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Liu JJ, Ein N, Gervasio J, Baker C, Plouffe R, Wanklyn S, Burhan AM, Lau B, Abreu E, Wasiuta T, Nazarov A, Richardson JD. Ketamine in the effective management of chronic pain, depression, and posttraumatic stress disorder for Veterans: A meta-analysis and systematic review. Front Psychiatry 2024; 15:1338581. [PMID: 38979497 PMCID: PMC11228764 DOI: 10.3389/fpsyt.2024.1338581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 06/03/2024] [Indexed: 07/10/2024] Open
Abstract
Introduction Ketamine has emerged as a promising treatment alternative for the management of chronic pain. Despite encouraging findings in civilian populations, and favourable results from trials examining its efficacy in military populations, there is still a dearth of information pointing to optimal specifications related to ketamine administration for pain, depression, and posttraumatic stress disorder (PTSD) in military populations. This meta-analysis and systematic review synthesised available evidence on the effectiveness, tolerability, and feasibility of ketamine in the management of chronic pain and mental health conditions in military populations. Methods This review followed the Cochrane's Guide for systematic reviews of interventions and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) as frameworks for data collection and synthesis. Results A total of 11 studies and 22 independent samples were retained for data analyses. Across samples, improvements in pain, depression, and PTSD outcomes were evident, with the use of ketamine leading to significant reductions, g = 1.76, SE = 0.19, 95% CI (1.39, 2.13), Z = 9.26, p <.001. These effect sizes were robust with moderate-to-large effects. In addition, the reductions in symptoms were observed in both active-duty and Veteran groups, and for different routes of ketamine administration, frequencies of ketamine administration, duration of ketamine treatments, dosage, study design, and allowance for concurrent treatments. Discussion This review provides a preliminary synthesis of available evidence which suggests that ketamine may be a potential option for the treatment of depression, PTSD, and chronic pain in military populations. The viability of ketamine as an alternative treatment may be particularly impactful for those who are treatment resistant, experience chronic symptoms, and/or have exhausted conventional treatments. More research is warranted in order verify the findings presented in this review.
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Affiliation(s)
- Jenny J.W. Liu
- MacDonald Franklin Operational Stress Injury Research Centre, London, ON, Canada
| | - Natalie Ein
- MacDonald Franklin Operational Stress Injury Research Centre, London, ON, Canada
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Julia Gervasio
- MacDonald Franklin Operational Stress Injury Research Centre, London, ON, Canada
| | - Clara Baker
- MacDonald Franklin Operational Stress Injury Research Centre, London, ON, Canada
| | - Rachel Plouffe
- MacDonald Franklin Operational Stress Injury Research Centre, London, ON, Canada
- Division of Psychology, School of Humanities, Social Sciences and Law, University of Dundee, Dundee, United Kingdom
| | - Sonya Wanklyn
- MacDonald Franklin Operational Stress Injury Research Centre, London, ON, Canada
- Operational Stress Injury Clinic, St Joseph’s Health Care, London, ON, Canada
| | - Amer M. Burhan
- MacDonald Franklin Operational Stress Injury Research Centre, London, ON, Canada
- Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Brenda Lau
- Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Change Pain Clinic, Vancouver, BC, Canada
| | - Emmanuel Abreu
- Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Change Pain Clinic, Vancouver, BC, Canada
| | - Thomas Wasiuta
- MacDonald Franklin Operational Stress Injury Research Centre, London, ON, Canada
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Operational Stress Injury Clinic, St Joseph’s Health Care, London, ON, Canada
| | - Anthony Nazarov
- MacDonald Franklin Operational Stress Injury Research Centre, London, ON, Canada
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - J. Don Richardson
- MacDonald Franklin Operational Stress Injury Research Centre, London, ON, Canada
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Operational Stress Injury Clinic, St Joseph’s Health Care, London, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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Hoisington AJ, Stearns-Yoder KA, Stamper CE, Simonetti JA, Oslin DW, Brenner LA. Longitudinal Influence of Prescribed Antidepressants on Fecal and Oral Microbiomes Among Veterans With Major Depressive Disorder. J Neuropsychiatry Clin Neurosci 2024; 36:151-159. [PMID: 38258376 DOI: 10.1176/appi.neuropsych.20220221] [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] [Indexed: 01/24/2024]
