinically significant 'apathy' which can affect treatment outcomes adversely. We aimed to review all relevant previous reports. METHODS We performed a PUBMED search of English-language studies, combining terms concerning psychopathology (e.g. apathy) and classes of antidepressants (e.g. SSRI). RESULTS According to certain inclusion (e.g. use of DSM/ICD diagnostic criteria) and exclusion (e.g. presence of a clinical condition that may induce apathy) criteria, 50 articles were eligible for review. Together, they suggest that administration of antidepressants - usually SSRIs - can induce an apathy syndrome or emotional blunting, i.e. a decrease in emotional responsiveness, to circumstances which would have triggered intense mood reactions prior to pharmacotherapy. The reported prevalence of antidepressant-induced apathy ranges between 5.8 and 50%, and for SSRIs ranges between 20 and 92%. Antidepressant-induced apathy emerges independently of diagnosis, age, and treatment outcome and appears dose-dependent and reversible. The main treatment strategy is dose reduction, though some data suggest the usefulness of treatment with olanzapine, bupropion, agomelatine or amisulpride, or the methylphenidate-modafinil-olanzapine combination. CONCLUSION Antidepressant-induced apathy needs careful clinical attention. Further systematic research is needed to investigate the prevalence, course, aetiology, and treatment of this important clinical condition.
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Affiliation(s)
- Vasilios G Masdrakis
- Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Manolis Markianos
- Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - David S Baldwin
- University Department of Psychiatry, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- University Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Jawad MY, Fatima M, Hassan U, Zaheer Z, Ayyan M, Ehsan M, Khan MHA, Qadeer A, Gull AR, Asif MT, Shad MU. Can antidepressant use be associated with emotional blunting in a subset of patients with depression? A scoping review of available literature. Hum Psychopharmacol 2023:e2871. [PMID: 37184083 DOI: 10.1002/hup.2871] [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: 07/12/2022] [Revised: 04/05/2023] [Accepted: 04/19/2023] [Indexed: 05/16/2023]
Abstract
INTRODUCTION Despite frequent recognition of emotional blunting in the published literature, either as a primary symptom of depression or as an adverse effect of antidepressants, there is no systematic synthesis on this topic to our knowledge. We undertook this scoping review to assess the prevalence, clinical features, implicated causes and management of emotional blunting, outlining the phenomenological and clinical gaps in research. METHOD A systematic search was done until March 15, 2022, to include all original studies (i.e., interventional trials, cohort & cross-sectional studies, case reports, and case series). All reviewed data were delineated to answer pertinent clinical, phenomenological, and management questions related to the phenomenon of emotional blunting. RESULTS A total of 25 original studies were included in our scoping review. Emotional blunting was described as a persistent diminution in both positive and negative feelings in depressed patients, who could subjectively differentiate it from their acute symptoms. However, the literature lacked the distinction between emotional blunting as a primary symptom of depression or an adverse effect of antidepressants. Common clinical strategies to manage antidepressant-induced emotional blunting included dose reduction or switching to a different antidepressant. CONCLUSION Emotional blunting was a significant patient-reported concern with antidepressants. Future research should clarify phenomenological and neurobiological constructs underlying emotional blunting to improve diagnostic and management skills.
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Affiliation(s)
- Muhammad Youshay Jawad
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Umer Hassan
- King Edward Medical University, Lahore, Pakistan
| | | | | | | | | | - Ahsan Qadeer
- King Edward Medical University, Lahore, Pakistan
| | | | | | - Mujeeb U Shad
- University of Nevada Las Vegas, Las Vegas, Nevada, USA
- Touro University Nevada College of Osteopathic Medicine, Las Vegas, Nevada, USA
- The Valley Health System, Las Vegas, Nevada, USA
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Fornaro M, Cattaneo CI, De Berardis D, Ressico FV, Martinotti G, Vieta E. Antidepressant discontinuation syndrome: A state-of-the-art clinical review. Eur Neuropsychopharmacol 2023; 66:1-10. [PMID: 36345093 DOI: 10.1016/j.euroneuro.2022.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/13/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022]
Abstract
Antidepressant drugs are prescribed to patients with depressive, anxiety disorders, and other conditions. Evidence about antidepressant discontinuation syndrome (ADS) and related outcomes is sparse, although potentially burdensome in some patients. The present state-of-the-art review aims to appraise the most current evidence about ADS critically. ADS has been documented for most antidepressant drugs, although most literature focuses on selective serotonin reuptake inhibitors prescribed for depression. While down-titration cannot exclude the chance of ADS, it is nonetheless warranted in the clinical setting, especially for short half-life and sedative compounds such as paroxetine. Integrative management with concurrent pharmacotherapy and psychotherapy may minimize the eventual unpleasant effects arising within the discontinuation process. In addition, patient-tailored interventions and education should be part of the discontinuation strategy. Future research must rely on broadly accepted definitions for ADS and related phenomena such as antidepressant withdrawal and shed further light on the underpinning neurobiology. Discriminating between ADS-related phenomena and relapse of depression is likewise warranted, along with a neuroscience-based nomenclature instead of a class one.
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Affiliation(s)
- M Fornaro
- Department of Psychiatry, Federico II University of Naples, via Pansini n.5, building 18, Psychiatry, Naples ZIP 80131, Italy.
| | - C I Cattaneo
- Department of Mental Health, Borgomanero ASL, Novara, Italy
| | - D De Berardis
- Department of Mental Health Psychiatric Service, Diagnosis and Treatment. Hospital "G. Mazzini", ASL 4, NHS, Teramo, Italy
| | - F V Ressico
- Department of Mental Health, Borgomanero ASL, Novara, Italy
| | - G Martinotti
- Department of Neuroscience, Imaging, and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy; Department of Pharmacy, Pharmacology, Postgraduate Medicine, University of Hertfordshire, Herts AL10 9AB, UK
| | - E Vieta
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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Holmen SJ. Cognitive Diminishments and Crime Prevention: “Too Smart for the Rest of Us”? NEUROETHICS-NETH 2022. [DOI: 10.1007/s12152-022-09488-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pupier E, Santos A, Etchamendy N, Lavielle A, Ferriere A, Marighetto A, Resmini E, Cota D, Webb SM, Tabarin A. Impaired quality of life, but not cognition, is linked to a history of chronic hypercortisolism in patients with Cushing's disease in remission. Front Endocrinol (Lausanne) 2022; 13:934347. [PMID: 36004342 PMCID: PMC9393704 DOI: 10.3389/fendo.2022.934347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
CONTEXT Impaired cognition and altered quality of life (QoL) may persist despite long-term remission of Cushing's disease (CD). Persistent comorbidities and treatment modalities may account for cognitive impairments. Therefore, the role of hypercortisolism per se on cognitive sequelae remains debatable. OBJECTIVE To investigate whether memory and QoL are impaired after long-term remission of CD in patients with no confounding comorbidity. DESIGN AND SETTING Cross-sectional case-control study in two tertiary referral centers. PATIENTS 25 patients (44.5 ± 2.4 years) in remission from CD for 102.7 ± 19.3 Mo and 25 well-matched controls, without comorbidity or treatment liable to impair cognition. MAIN OUTCOME MEASURES Hippocampus- and prefrontal cortex-dependent memory, including memory flexibility and working memory, were investigated using multiple tests including sensitive locally-developed computerized tasks. Depression and anxiety were evaluated with the MADRS and HADS questionnaires. QoL was evaluated with the SF-36 and CushingQoL questionnaires. The intensity of CD was assessed using mean urinary free cortisol and a score for clinical symptoms. RESULTS CD patients displayed similar performance to controls in all cognitive tests. In contrast, despite the absence of depression and a minimal residual clinical Cushing score, patients had worse QoL. Most of the SF36 subscales and the CushingQoL score were negatively associated only with the duration of exposure to hypercortisolism (p≤ 0.01 to 0.001). CONCLUSIONS Persistent comorbidities can be a primary cause of long-lasting cognitive impairment and should be actively treated. Persistently altered QoL may reflect irreversible effects of hypercortisolism, highlighting the need to reduce its duration. CLINICAL TRIAL REGISTRATION NUMBER https://clinicaltrials.gov, identifier NCT02603653.
