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Kukucka T, Ferencova N, Visnovcova Z, Ondrejka I, Hrtanek I, Kovacova V, Macejova A, Mlyncekova Z, Tonhajzerova I. Mechanisms Involved in the Link between Depression, Antidepressant Treatment, and Associated Weight Change. Int J Mol Sci 2024; 25:4511. [PMID: 38674096 PMCID: PMC11050075 DOI: 10.3390/ijms25084511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Major depressive disorder is a severe mood disorder associated with a marked decrease in quality of life and social functioning, accompanied by a risk of suicidal behavior. Therefore, seeking out and adhering to effective treatment is of great personal and society-wide importance. Weight changes associated with antidepressant therapy are often cited as the reason for treatment withdrawal and thus are an important topic of interest. There indeed exists a significant mechanistic overlap between depression, antidepressant treatment, and the regulation of appetite and body weight. The suggested pathomechanisms include the abnormal functioning of the homeostatic (mostly humoral) and hedonic (mostly dopaminergic) circuits of appetite regulation, as well as causing neuromorphological and neurophysiological changes underlying the development of depressive disorder. However, this issue is still extensively discussed. This review aims to summarize mechanisms linked to depression and antidepressant therapy in the context of weight change.
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Affiliation(s)
- Tomas Kukucka
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (T.K.); (I.O.); (I.H.); (V.K.); (A.M.); (Z.M.)
| | - Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (N.F.); (Z.V.)
| | - Zuzana Visnovcova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (N.F.); (Z.V.)
| | - Igor Ondrejka
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (T.K.); (I.O.); (I.H.); (V.K.); (A.M.); (Z.M.)
| | - Igor Hrtanek
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (T.K.); (I.O.); (I.H.); (V.K.); (A.M.); (Z.M.)
| | - Veronika Kovacova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (T.K.); (I.O.); (I.H.); (V.K.); (A.M.); (Z.M.)
| | - Andrea Macejova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (T.K.); (I.O.); (I.H.); (V.K.); (A.M.); (Z.M.)
| | - Zuzana Mlyncekova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (T.K.); (I.O.); (I.H.); (V.K.); (A.M.); (Z.M.)
| | - Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia
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Zelada MI, Garrido V, Liberona A, Jones N, Zúñiga K, Silva H, Nieto RR. Brain-Derived Neurotrophic Factor (BDNF) as a Predictor of Treatment Response in Major Depressive Disorder (MDD): A Systematic Review. Int J Mol Sci 2023; 24:14810. [PMID: 37834258 PMCID: PMC10572866 DOI: 10.3390/ijms241914810] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/16/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Brain-derived neurotrophic factor (BDNF) has been studied as a biomarker of major depressive disorder (MDD). Besides diagnostic biomarkers, clinically useful biomarkers can inform response to treatment. We aimed to review all studies that sought to relate BDNF baseline levels, or BDNF polymorphisms, with response to treatment in MDD. In order to achieve this, we performed a systematic review of studies that explored the relation of BDNF with both pharmacological and non-pharmacological treatment. Finally, we reviewed the evidence that relates peripheral levels of BDNF and BDNF polymorphisms with the development and management of treatment-resistant depression.
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Affiliation(s)
- Mario Ignacio Zelada
- Escuela de Medicina, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
| | - Verónica Garrido
- Escuela de Medicina, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
| | - Andrés Liberona
- Escuela de Medicina, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
| | - Natalia Jones
- Escuela de Medicina, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
| | - Karen Zúñiga
- Escuela de Medicina, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
| | - Hernán Silva
- Clínica Psiquiátrica Universitaria, Hospital Clínico de la Universidad de Chile, Universidad de Chile, Santiago 8380453, Chile
- Departamento de Psiquiatría y Salud Mental Norte, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
| | - Rodrigo R. Nieto
- Clínica Psiquiátrica Universitaria, Hospital Clínico de la Universidad de Chile, Universidad de Chile, Santiago 8380453, Chile
- Departamento de Psiquiatría y Salud Mental Norte, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
- Departamento de Neurociencias, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
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Kosanovic Rajacic B, Sagud M, Begic D, Nikolac Perkovic M, Dvojkovic A, Ganoci L, Pivac N. Plasma Brain-Derived Neurotrophic Factor Levels in First-Episode and Recurrent Major Depression and before and after Bright Light Therapy in Treatment-Resistant Depression. Biomolecules 2023; 13:1425. [PMID: 37759825 PMCID: PMC10526351 DOI: 10.3390/biom13091425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/16/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
Brain-derived neurotrophic factor (BDNF) is implicated in the etiology and treatment response in major depressive disorder (MDD). However, peripheral BDNF concentrations have not been compared across different MDD stages. Bright light therapy (BLT) offers some potential in treatment-resistant depression (TRD), but its effects on BDNF levels are unknown. This study included a cross-sectional analysis of plasma BDNF concentration in females with TRD, unmedicated MDD patients, and healthy controls (HC), and measurements of longitudinal BLT effects on plasma BDNF levels in TRD patients. The present study included 55 drug-naïve, first-episode patients, 25 drug-free recurrent-episode MDD patients, 71 HC participants, and 54 TRD patients. Patients were rated by Hamilton Depression Rating Scale (HAMD)-17 and the Montgomery-Åsberg Depression Rating Scale (MADRS). Patients with TRD received BLT during 4 weeks. The total HAMD-17 and MADRS scores decreased following BLT. All patient groups had lower plasma BDNF than HC, but BDNF levels did not differ between first- and recurrent-episode BDNF patients and TRD patients before or after BLT. However, responders and remitters to BLT had higher post-treatment plasma BDNF concentrations than patients who did not achieve response or remission. The changes in plasma BDNF levels may be candidates for biomarkers of treatment response to BLT in TRD patients.
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Affiliation(s)
- Biljana Kosanovic Rajacic
- Department for Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, 10000 Zagreb, Croatia; (B.K.R.); (M.S.); (D.B.)
| | - Marina Sagud
- Department for Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, 10000 Zagreb, Croatia; (B.K.R.); (M.S.); (D.B.)
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Drazen Begic
- Department for Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, 10000 Zagreb, Croatia; (B.K.R.); (M.S.); (D.B.)
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Matea Nikolac Perkovic
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, 10000 Zagreb, Croatia;
| | - Anja Dvojkovic
- University Psychiatric Hospital Vrapce, 10090 Zagreb, Croatia;
| | - Lana Ganoci
- Department of Laboratory Diagnostics, Division for Pharmacogenomics and Therapy Individualization, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
| | - Nela Pivac
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, 10000 Zagreb, Croatia;
- University of Applied Sciences Hrvatsko Zagorje Krapina, 49000 Krapina, Croatia
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Meshkat S, Alnefeesi Y, Jawad MY, D Di Vincenzo J, B Rodrigues N, Ceban F, Mw Lui L, McIntyre RS, Rosenblat JD. Brain-Derived Neurotrophic Factor (BDNF) as a biomarker of treatment response in patients with Treatment Resistant Depression (TRD): A systematic review & meta-analysis. Psychiatry Res 2022; 317:114857. [PMID: 36194941 DOI: 10.1016/j.psychres.2022.114857] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/12/2022] [Accepted: 09/18/2022] [Indexed: 01/04/2023]
Abstract
Multiple lines of evidence have implicated brain-derived neurotrophic factor (BDNF) in treatment-resistant depression (TRD). The aim of this synthesis was to determine the impact of TRD treatments on peripheral BDNF levels, and ascertain whether these changes are associated with antidepressant effects. Thirty-six articles involving 1198 patients with TRD were included herein. Electroconvulsive therapy (ECT), ketamine, and repetitive transcranial magnetic stimulation (rTMS) were the most common TRD treatments investigated. Serum BDNF levels significantly increased in six, two, four and one studies following ECT, ketamine, rTMS and atypical antipsychotics, respectively. The estimated mean baseline serum BDNF concentration in TRD patients ± 95% CI was 15.5 ± 4.34 ng/mL. Peripheral BDNF levels significantly increased overall (Hedges' g ± 95% CI = 0.336 ± 0.302; p < 0.05), but no association with depressive symptoms was found (p ≥ 0.05). These results demonstrate that peripheral measurements of total BDNF (i.e., mature and percursor forms of BDNF) are inadequate predictors of treatment response in TRD patients, and other considerations suggest that this would still apply to separable measurements of mature BDNF and its precursor.