Abstract
OBJECTIVE The purpose of this study was to evaluate the influence of a new course of antidepressant monotherapy on gut and oral microbiomes and the relationship to depressive symptoms. METHODS Longitudinal microbiome samples obtained from 10 U.S. veterans were analyzed. Baseline samples were taken before a new course of antidepressant monotherapy (either switching from a previous treatment or starting a new treatment). Targeted genomic sequencing of the microbiome samples was used to analyze changes in taxonomy and diversity across participants, medications, and medication class. Associations between these changes and Patient Health Questionnaire-9 (PHQ-9) scores were analyzed. RESULTS Taxonomic variability was observed across participants, with the individual being the main microbial community driver. In terms of the fecal microbiome, antidepressants were associated with shifts toward Bacteroides being less abundant and Blautia, Pseudomonas, or Faecalibacterium being more abundant. Likewise, the composition of the oral microbiome was variable, with individual participants being the primary drivers of community composition. In the oral samples, the relative abundance of Haemophilus decreased after antidepressants were started. Increases in Blautia and decreases in Bacteroides were associated with lower PHQ-9 scores. CONCLUSIONS Antidepressants were found to influence fecal and oral microbiomes such that a new course of antidepressant monotherapy was associated with taxonomic alterations toward healthier states in both fecal and oral microbiomes, which were associated with decreases in depressive symptoms. Additional longitudinal research is required to increase understanding of microbiomes and symptom-based changes, with a particular focus on potential differences between medication classes and underlying mechanisms.
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Affiliation(s)
- Andrew J Hoisington
- Veterans Affairs Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colo. (Hoisington, Stearns-Yoder, Stamper, Simonetti, Brenner); Military and Veteran Microbiome Consortium for Research and Education, Aurora, Colo. (Hoisington, Stearns-Yoder, Stamper, Brenner); Department of Physical Medicine and Rehabilitation (Hoisington, Stearns-Yoder, Stamper, Brenner), Division of Hospital Medicine, Department of Medicine (Simonetti), and Departments of Psychiatry and Neurology (Brenner), University of Colorado Anschutz Medical Campus, Aurora, Colo.; Department of Systems Engineering and Management, Air Force Institute of Technology, Wright-Patterson Air Force Base, Ohio (Hoisington); Veterans Integrated Services Network 4 MIRECC, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia (Oslin); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Oslin)
| | - Kelly A Stearns-Yoder
- Veterans Affairs Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colo. (Hoisington, Stearns-Yoder, Stamper, Simonetti, Brenner); Military and Veteran Microbiome Consortium for Research and Education, Aurora, Colo. (Hoisington, Stearns-Yoder, Stamper, Brenner); Department of Physical Medicine and Rehabilitation (Hoisington, Stearns-Yoder, Stamper, Brenner), Division of Hospital Medicine, Department of Medicine (Simonetti), and Departments of Psychiatry and Neurology (Brenner), University of Colorado Anschutz Medical Campus, Aurora, Colo.; Department of Systems Engineering and Management, Air Force Institute of Technology, Wright-Patterson Air Force Base, Ohio (Hoisington); Veterans Integrated Services Network 4 MIRECC, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia (Oslin); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Oslin)
| | - Christopher E Stamper
- Veterans Affairs Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colo. (Hoisington, Stearns-Yoder, Stamper, Simonetti, Brenner); Military and Veteran Microbiome Consortium for Research and Education, Aurora, Colo. (Hoisington, Stearns-Yoder, Stamper, Brenner); Department of Physical Medicine and Rehabilitation (Hoisington, Stearns-Yoder, Stamper, Brenner), Division of Hospital Medicine, Department of Medicine (Simonetti), and Departments of Psychiatry and Neurology (Brenner), University of Colorado Anschutz Medical Campus, Aurora, Colo.; Department of Systems Engineering and Management, Air Force Institute of Technology, Wright-Patterson Air Force Base, Ohio (Hoisington); Veterans Integrated Services Network 4 MIRECC, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia (Oslin); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Oslin)
| | - Joseph A Simonetti