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Affiliation(s)
- Emilie Pupier
- Department of Endocrinology, Diabetes and Nutrition, CHU of Bordeaux and University of Bordeaux, Pessac, France
| | - Alicia Santos
- Endocrinology Department, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747) Instituto de Salud Carlos III (ISCIII), Barcelona, Spain
- Department Medicine, Research Center for Pituitary Diseases, Hospital Sant Pau, Institut d'Investigació Biomèdica (IIB)-Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Nicole Etchamendy
- Neurocentre Magendie, University of Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux, France
| | - Aurélie Lavielle
- Department of Endocrinology, Diabetes and Nutrition, CHU of Bordeaux and University of Bordeaux, Pessac, France
| | - Amandine Ferriere
- Department of Endocrinology, Diabetes and Nutrition, CHU of Bordeaux and University of Bordeaux, Pessac, France
| | - Aline Marighetto
- Neurocentre Magendie, University of Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux, France
| | - Eugenia Resmini
- Endocrinology Department, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747) Instituto de Salud Carlos III (ISCIII), Barcelona, Spain
- Department Medicine, Research Center for Pituitary Diseases, Hospital Sant Pau, Institut d'Investigació Biomèdica (IIB)-Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Daniela Cota
- Neurocentre Magendie, University of Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux, France
| | - Susan M. Webb
- Endocrinology Department, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747) Instituto de Salud Carlos III (ISCIII), Barcelona, Spain
- Department Medicine, Research Center for Pituitary Diseases, Hospital Sant Pau, Institut d'Investigació Biomèdica (IIB)-Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Antoine Tabarin
- Department of Endocrinology, Diabetes and Nutrition, CHU of Bordeaux and University of Bordeaux, Pessac, France
- Neurocentre Magendie, University of Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux, France
- *Correspondence: Antoine Tabarin,
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Vieira A, Moreira A, Machado JP, Robinson N, Hu XY. Is auriculotherapy effective and safe for the treatment of anxiety disorders? – Protocol for a systematic review. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2021.101734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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High exposure to pharmacological treatments is associated with limited efficacy of electroconvulsive therapy in bipolar depression. Psychiatry Res 2021; 304:114169. [PMID: 34425459 DOI: 10.1016/j.psychres.2021.114169] [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: 10/15/2020] [Revised: 04/09/2021] [Accepted: 08/07/2021] [Indexed: 11/23/2022]
Abstract
Episode chronicity and medication failure are considered robust predictors of poor response to electroconvulsive therapy (ECT). In this study we explored the associations between indexes of drug exposure during current episode and outcomes of ECT in 168 bipolar depressive patients. The association between response or remission and number of previous pharmacological trials, failure of treatment with antidepressants, antipsychotics or combinations, and sum of maximum Antidepressant Treatment History Form (ATHF) scores obtained in each pharmacological class were tested. 98 patients (58%) were considered responders and 21 remitters (13%). Number of trials, number of adequate trials, ATHF sum, antidepressant-antipsychotic combination therapy failure and failure of two adequate trials were significantly negatively associated with remission. The association with ATHF sum stayed significant when controlling for episode duration and manic symptoms and survived stepwise model selection. No significant associations with response were identified. In conclusion, a history of multiple drug treatments may be linked to a greater resistance to all types of therapies, including ECT. However, we could not exclude that, at least in some patients, a prolonged exposure to pharmacological treatments may be responsible for a greater chronicity and for the presence of residual symptoms, which would explain reduced remission after ECT.
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Marazziti D, Avella MT, Ivaldi T, Palermo S, Massa L, Vecchia AD, Basile L, Mucci F. Neuroenhancement: State of the Art and Future Perspectives. CLINICAL NEUROPSYCHIATRY 2021; 18:137-169. [PMID: 34909030 PMCID: PMC8629054 DOI: 10.36131/cnfioritieditore20210303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Pharmacological neuroenhancement refers to the non-medical use of prescription drugs, alcohol, illegal drugs, or the so-called soft enhancers for the purpose of improving cognition, mood, pro-social behavior, or work and academic performance. This phenomenon is undoubtedly more frequent than previously supposed especially amongst university students. The aim of the present paper was to carefully review and comment on the available literature on neuroenhancement, according to Prisma guidelines. The results showed a great use of all prescribed drugs (benzodiazepines, antidepressants, antipsychotics, nootropic compounds, and especially stimulants) as neuroenhancers amongst healthy subjects, although probably the real prevalence is underestimated. The use of illicit drugs and soft enhancers is similarly quite common. Data on the improvement of cognition by other compounds, such as oxytocin and pheromones, or non-pharmacological techniques, specifically deep brain stimulation and transcranial magnetic stimulation, are still limited. In any case, if it is true that human beings are embedded by the desire to overcome the limits of their intrinsic nature, neuroenhancement practices put into question the concept of authenticity. Therefore, the problem appears quite complex and requires to be deepened and analyzed with no prejudice, although within an ethical conceptual frame.
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Affiliation(s)
- Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
- Unicamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Maria Teresa Avella
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Tea Ivaldi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Stefania Palermo
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Lucia Massa
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Alessandra Della Vecchia
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Lucia Basile
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Federico Mucci
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Italy
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"Novel Psychopharmacology for Depressive Disorders". ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1305:449-461. [PMID: 33834412 DOI: 10.1007/978-981-33-6044-0_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Major depressive disorder carries a significant burden and a high risk for suicide. The need for more effective, safer, and faster-acting drugs is, therefore, compelling. The present chapter briefly assesses the most promising agents, focusing on non-monoamine-targeting compounds, namely, the glutamate antagonist ketamine and its enantiomer esketamine. A critical overview of the evidence and the pitfalls associated with current antidepressant drug development is likewise provided in the following text.
