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Krupa AJ, Chrobak AA, Sołtys Z, Dudek D, Szewczyk B, Siwek M. Insulin resistance, clinical presentation and resistance to selective serotonin and noradrenaline reuptake inhibitors in major depressive disorder. Pharmacol Rep 2024:10.1007/s43440-024-00621-5. [PMID: 38980569 DOI: 10.1007/s43440-024-00621-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/15/2024] [Accepted: 06/26/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND The understanding of mechanisms underlying non-response to antidepressants is limited. The latest data highlights the role of insulin resistance (IR) in major depressive disorder (MDD) pathophysiology, presentation, and treatment efficacy. This work aimed to assess IR in MDD and explore the relationships between IR, MDD presentation and non-response to selective serotonin and noradrenaline reuptake inhibitors (SNRI). METHODS 67 MDD individuals: 36 responsive (MDD T[+]), 31 non-responsive (MDD T[-]) to SNRI and 30 healthy controls were recruited. The treatment response criteria were: Clinical Global Impression Scale-Improvement score of 1 or 2 after ≥ 8 weeks of treatment. Participants were assessed by physician and self-report tools measuring depression, anhedonia, anxiety, bipolarity, sleep quality. Blood samples were collected to assess fasting glucose and insulin levels and calculate HOMA-IR (homeostasis model assessment of insulin resistance). RESULTS MDD T[-] vs. MDD T[+] had significantly higher body mass index, insulin levels, and HOMA-IR. MDD T[-] presented higher levels of depressed mood, appetite/weight changes, loss of interest, energy, overall depressive symptoms, and sleep impairment; some evaluations suggested higher anhedonia and anxiety in MDD T[-] vs. MDD T[+]. Insulin and IR were weakly but significantly correlated with the severity of psychomotor symptoms, energy level, thoughts of death/suicide, self-criticism, appetite/weight, depressed mood symptoms, sleep problems. IR was weakly but significantly correlated with anhedonia. CONCLUSION IR appears to be linked to depressive symptoms characteristic of the "metabolic" MDD subtype, such as psychomotor changes, energy level, anhedonia, sleep problems, appetite/weight changes, state and trait anxiety, sleep quality, and non-response to SNRI.
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Affiliation(s)
- Anna J Krupa
- Department of Affective Disorders, Jagiellonian University Medical College, ul. Kopernika 21a, Krakow, 31-501, Poland
| | - Adrian A Chrobak
- Department of Adult Psychiatry, Jagiellonian University Medical College, Kopernika 21a, Krakow, 31-501, Poland
| | - Zbigniew Sołtys
- Institute of Zoology and Biomedical Research, Laboratory of Experimental Neuropathology, Jagiellonian University, Gronostajowa 9, Krakow, 30-387, Poland
| | - Dominika Dudek
- Department of Adult Psychiatry, Jagiellonian University Medical College, Kopernika 21a, Krakow, 31-501, Poland
| | - Bernadeta Szewczyk
- Department of Neurobiology, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, Krakow, 31-343, Poland
| | - Marcin Siwek
- Department of Affective Disorders, Jagiellonian University Medical College, ul. Kopernika 21a, Krakow, 31-501, Poland.
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Rindler GA, Gries A, Freidl W. Associations between overweight, obesity, and mental health: a retrospective study among European adults aged 50. Front Public Health 2023; 11:1206283. [PMID: 37533526 PMCID: PMC10390701 DOI: 10.3389/fpubh.2023.1206283] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 07/05/2023] [Indexed: 08/04/2023] Open
Abstract
Background The comorbidities associated with overweight and obesity have been well researched and scientifically proven while their relationship to mental health is still not verified. Methods This study is aimed at investigating reciprocal associations between obesity and mental health, and is intended to further analyze possible long-term effects using data from the Survey of Health, Ageing and Retirement in Europe (SHARE). In order to do that, waves 4 and 8, conducted in 2010 and 2019/20 of this survey, were analyzed in a cross-lagged panel approach including 16,184 adult Europeans (50+) using multiple linear regression analysis focusing on the Body Mass Index (BMI), depression status and quality of life (QoL). Results Findings yield significant cross-lagged effects in one direction regarding BMI predicting QoL and depression state, whereas depression state and QoL do not significantly predict BMI. Findings include people living with obesity, overweight, and underweight showing significantly decreased levels of QoL as well as increased depression scores compared to people of normal weight over a lag time of 10 years, where people living with obesity indicate the strongest effect. Conclusions However, results do not confirm reciprocal associations in the long term. Hence, there is a strong need to carry out further research on this issue.
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Affiliation(s)
| | - Anna Gries
- Division of Physiology and Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University, Graz, Austria
| | - Wolfgang Freidl
- Institute of Social Medicine and Epidemiology, Medical University, Graz, Austria
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Kremers SHM, Wild SH, Elders PJM, Beulens JWJ, Campbell DJT, Pouwer F, Lindekilde N, de Wit M, Lloyd C, Rutters F. The role of mental disorders in precision medicine for diabetes: a narrative review. Diabetologia 2022; 65:1895-1906. [PMID: 35729420 PMCID: PMC9213103 DOI: 10.1007/s00125-022-05738-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 04/11/2022] [Indexed: 02/07/2023]
Abstract
This narrative review aims to examine the value of addressing mental disorders as part of the care of people with type 1 and type 2 diabetes in terms of four components of precision medicine. First, we review the empirical literature on the role of common mental disorders in the development and outcomes of diabetes (precision prevention and prognostics). We then review interventions that can address mental disorders in individuals with diabetes or at risk of diabetes (precision treatment) and highlight recent studies that have used novel methods to individualise interventions, in person and through applications, based on mental disorders. Additionally, we discuss the use of detailed assessment of mental disorders using, for example, mobile health technologies (precision monitoring). Finally, we discuss future directions in research and practice and challenges to addressing mental disorders as a factor in precision medicine for diabetes. This review shows that several mental disorders are associated with a higher risk of type 2 diabetes and its complications, while there is suggestive evidence indicating that treating some mental disorders could contribute to the prevention of diabetes and improve diabetes outcomes. Using technologically enabled solutions to identify mental disorders could help individuals who stand to benefit from particular treatments. However, there are considerable gaps in knowledge and several challenges to be met before we can stratify treatment recommendations based on mental disorders. Overall, this review demonstrates that addressing mental disorders as a facet of precision medicine could have considerable value for routine diabetes care and has the potential to improve diabetes outcomes.
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Affiliation(s)
- Sanne H M Kremers
- Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Sarah H Wild
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Petra J M Elders
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- General Practice, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Joline W J Beulens
- Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - David J T Campbell
- Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
- Department of Cardiac Sciences, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- School of Psychology, Deakin University, Geelong, Australia
| | - Nanna Lindekilde
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Maartje de Wit
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Medical Psychology, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Cathy Lloyd
- School of Health, Wellbeing and Social Care, Faculty of Wellbeing, Education and Language Studies, Open University, Milton Keynes, UK
| | - Femke Rutters
- Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
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Ünler M, Ekmekçi Ertek İ, Afandiyeva N, Kavutçu M, Yüksel N. The role of neuropeptide Y, orexin-A, and ghrelin in differentiating unipolar and bipolar depression: a preliminary study. Nord J Psychiatry 2022; 76:162-169. [PMID: 35282777 DOI: 10.1080/08039488.2022.2048887] [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: 10/18/2022]
Abstract
BACKGROUND When depressive symptoms in bipolar and unipolar patients were compared, a number of studies reported that atypical vegetative features such as hypersomnia and hyperphagia were more common in bipolar patients. Moreover, neuropeptides such as orexin-A (ORX-A), ghrelin (GRL), and neuropeptide Y (NPY) are involved in the regulation of these vegetative functions. MATERIALS AND METHODS A total of 45 unipolar and 24 bipolar depressive patients, and 36 euthymic healthy controls were included in the study. The groups were compared in terms of peripheral blood samples of ORX-A, GRL, and NPY levels, as well as HAM-D, Epworth Sleepiness Scale, Three-Factor Eating Questionnaire-Revised, and Suicide Probability Scale scores. RESULTS Both unipolar and bipolar patients had lower ORX-A, GRL, and NPY levels compared to the controls, whereas NPY levels of bipolar patients were lower than unipolar patients. There was a negative correlation between NPY levels and emotional eating in the bipolar group. CONCLUSION While lower ORX-A, GRL, and NPY levels are associated with depressive episodes regardless of the diagnosis; NPY levels also differ in bipolar and unipolar depression patients.