- Veterans Affairs Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colo. (Hoisington, Stearns-Yoder, Stamper, Simonetti, Brenner); Military and Veteran Microbiome Consortium for Research and Education, Aurora, Colo. (Hoisington, Stearns-Yoder, Stamper, Brenner); Department of Physical Medicine and Rehabilitation (Hoisington, Stearns-Yoder, Stamper, Brenner), Division of Hospital Medicine, Department of Medicine (Simonetti), and Departments of Psychiatry and Neurology (Brenner), University of Colorado Anschutz Medical Campus, Aurora, Colo.; Department of Systems Engineering and Management, Air Force Institute of Technology, Wright-Patterson Air Force Base, Ohio (Hoisington); Veterans Integrated Services Network 4 MIRECC, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia (Oslin); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Oslin)
| | - David W Oslin
- Veterans Affairs Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colo. (Hoisington, Stearns-Yoder, Stamper, Simonetti, Brenner); Military and Veteran Microbiome Consortium for Research and Education, Aurora, Colo. (Hoisington, Stearns-Yoder, Stamper, Brenner); Department of Physical Medicine and Rehabilitation (Hoisington, Stearns-Yoder, Stamper, Brenner), Division of Hospital Medicine, Department of Medicine (Simonetti), and Departments of Psychiatry and Neurology (Brenner), University of Colorado Anschutz Medical Campus, Aurora, Colo.; Department of Systems Engineering and Management, Air Force Institute of Technology, Wright-Patterson Air Force Base, Ohio (Hoisington); Veterans Integrated Services Network 4 MIRECC, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia (Oslin); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Oslin)
| | - Lisa A Brenner
- Veterans Affairs Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colo. (Hoisington, Stearns-Yoder, Stamper, Simonetti, Brenner); Military and Veteran Microbiome Consortium for Research and Education, Aurora, Colo. (Hoisington, Stearns-Yoder, Stamper, Brenner); Department of Physical Medicine and Rehabilitation (Hoisington, Stearns-Yoder, Stamper, Brenner), Division of Hospital Medicine, Department of Medicine (Simonetti), and Departments of Psychiatry and Neurology (Brenner), University of Colorado Anschutz Medical Campus, Aurora, Colo.; Department of Systems Engineering and Management, Air Force Institute of Technology, Wright-Patterson Air Force Base, Ohio (Hoisington); Veterans Integrated Services Network 4 MIRECC, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia (Oslin); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Oslin)
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Hu J, Ji Y, Lang X, Zhang XY. Prevalence and clinical correlates of abnormal lipid metabolism in first-episode and drug-naïve patients with major depressive disorder: A large-scale cross-sectional study. J Psychiatr Res 2023; 163:55-62. [PMID: 37201238 DOI: 10.1016/j.jpsychires.2023.05.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/03/2023] [Accepted: 05/01/2023] [Indexed: 05/20/2023]
Abstract
OBJECTIVE Studies have shown an association between abnormal lipid profiles and MDD, but there are few studies on the clinical correlates of lipid abnormalities in patients with major depressive disorder (MDD). The purpose of this study was to investigate the prevalence of abnormal lipid metabolism and its correlates in Chinese first-episode and drug-naïve MDD patients, which has not yet been reported. METHODS A total of 1718 outpatients with first-episode and drug-naïve MDD were included. Demographic data were collected by a standardized questionnaire and blood lipid levels were measured, including total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C). The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Positive and Negative Syndrome Scale (PANSS) positive subscale, and Clinical Global Impression of Severity Scale (CGI-S) were assessed for each patient. RESULTS The prevalence of abnormal lipid metabolism was 72.73% (1301/1718), and the rates of high TC, high TG, high LDL-C and low HDL-C were 51.05% (877/1718), 61.18% (1051/1718), 30.09% (517/1718), 23.40% (402/1718), respectively. Logistic regression showed the risk factors for abnormal lipid metabolism were severe anxiety, HAMD score, CGI-S score, BMI and systolic blood pressure (SBP). Multiple linear regression analysis showed that age at onset, SBP, HAMD score, HAMA score, PANSS positive subscale score, and CGI-S were independently associated with TC levels. BMI, HAMD score, PANSS positive subscale score and CGI-S score were independently associated with TG levels. SBP, HAMD score, PANSS positive subscale score and CGI-S score were independently associated with LDL-C levels. Age of onset, SBP and CGI-S score were independently associated with HDL-C levels. CONCLUSIONS The prevalence of abnormal lipid metabolism in first-episode and drug-naïve MDD patients is quite high. The severity of psychiatric symptoms may be closely associated with the presence of abnormal lipid metabolism in patients with MDD.