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Seppälä EM, Bradley C, Moeller J, Harouni L, Nandamudi D, Brackett MA. Promoting Mental Health and Psychological Thriving in University Students: A Randomized Controlled Trial of Three Well-Being Interventions. Front Psychiatry 2020; 11:590. [PMID: 32760296 PMCID: PMC7373803 DOI: 10.3389/fpsyt.2020.00590] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 06/08/2020] [Indexed: 12/20/2022] Open
Abstract
This study aimed to address the decline in mental health on U.S. university campuses by examining the effects of three interventions. University students suffer from high levels of anxiety, depression, and suicide. Counseling centers on university campuses are struggling to meet increased demand. The cost to students and universities could be buffered by offering preventative, psychoeducational, and skill-building training programs that promote mental health and psychological thriving. To date, the research literature has not yielded systematically evaluated and recommendable preventative mental health and well-being programs for university students. In a registered, randomized controlled trial, 131 university students were either placed in a non-intervention control group (N = 47) or received training in one of three 30-hour, eight-week semester-long well-being programs: SKY Campus Happiness ("SKY"; N = 29), Foundations of Emotional Intelligence ("EI"; N = 21) or Mindfulness-Based Stress Reduction ("MBSR"; N = 34). Compared to the control group and controlling for variance of baseline measurements and multiple comparisons, SKY Campus Happiness showed the greatest impact, benefiting six outcomes: depression, stress, mental health, mindfulness, positive affect and social connectedness. EI benefited one outcome: mindfulness. The MBSR group showed no change. Delivering SKY or EI to university students may be a cost-effective and efficient way to proactively and preventatively address mental health for university students and reduce the financial strain on universities.
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Affiliation(s)
- Emma M. Seppälä
- Yale Child Study Center & Yale Center for Emotional Intelligence, Yale University, New Haven, CT, United States
- Center for Compassion and Altruism Research and Education, Stanford University, Stanford, CA, United States
| | - Christina Bradley
- Yale Child Study Center & Yale Center for Emotional Intelligence, Yale University, New Haven, CT, United States
| | - Julia Moeller
- Department of Education, Leipzig University, Leipzig, Germany
| | - Leilah Harouni
- Yale Child Study Center & Yale Center for Emotional Intelligence, Yale University, New Haven, CT, United States
- Yale School of Management, Yale University, New Haven, CT, United States
| | - Dhruv Nandamudi
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Marc A. Brackett
- Yale Child Study Center & Yale Center for Emotional Intelligence, Yale University, New Haven, CT, United States
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Synergistic antidepressant-like effect of capsaicin and citalopram reduces the side effects of citalopram on anxiety and working memory in rats. Psychopharmacology (Berl) 2020; 237:2173-2185. [PMID: 32388621 DOI: 10.1007/s00213-020-05528-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 04/16/2020] [Indexed: 12/20/2022]
Abstract
RATIONALE We have previously shown that in rats, capsaicin (Cap) has antidepressant-like properties when assessed using the forced swimming test (FST) and that a sub-threshold dose of amitriptyline potentiates the effects of Cap. However, synergistic antidepressant-like effects of the joint administration of Cap and the selective serotonin reuptake inhibitor citalopram (Cit) have not been reported. OBJECTIVES To assess whether combined administration of Cap and Cit has synergistic effects in the FST and to determine whether this combination prevents the side effects of Cit. METHODS Cap, Cit, and the co-administration of both substances were evaluated in a modified version of the FST (30-cm water depth) conducted in rats, as well as in the open field test (OFT), elevated plus maze (EPM), and Morris water maze (MWM). RESULTS In line with previous studies, independent administration of Cap and Cit displayed antidepressant-like properties in the FST, while the combined injection had synergistic effects. In the OFT, neither treatment caused significant increments in locomotion. In the EPM, the time spent in the closed arms was lower in groups administered either only Cap or a combination of Cap and Cit than in groups treated with Cit alone. In the MWM, both Cap and the joint treatment (Cap and Cit) improved the working memory of rats in comparison with animals treated only with Cit. CONCLUSION Combined administration of Cap and Cit produces a synergistic antidepressant-like effect in the FST and reduces the detrimental effects of Cit on anxiety and working memory.
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Krol FJ, Hagin M, Vieta E, Harazi R, Lotan A, Strous RD, Lerer B, Popovic D. Placebo-To be or not to be? Are there really alternatives to placebo-controlled trials? Eur Neuropsychopharmacol 2020; 32:1-11. [PMID: 31959380 DOI: 10.1016/j.euroneuro.2019.12.117] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 12/17/2019] [Accepted: 12/20/2019] [Indexed: 12/19/2022]
Abstract
Recent success of established treatment has driven concerns about the ethics of using placebo-controlled trials in psychiatry. Active-controlled (superiority or non-inferiority) trials do not include a placebo-arm and thus avoid the associated ethical concerns but show disadvantages in other respects. The aim of this paper is to review the available literature and critically discuss the evidence regarding the use of placebo-controlled- versus active-controlled trials. A MEDLINE/PubMed and Google Scholar search was performed. Studies included focused on the deliberation on placebo-controlled- versus active-controlled trials. Twenty-six studies were included. The most cited benefits of placebo-controlled trials were greater scientific reliability of the results and no average impact on patients' health. Disadvantages were mainly related to withholding effective treatment and limited generalizability. The most frequent argument in favor of active-controlled trials is the lower chance of receiving ineffective medication during the trial. Downsides include larger sample sizes, higher costs and lower scientific reliability of results. Most authors agree that all trial designs are relevant to psychiatric research depending on study goals. Whatsoever, data does not support forgoing placebo-controlled trials. Expert consensus is warranted to permit drawing conclusions on the debate on the relevance of placebo-controlled trials.
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Affiliation(s)
- Fas Jacob Krol
- Leiden University Medical Center, the Netherlands; Bipolar Disorders Program, Sheba Medical Center, 52621 Ramat Gan, Israel
| | - Michal Hagin
- Bipolar Disorders Program, Sheba Medical Center, 52621 Ramat Gan, Israel
| | - Eduard Vieta
- Bipolar and Depressive Disorders Program, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Rephael Harazi
- Bipolar Disorders Program, Sheba Medical Center, 52621 Ramat Gan, Israel
| | - Amit Lotan
- Biological Psychiatry Laboratory Hadassah - Hebrew University Medical Center, Jerusalem, Israel
| | - Rael D Strous
- Sackler Faculty of Medicine, Tel Aviv University, Israel; Maayenei Hayeshua Medical Center
| | - Bernard Lerer
- Biological Psychiatry Laboratory Hadassah - Hebrew University Medical Center, Jerusalem, Israel
| | - Dina Popovic
- Bipolar Disorders Program, Sheba Medical Center, 52621 Ramat Gan, Israel.
