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Jahan-Mihan A, Stevens P, Medero-Alfonso S, Brace G, Overby LK, Berg K, Labyak C. The Role of Water-Soluble Vitamins and Vitamin D in Prevention and Treatment of Depression and Seasonal Affective Disorder in Adults. Nutrients 2024; 16:1902. [PMID: 38931257 PMCID: PMC11206829 DOI: 10.3390/nu16121902] [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: 05/02/2024] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Depression is a major global health concern expected to worsen by 2030. In 2019, 28 million individuals were affected by depressive disorders. Dietary and supplemental vitamins show overall favorable preventative and therapeutic effects on depression. B vitamins are crucial for neurological function and mood regulation. Deficiencies in these vitamins are linked to depression. Studies on individual B vitamins show promise in improving depressive symptoms, particularly thiamin, riboflavin, niacin, and folate. Vitamin C deficiency may heighten depressive symptoms, but its exact role is not fully understood. Seasonal Affective Disorder (SAD) is associated with insufficient sunlight exposure and vitamin D deficiency. Vitamin D supplementation for SAD shows inconsistent results due to methodological variations. Further investigation is needed to understand the mechanisms of vitamins in depression treatment. Moreover, more research on SAD and light therapy's efficacy and underlying mechanisms involving photoreceptors, enzymes, and immune markers is needed. Although dietary and supplemental vitamins show overall favorable preventative and therapeutic effects on depression, dietitians treating psychiatric disorders face challenges due to diverse study designs, making direct comparisons difficult. Therefore, this article reviews the current literature to assess the role of dietary and supplemental vitamins in the prevention and treatment of depression. This review found that, although evidence supports the role of B vitamins and vitamins C and D in preventing and treating depression, further research is needed to clarify their mechanisms of action and determine the most effective intervention strategies.
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Affiliation(s)
- Alireza Jahan-Mihan
- Department of Nutrition and Dietetics, University of North Florida, 1 UNF Dr., Jacksonville, FL 32224, USA; (P.S.); (S.M.-A.); (G.B.); (L.K.O.); (K.B.); (C.L.)
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2
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Roy TA, Bubier JA, Dickson PE, Wilcox TD, Ndukum J, Clark JW, Sukoff Rizzo SJ, Crabbe JC, Denegre JM, Svenson KL, Braun RE, Kumar V, Murray SA, White JK, Philip VM, Chesler EJ. Discovery and validation of genes driving drug-intake and related behavioral traits in mice. GENES, BRAIN, AND BEHAVIOR 2024; 23:e12875. [PMID: 38164795 PMCID: PMC10780947 DOI: 10.1111/gbb.12875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/08/2023] [Accepted: 11/12/2023] [Indexed: 01/03/2024]
Abstract
Substance use disorders are heritable disorders characterized by compulsive drug use, the biological mechanisms for which remain largely unknown. Genetic correlations reveal that predisposing drug-naïve phenotypes, including anxiety, depression, novelty preference and sensation seeking, are predictive of drug-use phenotypes, thereby implicating shared genetic mechanisms. High-throughput behavioral screening in knockout (KO) mice allows efficient discovery of the function of genes. We used this strategy in two rounds of candidate prioritization in which we identified 33 drug-use candidate genes based upon predisposing drug-naïve phenotypes and ultimately validated the perturbation of 22 genes as causal drivers of substance intake. We selected 19/221 KO strains (8.5%) that had a difference from control on at least one drug-naïve predictive behavioral phenotype and determined that 15/19 (~80%) affected the consumption or preference for alcohol, methamphetamine or both. No mutant exhibited a difference in nicotine consumption or preference which was possibly confounded with saccharin. In the second round of prioritization, we employed a multivariate approach to identify outliers and performed validation using methamphetamine two-bottle choice and ethanol drinking-in-the-dark protocols. We identified 15/401 KO strains (3.7%, which included one gene from the first cohort) that differed most from controls for the predisposing phenotypes. 8 of 15 gene deletions (53%) affected intake or preference for alcohol, methamphetamine or both. Using multivariate and bioinformatic analyses, we observed multiple relations between predisposing behaviors and drug intake, revealing many distinct biobehavioral processes underlying these relationships. The set of mouse models identified in this study can be used to characterize these addiction-related processes further.