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Affiliation(s)
- Shakila Meshkat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Yazen Alnefeesi
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | | | - Joshua D Di Vincenzo
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Nelson B Rodrigues
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Felicia Ceban
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Leanna Mw Lui
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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Karthikeyan S, Dimick MK, Fiksenbaum L, Jeong H, Birmaher B, Kennedy JL, Lanctôt K, Levitt AJ, Miller GE, Schaffer A, Young LT, Youngstrom EA, Andreazza AC, Goldstein BI. Inflammatory markers, brain-derived neurotrophic factor, and the symptomatic course of adolescent bipolar disorder: A prospective repeated-measures study. Brain Behav Immun 2022; 100:278-286. [PMID: 34896179 DOI: 10.1016/j.bbi.2021.11.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 11/15/2021] [Accepted: 11/29/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Numerous studies have found elevated pro-inflammatory markers and reduced brain-derived neurotrophic factor (BDNF) during symptomatic episodes of bipolar disorder (BD) in adults. There is a paucity of research examining these markers in youth with BD, or longitudinally in any BD age group. METHODS 79 adolescents, ages 13-19 years, were enrolled, including 43 symptomatic adolescents with BD and 36 age-matched healthy controls (HC). Blood samples were collected from all participants at intake, and repeatedly from BD participants at pre-specified intervals over the course of two years. Serum was assayed for levels of pro-inflammatory markers (c-reactive protein [CRP], interleukin [IL]-6, tumor necrosis factor alpha [TNF-α]), BDNF and the anti-inflammatory marker, IL-10. Week-by-week severity of mood symptoms was assessed using semi-structured interviews. RESULTS Adolescents with BD provided an average of 4.6 blood samples, on average every 5.0 months. During the most severe symptomatic interval (i.e., highest sum of mood symptom scores) among BD adolescents, levels of CRP (p = 0.01) and pro- to anti-inflammatory ratios (CRP/IL-10; p < 0.001 and IL-6/IL-10; p = 0.046) were significantly greater, and IL-10 levels (p = 0.004) were significantly lower, vs. HC. There were no differences between BD and HC in IL-6, TNF-α or BDNF. Within BD participants, higher BDNF (p = 0.01) and IL-10 levels (p = 0.001) significantly predicted greater burden of mood symptoms over the subsequent epoch. Moreover, higher CRP levels (p = 0.009) at intake predicted greater time to recovery from the index symptomatic episode. CONCLUSIONS In the first repeated-measures study on this topic in adolescents with BD, we found evidence that CRP, an inexpensive and ubiquitous blood test, may be useful in predicting the prospective course of BD symptoms. Future larger studies are warranted.
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Affiliation(s)
- Sudhir Karthikeyan
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada; Sunnybrook Research Institute, Toronto, ON, Canada
| | - Mikaela K Dimick
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada; Sunnybrook Research Institute, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | | | - Hyunjin Jeong
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - James L Kennedy
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Krista Lanctôt
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Anthony J Levitt
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Gregory E Miller
- Institute for Policy Research & Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Ayal Schaffer
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - L Trevor Young
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Eric A Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ana C Andreazza
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada; Sunnybrook Research Institute, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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6
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Ai M, Wang J, Chen J, Wang W, Xu X, Gan Y, Li X, Gou X, Cao J, Lv Z, Chen X, Wang H, Ma Q, Kuang L. Plasma brain-derived neurotrophic factor (BDNF) concentration and the BDNF Val66Met polymorphism in suicide: a prospective study in patients with depressive disorder. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2019; 12:97-106. [PMID: 31308724 PMCID: PMC6614583 DOI: 10.2147/pgpm.s201187] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 05/18/2019] [Indexed: 12/20/2022]
Abstract
Purpose The relationship was investigated between brain-derived neurotrophic factor (BDNF) concentrations, a BDNF polymorphism (196G>A), and the response to selective serotonin reuptake inhibitors (SSRIs) among Chinese patients with major depressive disorder (MDD). Patients and methods A total of 125 patients and 91 healthy controls were enrolled. The disease progression and treatment responses were evaluated using the Hamilton depression rating scale (HAMD24), the Hamilton anxiety scale, the Beck depression index, and BDNF concentrations at the baseline, 4, 8, and 12 weeks after treatment. Responders were defined as patients with at least a 50% decrease in the HAMD24. Results The BDNF concentrations were significantly lower in MDD (947±297 vs 1187±236 pg/mL, p=0.019), in MDD with attempted suicide than those without (779±231 vs 993±298, p=0.024) at the baseline. The BDNF concentrations remarkably increased in response to SSRI treatment. Significant correlations were noted between the BDNF concentrations and suicide ideation or attempted suicide (p<0.01), but not with HAMD24 or depression. BDNF 196G>A correlated with neither suicide ideation nor treatment responses. Conclusion BDNF concentrations were significantly lower in patients with attempted suicide/ideation. BDNF concentrations could serve as a response marker for antidepressant treatment in MDD.
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Affiliation(s)
- Ming Ai
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Jun Wang
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Jianmei Chen
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Wo Wang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Xiaoming Xu
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Yao Gan
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Xuemei Li
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Xinyuan Gou
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Jun Cao
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Zhen Lv
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Xiaorong Chen
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Hengguang Wang
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Qing Ma
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, People's Republic of China.,Translational Pharmacology Research Core, New York State Center of Excellence in Bioinformatics and Life Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Li Kuang
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China.,Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, People's Republic of China
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7
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Ng CH, Kato T, Han C, Wang G, Trivedi M, Ramesh V, Shao D, Gala S, Narayanan S, Tan W, Feng Y, Kasper S. Definition of treatment-resistant depression - Asia Pacific perspectives. J Affect Disord 2019; 245:626-636. [PMID: 30445388 DOI: 10.1016/j.jad.2018.11.038] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/07/2018] [Accepted: 11/03/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND The lack of uniformity in the definition of treatment resistant depression (TRD) within the Asia-Pacific (APAC) region may have implications for patient management. We aimed to characterize the most commonly used TRD definition in selected APAC countries. METHODS A systematic literature review of TRD definitions in APAC countries was conducted in Medline and Embase (2010-2016) and conference proceedings (2014 and 2016). TRD guidelines (APAC, Europe regional, US, or international) were also searched. An expert-panel explored APAC nuances in TRD definitions to achieve consensus for a regional-level definition. RESULTS Ten guidelines and 89 studies qualified for study inclusion. Among the studies, variations were observed in definitions regarding: number of antidepressants failed (range: ≥1 to ≥3), classes of antidepressants (same or different; 59% did not specify class), duration of previous treatments (range: 4-12 weeks), dosage adequacy, and consideration of adherence (yes/no; 88% of studies did not consider adherence). No TRD-specific guidelines were identified. The emerging consensus from the literature review and panel discussion was that TRD is most commonly defined as failure to ≥2 antidepressant therapies given at adequate doses, for 6-8 weeks during a major depressive episode. LIMITATIONS Few studies provided definitions of TRD used in daily clinical practice, and a limited number of countries were represented in the included studies and expert panel. CONCLUSION Attaining consensus on TRD definition may promote accurate, and possibly early detection of patients with TRD to enable appropriate intervention that may impact patient outcomes and quality of life.
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Affiliation(s)
- C H Ng
- Department of Psychiatry, University of Melbourne, Victoria, Australia
| | - T Kato
- RIKEN Brain Science Institute, Saitama, Japan
| | - C Han
- Korea University, Seoul, South Korea
| | - G Wang
- Capital Medical University, Anding Hospital, Beijing, China
| | - M Trivedi
- University of Texas Southwestern Medical Center, TX, US
| | - V Ramesh
- Market Access Solutions, LLC, USA
| | - D Shao
- Market Access Solutions, LLC, USA
| | - S Gala
- Market Access Solutions, LLC, USA
| | | | - W Tan
- Janssen Asia Pacific, Singapore
| | - Y Feng
- Janssen Asia Pacific, Singapore
| | - S Kasper
- Medical University of Vienna, Vienna, Austria
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8
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Srikumar BN, Naidu PS, Kalidindi N, Paschapur M, Adepu B, Subramani S, Nagar J, Srivastava R, Sreedhara MV, Prasad DS, Das ML, Louis JV, Kuchibhotla VK, Dudhgaonkar S, Pieschl RL, Li YW, Bristow LJ, Ramarao M, Vikramadithyan RK. Diminished responses to monoaminergic antidepressants but not ketamine in a mouse model for neuropsychiatric lupus. J Psychopharmacol 2019; 33:25-36. [PMID: 30484737 DOI: 10.1177/0269881118812102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND A significant proportion of patients suffering from major depression fail to remit following treatment and develop treatment-resistant depression. Developing novel treatments requires animal models with good predictive validity. MRL/lpr mice, an established model of systemic lupus erythematosus, show depression-like behavior. AIMS We evaluated responses to classical antidepressants, and associated immunological and biochemical changes in MRL/lpr mice. METHODS AND RESULTS MRL/lpr mice showed increased immobility in the forced swim test, decreased wheel running and sucrose preference when compared with the controls, MRL/MpJ mice. In MRL/lpr mice, acute fluoxetine (30 mg/kg, intraperitoneally (i.p.)), imipramine (10 mg/kg, i.p.) or duloxetine (10 mg/kg, i.p.) did not decrease the immobility time in the Forced Swim Test. Interestingly, acute administration of combinations of olanzapine (0.03 mg/kg, subcutaneously)+fluoxetine (30 mg/kg, i.p.) or bupropion (10 mg/kg, i.p.)+fluoxetine (30 mg/kg, i.p.) retained efficacy. A single dose of ketamine but not three weeks of imipramine (10 mg/kg, i.p.) or escitalopram (5 mg/kg, i.p.) treatment in MRL/lpr mice restored sucrose preference. Further, we evaluated inflammatory, immune-mediated and neuronal mechanisms. In MRL/lpr mice, there was an increase in autoantibodies' titers, [3H]PK11195 binding and immune complex deposition. There was a significant infiltration of the brain by macrophages, neutrophils and T-lymphocytes. p11 mRNA expression was decreased in the prefrontal cortex. Further, there was an increase in the 5-HT2aR expression, plasma corticosterone and indoleamine 2,3-dioxygenase activity. CONCLUSION In summary, the MRL/lpr mice could be a useful model for Treatment Resistant Depression associated with immune dysfunction with potential to expedite antidepressant drug discovery.