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Castellano S, Torrent C, Petralia MC, Godos J, Cantarella RA, Ventimiglia A, De Vivo S, Platania S, Guarnera M, Pirrone C, Drago F, Vieta E, Di Nuovo S, Popovic D, Caraci F. Clinical and Neurocognitive Predictors of Functional Outcome in Depressed Patients with Partial Response to Treatment: One Year Follow-Up Study. Neuropsychiatr Dis Treat 2020; 16:589-595. [PMID: 32184600 PMCID: PMC7055477 DOI: 10.2147/ndt.s224754] [Citation(s) in RCA: 4] [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: 07/25/2019] [Accepted: 01/15/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Cognitive dysfunction represents a distinct biological and clinical dimension in major depression disorders (MDD) and cognitive performance strongly affects psychosocial functioning in patients diagnosed with MDD. OBJECTIVE To assess which neurocognitive variables at baseline predict the functional outcome of MDD patients in a 1-year follow-up study as assessed by Functioning Assessment Short Test (FAST) and whether the improvement observed on affective and cognitive symptoms in our 12 week-prospective observational study after treatment with selective serotonin reuptake inhibitors (SSRIs) and selective noradrenalin reuptake inhibitors (SNRIs) can affect the following long-term psychosocial functional outcome at 1 year in the same MDD patients. METHODS We recruited a total of 31 patients (8 males; 23 females) with MDD who had previously completed a pharmacological treatment with SSRIs (n = 22) or SNRIs (n = 9) for 12 weeks, and then continued the same pharmacological treatment for 1 year. After an average 1-year follow-up, they were interviewed with the FAST to assess functional outcome. Multivariate analyses were applied to identify clinical and neurocognitive predictors of functional outcome. RESULTS Total Montreal Cognitive Assessment (MoCA), Digit Span forward (Span F) and backward (Span B), and 15 Rey words immediate recall (Rey I) scores significantly correlated with FAST. However, after performing regression models only Rey immediate recall score was useful to predict long-term functional outcome (Pearson correlation coefficient R= -0.68, p < 0.001) in four specific subdomains of FAST. When considering changes in affective and cognitive symptoms at the end of the 12 weeks of pharmacological treatment with SSRI or SNRIs (T1-T0) by multiple regression analysis, we found that Span F-test predicted scores in the FAST leisure domain, whereas, changes in Span F, Frontal Assessment Battery (FAB) and Rey I predicted psychosocial functioning in the specific "cognitive" subdomains of FAST. CONCLUSION Our data suggest that long-term psychosocial functioning can be influenced by neurocognitive performance at baseline, with verbal memory playing a key role in overall functioning. Furthermore, improvement in verbal memory can predict functional outcome at one year in MDD patients with a recent history of partial response to antidepressants.
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Affiliation(s)
- Sabrina Castellano
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Carla Torrent
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | | | | | | | | | | | - Silvia Platania
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Maria Guarnera
- Faculty of Human and Social Sciences, University of Enna “KORE”, Enna, Italy
| | - Concetta Pirrone
- Department of Educational Sciences, University of Catania, Catania, Italy
| | | | - Eduard Vieta
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Santo Di Nuovo
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Dina Popovic
- Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
- Bipolar Disorders Program, Sheba Medical Center, Ramat Gan, Israel
| | - Filippo Caraci
- Oasi Research Institute-IRCCS, Troina94018, Italy
- Department of Drug Sciences, University of Catania, Catania, Italy
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Hekmatjah J, Tareen K, Tareen RS. Citalopram-Associated Alopecia: A Case Report and Brief Literature Review. Curr Drug Saf 2019; 14:167-170. [DOI: 10.2174/1574886314666190215115857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 02/11/2019] [Accepted: 02/11/2019] [Indexed: 11/22/2022]
Abstract
Background:Selective Serotonin Reuptake Inhibitors (SSRIs) are the first-line treatments for various psychiatric disorders. SSRIs offer an improved side effect profile compared to older treatments, which improves patients’ adherence and quality of life.Case Report:Here we discuss a case of an uncommon, but a distressing side effect of citalopram. A 76-year old woman was referred to the psychiatry clinic for bizarre behavior. The patient was diagnosed with behavioral variant frontotemporal dementia and was started on citalopram 20 mg and aripiprazole 5 mg daily. At 3.5 months the patient complained of diffuse hair thinning on her scalp. Citalopram was considered the offending agent and was discontinued. Within a few months, the patient regained most of her hair. Although drug-induced alopecia is common among other SSRIs, it is relatively rare with citalopram.Results and Conclusion:Early recognition, withdrawal of offending agent, and reassurance to the patient that hair loss is reversible can help alleviate patient distress and avoid relapse.
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Affiliation(s)
- Joshua Hekmatjah
- Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Kinza Tareen
- Michigan State University, College of Human Medicine, Lansing, MI, United States
| | - Ruqiya Shama Tareen
- Department of Psychiatry, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
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20
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Plowden KO. Antidepressant-Related Apathy: Implications for Practice. J Nurse Pract 2019. [DOI: 10.1016/j.nurpra.2018.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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21
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Clinical effect of auricular acupuncture in anxiety levels of students prior to the exams: A randomized controlled trial. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2018.05.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Salagre E, Grande I, Solé B, Sanchez-Moreno J, Vieta E. Vortioxetine: A new alternative for the treatment of major depressive disorder. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.rpsmen.2018.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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23
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Salagre E, Solé B, Tomioka Y, Fernandes BS, Hidalgo-Mazzei D, Garriga M, Jimenez E, Sanchez-Moreno J, Vieta E, Grande I. Treatment of neurocognitive symptoms in unipolar depression: A systematic review and future perspectives. J Affect Disord 2017. [PMID: 28651185 DOI: 10.1016/j.jad.2017.06.034] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cognitive symptoms in Major Depressive Disorder (MDD) are persistent and commonly entail neurocognitive impairment and a decline in quality of life. This systematic review gathers the current scientific evidence on therapeutic strategies for neuropsychological impairment in MDD. METHOD A systematic search on PubMed, PsycINFO and Clinicaltrials.gov was carried out on December 2016 according to PRISMA using Boolean terms to identify interventions for the treatment of cognitive dysfunction in MDD. Only English-written articles providing original data and focusing in adults with MDD were included with no time restrictions. RESULTS A total of 95 studies reporting data on 40 pharmacological and non-pharmacological interventions were included. Interventions were grouped into the following categories: 1) Pharmacological Therapies (antidepressants, stimulants, compounds acting on NMDA receptors, compounds acting on the cholinergic system, compounds showing anti-inflammatory or antioxidant properties, other mechanisms of action), 2) Physical Therapies and 3) Psychological Therapies, 4) Exercise. There are some promising compounds showing a positive impact on cognitive symptoms including vortioxetine, lisdexamfetamine or erythropoietin. LIMITATIONS The studies included showed significant methodological differences in heterogeneous samples. The lack of a standardized neuropsychological battery makes comparisons between studies difficult. CONCLUSION Current evidence is not sufficient to widely recommend the use of procognitive treatments in MDD although promising results are coming to light.