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Affiliation(s)
- Mehmet Ünler
- Gaziantep 25 Aralık State Hospital, Psychiatry Clinic, Gaziantep, Turkey
| | - İrem Ekmekçi Ertek
- Department of Psychiatry, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Nigar Afandiyeva
- Department of Biochemistry, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Mustafa Kavutçu
- Department of Biochemistry, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Nevzat Yüksel
- Department of Psychiatry, Faculty of Medicine, Gazi University, Ankara, Turkey
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Zhou Z, Liu S. Maprotiline Ameliorates High Glucose-Induced Dysfunction in Renal Glomerular Endothelial Cells. Exp Clin Endocrinol Diabetes 2022; 130:596-603. [PMID: 35320846 DOI: 10.1055/a-1713-7719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Maprotiline is an antidepressant that has been found to cause hypoglycemia. However, the effect of maprotiline on diabetic nephropathy (DN) has not been investigated. Here, we explored the effect of maprotiline on human renal glomerular endothelial cells (HRGECs) in response to high glucose (HG) stimulation. We found that maprotiline attenuated HG-induced oxidative stress in HRGECs with decreased reactive oxygen species production and increased superoxide dismutase activity. Maprotiline repressed the HG-induced expression of cyclooxygenases 2 at both mRNA and protein levels in HRGECs. The increased thromboxane B2 level and decreased 6-keto-prostaglandin F1α level induced by HG were significantly attenuated by maprotiline treatment. Maprotiline also prevented the HG-induced increase in the permeability of HRGECs and the decrease in the zonula occludens-1 expression and downregulated HG-induced increase in the expression of protein kinase C-α (PKC-α) in HRGECs. This protective effect of maprotiline on HG-induced HRGECs dysfunction was abolished by overexpression of PKC-α. In conclusion, maprotiline displayed a protective effect on HG-challenged HRGECs, which was mediated by the regulation of PKC-α. These findings provide further evidence for the potential use of maprotiline for the treatment of DN.
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Affiliation(s)
- Zhihong Zhou
- Department of Geriatrics, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou City, Hainan Province, China
| | - Shangjun Liu
- Department of Cardiovascular Medicine, Sanya Central Hospital (Hainan Third People's Hospital), Sanya City, Hainan Province, China
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Huang KL, Chen MH, Hsu JW, Tsai SJ, Bai YM. Using classification and regression tree modeling to investigate appetite hormones and proinflammatory cytokines as biomarkers to differentiate bipolar I depression from major depressive disorder. CNS Spectr 2021:1-7. [PMID: 33563365 DOI: 10.1017/s109285292100016x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Altered immunity and metabolic profiles have been compared between bipolar depression (BD) and major depressive disorder (MDD). This study aimed at developing a composite predictor of appetite hormones and proinflammatory cytokines to differentiate BD from MDD. METHODS This cross-sectional study enrolled patients with BD and those with MDD aged 20 to 59 years and displaying depressive episodes. Clinical characteristics (age, sex, body mass index, and depression severity), cytokines (C-reactive protein, interleukin [IL]-2, IL-6, tumor necrosis factor [TNF]-α, P-selectin, and monocyte chemoattractant protein), and appetite hormones (leptin, adiponectin, ghrelin, and insulin) were assessed as potential predictors using a classification and regression tree (CRT) model for differentiating BD from MDD. RESULTS The predicted probability of a composite predictor of ghrelin and TNF-α was significantly greater (for BD: area under curve = 0.877; for MDD: area under curve = 0.914) than that of any one marker (all P > .05) to distinguish BD from MDD. The most powerful predictors for diagnosing BD were high ghrelin and TNF-α levels, whereas those for MDD were low ghrelin and TNF-α levels. CONCLUSION A composite predictor of ghrelin and TNF-α driven by CRT could assist in the differential diagnosis of BD from MDD with high specificity. Further clinical studies are warranted to validate our results and to explore underlying mechanisms.
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Affiliation(s)
- Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Fritz EM, Singewald N, De Bundel D. The Good, the Bad and the Unknown Aspects of Ghrelin in Stress Coping and Stress-Related Psychiatric Disorders. Front Synaptic Neurosci 2020; 12:594484. [PMID: 33192444 PMCID: PMC7652849 DOI: 10.3389/fnsyn.2020.594484] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/14/2020] [Indexed: 12/16/2022] Open
Abstract
Ghrelin is a peptide hormone released by specialized X/A cells in the stomach and activated by acylation. Following its secretion, it binds to ghrelin receptors in the periphery to regulate energy balance, but it also acts on the central nervous system where it induces a potent orexigenic effect. Several types of stressors have been shown to stimulate ghrelin release in rodents, including nutritional stressors like food deprivation, but also physical and psychological stressors such as foot shocks, social defeat, forced immobilization or chronic unpredictable mild stress. The mechanism through which these stressors drive ghrelin release from the stomach lining remains unknown and, to date, the resulting consequences of ghrelin release for stress coping remain poorly understood. Indeed, ghrelin has been proposed to act as a stress hormone that reduces fear, anxiety- and depression-like behaviors in rodents but some studies suggest that ghrelin may - in contrast - promote such behaviors. In this review, we aim to provide a comprehensive overview of the literature on the role of the ghrelin system in stress coping. We discuss whether ghrelin release is more than a byproduct of disrupted energy homeostasis following stress exposure. Furthermore, we explore the notion that ghrelin receptor signaling in the brain may have effects independent of circulating ghrelin and in what way this might influence stress coping in rodents. Finally, we examine how the ghrelin system could be utilized as a therapeutic avenue in stress-related psychiatric disorders (with a focus on anxiety- and trauma-related disorders), for example to develop novel biomarkers for a better diagnosis or new interventions to tackle relapse or treatment resistance in patients.