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Affiliation(s)
- Bettadapura N Srikumar
- 1 Disease Sciences and Technology, Biocon-Bristol-Myers Squibb R&D Center, Bangalore, India
| | - Pattipati S Naidu
- 1 Disease Sciences and Technology, Biocon-Bristol-Myers Squibb R&D Center, Bangalore, India
| | | | - Mahesh Paschapur
- 1 Disease Sciences and Technology, Biocon-Bristol-Myers Squibb R&D Center, Bangalore, India
| | - Bharath Adepu
- 1 Disease Sciences and Technology, Biocon-Bristol-Myers Squibb R&D Center, Bangalore, India
| | - Siva Subramani
- 1 Disease Sciences and Technology, Biocon-Bristol-Myers Squibb R&D Center, Bangalore, India
| | - Jignesh Nagar
- 1 Disease Sciences and Technology, Biocon-Bristol-Myers Squibb R&D Center, Bangalore, India
| | - Ratika Srivastava
- 1 Disease Sciences and Technology, Biocon-Bristol-Myers Squibb R&D Center, Bangalore, India
| | - Muppana V Sreedhara
- 1 Disease Sciences and Technology, Biocon-Bristol-Myers Squibb R&D Center, Bangalore, India
| | - Durga Shiva Prasad
- 1 Disease Sciences and Technology, Biocon-Bristol-Myers Squibb R&D Center, Bangalore, India
| | - Manish Lal Das
- 1 Disease Sciences and Technology, Biocon-Bristol-Myers Squibb R&D Center, Bangalore, India
| | - Justin V Louis
- 1 Disease Sciences and Technology, Biocon-Bristol-Myers Squibb R&D Center, Bangalore, India
| | - Vijaya K Kuchibhotla
- 1 Disease Sciences and Technology, Biocon-Bristol-Myers Squibb R&D Center, Bangalore, India
| | - Shailesh Dudhgaonkar
- 1 Disease Sciences and Technology, Biocon-Bristol-Myers Squibb R&D Center, Bangalore, India
| | - Rick L Pieschl
- 2 Neuroscience Biology, Bristol-Myers Squibb Company, Wallingford, CT, USA
| | - Yu-Wen Li
- 2 Neuroscience Biology, Bristol-Myers Squibb Company, Wallingford, CT, USA
| | - Linda J Bristow
- 2 Neuroscience Biology, Bristol-Myers Squibb Company, Wallingford, CT, USA
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Mondal AC, Fatima M. Direct and indirect evidences of BDNF and NGF as key modulators in depression: role of antidepressants treatment. Int J Neurosci 2018; 129:283-296. [PMID: 30235967 DOI: 10.1080/00207454.2018.1527328] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE Depression is one of the most prevalent, recurrent and life-threatening mental illnesses. However, the precise mechanism underlying the disorder is not yet clearly understood. It is therefore, essential to identify the novel biomarkers which may help in the development of effective treatment. METHODS In this milieu, the profile of the brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) were considered as biomarkers in the light of pathophysiology of depression and its treatment. RESULTS Previously, we have reported that BDNF level in the postmortem brain of suicide victims was significantly lower than those of normal controls. We also found decreased BDNF levels in the specific brain regions of the learned helplessness model of depression in rat, and was found to increase normal level following chronic fluoxetine hydrochloride treatment. NGF is another important member of neurotrophin, which is dysregulated in the pathophysiology of depression in some models of peripheral nerve damage and stress. The results shown evidences of the effect of antidepressants on modulating depression via the NGF in preclinical and clinical models of depression, but conflicted, therefore make it currently difficult to affirm the therapeutic role of antidepressants. CONCLUSIONS Here, we review some of the preclinical and clinical studies aimed at disclosing the role of BDNF and NGF mediated pathophysiological mechanisms of depression and the new therapeutic approaches targeting those key molecules. In addition, an important link between BDNF, NGF and depression has been discussed in the light of current existing knowledge.
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Affiliation(s)
- Amal Chandra Mondal
- a Laboratory of Cellular and Molecular Neurobiology , School of Life Sciences, Jawaharlal Nehru University , New Delhi , India
| | - Mahino Fatima
- a Laboratory of Cellular and Molecular Neurobiology , School of Life Sciences, Jawaharlal Nehru University , New Delhi , India
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10
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Kagawa S, Mihara K, Suzuki T, Nagai G, Nakamura A, Nemoto K, Kondo T. Both Serum Brain-Derived Neurotrophic Factor and Interleukin-6 Levels Are Not Associated with Therapeutic Response to Lamotrigine Augmentation Therapy in Treatment-Resistant Depressive Disorder. Neuropsychobiology 2018; 75:145-150. [PMID: 29332095 DOI: 10.1159/000484665] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 10/24/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Serum levels of brain-derived neurotrophic factor (BDNF) and interleukin-6 (IL-6) were prospectively monitored in relation with therapeutic response to lamotrigine augmentation therapy in 46 (15 males and 31 females) inpatients with treatment-resistant depressive disorder during an 8-week treatment with lamotrigine using an open-study design. METHODS The subjects were 46 depressed patients who had already shown insufficient response to at least 3 psychotropics including antidepressants, mood stabilizers, and atypical antipsychotics. The diagnoses were major depressive disorder (n = 19), bipolar I disorder (n = 6), and bipolar II disorder (n = 22). The final doses of lamotrigine were 100 mg/day for 26 subjects who were not taking valproate and 75 mg/day for 20 subjects taking valproate, respectively. Depressive symptoms were evaluated by the Montgomery-Åsberg Depression Rating Scale (MADRS) before and after the 8-week treatment. Blood sampling was performed before the start of lamotrigine treatment and at week 8. Serum BDNF and IL-6 levels were measured using quantitative sandwich enzyme immunoassays. RESULTS No significant changes in serum BDNF or IL-6 levels during the 8-week lamotrigine treatment were observed in the total of subjects, responders or nonresponders. There was no significant correlation between the changes in serum BDNF or IL-6 levels and the percent improvement in MADRS scores in the overall subjects. CONCLUSION The present study suggests that the acute effect of lamotrigine augmentation therapy for a major depressive episode is not related to either BDNF or IL-6, at least in patients with treatment-resistant depressive disorder.
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Affiliation(s)
- Shoko Kagawa
- Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Kazuo Mihara
- Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Takeshi Suzuki
- Department of Hospital Pharmacy, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Goyo Nagai
- Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Akifumi Nakamura
- Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Kenji Nemoto
- Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Tsuyoshi Kondo
- Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
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11
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Enette L, Vogel T, Fanon JL, Lang PO. Effect of Interval and Continuous Aerobic Training on Basal Serum and Plasma Brain-Derived Neurotrophic Factor Values in Seniors: A Systematic Review of Intervention Studies. Rejuvenation Res 2017; 20:473-483. [DOI: 10.1089/rej.2016.1886] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Lievyn Enette
- Doctoral School in Life and Health Sciences, European Doctoral College (CDE), Strasbourg, France
- Department of Physiology and EA-3072, Medicine School, Strasbourg University, Strasbourg, France
| | - Thomas Vogel
- Department of Physiology and EA-3072, Medicine School, Strasbourg University, Strasbourg, France
- Geriatric Department, University Hospital, Strasbourg, France
| | - Jean Luc Fanon
- Department of Geriatric and Gerontology, University Hospital Centre of Martinique, Fort de France, France
| | - Pierre Olivier Lang
- Health and Wellbeing Academy, Anglia Ruskin University, Cambridge, United Kingdom
- Division of Geriatrics and Geriatric Rehabilitation, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
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12
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Srikumar BN, Paschapur M, Kalidindi N, Adepu B, Das ML, Sreedhara MV, Kuchibhotla VK, Pieschl RL, Li YW, Ega DSP, Louis JV, Murugesan S, Naidu PS, Ramarao M, Bristow LJ, Vikramadithyan RK. Characterization of the adrenocorticotrophic hormone - induced mouse model of resistance to antidepressant drug treatment. Pharmacol Biochem Behav 2017; 161:53-61. [PMID: 28911960 DOI: 10.1016/j.pbb.2017.09.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 09/01/2017] [Accepted: 09/08/2017] [Indexed: 02/08/2023]
Abstract
Approximately 30-60% of patients treated with existing antidepressants fail to achieve remission of depressive symptoms leading to Treatment Resistant Depression (TRD). There is an urgent need to develop novel medications, which is highly limited by the non-availability of relevant animal models with good predictive validity. ACTH administration has been shown to result in the resistance to acute and chronic effects of imipramine. However, the pharmacology of the model and the mechanisms contributing to the resistance are not completely understood. Furthermore, it is not known whether the ACTH administered animals show signs of depression-like behavior. Accordingly, we characterized the behavioral profile and sensitivity to antidepressants in BALB/c mice treated with ACTH and to evaluate some of the mechanisms responsible for the behavioral effects. Daily treatment with ACTH for 14, 21 or 28days failed to produce a depression-like phenotype in the sucrose preference test, voluntary wheel running or FST. In contrast, the acute antidepressant response in the FST was no longer observed in ACTH mice treated with fluoxetine, imipramine, duloxetine or bupropion. Interestingly, the combination of fluoxetine and a low dose of olanzapine, or the combination of fluoxetine and bupropion was efficacious in ACTH treated mice. Further, the sensitivity to a GluN2B receptor antagonist, radiprodil was retained in the ACTH model. To understand the mechanism responsible for the diminished response in these mice, we evaluated p11 (S100A10) mRNA expression and 5-HT2A protein expression. p11 expression was decreased and 5-HT2A protein content increased in ACTH treated mice. In summary, this model may have utility for the identification of novel treatments for TRD.