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Affiliation(s)
- E Salagre
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Solé
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Y Tomioka
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B S Fernandes
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia; Laboratory of Calcium Binding Proteins in the Central Nervous System, Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - D Hidalgo-Mazzei
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - M Garriga
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Jimenez
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - J Sanchez-Moreno
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Vieta
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - I Grande
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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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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Abstract
Previous attempts to identify a unified theory of brain serotonin function have largely failed to achieve consensus. In this present synthesis, we integrate previous perspectives with new and older data to create a novel bipartite model centred on the view that serotonin neurotransmission enhances two distinct adaptive responses to adversity, mediated in large part by its two most prevalent and researched brain receptors: the 5-HT1A and 5-HT2A receptors. We propose that passive coping (i.e. tolerating a source of stress) is mediated by postsynaptic 5-HT1AR signalling and characterised by stress moderation. Conversely, we argue that active coping (i.e. actively addressing a source of stress) is mediated by 5-HT2AR signalling and characterised by enhanced plasticity (defined as capacity for change). We propose that 5-HT1AR-mediated stress moderation may be the brain's default response to adversity but that an improved ability to change one's situation and/or relationship to it via 5-HT2AR-mediated plasticity may also be important - and increasingly so as the level of adversity reaches a critical point. We propose that the 5-HT1AR pathway is enhanced by conventional 5-HT reuptake blocking antidepressants such as the selective serotonin reuptake inhibitors (SSRIs), whereas the 5-HT2AR pathway is enhanced by 5-HT2AR-agonist psychedelics. This bipartite model purports to explain how different drugs (SSRIs and psychedelics) that modulate the serotonergic system in different ways, can achieve complementary adaptive and potentially therapeutic outcomes.
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Affiliation(s)
- RL Carhart-Harris
- Psychedelic Research Group, Neuropsychopharmacology Unit, Centre for Psychiatry, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - DJ Nutt
- Psychedelic Research Group, Neuropsychopharmacology Unit, Centre for Psychiatry, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
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Salagre E, Grande I, Solé B, Sanchez-Moreno J, Vieta E. Vortioxetine: A new alternative for the treatment of major depressive disorder. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2017; 11:48-59. [PMID: 28800937 DOI: 10.1016/j.rpsm.2017.06.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 05/08/2017] [Accepted: 06/14/2017] [Indexed: 12/20/2022]
Abstract
Major Depressive Disorder (MDD) is a serious psychiatric condition. Its treatment remains a challenge nowadays. Vortioxetine is a novel antidepressant with a unique profile, as it acts as a multimodal serotoninergic agent. Its efficacy in MDD has been established in many short- and long-term studies, with 7 positive, 4 negative and 1 failed randomized controlled trials. Moreover, its ability to modulate a wide range of neurotransmitters (serotonin, dopamine, norepinephrine, histamine, glutamate or GABA) confers vortioxetine pro-cognitive effects. Side effects are also different from conventional antidepressants, according to its low incidence of sexual dysfunction, weight gain or cardiovascular alterations. The aim of this systematic review is to describe the pharmacology, clinical efficacy and safety profile of vortioxetine, as well as its potential effectiveness in improving cognitive symptoms.
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Affiliation(s)
- Estela Salagre
- Servicio de Psiquiatría y Psicología, Hospital Clínic, Instituto de Neurociencias, Universidad de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Cataluña, España
| | - Iria Grande
- Servicio de Psiquiatría y Psicología, Hospital Clínic, Instituto de Neurociencias, Universidad de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Cataluña, España
| | - Brisa Solé
- Servicio de Psiquiatría y Psicología, Hospital Clínic, Instituto de Neurociencias, Universidad de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Cataluña, España
| | - Jose Sanchez-Moreno
- Servicio de Psiquiatría y Psicología, Hospital Clínic, Instituto de Neurociencias, Universidad de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Cataluña, España
| | - Eduard Vieta
- Servicio de Psiquiatría y Psicología, Hospital Clínic, Instituto de Neurociencias, Universidad de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Cataluña, España.
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Li Y, Sanchez C, Gulinello M. Distinct Antidepressant-Like and Cognitive Effects of Antidepressants with Different Mechanisms of Action in Middle-Aged Female Mice. Int J Neuropsychopharmacol 2017; 20:510-515. [PMID: 28158336 PMCID: PMC5458342 DOI: 10.1093/ijnp/pyx004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 01/25/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Cognitive dysfunction is among the key symptoms of major depressive disorder and can be affected by antidepressants. Cognitive decline also occurs in normal aging. The effects of different antidepressants on affective and cognitive domains in older subjects are seldom assessed simultaneously. METHODS Healthy middle-aged female mice received vehicle or antidepressant (vortioxetine, vilazodone, duloxetine, or fluoxetine) at therapeutic doses. After 1 month treatment, mice were accessed for visuospatial memory and depression-like behavior. A separate cohort of mice received 3 months of treatment and was test for recognition memory and depression-like behavior. RESULTS After 1 month treatment, vortioxetine improved visuospatial memory and reduced depression-like behavior. Vilazodone reduced depression-like behavior. Duloxetine and fluoxetine were ineffective in both tests. After 3 months treatment, vortioxetine reduced depression-like behavior without affecting recognition memory, while fluoxetine impaired recognition memory. Duloxetine and vilazodone had no effect in both tests. CONCLUSION Different antidepressants have distinct effects in middle-aged female mice.
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Affiliation(s)
- Yan Li
- Lundbeck Research USA, Paramus, New Jersey (Drs Li and Sanchez); Behavioral Core Facility, Neuroscience Dept., Albert Einstein College of Medicine (Dr Gulinello)
| | - Connie Sanchez
- Lundbeck Research USA, Paramus, New Jersey (Drs Li and Sanchez); Behavioral Core Facility, Neuroscience Dept., Albert Einstein College of Medicine (Dr Gulinello)
| | - Maria Gulinello
- Lundbeck Research USA, Paramus, New Jersey (Drs Li and Sanchez); Behavioral Core Facility, Neuroscience Dept., Albert Einstein College of Medicine (Dr Gulinello)
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Qiu ZK, He JL, Liu X, Zhang GH, Zeng J, Nie H, Shen YG, Chen JS. The antidepressant-like activity of AC-5216, a ligand for 18KDa translocator protein (TSPO), in an animal model of diabetes mellitus. Sci Rep 2016; 6:37345. [PMID: 27886206 PMCID: PMC5122851 DOI: 10.1038/srep37345] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 10/27/2016] [Indexed: 11/27/2022] Open
Abstract
Diabetes mellitus is a chronic disease that is associated with depression. Also, depression is common in adults with type 2 diabetes mellitus (T2DM). Translocator protein (18kDa) (TSPO) and allopregnanolone play an important role in the depression treatment. However, few studies have evaluated TSPO and allopregnanolone in the treatment of depression in T2DM. AC-5216, a ligand for TSPO, produces anxiolytic- and antidepressant-like effects in animal models. The present study aimed to explore antidepressant-like effects of AC-5216 on diabetic rats. Following the development of diabetic model induced by high fat diet (HFD) feeding and streptozotocin (STZ), AC-5216 (0.3 and 1 mg/kg, i.g.) elicited the antidepressant-like effects in behavioral tests while these activities were blocked by TSPO antagonist PK11195 (3 mg/kg, i.p.). The levels of allopregnanolone in the prefrontal cortex and hippocampus were increased by AC-5216 (0.3 and 1 mg/kg, i.g.), which was antagonized by PK11195 (3 mg/kg, i.p.). The increased plasma glucose (PG) and decreased insulin (INS) in HFD-STZ rats were reversed by AC-5216 (0.3 and 1 mg/kg, i.g.). This study indicates that the antidepressant-like effects of AC-5216 on HFD-STZ rats, suggesting that TSPO may represent a novel therapeutic target for depression in T2DM.