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Affiliation(s)
- Eva Maria Fritz
- Department of Pharmacology and Toxicology, Institute of Pharmacy and CMBI, University of Innsbruck, Innsbruck, Austria
| | - Nicolas Singewald
- Department of Pharmacology and Toxicology, Institute of Pharmacy and CMBI, University of Innsbruck, Innsbruck, Austria
| | - Dimitri De Bundel
- Department of Pharmaceutical Sciences, Research Group Experimental Pharmacology, Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium
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Vuong E, Nothling J, Lombard C, Jewkes R, Peer N, Abrahams N, Seedat S. Peripheral adiponectin levels in anxiety, mood, trauma- and stressor-related disorders: A systematic review and meta-analysis. J Affect Disord 2020; 260:372-409. [PMID: 31539673 DOI: 10.1016/j.jad.2019.09.050] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 07/01/2019] [Accepted: 09/08/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Anxiety, mood, trauma- and stressor-related disorders confer increased risk for metabolic disease. Adiponectin, a cytokine released by adipose tissue is associated with these disorders and obesity via inflammatory processes. Available data describing associations with mental disorders remain limited and conflicted. METHODS A systematic search was conducted for English, peer-reviewed articles from inception until February 2019 that assessed for serum or plasma adiponectin levels in adults with an anxiety, mood or trauma-related disorder. Diagnoses were determined by psychiatric interview, based on DSM-IV, DSM-5 or ICD-10 criteria. Analyses were performed using STATA 15 and Standardized mean difference (SMD) with 95% confidence interval was applied to pool the effect size of meta-analysis studies. RESULTS In total 65 eligible studies were included in the systematic review and 30 studies in this meta-analysis. 19,178 participants (11,262 females and 7916 males), comprising healthy adults and adults with anxiety, mood and trauma-related disorders, were included. Overall results indicated an inverse association between adiponectin levels and examined mental disorders. Specifically, patients with an anxiety disorder (SMD = -1.18 µg/mL, 95% CI, -2.34; -0.01, p = 0.047); trauma or stressor-related disorder (SMD = -0.34 µg/mL, 95% CI, -0.52; -0.17, p = 0.0000) or bipolar disorder (SMD = -0.638 µg/mL, 95% CI, -1.16, -0.12, p = 0.017) had significant lower adiponectin levels compared to healthy adults. LIMITATIONS Heterogeneity, potential publication bias, and lack of control for important potential confounders were significant limitations. CONCLUSION Peripheral adiponectin levels appear to be inversely associated with anxiety, mood, trauma- and stressor related disorders and may be a promising biomarker for diagnosis and disease monitoring.
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Affiliation(s)
- E Vuong
- South African Research Chairs Initiative (SARChI), PTSD Program, Department of Psychiatry, Stellenbosch University, South Africa; Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa.
| | - J Nothling
- South African Research Chairs Initiative (SARChI), PTSD Program, Department of Psychiatry, Stellenbosch University, South Africa; Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - C Lombard
- Biostatistics Unit, South Africa Medical Research Council, Cape Town, South Africa
| | - R Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - N Peer
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Durban, South Africa
| | - N Abrahams
- Gender and Health Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - S Seedat
- South African Research Chairs Initiative (SARChI), PTSD Program, Department of Psychiatry, Stellenbosch University, South Africa; Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
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Increasing Adiponergic System Activity as a Potential Treatment for Depressive Disorders. Mol Neurobiol 2019; 56:7966-7976. [PMID: 31140056 PMCID: PMC6834732 DOI: 10.1007/s12035-019-01644-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/09/2019] [Accepted: 05/10/2019] [Indexed: 12/22/2022]
Abstract
Depression is the most devastating mental disorder and one of the leading contributors to the global medical burden. Current antidepressant prescriptions present drawbacks, including treatment resistance, delayed onset of treatment response, and side effects. The rapid and long-lasting antidepressant effect of ketamine has brought hope to treatment-resistant major depressive disorder patients. However, ketamine has undesirable addictive properties and is a drug of abuse. There is an urgent need, therefore, to develop novel pharmacological interventions that could be as effective as ketamine, but without its side effects. Adiponectin, a pleiotropic adipocyte-secreted hormone, has insulin-sensitizing and neurotrophic properties. It can cross the blood-brain barrier and target multiple brain regions where the adiponectin receptors are detected. Emerging evidence has suggested that adiponectin and the adiponectin receptor agonist, AdipoRon, could promote adult neurogenesis, dendritic and spine remodeling, and synaptic plasticity in the hippocampus, resulting in antidepressant effects in adult mice. By summarizing the most recent clinical and animal studies, this review provides a timely insight on how modulating the adiponergic system in the hippocampus could be a potential therapeutic target for an effective and fast-acting antidepressant response.
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Furman JL, Soyombo A, Czysz AH, Jha MK, Carmody TJ, Mason BL, Scherer PE, Trivedi MH. Adiponectin Moderates Antidepressant Treatment Outcome in the Combining Medications to Enhance Depression Outcomes Randomized Clinical Trial. ACTA ACUST UNITED AC 2018; 9-10:1-7. [PMID: 30859144 DOI: 10.1016/j.pmip.2018.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Major depressive disorder (MDD) is often comorbid with metabolic diseases such as obesity, cardiovascular disease, and type 2 diabetes. A potential link between these disorders is adiponectin, an adipocyte-derived circulating hormone with insulin-sensitizing, anti-inflammatory, and neuroplasticity effects. Reductions in plasma levels of adiponectin have been reported in both humans with depression and in the chronic-defeat mouse model of depression. However, the predictive value of adiponectin for treatment response to depression has not been determined. Methods We investigated the potential predictive effect of baseline adiponectin levels in patients who provided plasma and were undergoing one of three pharmacological treatments (escitalopram monotherapy; escitalopram plus bupropion; and venlafaxine plus mirtazapine) in the Combining Medications to Enhance Depression Outcomes clinical trial (n=160). Specifically, we assessed whether adiponectin moderates-that is, differentially predicts-treatment response among the treatment arms. Improvements with treatment were assessed using change in the clinician-rated 30-item Inventory of Depressive Symptomatology (IDS-C) from baseline through week 12. Moderator effects were tested using separate pairwise repeated measures mixed-effects models with a treatment-arm-by-adiponectin interaction. Results Baseline adiponectin levels moderated treatment outcome between two combination therapies. Specifically, low adiponectin predicted better response to escitalopram plus bupropion compared to venlafaxine plus mirtazapine, whereas high adiponectin predicted better response to venlafaxine plus mirtazapine compared to escitalopram plus bupropion (F=4.84, p=0.03). Adiponectin levels did not correlate with baseline depression severity (r=-0.03, p=.59). Conclusions Antidepressant selection for patients with MDD can be personalized using pre-treatment blood-based biomarkers, such as adiponectin, thereby improving treatment outcomes.
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Affiliation(s)
- Jennifer L Furman
- Department of Psychiatry, Center for Depression Research and Clinical Care, UT Southwestern Medical Center, 6363 Forest Park Rd, Ste BL13.408, Dallas, TX, 75390-9119, USA
| | - Abigail Soyombo
- Department of Psychiatry, Center for Depression Research and Clinical Care, UT Southwestern Medical Center, 6363 Forest Park Rd, Ste BL13.408, Dallas, TX, 75390-9119, USA
| | - Andrew H Czysz
- Department of Psychiatry, Center for Depression Research and Clinical Care, UT Southwestern Medical Center, 6363 Forest Park Rd, Ste BL13.408, Dallas, TX, 75390-9119, USA
| | - Manish K Jha
- Department of Psychiatry, Center for Depression Research and Clinical Care, UT Southwestern Medical Center, 6363 Forest Park Rd, Ste BL13.408, Dallas, TX, 75390-9119, USA
| | - Thomas J Carmody
- Department of Psychiatry, Center for Depression Research and Clinical Care, UT Southwestern Medical Center, 6363 Forest Park Rd, Ste BL13.408, Dallas, TX, 75390-9119, USA
| | - Brittany L Mason
- Department of Psychiatry, Center for Depression Research and Clinical Care, UT Southwestern Medical Center, 6363 Forest Park Rd, Ste BL13.408, Dallas, TX, 75390-9119, USA
| | - Philipp E Scherer
- Departments of Internal Medicine and Cell Biology, Touchstone Diabetes Center University of Texas Southwestern Medical School, 5323 Harry Hines Blvd, Dallas, Texas, 75390-9119, USA
| | - Madhukar H Trivedi
- Department of Psychiatry, Center for Depression Research and Clinical Care, UT Southwestern Medical Center, 6363 Forest Park Rd, Ste BL13.408, Dallas, TX, 75390-9119, USA
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Morin V, Hozer F, Costemale-Lacoste JF. The effects of ghrelin on sleep, appetite, and memory, and its possible role in depression: A review of the literature. Encephale 2018; 44:256-263. [DOI: 10.1016/j.encep.2017.10.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 10/01/2017] [Accepted: 10/02/2017] [Indexed: 12/13/2022]
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Hacimusalar Y, Eşel E. Suggested Biomarkers for Major Depressive Disorder. ACTA ACUST UNITED AC 2018; 55:280-290. [PMID: 30224877 DOI: 10.5152/npa.2017.19482] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 06/08/2017] [Indexed: 12/21/2022]
Abstract
Currently, the diagnosis of major depressive disorder (MDD) mainly relies on clinical examination and subjective evaluation of depressive symptoms. There is no non-invasive, quantitative test available today for the diagnosis of MDD. In MDD, exploration of biomarkers will be helpful in diagnosing the disorder as well as in choosing a treatment, and predicting the treatment response. In this article, it is aimed to review the findings of suggested biomarkers such as growth factors, cytokines and other inflammatory markers, oxidative stress markers, endocrine markers, energy balance hormones, genetic and epigenetic features, and neuroimaging in MDD and to evaluate how these findings contribute to the pathophysiology of MDD, the prediction of treatment response, severity of the disorder, and identification of subtypes. Among these, the findings related to the brain-derived neurotrophic factor, the hypothalamo-pituitary-adrenal axis, cytokines, and neuroimaging may be strong candidates for being biomarkers MDD, and may provide critical information in understanding biological etiology of depression. Although the findings are not sufficient yet, we think that the results of epigenetic studies will also provide very important contributions to the biomarker research in MDD. The availability of biomarkers in MDD will be an advancement that will facilitate the diagnosis of the disorder, treatment choices in the early stages, and prediction of the course of the disorder.