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Affiliation(s)
- Bettadapura N Srikumar
- Biocon-Bristol-Myers Squibb Research & Development Center, Biocon Park, Jigani Link Road, Bommasandra IV phase, Bangalore 560 099, India; Syngene International Limited, Bangalore, India.
| | - Mahesh Paschapur
- Biocon-Bristol-Myers Squibb Research & Development Center, Biocon Park, Jigani Link Road, Bommasandra IV phase, Bangalore 560 099, India; Syngene International Limited, Bangalore, India
| | - Narasimharaju Kalidindi
- Biocon-Bristol-Myers Squibb Research & Development Center, Biocon Park, Jigani Link Road, Bommasandra IV phase, Bangalore 560 099, India; Syngene International Limited, Bangalore, India
| | - Bharath Adepu
- Biocon-Bristol-Myers Squibb Research & Development Center, Biocon Park, Jigani Link Road, Bommasandra IV phase, Bangalore 560 099, India; Syngene International Limited, Bangalore, India
| | - Manish L Das
- Biocon-Bristol-Myers Squibb Research & Development Center, Biocon Park, Jigani Link Road, Bommasandra IV phase, Bangalore 560 099, India; Syngene International Limited, Bangalore, India
| | - Muppana V Sreedhara
- Biocon-Bristol-Myers Squibb Research & Development Center, Biocon Park, Jigani Link Road, Bommasandra IV phase, Bangalore 560 099, India; Syngene International Limited, Bangalore, India
| | - Vijaya K Kuchibhotla
- Biocon-Bristol-Myers Squibb Research & Development Center, Biocon Park, Jigani Link Road, Bommasandra IV phase, Bangalore 560 099, India; Syngene International Limited, Bangalore, India
| | - Rick L Pieschl
- Neuroscience Biology, Bristol-Myers Squibb Company, Wallingford, CT, USA
| | - Yu-Wen Li
- Neuroscience Biology, Bristol-Myers Squibb Company, Wallingford, CT, USA
| | - Durga Shiva Prasad Ega
- Biocon-Bristol-Myers Squibb Research & Development Center, Biocon Park, Jigani Link Road, Bommasandra IV phase, Bangalore 560 099, India; Syngene International Limited, Bangalore, India
| | - Justin V Louis
- Biocon-Bristol-Myers Squibb Research & Development Center, Biocon Park, Jigani Link Road, Bommasandra IV phase, Bangalore 560 099, India; Syngene International Limited, Bangalore, India
| | - Senthilkumar Murugesan
- Biocon-Bristol-Myers Squibb Research & Development Center, Biocon Park, Jigani Link Road, Bommasandra IV phase, Bangalore 560 099, India; Syngene International Limited, Bangalore, India
| | - Pattipati S Naidu
- Biocon-Bristol-Myers Squibb Research & Development Center, Biocon Park, Jigani Link Road, Bommasandra IV phase, Bangalore 560 099, India; Syngene International Limited, Bangalore, India
| | - Manjunath Ramarao
- Biocon-Bristol-Myers Squibb Research & Development Center, Biocon Park, Jigani Link Road, Bommasandra IV phase, Bangalore 560 099, India; Bristol-Myers Squibb India Pvt. Ltd., India.
| | - Linda J Bristow
- Neuroscience Biology, Bristol-Myers Squibb Company, Wallingford, CT, USA
| | - Reeba K Vikramadithyan
- Biocon-Bristol-Myers Squibb Research & Development Center, Biocon Park, Jigani Link Road, Bommasandra IV phase, Bangalore 560 099, India; Bristol-Myers Squibb India Pvt. Ltd., India
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Zhang Y, Shi J, Li J, Liu R, Yu Y, Xu Y. Role of brain-derived neurotrophic factor in the molecular neurobiology of major depressive disorder. TRANSLATIONAL PERIOPERATIVE AND PAIN MEDICINE 2017; 4:20-30. [PMID: 31595217 PMCID: PMC6782061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Major depressive disorder (MDD) is one of the most common neuropsychiatric disorders, which affects up to 20% of people in their lifetime in the United States. The exact neurobiological mechanisms of MDD remain elusive, and the diagnostics are still uncertain. Basic and clinical research from recent years demonstrated that the etiology of MDD might be associated with genetic changes of neurotrophins, particularly brain-derived neurotrophic factor (BDNF). BDNF plays a key role in neuronal development and neurogenesis. However, the detailed mechanisms related to depression and antidepressant responses are not fully understood. This review summarizes the current knowledge of the causal relationship between BDNF and MDD, and describes the important role of BDNF in the progress of depression in animal models and patients with depressive disorders.
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Affiliation(s)
- Yi Zhang
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, the State University of New York at Buffalo, Buffalo, NY, USA
| | - Jing Shi
- School of Pharmacy and Pharmaceutical Sciences, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Jianxin Li
- Wenzhou People's Hospital, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Renyu Liu
- Departments of Anesthesiology and Critical Care, Hospital of University of Pennsylvania, Philadelphia, PA, USA
| | - Yingcong Yu
- Wenzhou People's Hospital, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ying Xu
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, the State University of New York at Buffalo, Buffalo, NY, USA
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Peripheral blood brain-derived neurotrophic factor in bipolar disorder: a comprehensive systematic review and meta-analysis. Mol Psychiatry 2016; 21:216-28. [PMID: 26194180 DOI: 10.1038/mp.2015.54] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 03/11/2015] [Accepted: 03/18/2015] [Indexed: 12/12/2022]
Abstract
Peripheral blood brain-derived neurotrophic factor (BDNF) has been proposed as a potential biomarker related to disease activity and neuroprogression in bipolar disorder, speculated to mirror alterations in brain expression of BDNF. The research area is rapidly evolving; however, recent investigations have yielded conflicting results with substantial variation in outcomes, highlighting the need to critically assess the state of current evidence. The aims of the study were to investigate differences in peripheral blood BDNF concentrations between bipolar disorder patients and healthy control subjects and between affective states in bipolar disorder patients, including assessment of the effect of treatment of acute episodes on BDNF levels. A systematic review of English language studies without considering publication status was conducted in PubMed (January 1950-November 2014), Embase (1974-November 2014) and PsycINFO (1806-November 2014), and 35 studies comprising a total of 3798 participants were included in the meta-analysis. The results indicated that crude peripheral blood BDNF levels may be lower in bipolar disorder patients overall (Hedges' g=-0.28, 95% CI: -0.51 to -0.04, P=0.02) and in serum of manic (g=-0.77, 95% CI: -1.36 to -0.18, P=0.01) and depressed (g=-0.87, 95% CI: -1.42 to -0.32, P=0.002) bipolar disorder patients compared with healthy control subjects. No differences in peripheral BDNF levels were observed between affective states overall. Longer illness duration was associated with higher BDNF levels in bipolar disorder patients. Relatively low study quality, substantial unexplained between-study heterogeneity, potential bias in individual studies and indications of publication bias, was observed and studies were overall underpowered. It could thus not be excluded that identified differences between groups were due to factors not related to bipolar disorder. In conclusion, limitations in the evidence base prompt tempered conclusions regarding the role of peripheral BDNF as a biomarker in bipolar disorder and substantially improving the quality of further research is warranted.