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Affiliation(s)
- Jieqiong Hu
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - Yunxin Ji
- Department of Psychosomatic Medicine, Ningbo First Hospital, Ningbo, Zhejiang, China
| | - XiaoE Lang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Vas C, Jain A, Trivedi M, Jha MK, Mathew SJ. Pharmacotherapy for Treatment-Resistant Depression: Antidepressants and Atypical Antipsychotics. Psychiatr Clin North Am 2023; 46:261-275. [PMID: 37149344 DOI: 10.1016/j.psc.2023.02.012] [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] [Indexed: 05/08/2023]
Abstract
Treatment-resistant depression (TRD) affects one in three patients with major depressive disorder and is associated with increased risk of all-cause mortality. Studies of real-world practices suggest that antidepressant monotherapy continues to be the most widely used treatment after inadequate response to a first-line treatment. However, rates of remission with antidepressants in TRD are suboptimal. Atypical antipsychotics are the most widely studied augmentation agent and aripiprazole, brexpiprazole, cariprazine, quetiapine extended-release, and olanzapine-fluoxetine combination are approved for depression. Benefits of using atypical antipsychotics for TRD has to be weighted against their potential adverse events, such as weight gain, akathisia, and tardive dyskinesia.
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Affiliation(s)
- Collin Vas
- UT Southwestern Medical Center, Dallas, TX, USA
| | - Ayush Jain
- The Shri Ram School, Aravali, Gurgaon, Haryana, India
| | - Mili Trivedi
- Colleyville Heritage High School, Colleyville, TX, USA
| | - Manish Kumar Jha
- Center for Depression Research and Clinical Care, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9119, USA.
| | - Sanjay J Mathew
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Michael E. DeBakey VA Medical Center, The Menninger Clinic, Houston, TX, USA
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Itoh K, Tsutani H, Mitsuke Y, Iwasaki H. Two possible mechanisms of ganciclovir for treatment of major depressive disorder. Front Psychiatry 2023; 14:1109723. [PMID: 37181897 PMCID: PMC10166851 DOI: 10.3389/fpsyt.2023.1109723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/04/2023] [Indexed: 05/16/2023] Open
Affiliation(s)
- Kazuhiro Itoh
- Department of Internal Medicine, National Hospital Organization Awara Hospital, Awara, Japan
- Division of Infection Control and Prevention, University of Fukui Hospital, Fukui, Japan
| | - Hiroshi Tsutani
- Department of Internal Medicine, National Hospital Organization Awara Hospital, Awara, Japan
| | - Yasuhiko Mitsuke
- Department of Internal Medicine, National Hospital Organization Awara Hospital, Awara, Japan
| | - Hiromichi Iwasaki
- Division of Infection Control and Prevention, University of Fukui Hospital, Fukui, Japan
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Jha MK, Mathew SJ. Pharmacotherapies for Treatment-Resistant Depression: How Antipsychotics Fit in the Rapidly Evolving Therapeutic Landscape. Am J Psychiatry 2023; 180:190-199. [PMID: 36855876 DOI: 10.1176/appi.ajp.20230025] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
One in three adults with major depressive disorder (MDD) do not experience clinically significant improvement after multiple sequential courses of antidepressants and have treatment-resistant depression (TRD). The presence of TRD contributes to the morbidity and excess mortality associated with MDD and has been linked to significantly increased health care expenses. In the absence of a consensus definition of TRD, this report takes a broad approach by considering inadequate response to one or more courses of antidepressants and focuses on atypical antipsychotics that are approved by the U.S. Food and Drug Administration for treatment of depression (aripiprazole, brexpiprazole, cariprazine, extended-release quetiapine, and olanzapine-fluoxetine combination). While multiple acute-phase studies have demonstrated the efficacy of these medications in improving depressive symptoms, clinically meaningful improvement (i.e., remission) remains limited, with significant concerns about side effects (including weight gain, metabolic dysfunction, extrapyramidal symptoms, and tardive dyskinesia), especially with long-term use. With the rapidly evolving landscape of antidepressant treatments over the past few years, which has witnessed approval of rapid-acting antidepressants (e.g., esketamine nasal spray and dextromethorphan-bupropion combination) and several more in the late-stage pipeline (e.g., zuranolone and psilocybin), it remains to be seen whether the use of atypical antipsychotics will go the way of the older and rarely prescribed antidepressants (such as tricyclics and monoamine oxidase inhibitors). Pragmatic clinical trials are needed to compare the effectiveness of atypical antipsychotics with TRD-specific pharmacotherapies and neuromodulation treatments and to identify the optimal sequencing of these varied approaches for patients with MDD. When using atypical antipsychotics, clinicians and patients are encouraged to use a shared decision-making approach by personalizing treatment selection based on anticipated side effects, tolerability, cost, and feasibility.