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Affiliation(s)
- Yunus Hacimusalar
- Department of Psychiatry, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Ertuğrul Eşel
- Department of Psychiatry, Erciyes University Faculty of Medicine, Kayseri, Turkey
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Sominsky L, Hodgson DM, McLaughlin EA, Smith R, Wall HM, Spencer SJ. Linking Stress and Infertility: A Novel Role for Ghrelin. Endocr Rev 2017; 38:432-467. [PMID: 28938425 DOI: 10.1210/er.2016-1133] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 07/24/2017] [Indexed: 12/23/2022]
Abstract
Infertility affects a remarkable one in four couples in developing countries. Psychological stress is a ubiquitous facet of life, and although stress affects us all at some point, prolonged or unmanageable stress may become harmful for some individuals, negatively impacting on their health, including fertility. For instance, women who struggle to conceive are twice as likely to suffer from emotional distress than fertile women. Assisted reproductive technology treatments place an additional physical, emotional, and financial burden of stress, particularly on women, who are often exposed to invasive techniques associated with treatment. Stress-reduction interventions can reduce negative affect and in some cases to improve in vitro fertilization outcomes. Although it has been well-established that stress negatively affects fertility in animal models, human research remains inconsistent due to individual differences and methodological flaws. Attempts to isolate single causal links between stress and infertility have not yet been successful due to their multifaceted etiologies. In this review, we will discuss the current literature in the field of stress-induced reproductive dysfunction based on animal and human models, and introduce a recently unexplored link between stress and infertility, the gut-derived hormone, ghrelin. We also present evidence from recent seminal studies demonstrating that ghrelin has a principal role in the stress response and reward processing, as well as in regulating reproductive function, and that these roles are tightly interlinked. Collectively, these data support the hypothesis that stress may negatively impact upon fertility at least in part by stimulating a dysregulation in ghrelin signaling.
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Affiliation(s)
- Luba Sominsky
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria 3083, Australia
| | - Deborah M Hodgson
- School of Psychology, Faculty of Science and IT, The University of Newcastle, New South Wales 2308, Australia
| | - Eileen A McLaughlin
- School of Biological Sciences, Faculty of Science, The University of Auckland, Auckland 1010, New Zealand.,School of Environmental & Life Sciences, Faculty of Science and IT, The University of Newcastle, New South Wales 2308, Australia
| | - Roger Smith
- Mothers and Babies Research Centre, Hunter Medical Research Institute, Lookout Road, New Lambton Heights, New South Wales 2305, Australia.,Priority Research Centre in Reproductive Science, The University of Newcastle, New South Wales 2308, Australia
| | - Hannah M Wall
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria 3083, Australia
| | - Sarah J Spencer
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria 3083, Australia
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Ricken R, Bopp S, Schlattmann P, Himmerich H, Bschor T, Richter C, Elstner S, Stamm TJ, Schulz-Ratei B, Lingesleben A, Reischies FM, Sterzer P, Borgwardt S, Bauer M, Heinz A, Hellweg R, Lang UE, Adli M. Ghrelin Serum Concentrations Are Associated with Treatment Response During Lithium Augmentation of Antidepressants. Int J Neuropsychopharmacol 2017; 20:692-697. [PMID: 28911006 PMCID: PMC5581484 DOI: 10.1093/ijnp/pyw082] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 10/28/2016] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Lithium augmentation of antidepressants is an effective strategy in treatment-resistant depression. The proteohormone ghrelin is thought to be involved in the pathophysiology of depression. The purpose of this study was to investigate the association of treatment response with the course of ghrelin levels during lithium augmentation. METHOD Ghrelin serum concentrations and severity of depression were measured in 85 acute depressive patients before and after 4 weeks of lithium augmentation. RESULTS In a linear mixed model analysis, we found a significant effect of response*time interaction (F1.81=9.48; P=.0028): under treatment, ghrelin levels increased in nonresponders and slightly decreased in responders to lithium augmentation. The covariate female gender had a significant positive effect (F1.83=4.69; P=.033), whereas time, response, appetite, and body mass index (kg/m2) did not show any significant effect on ghrelin levels (P>.05). CONCLUSION This is the first study showing that the course of ghrelin levels separates responders and nonresponders to lithium augmentation. Present results support the hypothesis that ghrelin serum concentrations might be involved in response to pharmacological treatment of depression.