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15
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Fernandes BS, Molendijk ML, Köhler CA, Soares JC, Leite CMGS, Machado-Vieira R, Ribeiro TL, Silva JC, Sales PMG, Quevedo J, Oertel-Knöchel V, Vieta E, González-Pinto A, Berk M, Carvalho AF. Peripheral brain-derived neurotrophic factor (BDNF) as a biomarker in bipolar disorder: a meta-analysis of 52 studies. BMC Med 2015; 13:289. [PMID: 26621529 PMCID: PMC4666054 DOI: 10.1186/s12916-015-0529-7] [Citation(s) in RCA: 182] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 11/18/2015] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The neurotrophic hypothesis postulates that mood disorders such as bipolar disorder (BD) are associated with a lower expression of brain-derived neurotrophic factor (BDNF). However, its role in peripheral blood as a biomarker of disease activity and of stage for BD, transcending pathophysiology, is still disputed. In the last few years an increasing number of clinical studies assessing BDNF in serum and plasma have been published. Therefore, it is now possible to analyse the association between BDNF levels and the severity of affective symptoms in BD as well as the effects of acute drug treatment of mood episodes on BDNF levels. METHODS We conducted a systematic review and meta-analysis of all studies on serum and plasma BDNF levels in bipolar disorder. RESULTS Through a series of meta-analyses including a total of 52 studies with 6,481 participants, we show that, compared to healthy controls, peripheral BDNF levels are reduced to the same extent in manic (Hedges' g = -0.57, P = 0.010) and depressive (Hedges' g = -0.93, P = 0.001) episodes, while BDNF levels are not significantly altered in euthymia. In meta-regression analyses, BDNF levels additionally negatively correlate with the severity of both manic and depressive symptoms. We found no evidence for a significant impact of illness duration on BDNF levels. In addition, in plasma, but not serum, peripheral BDNF levels increase after the successful treatment of an acute mania episode, but not of a depressive one. CONCLUSIONS In summary, our data suggest that peripheral BDNF levels, more clearly in plasma than in serum, is a potential biomarker of disease activity in BD, but not a biomarker of stage. We suggest that peripheral BDNF may, in future, be used as a part of a blood protein composite measure to assess disease activity in BD.
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Affiliation(s)
- Brisa S Fernandes
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong, Australia.
- Laboratory of Calcium Binding Proteins in the Central Nervous System, Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
| | - Marc L Molendijk
- Institute of Psychology, Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands
| | - Cristiano A Köhler
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Jair C Soares
- Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, Texas Health and Science University, Houston, TX, USA
| | - Cláudio Manuel G S Leite
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Rodrigo Machado-Vieira
- Laboratory of Neuroscience, LIM-27, Institute and Department of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil
- Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of Sao Paulo, Sao Paulo, Brazil
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, NIH, Bethesda, MD, USA
| | - Thamara L Ribeiro
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Jéssica C Silva
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Paulo M G Sales
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - João Quevedo
- Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, Texas Health and Science University, Houston, TX, USA
- Center for Translational Psychiatry, Department of Psychiatry and Behavioral Sciences, The University of Texas Medical School at Houston, Houston, TX, USA
- Neuroscience Graduate Program, Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
- Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, Criciúma, SC, Brazil
| | - Viola Oertel-Knöchel
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt/Main, Germany
| | - Eduard Vieta
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Ana González-Pinto
- University of the Basque Country, Biomedical Research Center in Mental Health Net (CIBERSAM), Department of Neurosciences, University of the Basque Country, Leioa, Spain
| | - Michael Berk
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong, Australia
- Florey Institute of Neuroscience and Mental Health, Orygen, The National Centre of Excellence in Youth Mental Health and Orygen Youth Health Research Centre, Parkville, VIC, Australia
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - André F Carvalho
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil.
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Polyakova M, Stuke K, Schuemberg K, Mueller K, Schoenknecht P, Schroeter ML. BDNF as a biomarker for successful treatment of mood disorders: a systematic & quantitative meta-analysis. J Affect Disord 2015; 174:432-40. [PMID: 25553404 DOI: 10.1016/j.jad.2014.11.044] [Citation(s) in RCA: 326] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 11/20/2014] [Accepted: 11/23/2014] [Indexed: 01/09/2023]
Abstract
BACKGROUND Peripheral brain-derived neurotrophic factor (BDNF) is decreased in acute major depressive disorder (MDD) and bipolar disorder (BD) and recovered after treatment. Here we validated on a meta-analytical level whether BDNF restores differentially according to treatment response and whose measurements could be used as a biomarker, plasma or serum. METHODS Using strict inclusion criteria, we compared BDNF in healthy controls and patients with MDD (38 studies, n=6619), and BD (17 studies, n=1447). Pre- and post-treatment BDNF levels were meta-analyzed according to treatment response in patients from 21 MDD studies (n=735) and 7 BD studies (n=88). Serum and plasma subgroups were analyzed, publication bias was assessed and heterogeneity was investigated. RESULTS Serum and plasma BDNF were decreased in acute MDD and BD, and did not differ in euthymia in comparison with control subjects. Antidepressive treatment increased serum BDNF levels in MDD in responders (Cohen׳s d (d)=1.27, p=4.4E-07) and remitters (d=0.89, p=0.01), significantly more than in non-responders (d=0.11, p=0.69). For plasma BDNF in MDD and for BD, the evidence was insufficient for a meta-analysis. Although no significant difference was found between serum and plasma ES, variance of plasma ES was higher. LIMITATIONS Between-study heterogeneity was explained only partially; signs of publication bias in serum studies. CONCLUSION Serum BDNF might be regarded as a biomarker for the successful treatment of MDD. Serum measurements seem more reliable than plasma ones. Further research should focus on defining optimal time points for BDNF measurements and increase evidence for the usage of BDNF as a predictive biomarker in BD.
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Affiliation(s)
- Maryna Polyakova
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Clinic for Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.
| | - Katharina Stuke
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Katharina Schuemberg
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Karsten Mueller
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Peter Schoenknecht
- Clinic for Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany
| | - Matthias L Schroeter
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany; LIFE-Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany
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Soeiro-DE-Souza MG, Dias VV, Missio G, Balanzá-Martinez V, Valiengo L, Carvalho AF, Moreno RA. Role of quetiapine beyond its clinical efficacy in bipolar disorder: From neuroprotection to the treatment of psychiatric disorders (Review). Exp Ther Med 2015; 9:643-652. [PMID: 25667608 PMCID: PMC4316978 DOI: 10.3892/etm.2015.2213] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 12/05/2014] [Indexed: 02/06/2023] Open
Abstract
The aim of the present review was to discuss the following aspects of treatment with quetiapine in psychiatric disorders: i) Neurocognition and functional recovery in bipolar disorder (BD); ii) neuroprotective profile in different models; and iii) potential off-label indications. A PubMed search was conducted of articles published in English between 2000 and 2012 on quetiapine, cross-referenced with the terms ‘anxiety’, ‘attention deficit disorder’, ‘borderline personality disorder’, ‘dementia’, ‘insomnia’, ‘major depressive disorder’ (MDD), ‘obsessive-compulsive disorder’, ‘post-traumatic stress disorder’, ‘remission’, ‘cognition’, ‘neurobiology’, ‘neuroprotection’, ‘efficacy’ and ‘effectiveness’. Articles were selected from meta-analyses, randomized clinical trials and open trials, and the results were summarized. Quetiapine, when studied in off-label conditions, has shown efficacy as a monotherapy in MDD and general anxiety disorder. Quetiapine also appears to exhibit a small beneficial effect in dementia. The review of other conditions was affected by methodological limitations that precluded any definitive conclusions on the efficacy or safety of quetiapine. Overall, the present review shows evidence supporting a potential role for quetiapine in improving cognition, functional recovery and negative symptoms in a cost-effective manner in BD. These benefits of quetiapine are potentially associated with its well-described neuroprotective effects; however, further studies are clearly warranted.
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Affiliation(s)
- Márcio G Soeiro-DE-Souza
- Mood Disorders Unit (GRUDA), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Vasco Videira Dias
- Mood Disorders Unit (GRUDA), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Giovanni Missio
- Mood Disorders Unit (GRUDA), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Vicent Balanzá-Martinez
- University Hospital Doctor Peset and Section of Psychiatry, University of Valencia, Valencia, Spain ; CIBER Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
| | - Leandro Valiengo
- Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - André F Carvalho
- Psychiatry Research Group and Department of Clinical Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Ricardo Alberto Moreno
- Mood Disorders Unit (GRUDA), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
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18
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Baek JH, Kang ES, Fava M, Mischoulon D, Nierenberg AA, Lee D, Heo JY, Jeon HJ. Thyroid stimulating hormone and serum, plasma, and platelet brain-derived neurotrophic factor during a 3-month follow-up in patients with major depressive disorder. J Affect Disord 2014; 169:112-7. [PMID: 25189990 DOI: 10.1016/j.jad.2014.08.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 07/24/2014] [Accepted: 08/07/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Thyroid dysfunction and elevated thyroid stimulating hormone (TSH) are common in patients with depression. TSH might exert its function in the brain through blood levels of brain-derived neurotrophic factor (BDNF). BDNF decreases during depressed states and normalize after treatment. The gap is that the association between TSH and BDNF in patients with major depressive disorder (MDD) is unknown. METHODS We studied 105 subjects ≥18 years of age with MDD and measured serum, plasma, and platelet BDNF at baseline, 1 month and 3 months during antidepressant treatment. Other baseline measurements included hypothalamic-pituitary-thyroid axis hormones such as TSH, triiodothyronine (T3) and thyroxine (T4); hypothalamic-pituitary-adrenal (HPA) axis hormones and hypothalamic-pituitary-gonadal (HPG) axis hormones and prolactin. RESULTS Linear mixed model effect analyses revealed that baseline TSH level was negatively associated with changes of serum BDNF from baseline to 3 months (F=7.58, p=0.007) after adjusting for age, sex, and body mass index, but was not associated with plasma and platelet BDNF. In contrast, T3 and T4, HPA axis hormones, HPG axis hormones, and prolactin were not associated with serum, plasma, or platelet BDNF levels. Patients in the highest quartile of TSH showed significantly lower serum BDNF than in the other quartiles (F=4.54, p=0.038), but no significant differences were found based on T3 and T4 levels. LIMITATIONS TSH was only measured at baseline. CONCLUSIONS Higher TSH is associated with lower baseline and reduced the increase of serum BDNF levels during antidepressant treatment in patients with MDD.