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Affiliation(s)
- Manish K Jha
- Center for Depression Research and Clinical Care, Department of Psychiatry, UT Southwestern Medical Center, and O'Donnell Brain Institute, UT Southwestern Medical Center, Dallas (Jha); Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Mathew); Michael E. DeBakey VA Medical Center, Houston (Mathew); Menninger Clinic, Houston (Mathew)
| | - Sanjay J Mathew
- Center for Depression Research and Clinical Care, Department of Psychiatry, UT Southwestern Medical Center, and O'Donnell Brain Institute, UT Southwestern Medical Center, Dallas (Jha); Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Mathew); Michael E. DeBakey VA Medical Center, Houston (Mathew); Menninger Clinic, Houston (Mathew)
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Zou J, Zhu Y. Antidepressant use pattern and disparities among cancer patients in the United States. Front Public Health 2022; 10:1000000. [PMID: 36438264 PMCID: PMC9682280 DOI: 10.3389/fpubh.2022.1000000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/20/2022] [Indexed: 11/11/2022] Open
Abstract
Many cancer patients also suffer from depression, however, pharmacotherapy of depression and related disparities in US cancer survivors have not been examined in a nationally representative sample. In the present study, 2,590 adult cancer survivors participating in the National Health and Nutrition Examination Survey 2011-2020 were included and antidepressant use pattern was investigated. To examine disparities by social-demographic characteristics and access to healthcare, multivariate logistic regression analysis was conducted in 422 cancer patients who were using antidepressants and 230 cancer patients who were not using antidepressants but were diagnosed with depression. Results suggested that 21% of adult cancer survivors were using antidepressants and selective serotonin reuptake inhibitors were the most common type of antidepressants used. Antidepressant users were more likely to be female, non-Hispanic white, those who were married or living with partner. In addition, those without a routine place to go for healthcare were less likely to use antidepressants. Disparities were not found by age, family income levels, education, or health insurance coverage. The findings highlight disparities in antidepressant use in cancer patients in the US. Policy makers need to better allocate healthcare resources and facilitate availabilities of affordable care to every patient in need.
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Affiliation(s)
- Jingrui Zou
- Department of Scientific Affairs, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Zhu
- Wayzek Science, St. Paul, MN, United States
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Miyata S, Ishino Y, Shimizu S, Tohyama M. Involvement of inflammatory responses in the brain to the onset of major depressive disorder due to stress exposure. Front Aging Neurosci 2022; 14:934346. [PMID: 35936767 PMCID: PMC9354609 DOI: 10.3389/fnagi.2022.934346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022] Open
Abstract
Major depressive disorder (MDD) is a multifactorial disease affected by several environmental factors. Although several potential onset hypotheses have been identified, the molecular mechanisms underlying the pathogenesis of this disorder remain unclear. Several recent studies have suggested that among many environmental factors, inflammation and immune abnormalities in the brain or the peripheral tissues are associated with the onset of MDDs. Furthermore, several stress-related hypotheses have been proposed to explain the onset of MDDs. Thus, inflammation or immune abnormalities can be considered stress responses that occur within the brain or other tissues and are regarded as one of the mechanisms underlying the stress hypothesis of MDDs. Therefore, we introduce several current advances in inflammation studies in the brain that might be related to the pathophysiology of MDD due to stress exposure in this review.
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Affiliation(s)
- Shingo Miyata
- Division of Molecular Brain Science, Research Institute of Traditional Asian Medicine, Kindai University, Osaka, Japan
- *Correspondence: Shingo Miyata
| | - Yugo Ishino
- Division of Molecular Brain Science, Research Institute of Traditional Asian Medicine, Kindai University, Osaka, Japan
| | - Shoko Shimizu
- Division of Molecular Brain Science, Research Institute of Traditional Asian Medicine, Kindai University, Osaka, Japan
| | - Masaya Tohyama
- Division of Molecular Brain Science, Research Institute of Traditional Asian Medicine, Kindai University, Osaka, Japan
- Osaka Prefectural Hospital Organization, Osaka, Japan
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