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Affiliation(s)
- Roland Ricken
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor).,Correspondence: Roland Ricken, MD, Department of Psychiatry and Psychotherapy Charité – Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany ()
| | - Sandra Bopp
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Peter Schlattmann
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Hubertus Himmerich
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Tom Bschor
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Christoph Richter
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Samuel Elstner
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Thomas J Stamm
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Brigitte Schulz-Ratei
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Alexandra Lingesleben
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Friedel M Reischies
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Philipp Sterzer
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Stefan Borgwardt
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Rainer Hellweg
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Undine E Lang
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
| | - Mazda Adli
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany (Drs Ricken, Bopp, Richter, Stamm, Sterzer, Heinz, Hellweg, and Adli); Department of Statistics, Informatics and Documentation, Friedrich-Schiller-Universität Jena, Jena, Germany (Dr Schlattmann); Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany (Dr Himmerich); King’s College London, London, Great Britain (Dr Himmerich); Department of Psychiatry and Psychotherapy, Schlosspark-Klinik Berlin, Berlin, Germany (Dr Bschor); Department of Psychiatry and Psychotherapy, Vivantes Wenckebach Klinikum, Berlin, Germany (Dr Richter); Vivantes Klinikum Kaulsdorf, Berlin, Germany (Dr Richter); Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Königin Elisabeth Herzberge gGmbH, Berlin, Germany (Dr Elstner); Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany (Dr Stamm); Department of Psychiatry and Psychotherapy, Fliedner Klinik Berlin, Berlin, Germany (Dr Schulz-Ratei); Department of Psychiatry and Psychotherapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany (Dr Lingesleben); Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany (Dr Reischies); Department of Psychiatry and Psychotherapy, University Psychiatric Clinics (UPK), Switzerland (Drs Borgwardt and Lang); Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Drs Bauer and Bschor)
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15
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Lee SH, Paz-Filho G, Mastronardi C, Licinio J, Wong ML. Is increased antidepressant exposure a contributory factor to the obesity pandemic? Transl Psychiatry 2016; 6:e759. [PMID: 26978741 PMCID: PMC4872449 DOI: 10.1038/tp.2016.25] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 01/25/2016] [Accepted: 01/26/2016] [Indexed: 01/03/2023] Open
Abstract
Major depressive disorder (MDD) and obesity are both common heterogeneous disorders with complex aetiology, with a major impact on public health. Antidepressant prescribing has risen nearly 400% since 1988, according to data from the Centers for Disease Control and Prevention (CDC). In parallel, adult obesity rates have doubled since 1980, from 15 to 30 percent, while childhood obesity rates have more than tripled. Rising obesity rates have significant health consequences, contributing to increased rates of more than thirty serious diseases. Despite the concomitant rise of antidepressant use and of the obesity rates in Western societies, the association between the two, as well as the mechanisms underlying antidepressant-induced weight gain, remain under explored. In this review, we highlight the complex relationship between antidepressant use, MDD and weight gain. Clinical findings have suggested that obesity may increase the risk of developing MDD, and vice versa. Hypothalamic-pituitary-adrenal (HPA) axis activation occurs in the state of stress; concurrently, the HPA axis is also dysregulated in obesity and metabolic syndrome, making it the most well-understood shared common pathophysiological pathway with MDD. Numerous studies have investigated the effects of different classes of antidepressants on body weight. Previous clinical studies suggest that the tricyclics amitriptyline, nortriptyline and imipramine, and the serotonin norepinephrine reuptake inhibitor mirtazapine are associated with weight gain. Despite the fact that selective serotonin reuptake inhibitor (SSRI) use has been associated with weight loss during acute treatment, a number of studies have shown that SSRIs may be associated with long-term risk of weight gain; however, because of high variability and multiple confounds in clinical studies, the long-term effect of SSRI treatment and SSRI exposure on body weight remains unclear. A recently developed animal paradigm shows that the combination of stress and antidepressants followed by long-term high-fat diet results, long after discontinuation of antidepressant treatment, in markedly increased weight, in excess of what is caused by high-fat diet alone. On the basis of existing epidemiological, clinical and preclinical data, we have generated the testable hypothesis that escalating use of antidepressants, resulting in high rates of antidepressant exposure, might be a contributory factor to the obesity epidemic.
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Affiliation(s)
- S H Lee
- Department of Genome Sciences, John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia
| | - G Paz-Filho
- Department of Genome Sciences, John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia
| | - C Mastronardi
- Department of Genome Sciences, John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia
| | - J Licinio
- Pharmacogenomics Research Program, Mind and Brain Theme, South Australian Health and Medical Research Institute and Department of Psychiatry, School of Medicine, Flinders University, Adelaide, SA, Australia
| | - M-L Wong
- Pharmacogenomics Research Program, Mind and Brain Theme, South Australian Health and Medical Research Institute and Department of Psychiatry, School of Medicine, Flinders University, Adelaide, SA, Australia,Pharmacogenomics Research Program, Mind and Brain Theme, South Australian Health and Medical Research Institute and Department of Psychiatry, School of Medicine, Flinders University, PO Box 11060, Adelaide, SA 5001, Australia. E-mail:
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16
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Modulation of triglyceride accumulation in adipocytes by psychopharmacological agents in vitro. J Psychiatr Res 2016; 72:37-42. [PMID: 26524413 DOI: 10.1016/j.jpsychires.2015.10.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 10/06/2015] [Accepted: 10/09/2015] [Indexed: 11/24/2022]
Abstract
Weight gain is a major problem during psychopharmacological treatment. Research has concentrated on the appetite inducing properties and mechanisms of these drugs in the central nervous system. The potential contribution of direct effects of drugs on metabolically relevant peripheral cells such as adipocytes is less well understood. We examined the influence of the antidepressant imipramine, the antipsychotic clozapine, and the mood stabilizer lithium on preadipocytes and adipocytes in vitro, using Simpson-Golabi-Behmel syndrome (SGBS) cells, an established human preadipocyte model. Parameters of cell differentiation and signaling, and cell metabolism were measured. We found significantly increased triglyceride accumulation in adipocytes after supplementation with imipramine and lithium at therapeutic concentrations, compared to non-supplemented control samples. However, gene expression levels of an early marker of adipogenesis, the peroxisome proliferator-activated receptor gamma (PPAR-γ) and a late marker of adipogenesis, the fatty acid binding protein 4 (FABP4), as well as expression of adiponectin (ADIPOQ) did not change significantly in the presence of these psychopharmacological agents. The results suggest a direct influence of imipramine and lithium but not clozapine on fat storage of adipocytes. The underlying mechanisms of fatty acid storage and adipocyte differentiation however remain to be elucidated.
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17
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Liu J, Jia L, Lei XG, Jiang SM, Wang SB, Xu M. The clinical-psychological features of functional dyspepsia patients with weight loss: a multi-center study from China. Digestion 2015; 91:197-201. [PMID: 25790833 DOI: 10.1159/000375400] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 01/10/2015] [Indexed: 02/04/2023]
Abstract
AIMS To investigate the clinical features, appetite, quality of life (QOL), and their associated psychological factors of functional dyspepsia (FD) patients with weight loss. METHODS For a multicenter study, FD patients were recruited and divided into two groups according to the degree of weight changes during the previous 12 months or less with the onset of dyspepsia symptoms: Group A (≥5%) and Group B (<5%). Patients were evaluated based on the Nepean dyspepsia index (NDI), appetite questionnaire, Hamilton Rating Scale of Anxiety/Depression (HAMA/HAMD). RESULTS The body mass index in Group A was lower than in Group B, while, the frequency of physician visits in Group A was higher than in Group B. There were no differences in the total scores of NDI-symptom checklist or the items of intensity and bothersomeness between them (p > 0.05), but the frequency item for Group A was significantly higher than Group B (p = 0.035). The incidence of anxiety or depression, the proportion of poor or very poor appetite for Group A was higher than those for Group B (p < 0.05). Subscale scores of the NDI-QOL for Group A were significantly lower than those for Group B (p < 0.05). CONCLUSIONS FD patients with weight loss have lower BMI, more frequent physician visits, higher psychological disorders, poorer appetite and QoL.
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Affiliation(s)
- Jing Liu
- Department of Gastroenterology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, China
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18
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Wittekind DA, Kluge M. Ghrelin in psychiatric disorders - A review. Psychoneuroendocrinology 2015; 52:176-94. [PMID: 25459900 DOI: 10.1016/j.psyneuen.2014.11.013] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 11/13/2014] [Accepted: 11/13/2014] [Indexed: 12/21/2022]
Abstract
Ghrelin is a 28-amino-acid peptide hormone, first described in 1999 and broadly expressed in the organism. As the only known orexigenic hormone secreted in the periphery, it increases hunger and appetite, promoting food intake. Ghrelin has also been shown to be involved in various physiological processes being regulated in the central nervous system such as sleep, mood, memory and reward. Accordingly, it has been implicated in a series of psychiatric disorders, making it subject of increasing investigation, with knowledge rapidly accumulating. This review aims at providing a concise yet comprehensive overview of the role of ghrelin in psychiatric disorders. Ghrelin was consistently shown to exert neuroprotective and memory-enhancing effects and alleviated psychopathology in animal models of dementia. Few human studies show a disruption of the ghrelin system in dementia. It was also shown to play a crucial role in the pathophysiology of addictive disorders, promoting drug reward, enhancing drug seeking behavior and increasing craving in both animals and humans. Ghrelin's exact role in depression and anxiety is still being debated, as it was shown to both promote and alleviate depressive and anxiety-behavior in animal studies, with an overweight of evidence suggesting antidepressant effects. Not surprisingly, the ghrelin system is also implicated in eating disorders, however its exact role remains to be elucidated. Its widespread involvement has made the ghrelin system a promising target for future therapies, with encouraging findings in recent literature.