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Affiliation(s)
- Ji Hyun Baek
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Bipolar Clinic and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Eun-Suk Kang
- Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Maurizio Fava
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Andrew A Nierenberg
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA; Bipolar Clinic and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Dongsoo Lee
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung-Yoon Heo
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Seoul, Republic of Korea; Bipolar Clinic and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
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Lin CH, Chen MC, Lee WK, Chen CC, Huang CH, Lane HY. Electroconvulsive therapy improves clinical manifestation with plasma BDNF levels unchanged in treatment-resistant depression patients. Neuropsychobiology 2014; 68:110-5. [PMID: 23881232 DOI: 10.1159/000352013] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 05/06/2013] [Indexed: 01/17/2023]
Abstract
Electroconvulsive therapy (ECT) is the most effective treatment in treatment-resistant depression; it may modulate intracellular processes in such patients. This study aimed to investigate the association between changes in plasma brain-derived neurotrophic factor (BDNF) levels and the clinical improvements after ECT for patients with treatment-resistant depression. Fifty-five inpatients with treatment-resistant depression were recruited. The severity of depression was measured using the 17-item Hamilton Rating Scale for Depression (HAMD-17) and the Clinical Global Impression-Severity (CGI-S) before ECT, after every 3 sessions of ECT, and at the end of ECT. Plasma BDNF levels were measured in all subjects before and after ECT. The severity of depression was significantly reduced on the HAMD-17 (p < 0.001) and the CGI-S (p < 0.001) after the end of ECT. There were no significant differences in plasma BDNF levels after ECT (p = 0.615). No significant correlation was found between changes in plasma BDNF levels and changes in HAMD-17 scores (r = 0.188, p = 0.169). Our results do not support the hypothesis that improvements in treatment-resistant depression patients after ECT are due to changes in BDNF levels.
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Affiliation(s)
- Ching-Hua Lin
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Fooyin University, Kaohsiung, Taiwan, ROC
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Wang P, Si T. Use of antipsychotics in the treatment of depressive disorders. SHANGHAI ARCHIVES OF PSYCHIATRY 2014; 25:134-40. [PMID: 24991148 PMCID: PMC4054548 DOI: 10.3969/j.issn.1002-0829.2013.03.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Summary There is a long history of using antipsychotic medications in the treatment of depressive disorders. Atypical antipsychotics, which have fewer side effects than traditional antipsychotics, have been used as monotherapy or adjunctively with antidepressants to treat depressive disorders with or without psychotic symptoms. The antidepressant effect of atypical antipsychotics involves regulation of monoamine, glutamate, gamma-aminobutyric acid (GABA), cortisol, and neurotrophic factors. To date, the United States Food and Drug Administration (USFDA) has approved aripiprazole and quetiapine slow-release tablets as adjunctive treatment for depressive disorders, and the combination of olanzapine and fluoxetine for the treatment of treatment-resistant depression. When using atypical antipsychotics in the treatment of depressed patients, clinicians need to monitor patients for the emergence of adverse effects including extrapyramidal symptoms (EPS), weight gain, and hyperglycemia.
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Affiliation(s)
- Ping Wang
- Beijing Shijitan Hospital, Capital University of Medical Sciences, Beijing, China
| | - Tianmei Si
- Peking University Institute of Mental Health, National Key Laboratory of China, Beijing, China
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Yoshimura R, Hori H, Umene-Nakano W, Ikenouchi-Sugita A, Katsuki A, Atake K, Nakamura J. Comparison of lithium, aripiprazole and olanzapine as augmentation to paroxetine for inpatients with major depressive disorder. Ther Adv Psychopharmacol 2014; 4:123-9. [PMID: 25057345 PMCID: PMC4107705 DOI: 10.1177/2045125313514767] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Selective serotonin reuptake inhibitors (SSRIs) are considered first-line treatments for major depressive disorders (MDD). It has been reported, however, that 30-40% of patients with MDD who received SSRIs failed to respond to treatment. Use of lithium (Li) to augment SSRIs seems to be the most common strategy in such cases. It was recently demonstrated that atypical antipsychotics are effective augmentation agents in MDD. Here, we present a randomized controlled study that compared augmentation with Li, olanzapine (OLA) or aripiprazole (ARI) in paroxetine-refractory patients with MDD. METHODS Participants were 30 patients who met Diagnostic and Statistical Manual of Mental Disorders IV criteria for MDD and refractory to paroxetine treatment. Treatment with Li, OLA or ARI was added to paroxetine in a randomized protocol for 4 weeks. We defined the patients whose scores on the Hamilton Rating Scale for Depression decreased 50% or more as responders. RESULTS Two patients dropped out because of adverse effects. Response rates to Li, OLA or ARI augmentation were 4/10 (40%), 3/10 (30%) and 4/10 (40%), respectively. In addition, Li, OLA and ARI did not influence plasma paroxetine concentrations. CONCLUSIONS We concluded that OLA or ARI could be used as alternatives to Li as options for patients who do not respond to paroxetine treatment.
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Affiliation(s)
- Reiji Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health, 1-1Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 80785555, Japan
| | - Hikaru Hori
- University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Wakako Umene-Nakano
- University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | | | - Asuka Katsuki
- University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Kiyokazu Atake
- University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Jun Nakamura
- University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
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Yasui-Furukori N, Tsuchimine S, Kaneda A, Sugawara N, Ishioka M, Kaneko S. Association between plasma brain-derived neurotrophic factor levels and personality traits in healthy Japanese subjects. Psychiatry Res 2013; 210:220-3. [PMID: 23806624 DOI: 10.1016/j.psychres.2013.05.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 05/04/2013] [Accepted: 05/07/2013] [Indexed: 11/17/2022]
Abstract
Although depression has been associated with decreased brain-derived neurotrophic factor (BDNF) levels for specific personality traits, there is a little information regarding the association between peripheral BDNF levels and such traits. The sample consisted of 178 healthy Japanese subjects (age range, 37.4 ± 11.5 years). All subjects filled out the Temperament and Character Inventory (TCI). Plasma BDNF levels were measured using the enzyme-linked immunosorbent assay. A simple regression analysis revealed that plasma BDNF levels were significantly correlated with harm avoidance (r=-0.177, p=0.018) and self-directedness scores (r=0.165, p=0.028). Our findings suggest that plasma BDNF levels are associated with depression-related personality traits.
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Affiliation(s)
- Norio Yasui-Furukori
- Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki 036-8562, Japan.
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Wu R, Fan J, Zhao J, Calabrese JR, Gao K. The relationship between neurotrophins and bipolar disorder. Expert Rev Neurother 2013; 14:51-65. [DOI: 10.1586/14737175.2014.863709] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Brietzke E, Mansur RB, Zugman A, Carvalho AF, Macêdo DS, Cha DS, Abílio VC, McIntyre RS. Is there a role for curcumin in the treatment of bipolar disorder? Med Hypotheses 2013; 80:606-12. [DOI: 10.1016/j.mehy.2013.02.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 01/24/2013] [Accepted: 02/01/2013] [Indexed: 11/28/2022]
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Yoshimura R, Kishi T, Hori H, Ikenouchi-Sugita A, Katsuki A, Umene-Nakano W, Iwata N, Nakamura J. Comparison of the efficacy between paroxetine and sertraline augmented with aripiprazole in patients with refractory major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2012; 39:355-7. [PMID: 22813840 DOI: 10.1016/j.pnpbp.2012.07.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 07/09/2012] [Accepted: 07/09/2012] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Only two-thirds of depressive patients respond to antidepressant treatment. In recent years, addition of an atypical antipsychotic drug to ongoing treatment with an antidepressant has been considered effective and well-tolerated. In the present study, we compared the efficacy between paroxetine and sertraline augmented with aripiprazole in patients with refractory major depression. SUBJECTS AND METHODS Twenty-four patients who met the DSM-IV criteria for major depressive disorder who did not at least two different classes of antidepressants were enrolled in the study. Nine were male and thirteen were female, and their ages ranged from 28 to 66 (mean±SD=39±12) years. Patients were prescribed paroxetine (n=11) or sertraline (n=13) for 4weeks. Then, those whose scores on the 17-item Hamilton Rating Scale for Depression (HAMD17) decreased below 50% received adjunctive therapy of aripiprazole for 4weeks. RESULTS Although the use of either combination treatment decreased the HAMD17 scores compared to the respective monotherapy, there was no significant difference in HAMD17 scores between the paroxetine plus aripiprazole group and sertraline plus aripiprazole group. CONCLUSION Aripiprazole augmentation therapy with paroxetine or sertraline was equally effective and tolerated in patients with refractory major depressive order.
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Affiliation(s)
- Reiji Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu 8078555, Japan.