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Affiliation(s)
- Zhi-Kun Qiu
- Pharmaceutical Department of the First Affiliated Hospital of Guangdong Pharmaceutical University, Clinical Pharmacy Department of Guangdong Pharmaceutical University, Guangzhou, 510080, P.R. China
- College of Pharmacy, Jinan University, Guangzhou 510632, P.R. China
| | - Jia-Li He
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, P.R. China
| | - Xu Liu
- Pharmacy Department of General Hospital of Chinese People’s Armed Police Forces, Beijing 100039, P.R. China
- Academy of Military Medical Sciences, Beijing 100850, P.R. China
| | - Guan-Hua Zhang
- Neurosurgery Department of the Third Affiliated Hospital of Southern Medical University, Guangzhou 510060, P.R. China
| | - Jia Zeng
- Pharmaceutical Department of the First Affiliated Hospital of Guangdong Pharmaceutical University, Clinical Pharmacy Department of Guangdong Pharmaceutical University, Guangzhou, 510080, P.R. China
| | - Hong Nie
- Academy of Military Medical Sciences, Beijing 100850, P.R. China
| | - Yong-Gang Shen
- Pharmaceutical Department of the First Affiliated Hospital of Guangdong Pharmaceutical University, Clinical Pharmacy Department of Guangdong Pharmaceutical University, Guangzhou, 510080, P.R. China
| | - Ji-Sheng Chen
- Pharmaceutical Department of the First Affiliated Hospital of Guangdong Pharmaceutical University, Clinical Pharmacy Department of Guangdong Pharmaceutical University, Guangzhou, 510080, P.R. China
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Cognitive Function before and during Treatment with Selective Serotonin Reuptake Inhibitors in Patients with Depression or Obsessive-Compulsive Disorder. PSYCHIATRY JOURNAL 2016; 2016:5480391. [PMID: 27597949 PMCID: PMC5002481 DOI: 10.1155/2016/5480391] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Accepted: 07/21/2016] [Indexed: 12/14/2022]
Abstract
Objectives. Identification of adverse effects of selective serotonin reuptake inhibitors (SSRIs) is of great importance due to their extensive use in medicine. Some studies have reported the effects of SSRIs on cognitive functions, but the results are conflicting. This study was designed to assess the effect of these drugs on cognition of patients with depression or obsessive-compulsive disorder (OCD). Methods. Patients with depression or OCD, naïve to therapy, and candidates of receiving one drug from SSRI class, voluntarily, entered this study. Mini-Mental State Examination (MMSE) test was the tool to assess their cognitive functions. MMSE scores of each patient were recorded prior to taking SSRIs and at weeks 3, 5, and 8 of drug therapy. Results. 50 patients met our inclusion criteria, with a baseline mean MMSE score of 23.94. At 3, 5, and 8 weeks of treatment, the mean scores were 22.1, 21.4, and 20.66, respectively. With a p value of <0.0001, the gradual decline was statistically significant. Conclusion. The MMSE scores of our patients showed a gradual decline over the consecutive weeks after taking SSRI drugs. It seems that the use of SSRIs in patients with depression or OCD, can cause cognitive dysfunction in the acute phase of treatment.
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Kandola A, Hendrikse J, Lucassen PJ, Yücel M. Aerobic Exercise as a Tool to Improve Hippocampal Plasticity and Function in Humans: Practical Implications for Mental Health Treatment. Front Hum Neurosci 2016; 10:373. [PMID: 27524962 PMCID: PMC4965462 DOI: 10.3389/fnhum.2016.00373] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 07/11/2016] [Indexed: 12/24/2022] Open
Abstract
Aerobic exercise (AE) has been widely praised for its potential benefits to cognition and overall brain and mental health. In particular, AE has a potent impact on promoting the function of the hippocampus and stimulating neuroplasticity. As the evidence-base rapidly builds, and given most of the supporting work can be readily translated from animal models to humans, the potential for AE to be applied as a therapeutic or adjunctive intervention for a range of human conditions appears ever more promising. Notably, many psychiatric and neurological disorders have been associated with hippocampal dysfunction, which may underlie the expression of certain symptoms common to these disorders, including (aspects of) cognitive dysfunction. Augmenting existing treatment approaches using AE based interventions may promote hippocampal function and alleviate cognitive deficits in various psychiatric disorders that currently remain untreated. Incorporating non-pharmacological interventions into clinical treatment may also have a number of other benefits to patient well being, such as limiting the risk of adverse side effects. This review incorporates both animal and human literature to comprehensively detail how AE is associated with cognitive enhancements and stimulates a cascade of neuroplastic mechanisms that support improvements in hippocampal functioning. Using the examples of schizophrenia and major depressive disorder, the utility and implementation of an AE intervention to the clinical domain will be proposed, aimed to reduce cognitive deficits in these, and related disorders.
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Affiliation(s)
- Aaron Kandola
- Brain and Mental Health Lab, School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, MelbourneVIC, Australia; Amsterdam Brain and Cognition, University of AmsterdamAmsterdam, Netherlands
| | - Joshua Hendrikse
- Brain and Mental Health Lab, School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne VIC, Australia
| | - Paul J Lucassen
- Centre for Neuroscience, Swammerdam Institute of Life Sciences, University of Amsterdam Amsterdam, Netherlands
| | - Murat Yücel
- Brain and Mental Health Lab, School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne VIC, Australia
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31
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Knöchel C, Voss M, Grüter F, Alves GS, Matura S, Sepanski B, Stäblein M, Wenzler S, Prvulovic D, Carvalho AF, Oertel-Knöchel V. Omega 3 Fatty Acids: Novel Neurotherapeutic Targets for Cognitive Dysfunction in Mood Disorders and Schizophrenia? Curr Neuropharmacol 2016; 13:663-80. [PMID: 26467414 PMCID: PMC4761636 DOI: 10.2174/1570159x13666150630173047] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 02/25/2015] [Accepted: 02/27/2015] [Indexed: 01/23/2023] Open
Abstract
An increasing body of evidences from preclinical as well as epidemiological and clinical
studies suggest a potential beneficial role of dietary intake of omega-3 fatty acids for cognitive functioning.