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Affiliation(s)
| | - Michael Kluge
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
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19
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Carvalho AF, Rocha DQC, McIntyre RS, Mesquita LM, Köhler CA, Hyphantis TN, Sales PMG, Machado-Vieira R, Berk M. Adipokines as emerging depression biomarkers: a systematic review and meta-analysis. J Psychiatr Res 2014; 59:28-37. [PMID: 25183029 DOI: 10.1016/j.jpsychires.2014.08.002] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 08/06/2014] [Accepted: 08/07/2014] [Indexed: 12/15/2022]
Abstract
Adiponectin, leptin and resistin may play a role in the pathophysiology of major depressive disorder (MDD). However, differences in peripheral levels of these hormones are inconsistent across diagnostic and intervention studies. Therefore, we performed meta-analyses of diagnostic studies (i.e., MDD subjects versus healthy controls) and intervention investigations (i.e., pre-vs. post-antidepressant treatment) in MDD. Adiponectin (N = 1278; Hedge's g = -0.35; P = 0.16) and leptin (N = 893; Hedge's g = -0.018; P = 0.93) did not differ across diagnostic studies. Meta-regression analyses revealed that gender and depression severity explained the heterogeneity observed in adiponectin diagnostic studies, while BMI and the difference in BMI between MDD individuals and controls explained the heterogeneity of leptin diagnostic studies. Subgroup analyses revealed that adiponectin peripheral levels were significantly lower in MDD participants compared to controls when assayed with RIA, but not ELISA. Leptin levels were significantly higher in individuals with mild/moderate depression versus controls. Resistin serum levels were lower in MDD individuals compared to healthy controls (N = 298; Hedge's g = -0.25; P = 0.03). Leptin serum levels did not change after antidepressant treatment. However, heterogeneity was significant and sample size was low (N = 108); consequently meta-regression analysis could not be performed. Intervention meta-analyses could not be performed for adiponectin and resistin (i.e., few studies met inclusion criteria). In conclusion, this systematic review and meta-analysis underscored that relevant moderators/confounders (e.g., BMI, depression severity and type of assay) should be controlled for when considering the role of leptin and adiponectin as putative MDD diagnostic biomarkers.
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Affiliation(s)
- André F Carvalho
- Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil.
| | - Davi Q C Rocha
- Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - Roger S McIntyre
- Departments of Pharmacology and Psychiatry, University of Toronto, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University of Toronto, Toronto, ON, Canada
| | - Lucas M Mesquita
- Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - Cristiano A Köhler
- Memory Research Laboratory, Brain Institute (ICe), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Thomas N Hyphantis
- Department of Psychiatry, Medical School, University of Ioaninna, Ioaninna, Greece
| | - Paulo M G Sales
- Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - Rodrigo Machado-Vieira
- National Institute of Mental Health (NIMH), Bethesda, USA; Laboratory of Neuroscience, LIM-27, Department and Institute of Psychiatry, University of São Paulo, USP, Brazil; Center for Interdisciplinary Research in Applied Neuroscience (NAPNA), USP, Brazil
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Vic., Australia; Florey Institute of Neuroscience and Mental Health, Australia; Orygen Youth Health Research Centre, University of Melbourne, Parkville, Vic., Australia
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20
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Paslakis G, Westphal S, Hamann B, Gilles M, Lederbogen F, Deuschle M. Unstimulated and glucose-stimulated ghrelin in depressed patients and controls. J Psychopharmacol 2014; 28:582-6. [PMID: 24671339 DOI: 10.1177/0269881114527655] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The neuropeptide ghrelin stimulates hunger and weight gain. Ghrelin actions have been associated with depression in a number of preclinical and clinical studies, although some studies comparing basal peripheral ghrelin levels between depressed patients and controls found no differences between the groups. METHODS Twenty patients with a melancholic depressive episode and 15 controls received a 75 g glucose load and ghrelin levels were measured at 0, 30, 60 and 90 min after the beginning of the test. The patients were then either treated with mirtazapine (n=10) or venlafaxine (n=10) and underwent the same procedure (glucose load and ghrelin assessment) after four weeks of treatment. RESULTS Basal ghrelin concentrations did not differ between patients and controls, although the ghrelin responses following the glucose load were lower in patients and differed significantly to the controls' responses. After treatment, the patients' ghrelin responses to the glucose load increased by trend and approximated those in the control group. CONCLUSION Ghrelin is involved in appetite-regulating pathways during depression. For the first time we show that a functional test procedure using a standardised glucose load is more suitable than the assessment of basal peripheral ghrelin levels to detect differences between diagnostic groups.
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Affiliation(s)
- Georgios Paslakis
- Department of Psychiatry and Psychotherapy, University of Heidelberg, Mannheim, Germany
| | - Sabine Westphal
- Institute of Clinical Chemistry, Magdeburg University Hospital, Magdeburg, Germany
| | - Bettina Hamann
- Department of Psychiatry and Psychotherapy, University of Heidelberg, Mannheim, Germany
| | - Maria Gilles
- Department of Psychiatry and Psychotherapy, University of Heidelberg, Mannheim, Germany
| | - Florian Lederbogen
- Department of Psychiatry and Psychotherapy, University of Heidelberg, Mannheim, Germany
| | - Michael Deuschle
- Department of Psychiatry and Psychotherapy, University of Heidelberg, Mannheim, Germany
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21
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Ozsoy S, Besirli A, Abdulrezzak U, Basturk M. Serum ghrelin and leptin levels in patients with depression and the effects of treatment. Psychiatry Investig 2014; 11:167-72. [PMID: 24843372 PMCID: PMC4023091 DOI: 10.4306/pi.2014.11.2.167] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Revised: 09/05/2013] [Accepted: 09/11/2013] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Ghrelin and leptin, appetite-regulating hormones, play a role in mood regulation. Current data about the relation between leptin/ghrelin and depression are still controversial. This study aimed to investigate serum leptin and ghrelin levels in patients with depression and the effects of treatment on these levels. METHODS Serum ghrelin and leptin levels were measured before and after treatment with antidepressant drugs and/or electroconvulsive therapy in 28 patients with depression and once in 21 healthy controls. RESULTS Serum ghrelin levels of the patients were high in the pre-treatment. After the treatment, ghrelin levels were not different from those of the controls. We found no difference in serum levels of leptin between the patients and controls and no change with treatment. body mass index of the patients increased after the treatment especially in the drug-treated group. CONCLUSION The present study found increased serum ghrelin levels in depressive patients and normalization with improving of depression but no alteration in leptin levels.