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Peripheral brain-derived neurotrophic factor changes along treatment with extended release quetiapine during acute mood episodes: an open-label trial in drug-free patients with bipolar disorder. J Psychiatr Res 2012; 46:1511-4. [PMID: 22939945 DOI: 10.1016/j.jpsychires.2012.08.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 07/13/2012] [Accepted: 08/16/2012] [Indexed: 10/28/2022]
Abstract
Molecules that are involved in neuronal intercommunication and adaptability of neural networks, such as brain-derived neurotrophic factor (BDNF), are targets of pathophysiological investigation in bipolar disorder (BD). Quetiapine is an attested treatment in this disorder, used in acute mood episodes. The aim of this study was to report prospective changes in serum BDNF levels in drug-free patients in acute mood episodes of BD who received treatment with extended-release quetiapine along a 16 week follow-up. Assessments were performed at baseline and weeks 2, 4, 8 and 16 with the Young Mania Rating Scale, the Hamilton Depression Rating Scale and the Clinical Global Impression severity scale. In these visits, serum BDNF levels were measured. Mixed effect models were used to investigate longitudinal changes. Twenty-five patients were included for this analysis, seventeen in a current depressive episode and eight in a manic/mixed episode. A significant improvement from baseline to endpoint was displayed. In the mixed model, significant main effects for episode and time appeared, and a time versus episode interaction showing increasing BDNF levels with time in those with a depressive episode, but a decrease in BDNF levels with time in those with a manic/mixed episode. BDNF may be a biomarker with differential response according to the polarity of mood episodes.
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27
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Mason JS, Kenna HA, Rasgon NL. Insulin resistance in major depressive disorder and the effects of psychotropic medications. ACTA ACUST UNITED AC 2012. [DOI: 10.2217/cpr.12.46] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Neto FL, Borges G, Torres-Sanchez S, Mico JA, Berrocoso E. Neurotrophins role in depression neurobiology: a review of basic and clinical evidence. Curr Neuropharmacol 2012; 9:530-52. [PMID: 22654714 PMCID: PMC3263450 DOI: 10.2174/157015911798376262] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2010] [Revised: 08/18/2010] [Accepted: 08/09/2010] [Indexed: 01/02/2023] Open
Abstract
Depression is a neuropsychiatric disorder affecting a huge percentage of the active population especially in developed countries. Research has devoted much of its attention to this problematic and many drugs have been developed and are currently prescribed to treat this pathology. Yet, many patients are refractory to the available therapeutic drugs, which mainly act by increasing the levels of the monoamines serotonin and noradrenaline in the synaptic cleft. Even in the cases antidepressants are effective, it is usually observed a delay of a few weeks between the onset of treatment and remission of the clinical symptoms. Additionally, many of these patients who show remission with antidepressant therapy present a relapse of depression upon treatment cessation. Thus research has focused on other possible molecular targets, besides monoamines, underlying depression. Both basic and clinical evidence indicates that depression is associated with
several structural and neurochemical changes where the levels of neurotrophins, particularly of brain-derived neurotrophic factor (BDNF), are altered. Antidepressants, as well as other therapeutic strategies, seem to restore these levels. Neuronal atrophy, mostly detected in limbic structures that regulate mood and cognition, like the hippocampus, is observed in depressed patients and in animal behavioural paradigms for depression. Moreover, chronic antidepressant treatment enhances adult hippocampal neurogenesis, supporting the notion that this event underlies antidepressants effects. Here we review some of the preclinical and clinical studies, aimed at disclosing the role of neurotrophins in the pathophysiological
mechanisms of depression and the mode of action of antidepressants, which favour the neurotrophic/neurogenic hypothesis.
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Affiliation(s)
- Fani L Neto
- Instituto de Histologia e Embriologia, Faculdade de Medicina e IBMC, Universidade do Porto, 4200-319, Porto, Portugal
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Jeon HJ, Kang ES, Lee EH, Jeong EG, Jeon JR, Mischoulon D, Lee D. Childhood trauma and platelet brain-derived neurotrophic factor (BDNF) after a three month follow-up in patients with major depressive disorder. J Psychiatr Res 2012; 46:966-72. [PMID: 22551661 DOI: 10.1016/j.jpsychires.2012.04.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2012] [Revised: 04/04/2012] [Accepted: 04/05/2012] [Indexed: 12/13/2022]
Abstract
A large amount of brain-derived neurotrophic factor (BDNF) is stored in the human platelets and only small amounts of it circulate in the plasma. However, a few studies have focused on platelet BDNF in patients with major depressive disorder (MDD) and childhood trauma. Our study population consisted of 105 MDD patients and 50 healthy controls. We used the mini-international neuropsychiatric interview (M.I.N.I.), the early trauma inventory self report-short form (ETISR-SF), as well as measured serum, plasma, and platelet BDNF at baseline, 1 month, and 3 month periods. There was a significant association between childhood trauma and platelet BDNF at baseline, 1 month, and 3 months, after adjusting for age, gender, education, body mass index, severity of depression, anxiety, alcohol consumption, and current stress. Conversely, plasma and serum BDNF did not have a significant association with childhood trauma. MDD patients revealed significantly higher levels of platelet BDNF in those with childhood trauma than in those without (t = 2.4, p = 0.018), and platelet BDNF was significantly higher in cases with sexual abuse on post-hoc analysis (p = 0.042). However, no significant differences were found in healthy controls, according to whether or not they had experienced childhood trauma. Platelet BDNF showed a significant correlation with severity of childhood trauma at baseline (r = 0.25, p = 0.012) and at 3 months (r = 0.38, p = 0.003) in MDD. In conclusion, platelet BDNF was significantly higher in MDD patients with childhood trauma than in those without, and it was correlated with severity of trauma.
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Affiliation(s)
- Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50 Irwon-dong, Gangnam-gu, Seoul 135-710, Republic of Korea
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Yoshimura R, Kishi T, Hori H, Ikenouchi-Sugita A, Umene-Nakano W, Katsuki A, Hayashi K, Iwata N, Nakamura J. No Association between the Response to the Addition of an Atypical Antipsychotic Drug to an SSRI or SNRI and the BDNF (Val66Met) Polymorphism in Refractory Major Depressive Disorder in Japanese Patients. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2012; 10:49-53. [PMID: 23429762 PMCID: PMC3569156 DOI: 10.9758/cpn.2012.10.1.49] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 01/07/2012] [Accepted: 02/20/2012] [Indexed: 12/28/2022]
Abstract
Objective This study examined the association between the brain-derived neurotrophic factor (BDNF) (Val66Met) polymorphism and the response to the addition of an atypical antipsychotic drug to a selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI) in treatment-refractory depression. Methods The study enrolled 64 patients meeting the Diagnostic and Statistical Manual of Mental Disorders-IV criteria for major depressive disorder who were treated with at least two courses of a single antidepressant, but who had Hamilton Depression Rating Scale (HAMD-17) scores ≥15 points that were reduced less than 50% over at least a 4-week treatment period. There were 24 males and 40 females (age range 27-68 years; mean±SD, 48±13 years). The patients' clinical improvement was evaluated using the HAMD-17. Patients with at least a 50% decrease in the HAMD-17 score were defined as responders. Serum BDNF levels were assayed using enzyme-linked immunosorbent assays and the presence of the BDNF (Val66Met) polymorphism was determined using the TaqMan genotyping assay. Results No correlation was found between the BDNF (Val66Met) polymorphism and a positive response to adding an atypical antipsychotic drug. No differences were observed in the changes in the serum BDNF levels and HAMD-17 scores between Val66Val and Met-carriers. In addition, in patients who experienced remission, the atypical antipsychotic drug was discontinued after at least 3 months of treatment and the patients were then followed for 1 year; 14 of 27 patients (52%) relapsed within 1 year. Conclusion These results suggest that the BDNF (Val66Met) polymorphism is not associated with the response to the augmentation of a SSRI or SNRI with an atypical antipsychotic drug, and that the combination of an atypical antipsychotic drug and a SSRI or SNRI should be continued for 3 months or more in refractory depressed patients in the Japanese population.
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Affiliation(s)
- Reiji Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan
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Toups MS, Greer TL, Kurian BT, Grannemann BD, Carmody TJ, Huebinger R, Rethorst C, Trivedi MH. Effects of serum Brain Derived Neurotrophic Factor on exercise augmentation treatment of depression. J Psychiatr Res 2011; 45:1301-6. [PMID: 21641002 PMCID: PMC9900870 DOI: 10.1016/j.jpsychires.2011.05.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 05/03/2011] [Accepted: 05/06/2011] [Indexed: 02/08/2023]
Abstract
BACKGROUND Brain Derived Neurotrophic Factor (BDNF) has potential as a biomarker of depression treatment because serum BDNF in depressed human subjects is decreased and normalizes with treatment. The relationship between serum BDNF and exercise treatment of depression is not known. The Treatment with Exercise Augmentation for Depression (TREAD) study examined dosed exercise augmentation treatment of partial responders to antidepressants. Serum BDNF in TREAD subjects was analyzed to understand its relationship with exercise training. METHODS Subjects were randomized to high (16 kcal/kg/week or KKW) or low (4 KKW) energy expenditure exercise over 12 weeks. Actual kcal/week expended and IDS-C scores were collected weekly. One hundred four subjects in TREAD provided baseline blood samples; a subset of 70 subjects also provided week 12 samples. Serum BDNF was determined using ELISA. Correlations were examined between change in BDNF and 1) mean kcal/week expended, and 2) change in IDS-C score. Mixed-effects ANOVA examined the effect of baseline BDNF on outcome. RESULTS Resting serum BDNF was stable and did not correlate with energy expenditure (p = 0.15) or IDS-C improvement (p = 0.89). Subjects entering the study with higher BDNF improved more rapidly on the IDS-C (p = 0.003). LIMITATIONS Serum may not be the most sensitive blood fraction in which to measure BDNF change. Pre-treatment with medication may mask exercise effect on BDNF. CONCLUSIONS These results suggest that change in serum BDNF does not reflect efficacy of exercise augmentation treatment of MDD. Instead BDNF may function as an augmentation moderator. Pre-treatments that raise BDNF may improve the efficacy of exercise treatment of MDD.