In this narrative review, we will summarize and discuss recent findings from epidemiological, interventional
and experimental studies linking dietary consumption of omega-3 fatty acids to cognitive
function in healthy adults. Furthermore, affective disorders and schizophrenia (SZ) are characterized
by cognitive dysfunction encompassing several domains. Cognitive dysfunction is closely related to impaired functioning
and quality of life across these conditions. Therefore, the current review focues on the potential influence of omega-3 fatty
acids on cognition in SZ and affective disorders. In sum, current data predominantly from mechanistic models and animal
studies suggest that adjunctive omega-3 fatty acid supplementation could lead to improved cognitive functioning in SZ
and affective disorders. However, besides its translational promise, evidence for clinical benefits in humans has been
mixed. Notwithstanding evidences indicate that adjunctive omega-3 fatty acids may have benefit for affective symptoms
in both unipolar and bipolar depression, to date no randomized controlled trial had evaluated omega-3 as cognitive
enhancer for mood disorders, while a single published controlled trial suggested no therapeutic benefit for cognitive
improvement in SZ. Considering the pleiotropic mechanisms of action of omega-3 fatty acids, the design of well-designed
controlled trials of omega-3 supplementation as a novel, domain-specific, target for cognitive impairment in SZ and
affective disorders is warranted.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Viola Oertel-Knöchel
- Laboratory for Neuroimaging, Dept. of Psychiatry, Dept. of Psychiatry, Psychosomatic Medicine and Psychotherapy; Heinrich-Hoffmann-Str. 10, Goethe-University, 60528 Frankfurt
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Tian Y, Du J, Spagna A, Mackie MA, Gu X, Dong Y, Fan J, Wang K. Venlafaxine treatment reduces the deficit of executive control of attention in patients with major depressive disorder. Sci Rep 2016; 6:28028. [PMID: 27306061 PMCID: PMC4910055 DOI: 10.1038/srep28028] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 05/23/2016] [Indexed: 01/03/2023] Open
Abstract
Attention plays an essential role in supporting other cognitive functions and behavior, and disturbance of attention is one of the most common symptoms in major depressive disorder (MDD). Although treatment with venlafaxine for MDD symptoms has been shown to reduce deficits in cognition and emotion regulation, it remains unclear whether venlafaxine improves specific attentional functions. We used the Attention Network Test to measure the attentional functions of alerting, orienting, and executive control before and after treatment with venlafaxine in patients with MDD compared to untreated healthy controls. Before treatment, the MDD group showed a selective impairment in alerting and executive control of attention, while there were no significant group differences in the orienting function. The interaction between group and session was significant for executive control, and after treatment with venlafaxine, the performance of the MDD group on executive control of attention was not significantly different from that of controls. Reported symptoms of MDD were also significantly reduced after treatment with venlafaxine. These results demonstrate that treatment with venlafaxine selectively normalizes the executive control function of attention in addition to improving clinical symptoms in MDD.
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Affiliation(s)
- Yanghua Tian
- Department of Neurology, the First Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Jing Du
- Department of Neurology, the Second Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Alfredo Spagna
- Department of Psychology, Queens College, the City University of New York, Flushing, NY, USA
| | - Melissa-Ann Mackie
- Department of Psychology, Queens College, the City University of New York, Flushing, NY, USA
| | - Xiaosi Gu
- Center for BrainHealth, School of Behavioral and Brain Sciences, the University of Texas at Dallas, Dallas, TX, 75235, USA
| | - Yi Dong
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Jin Fan
- Department of Psychology, Queens College, the City University of New York, Flushing, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kai Wang
- Department of Neurology, the First Hospital of Anhui Medical University, Hefei, Anhui Province, China
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Henje Blom E, Ho TC, Connolly CG, LeWinn KZ, Sacchet MD, Tymofiyeva O, Weng HY, Yang TT. The neuroscience and context of adolescent depression. Acta Paediatr 2016; 105:358-65. [PMID: 26663379 PMCID: PMC4779656 DOI: 10.1111/apa.13299] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 10/24/2015] [Accepted: 12/03/2015] [Indexed: 01/19/2023]
Abstract
UNLABELLED Adolescent depression is a growing public health concern with an increased risk of negative health outcomes, including suicide. The use of antidepressants and psychotherapy has not halted its increasing prevalence, and there is a critical need for effective prevention and treatment. We reviewed the neuroscience of adolescent depression, with a focus on the neurocircuitry of sustained threat and summarised contextual factors that have an impact on brain development and the pathophysiology of depression. We also reviewed novel treatment models. CONCLUSION Attention to the relevant neurocircuitry and contextual factors implicated in adolescent depression is necessary to advance prevention and treatment development.
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Affiliation(s)
- Eva Henje Blom
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Tiffany C Ho
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Colm G Connolly
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Kaja Z LeWinn
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Matthew D Sacchet
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Neurosciences Program and Department of Psychology, Stanford University, Stanford, CA, USA
| | - Olga Tymofiyeva
- Department of Radiology, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Helen Y Weng
- The Osher Center for Integrative Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Tony T Yang
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (UCSF), San Francisco, CA, USA
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Szmulewicz A, Samamé C, Caravotta P, Martino DJ, Igoa A, Hidalgo-Mazzei D, Colom F, Strejilevich SA. Behavioral and emotional adverse events of drugs frequently used in the treatment of bipolar disorders: clinical and theoretical implications. Int J Bipolar Disord 2016; 4:6. [PMID: 26879750 PMCID: PMC4754238 DOI: 10.1186/s40345-016-0047-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 02/04/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Behavioral and emotional adverse events induced by drugs commonly prescribed to patients with bipolar disorders are of paramount importance to clinical practice and research. However, no reviews on the topic have been published so far. METHODS An extensive search was performed. Reports were reviewed if they described behavioral side effects related to pharmacological treatments for bipolar disorders in healthy subjects or patients with different neuropsychiatric disorders. For this review, lithium, antipsychotics, anticonvulsants and selective serotonin reuptake inhibitors were included. RESULTS Apathy or emotional blunting, diminished sexual desire, and inability to cry were reported to be associated with exposure to selective serotonin reuptake inhibitors. Neuroleptic-induced deficit syndrome/emotional detachment and obsessive-compulsive symptomatology and decision-making modifications. A lithium-related amotivational syndrome was also reported in the literature. Furthermore, hypersexuality and obsessive-compulsive symptoms have been noted in subjects treated with lamotrigine. LIMITATIONS Primary studies on drug-related adverse events are scant so far and most of the data currently available derive from case reports. Moreover, most of the evidence reviewed is based on studies performed on healthy subjects and patients with neuropsychiatric conditions other than bipolar disorders. DISCUSSION There is a remarkable dearth of data on behavioral adverse events of pharmacological treatment for bipolar disorders. However, the pieces of evidence available at present, though scant and scattered, suggest that different behavioral adverse events may be related to pharmacological treatment for these disorders. The implications of these findings for research and management of patients with mood disorders are discussed.
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Affiliation(s)
- Alejandro Szmulewicz
- Bipolar Disorder Program, Neurosciences Institute, Favaloro University, Buenos Aires, Argentina. .,Hospital de Emergencias Psiquiátricas Torcuato de Alvear (HEPTA), Buenos Aires, Argentina.
| | - Cecilia Samamé
- Bipolar Disorder Program, Neurosciences Institute, Favaloro University, Buenos Aires, Argentina. .,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.
| | - Pablo Caravotta
- Bipolar Disorder Program, Neurosciences Institute, Favaloro University, Buenos Aires, Argentina. .,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.
| | - Diego J Martino
- Bipolar Disorder Program, Neurosciences Institute, Favaloro University, Buenos Aires, Argentina. .,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.
| | - Ana Igoa
- Bipolar Disorder Program, Neurosciences Institute, Favaloro University, Buenos Aires, Argentina.
| | | | - Francesc Colom
- Bipolar Disorders Program, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - Sergio A Strejilevich
- Bipolar Disorder Program, Neurosciences Institute, Favaloro University, Buenos Aires, Argentina. .,, Congreso 2477 Dto. D (1428), Buenos Aires, Argentina.