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Affiliation(s)
- Saliha Ozsoy
- Department of Psychiatry, Erciyes University School of Medicine, Kayseri, Turkey
| | - Aslı Besirli
- Department of Psychiatry, Mus State Hospital, Mus, Turkey
| | - Ummuhan Abdulrezzak
- Department of Nuclear Medicine, Erciyes University Medical School, Kayseri, Turkey
| | - Mustafa Basturk
- Department of Psychiatry, Erciyes University School of Medicine, Kayseri, Turkey
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22
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Labarthe A, Fiquet O, Hassouna R, Zizzari P, Lanfumey L, Ramoz N, Grouselle D, Epelbaum J, Tolle V. Ghrelin-Derived Peptides: A Link between Appetite/Reward, GH Axis, and Psychiatric Disorders? Front Endocrinol (Lausanne) 2014; 5:163. [PMID: 25386163 PMCID: PMC4209873 DOI: 10.3389/fendo.2014.00163] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 09/23/2014] [Indexed: 12/25/2022] Open
Abstract
Psychiatric disorders are often associated with metabolic and hormonal alterations, including obesity, diabetes, metabolic syndrome as well as modifications in several biological rhythms including appetite, stress, sleep-wake cycles, and secretion of their corresponding endocrine regulators. Among the gastrointestinal hormones that regulate appetite and adapt the metabolism in response to nutritional, hedonic, and emotional dysfunctions, at the interface between endocrine, metabolic, and psychiatric disorders, ghrelin plays a unique role as the only one increasing appetite. The secretion of ghrelin is altered in several psychiatric disorders (anorexia, schizophrenia) as well as in metabolic disorders (obesity) and in animal models in response to emotional triggers (psychological stress …) but the relationship between these modifications and the physiopathology of psychiatric disorders remains unclear. Recently, a large literature showed that this key metabolic/endocrine regulator is involved in stress and reward-oriented behaviors and regulates anxiety and mood. In addition, preproghrelin is a complex prohormone but the roles of the other ghrelin-derived peptides, thought to act as functional ghrelin antagonists, are largely unknown. Altered ghrelin secretion and/or signaling in psychiatric diseases are thought to participate in altered appetite, hedonic response and reward. Whether this can contribute to the mechanism responsible for the development of the disease or can help to minimize some symptoms associated with these psychiatric disorders is discussed in the present review. We will thus describe (1) the biological actions of ghrelin and ghrelin-derived peptides on food and drugs reward, anxiety and depression, and the physiological consequences of ghrelin invalidation on these parameters, (2) how ghrelin and ghrelin-derived peptides are regulated in animal models of psychiatric diseases and in human psychiatric disorders in relation with the GH axis.
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Affiliation(s)
- Alexandra Labarthe
- UMR-S 894, Centre de Psychiatrie et Neurosciences, L’Institut national de la santé et de la recherche médicale, Université Paris Descartes, Paris, France
| | - Oriane Fiquet
- UMR-S 894, Centre de Psychiatrie et Neurosciences, L’Institut national de la santé et de la recherche médicale, Université Paris Descartes, Paris, France
| | - Rim Hassouna
- UMR-S 894, Centre de Psychiatrie et Neurosciences, L’Institut national de la santé et de la recherche médicale, Université Paris Descartes, Paris, France
| | - Philippe Zizzari
- UMR-S 894, Centre de Psychiatrie et Neurosciences, L’Institut national de la santé et de la recherche médicale, Université Paris Descartes, Paris, France
| | - Laurence Lanfumey
- UMR-S 894, Centre de Psychiatrie et Neurosciences, L’Institut national de la santé et de la recherche médicale, Université Paris Descartes, Paris, France
| | - Nicolas Ramoz
- UMR-S 894, Centre de Psychiatrie et Neurosciences, L’Institut national de la santé et de la recherche médicale, Université Paris Descartes, Paris, France
| | - Dominique Grouselle
- UMR-S 894, Centre de Psychiatrie et Neurosciences, L’Institut national de la santé et de la recherche médicale, Université Paris Descartes, Paris, France
| | - Jacques Epelbaum
- UMR-S 894, Centre de Psychiatrie et Neurosciences, L’Institut national de la santé et de la recherche médicale, Université Paris Descartes, Paris, France
| | - Virginie Tolle
- UMR-S 894, Centre de Psychiatrie et Neurosciences, L’Institut national de la santé et de la recherche médicale, Université Paris Descartes, Paris, France
- *Correspondence: Virginie Tolle, UMR-S 894, Centre de Psychiatrie et Neurosciences, INSERM, Université Paris Descartes, 2 ter rue d’Alésia, Paris 75014, France e-mail:
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Tasci I, Safer U. Depression and anxiety disorders among gastroenterologic outpatients. Saudi J Gastroenterol 2014; 20:327. [PMID: 25253372 PMCID: PMC4196354 DOI: 10.4103/1319-3767.141702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ilker Tasci
- Department of Internal Medicine, Gulhane School of Medicine, 06018 Ankara, Turkey E-mail:
| | - Umut Safer
- Department of Internal Medicine, Gulhane School of Medicine, 06018 Ankara, Turkey E-mail:
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Ishitobi Y, Kohno K, Kanehisa M, Inoue A, Imanaga J, Maruyama Y, Ninomiya T, Higuma H, Okamoto S, Tanaka Y, Tsuru J, Hanada H, Isogawa K, Akiyoshi J. Serum ghrelin levels and the effects of antidepressants in major depressive disorder and panic disorder. Neuropsychobiology 2013; 66:185-92. [PMID: 22948519 DOI: 10.1159/000339948] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 06/08/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Two opposing models for the action of ghrelin in the behavioral responses to stress were recently proposed. Some studies suggest that an increase in ghrelin contributes to the mechanisms responsible for the development of stress-induced depression and anxiety, while others suggest that it helps minimize what otherwise would be more severe manifestations of depression and anxiety following stress. METHODS We measured serum ghrelin levels, Profile of Mood States (POMS) scores and State-Trait Anxiety Inventory scores in nonresponders (treatment-resistant patients; 30) and responders (38) with major depressive disorder (MDD), nonresponders (29) and responders (51) with panic disorder and 97 healthy controls. RESULTS The ghrelin concentration in nonresponders with MDD was higher than that of responders with MDD and normal controls. The ghrelin concentration in nonresponders with panic disorder was higher than that of normal controls. POMS vigor scores in patients with MDD and panic disorder were significantly decreased compared with those in healthy controls. Other POMS scores in patients with MDD and panic disorder were significantly increased compared with those of healthy controls. Trait and state anxiety of the State-Trait Anxiety Inventory in MDD and panic disorder patients were higher than those in healthy controls. CONCLUSIONS These results indicate that decreased serum ghrelin levels might be associated with antidepressant treatment to confer the maximum therapeutic effect in patients with MDD and panic disorder.
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Affiliation(s)
- Yoshinobu Ishitobi
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Oita, Japan
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Abstract
PURPOSE OF REVIEW Depression and diabetes mellitus type 2 (DM2) are frequently comorbid conditions. It is of considerable clinical significance to avoid metabolic risks in nondiabetic depressed patients and to consider effects on glucose regulation in depressed DM2 patients. This review is an overview on antidepressant treatment and its potential metabolic risks. RECENT FINDINGS It is increasingly recognized that effective treatment with antidepressants improves glucose homeostasis in nondiabetic depressed patients in the short run, whereas long-term effects are a matter of debate. Cognitive behavioral and selective serotonin reuptake inhibitor (SSRI) treatment may improve glycemic control in depressed DM2 patients, whereas noradrenergic antidepressants and tricyclic antidepressants (TCAs) may cause the metabolic situation to deteriorate. SUMMARY SSRIs are preferable in nondiabetic depressed patients since they improve glucose regulation in the short run and may have little untoward effects in the long run. In depressed DM2 patients, SSRIs are the only class of antidepressants with confirmed favorable effects on glycemic control.