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Affiliation(s)
- Marisa S.P. Toups
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX 75235, USA
| | - Tracy L. Greer
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX 75235, USA
| | - Benji T. Kurian
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX 75235, USA
| | - Bruce D. Grannemann
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX 75235, USA
| | - Thomas J. Carmody
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX 75235, USA
- Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX 75235, USA
| | - Ryan Huebinger
- Department of Surgery, UT Southwestern Medical Center, Dallas, TX 75235, USA
| | - Chad Rethorst
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX 75235, USA
| | - Madhukar H. Trivedi
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX 75235, USA
- Corresponding author: (M.H. Trivedi)
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Yoshimura R, Kishi T, Suzuki A, Umene-Nakano W, Ikenouchi-Sugita A, Hori H, Otani K, Iwata N, Nakamura J. The brain-derived neurotrophic factor (BDNF) polymorphism Val66Met is associated with neither serum BDNF level nor response to selective serotonin reuptake inhibitors in depressed Japanese patients. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:1022-5. [PMID: 21338649 DOI: 10.1016/j.pnpbp.2011.02.009] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Revised: 02/15/2011] [Accepted: 02/15/2011] [Indexed: 12/14/2022]
Abstract
BACKGROUND We investigated the relationship between a brain-derived neurotrophic factor (BDNF) polymorphism (Val66Met) and the clinical response of patients with major depressive disorder to selective serotonin reuptake inhibitors (SSRIs; here, paroxetine and sertraline). In addition, serum BDNF levels in these patients were considered together with the clinical response. METHODS A total of 132 patients who met the DSM-IV criteria for major depressive disorder were enrolled in the study. 54 of these patients were male and 78 were female (age range, 20-74years; mean±S.D., 51±15). The patients' clinical improvement was evaluated using the 17-item Hamilton Rating Scale for Depression (HAMD-17) before (T0) and at 8weeks after the administration of SSRI treatment (T8). Patients with at least a 50% decrease in the HAMD-17 score were classified as responders. RESULTS No correlation was observed between the BDNF Val66Met polymorphism and response to SSRIs or between the BDNF Val66Met polymorphism and serum BDNF levels at T0. An inverse correlation was found between serum BDNF levels and HAMD-17 scores at T0. CONCLUSIONS These results suggest that the BDNF Val66Met polymorphism is independent of both the response to SSRI treatment and serum BDNF levels. The findings in the present study reconfirm that the serum BDNF level is a state biomarker for depression.
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Affiliation(s)
- Reiji Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 8078555, Japan.
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SSRI augmentation of antipsychotic alters expression of GABA(A) receptor and related genes in PMC of schizophrenia patients. Int J Neuropsychopharmacol 2011; 14:573-84. [PMID: 21208484 DOI: 10.1017/s1461145710001471] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Clinical studies have shown that negative symptoms of schizophrenia unresponsive to antipsychotic given alone can improve after augmentation with SSRI antidepressant. Laboratory investigations into the mechanism of this synergism showed that co-administration of SSRI and antipsychotic produces changes in GABA(A) receptor and related systems, which differ from the effects of each drug alone. To examine the clinical relevance of these findings, the current study examined the effects of SSRI augmentation treatment on GABA(A) receptor and related systems in schizophrenia patients. Schizophrenia patients with high levels of negative symptoms unresponsive to antipsychotic treatment received add-on fluvoxamine (100 mg/d). Blood was taken before and 1, 3 and 6 wk after adding fluvoxamine and peripheral mononuclear cells (PMC) isolated. RNA encoding for GABA(A)β3, 5-HT2A, and 5-HT7 receptors, PKCβ2, and brain-derived neurotrophic factor (BDNF) was assayed with real-time RT-PCR. Plasma BDNF protein was assayed using ELISA. Clinical symptoms were assessed with validated rating scales. We found significant increase in mRNA encoding for GABA(A)β3 and 5-HT2A, 5-HT7 receptors and BDNF and a reduction in PKCβ2 mRNA. Plasma BDNF protein concentrations were increased. There were significant correlations among the genes. Clinical symptoms improved significantly. mRNA expression of PKCβ2, 5-HT2A and 5-HT7 showed significant associations with clinical symptoms. Combined SSRI+antipsychotic treatment is associated with changes in GABA(A) receptor and in related signalling systems in patients. These changes may be part of the mechanism of clinically effective drug action and may prove to be biomarkers of pharmacological response.
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Yasui-Furukori N, Tsuchimine S, Nakagami T, Fujii A, Sato Y, Tomita T, Yoshizawa K, Inoue Y, Kaneko S. Association between plasma paroxetine concentration and changes in plasma brain‐derived neurotrophic factor levels in patients with major depressive disorder. Hum Psychopharmacol 2011; 26:194-200. [PMID: 21638327 DOI: 10.1002/hup.1192] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Recent studies have implicated brain‐derived neurotrophic factor (BDNF) in the pathophysiology of depression and in the activities of antidepressant drugs. Serum BDNF levels are lower in depressed patients and increase in response to antidepressant medications; however, no studies have examined the association between plasma concentrations of antidepressant drugs and plasma BDNF levels. We assessed plasma BDNF levels and paroxetine concentrations in 45 patients with major depression who were being treated with paroxetine. Plasma samples were collected between 10:00 h and 12:00 h at baseline and after 1, 2 and 6 weeks of treatment. The BDNF level and paroxetine concentration of each sample were measured via enzyme immunoassay and high‐performance liquid chromatography, respectively. Plasma BDNF levels increased after 2 and 6 weeks of paroxetine treatment. Plasma BDNF levels were significantly lower in men than in women. Changes in plasma BDNF level were correlated with plasma drug concentration after 2 (r = 0.309, p < 0.05) and 6 weeks (r = 0.329, p < 0.05) but not correlated with plasma drug concentration after 1 week (r = 0.284, ns). Multiple regression analysis confirmed that this change was only significantly correlated with plasma paroxetine concentration after 2 (standardised beta = 0.343, p < 0.05) and 6 weeks (standardised beta = 0.375, p < 0.05). These results suggest that paroxetine treatment increases plasma BDNF levels and that plasma paroxetine levels play an important role in changes in plasma BDNF levels.
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Affiliation(s)
- Norio Yasui-Furukori
- Department of Neuropsychiatry, School of Medicine, Hirosaki Graduate University, Hirosaki, Japan. ‐u.ac.jp
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Yoshimura R, Umene-Nakano W, Ueda N, Ikenouchi-Sugita A, Hori H, Katsuki A, Hayashi K, Miyamoto K, Kodama Y, Nakamura J. No difference in adherence to paroxetine between depressed patients with early remission and those with late remission based on monitoring of plasma paroxetine concentrations. Hum Psychopharmacol 2010; 25:487-90. [PMID: 20725911 DOI: 10.1002/hup.1136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Selective serotonin reuptake inhibitors (SSRIs) are widely used to treat both anxiety disorders and depressive disorders. However, nonadherence to SSRIs is a major issue in recurrence. In the present study, we investigated paroxetine adherence in depressed patients by monitoring the plasma paroxetine concentrations between patients with rapid and those with a late response to paroxetine treatment. Twenty inpatients in our university hospital, who met the DSM-IV-TR diagnosis of major depressive disorder in a single episode, were enrolled in the study. Twelve patients (M/F: 7/13, age: 37.4 +/- 10.4 years) were treated with paroxetine (40 mg/day), and all achieved remission (HAMD < or = 7) within at least 12 weeks. We divided the patients into two groups, an early-remission group (HAMD < or = 7 within 4 weeks) and a late-remission group (HAMD < or = 7 within 8-12 weeks). Their dosages of paroxetine were constant because of no emerging adverse effects. Blood samples were obtained on the day the subjects were discharged (B) and 12 weeks after discharge. The paroxetine concentrations in the early-remission group were significantly decreased 12 weeks after discharge, and no difference was found between the early- and late-remission groups. These results suggest that adherence to paroxetine was independent of the duration of the depressive state suffered by the patients. Clinicians always take their cautions for the adherence to paroxetine regardless of the clinical time courses the patients recovering from their depressive symptoms.
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Affiliation(s)
- Reiji Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, Japan.
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