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Qiu ZK, Li MS, He JL, Liu X, Zhang GH, Lai S, Ma JC, Zeng J, Li Y, Wu HW, Chen Y, Shen YG, Chen JS. Translocator protein mediates the anxiolytic and antidepressant effects of midazolam. Pharmacol Biochem Behav 2015; 139:77-83. [PMID: 26455280 DOI: 10.1016/j.pbb.2015.10.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 09/13/2015] [Accepted: 10/07/2015] [Indexed: 02/04/2023]
Abstract
The translocator protein (18 kDa) (TSPO) plays an important role in stress-related disorders, such as anxiety, depression and post-traumatic stress disorder (PTSD), caused by neurosteroids (e.g. allopregnanolone). The present study sought to evaluate the significance of TSPO in anxiolytic and antidepressant effects induced by midazolam. The animals were administrated midazolam (0.25, 0.5 and 1 mg/kg, i.p.) and subjected to behavioral tests, including Vogel-type conflict test, elevated plus-maze test, forced swimming test. Midazolam produced anxiolytic- and antidepressant-like effects Vogel-type conflict test (1 mg/kg, i.p.), elevated plus-maze test (0.5 and 1 mg/kg, i.p.), and forced swimming test (0.5 and 1 mg/kg, i.p.). These effects of Midazolam were totally blocked by the TSPO antagonist PK11195 (3 mg/kg, i.p.). To evaluate the role of allopregnanolone in the anxiolytic- and antidepressant-like effects of midazolam, the animals were decapitated at the end of the behavioral tests. The allopregnanolone levels of the prefrontal cortex and hippocampus were measured by enzyme-linked immunosorbent assay (ELISA). The allopregnanolone level of the prefrontal cortex and hippocampus was increased by midazolam (0.5, 1 mg/kg, i.p.) and the increase was reversed by PK11195 (3 mg/kg, i.p.). Overall, the results indicated that the anxiolytic- and antidepressant-like effects of midazolam were mediated by TSPO, via stimulation of allopregnanolone biosynthesis.
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Affiliation(s)
- Zhi-Kun Qiu
- Pharmaceutical Department of the First Affiliated Hospital of Guangdong Pharmaceutical University, Clinical Pharmacy Department of Guangdong Pharmaceutical University, Guangzhou 510080, PR China
| | - Ming-Sheng Li
- Department of Anesthesiology, The Centre Hospital of Taian, Taian 271000, PR China
| | - Jia-Li He
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, PR China.
| | - Xu Liu
- Pharmacy Department of General Hospital of Chinese People's Armed Police Forces, Beijing 100039, PR China
| | - Guan-Hua Zhang
- Neurosurgery Department of the Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, PR China
| | - Sha Lai
- Pharmaceutical Department of the First Affiliated Hospital of Guangdong Pharmaceutical University, Clinical Pharmacy Department of Guangdong Pharmaceutical University, Guangzhou 510080, PR China
| | - Jian-Chun Ma
- Pharmaceutical Department of the First Affiliated Hospital of Guangdong Pharmaceutical University, Clinical Pharmacy Department of Guangdong Pharmaceutical University, Guangzhou 510080, PR China
| | - Jia Zeng
- Pharmaceutical Department of the First Affiliated Hospital of Guangdong Pharmaceutical University, Clinical Pharmacy Department of Guangdong Pharmaceutical University, Guangzhou 510080, PR China
| | - Yan Li
- Pharmaceutical Department of the First Affiliated Hospital of Guangdong Pharmaceutical University, Clinical Pharmacy Department of Guangdong Pharmaceutical University, Guangzhou 510080, PR China
| | - Hong-Wei Wu
- Pharmaceutical Department of the First Affiliated Hospital of Guangdong Pharmaceutical University, Clinical Pharmacy Department of Guangdong Pharmaceutical University, Guangzhou 510080, PR China
| | - Yong Chen
- Pharmaceutical Department of the First Affiliated Hospital of Guangdong Pharmaceutical University, Clinical Pharmacy Department of Guangdong Pharmaceutical University, Guangzhou 510080, PR China
| | - Yong-Gang Shen
- Pharmaceutical Department of the First Affiliated Hospital of Guangdong Pharmaceutical University, Clinical Pharmacy Department of Guangdong Pharmaceutical University, Guangzhou 510080, PR China
| | - Ji-Sheng Chen
- Pharmaceutical Department of the First Affiliated Hospital of Guangdong Pharmaceutical University, Clinical Pharmacy Department of Guangdong Pharmaceutical University, Guangzhou 510080, PR China.
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Cole RD, Kawasumi Y, Parikh V, Bangasser DA. Corticotropin releasing factor impairs sustained attention in male and female rats. Behav Brain Res 2015; 296:30-34. [PMID: 26306826 DOI: 10.1016/j.bbr.2015.08.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 07/31/2015] [Accepted: 08/18/2015] [Indexed: 11/29/2022]
Abstract
Stressful life events and stress-related psychiatric disorders impair sustained attention, the ability to monitor rare and unpredictable stimulus events over prolonged periods of time. Despite the link between stress and attentional disruptions, the neurobiological basis for stress regulation of attention systems remains underexplored. Here we examined whether corticotropin releasing factor (CRF), which orchestrates stress responses and is hypersecreted in patients with stress-related psychiatric disorders, impairs sustained attention. To this end, male and female rats received central infusions of CRF prior to testing on an operant sustained attention task (SAT), where rats were trained to discriminate signaled from non-signaled events. CRF caused a dose-dependent decrease in SAT performance in both male and female rats. Females were more impaired than males following a moderate dose of CRF, particularly during the middle part of the session. This sex difference was moderated by ovarian hormones. Females in the estrous cycle stage characterized by lower ovarian hormones had a greater CRF-induced attentional impairment than males and females in other cycle stages. Collectively, these studies highlight CRF as a critical stress-related factor that can regulate attentional performance. As sustained attention subserves other cognitive processes, these studies suggest that mitigating high levels of CRF in patients with stress-related psychiatric disorders may ameliorate their cognitive deficits.
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Affiliation(s)
- Robert D Cole
- Department of Psychology and Neuroscience Program, Temple University, 1701 N. 13th Street, Philadelphia, PA 19,122, USA
| | - Yushi Kawasumi
- Department of Psychology and Neuroscience Program, Temple University, 1701 N. 13th Street, Philadelphia, PA 19,122, USA
| | - Vinay Parikh
- Department of Psychology and Neuroscience Program, Temple University, 1701 N. 13th Street, Philadelphia, PA 19,122, USA
| | - Debra A Bangasser
- Department of Psychology and Neuroscience Program, Temple University, 1701 N. 13th Street, Philadelphia, PA 19,122, USA.
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Martinez-Aran A, Vieta E. Cognition as a target in schizophrenia, bipolar disorder and depression. Eur Neuropsychopharmacol 2015; 25:151-7. [PMID: 25661911 DOI: 10.1016/j.euroneuro.2015.01.007] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 01/08/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Anabel Martinez-Aran
- Bipolar Disorders Unit, Department of Psychiatry, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Bipolar Disorders Unit, Department of Psychiatry, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
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