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Deuschle M, Schweiger U. Depression und Diabetes mellitus Typ 2. DER NERVENARZT 2012; 83:1410-22. [DOI: 10.1007/s00115-012-3656-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Matsuo K, Nakano M, Nakashima M, Watanuki T, Egashira K, Matsubara T, Watanabe Y. Neural correlates of plasma acylated ghrelin level in individuals with major depressive disorder. Brain Res 2012; 1473:185-92. [PMID: 22819931 DOI: 10.1016/j.brainres.2012.07.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Revised: 07/12/2012] [Accepted: 07/13/2012] [Indexed: 12/20/2022]
Abstract
Anhedonic symptoms, which include loss of pleasure, appetite and motivation, are key symptoms of major depressive disorder (MDD) and are thought to depend on a neural circuit of the mesolimbic system. The neuropeptide ghrelin plays a crucial role in appetite and reward. Little is known, however, about the role of ghrelin in MDD. We examined the association between morphometric change and plasma ghrelin levels in patients with MDD. Twenty-four patients with MDD and 24 healthy control subjects were studied. Plasma concentration of acylated ghrelin was measured after a period of fasting. Using voxel-based morphometry, we found a main effect of ghrelin on the volume of several brain regions. We then compared these regional volumes in patients with MDD versus healthy subjects. We also compared brain volumes between the two groups, controlling for ghrelin level. There was no significant difference in plasma acylated ghrelin level between patients with MDD and healthy subjects. In the MDD group, ghrelin levels positively correlated with the severity of reduced appetite. Ghrelin levels negatively correlated with gray matter volume of the ventral tegmental area (VTA) in the total sample. The patients with MDD showed significantly smaller VTA gray matter volume compared to healthy subjects. Controlling for the plasma acylated ghrelin level, patients with MDD showed significantly smaller gray matter volume of right substantia nigra compared to healthy subjects. Our findings suggest that plasma acylated ghrelin is associated with neural abnormalities of the pleasure/reward system and may be involved in the pathophysiology of MDD.
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Affiliation(s)
- Koji Matsuo
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University of Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan.
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Jeong HG, Min BJ, Lim S, Kim TH, Lee JJ, Park JH, Lee SB, Han JW, Choi SH, Park YJ, Jang HC, Kim KW. Plasma adiponectin elevation in elderly individuals with subsyndromal depression. Psychoneuroendocrinology 2012; 37:948-55. [PMID: 22130479 DOI: 10.1016/j.psyneuen.2011.11.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Revised: 11/01/2011] [Accepted: 11/02/2011] [Indexed: 12/15/2022]
Abstract
Adiponectin, one of the adipokines, has believed to play a role in developing of depression, but the relationship between plasma adiponectin and depressive disorder is still unclear. To investigate the association between plasma adiponectin and depressive disorders, we measured plasma adiponectin concentrations in 785 randomly sampled elderly Koreans including 41 patients with major depressive disorder (MDD), 46 with minor depressive disorder (MnDD), and 61 with subsyndromal depression (SSD). Plasma adiponectin levels were different among the diagnostic groups (df=3, F=4.928, P=0.002). The plasma adiponectin level in the SSD patients was higher than in the non-depressed controls (NC) (12.48 ± 8.38 μg/ml versus 9.27 ± 6.21 μg/ml, P=0.001, Tukey's post hoc comparison). However, plasma adiponectin levels in the MnDD and MDD patients were comparable with those found in the NC (P>0.1, Tukey's post hoc comparison). The elevation of plasma adiponectin in the SSD patients remained significant in men (P=0.002, Tukey's post hoc comparison) but not in women. In the subjects without MDD and MnDD, plasma adiponectin level was positively correlated with the Hamilton Depression Rating Scale score (r=0.156, P<0.001) and the Geriatric Depression Scale (r=0.117, P=0.002). When men and women were analyzed separately, these significant correlations were confined to men. Circulating adiponectin concentration may play a role in compensation on process for depressive mood.
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Affiliation(s)
- Hyun-Ghang Jeong
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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Khoza S, Barner JC. Glucose dysregulation associated with antidepressant agents: an analysis of 17 published case reports. Int J Clin Pharm 2011; 33:484-92. [PMID: 21487738 DOI: 10.1007/s11096-011-9507-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Accepted: 03/21/2011] [Indexed: 01/03/2023]
Abstract
AIM OF THE REVIEW Although there are several case reports in literature linking use of antidepressants and disturbances in glucose control, it is difficult to identify risk factors for serious adverse drug events from individual case reports. The aim of this review is to provide a descriptive analysis of the demographic and clinical characteristics of published glucose dysregulation case reports following initiation of antidepressant agents. METHODS Published case reports of glucose dysregulation associated with antidepressants were accessed through PubMed (Medline), PsycINFO, and Web of Science (WOS) between January 1, 1970 and April 30, 2010. The following key words were used: antidepressant agents, glucose dysregulation, hypoglycemia, hyperglycemia, diabetes mellitus, and diabetic ketoacidosis. Case reports were excluded if glucose dysregulation occurred after a drug overdose/improper dosing or after the patient was prescribed drugs known to cause glucose disturbances in addition to antidepressant agents. RESULTS Out of the 17 cases reports reviewed, nine (53%) were of hyperglycemia while eight (47%) were of hypoglycemia. Hyperglycemia was reported following treatment with clomipramine, fluvoxamine, imipramine, mianserin, mirtazapine, paroxetine, and sertraline. Hypoglycemia was reported following treatment with doxepine, fluoxetine, imipramine, nefazodone, nortriptyline, maprotiline, and sertraline. Fourteen out of the seventeen patients were female (82%) while ten had a history of diabetes mellitus (59%). The average age of the patients was 53.9 (SD = 17.5) years (range: 24-84 years). The time to onset of glucose dysregulation ranged from 4 days to 5 months after initiation of antidepressant therapy. More than two-thirds (68%) of the cases (n = 11) reported glucose control disturbances within 1 month of therapy. CONCLUSIONS It is not clear from published case reports whether changes in glucose regulation, following antidepressant therapy initiation are due to antidepressants or changes in mood and lifestyle. Nonetheless, healthcare providers should be aware of the potential changes in glucose regulation especially in the first month of antidepressant therapy, and use appropriate clinical and laboratory monitoring to prevent serious adverse events in patients at risk.
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Affiliation(s)
- Star Khoza
- College of Pharmacy, The University of Texas at Austin, 1 University Station A1900, Austin, TX 78712, USA
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Mood disorders and obesity: understanding inflammation as a pathophysiological nexus. Neuromolecular Med 2010; 13:93-116. [PMID: 21165712 DOI: 10.1007/s12017-010-8140-8] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Accepted: 11/19/2010] [Indexed: 02/06/2023]
Abstract
The aim of this review is to evaluate the evidentiary base supporting the hypothesis that the increased hazard for obesity in mood disorder populations (and vice versa) is a consequence of shared pathophysiological pathways. We conducted a PubMed search of all English-language articles with the following search terms: obesity, inflammation, hypothalamic-pituitary-adrenal axis, insulin, cognition, CNS, and neurotransmitters, cross-referenced with major depressive disorder and bipolar disorder. The frequent co-occurrence of mood disorders and obesity may be characterized by interconnected pathophysiology. Both conditions are marked by structural and functional abnormalities in multiple cortical and subcortical brain regions that subserve cognitive and/or affective processing. Abnormalities in several interacting biological networks (e.g. immuno-inflammatory, insulin signaling, and counterregulatory hormones) contribute to the co-occurence of mood disorders and obesity. Unequivocal evidence now indicates that obesity and mood disorders are chronic low-grade pro-inflammatory states that result in a gradual accumulation of allostatic load. Abnormalities in key effector proteins of the pro-inflammatory cascade include, but are not limited to, cytokines/adipokines such as adiponectin, leptin, and resistin as well as tumor necrosis factor alpha and interleukin-6. Taken together, the bidirectional relationship between obesity and mood disorders may represent an exophenotypic manifestation of aberrant neural and inflammatory networks. The clinical implications of these observations are that, practitioners should screen individuals with obesity for the presence of clinically significant depressive symptoms (and vice versa). This clinical recommendation is amplified in individuals presenting with biochemical indicators of insulin resistance and other concurrent conditions associated with abnormal inflammatory signaling (e.g. cardiovascular disease).
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2008. [DOI: 10.1002/pds.1491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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