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Affiliation(s)
- Tyler A. Roy
- Center for Addiction BiologyThe Jackson LaboratoryBar HarborMaineUSA
| | - Jason A. Bubier
- Center for Addiction BiologyThe Jackson LaboratoryBar HarborMaineUSA
| | - Price E. Dickson
- Joan C Edwards School of MedicineMarshall UniversityHuntingtonWest VirginiaUSA
| | - Troy D. Wilcox
- Center for Addiction BiologyThe Jackson LaboratoryBar HarborMaineUSA
| | - Juliet Ndukum
- Center for Addiction BiologyThe Jackson LaboratoryBar HarborMaineUSA
| | - James W. Clark
- Center for Addiction BiologyThe Jackson LaboratoryBar HarborMaineUSA
| | - Stacey J. Sukoff Rizzo
- Center for Addiction BiologyThe Jackson LaboratoryBar HarborMaineUSA
- School of MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - John C. Crabbe
- VA Portland Health Care SystemOregon Health & Science UniversityPortlandOregonUSA
| | - James M. Denegre
- Center for Addiction BiologyThe Jackson LaboratoryBar HarborMaineUSA
| | - Karen L. Svenson
- Center for Addiction BiologyThe Jackson LaboratoryBar HarborMaineUSA
| | - Robert E. Braun
- Center for Addiction BiologyThe Jackson LaboratoryBar HarborMaineUSA
| | - Vivek Kumar
- Center for Addiction BiologyThe Jackson LaboratoryBar HarborMaineUSA
| | - Stephen A. Murray
- Center for Addiction BiologyThe Jackson LaboratoryBar HarborMaineUSA
| | | | - Vivek M. Philip
- Center for Addiction BiologyThe Jackson LaboratoryBar HarborMaineUSA
| | - Elissa J. Chesler
- Center for Addiction BiologyThe Jackson LaboratoryBar HarborMaineUSA
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3
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Roy TA, Bubier JA, Dickson PE, Wilcox TD, Ndukum J, Clark JW, Rizzo SJS, Crabbe JC, Denegre JM, Svenson KL, Braun RE, Kumar V, Murray SA, White JK, Philip VM, Chesler EJ. DISCOVERY AND VALIDATION OF GENES DRIVING DRUG-INTAKE AND RELATED BEHAVIORAL TRAITS IN MICE. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.09.548280. [PMID: 37503148 PMCID: PMC10369854 DOI: 10.1101/2023.07.09.548280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Substance use disorders (SUDs) are heritable disorders characterized by compulsive drug use, but the biological mechanisms driving addiction remain largely unknown. Genetic correlations reveal that predisposing drug-naïve phenotypes, including anxiety, depression, novelty preference, and sensation seeking, are predictive of drug-use phenotypes, implicating shared genetic mechanisms. Because of this relationship, high-throughput behavioral screening of predictive phenotypes in knockout (KO) mice allows efficient discovery of genes likely to be involved in drug use. We used this strategy in two rounds of screening in which we identified 33 drug-use candidate genes and ultimately validated the perturbation of 22 of these genes as causal drivers of substance intake. In our initial round of screening, we employed the two-bottle-choice paradigms to assess alcohol, methamphetamine, and nicotine intake. We identified 19 KO strains that were extreme responders on at least one predictive phenotype. Thirteen of the 19 gene deletions (68%) significantly affected alcohol use three methamphetamine use, and two both. In the second round of screening, we employed a multivariate approach to identify outliers and performed validation using methamphetamine two-bottle choice and ethanol drinking-in-the-dark protocols. We identified 15 KO strains that were extreme responders across the predisposing drug-naïve phenotypes. Eight of the 15 gene deletions (53%) significantly affected intake or preference for three alcohol, eight methamphetamine or three both (3). We observed multiple relations between predisposing behaviors and drug intake, revealing many distinct biobehavioral processes underlying these relationships. The set of mouse models identified in this study can be used to characterize these addiction-related processes further.
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Affiliation(s)
| | | | - Price E. Dickson
- Joan C Edwards School of Medicine, Marshall University Huntington, WV
| | | | | | | | - Stacey J. Sukoff Rizzo
- The Jackson Laboratory, Bar Harbor, ME
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - John C. Crabbe
- Oregon Health & Science University and VA Portland Health Care System, Portland, OR
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4
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Nunes EJ, Kebede N, Bagdas D, Addy NA. Cholinergic and dopaminergic-mediated motivated behavior in healthy states and in substance use and mood disorders. J Exp Anal Behav 2022; 117:404-419. [PMID: 35286712 PMCID: PMC9743782 DOI: 10.1002/jeab.747] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/16/2022] [Accepted: 01/20/2022] [Indexed: 02/06/2023]
Abstract
Acetylcholine is an important neuromodulator of the mesolimbic dopamine (DA) system, which itself is a mediator of motivated behavior. Motivated behavior can be described by two primary components, termed directional and activational motivation, both of which can be examined and dissociated using effort-choice tasks. The directional component refers to motivated behavior directed towards reinforcing stimuli and away from aversive stimuli. Behaviors characterized by increased vigor, persistence, and work output are considered to reflect activational components of motivation. Disruption of DA signaling has been shown to decrease activational components of motivation, while leaving directional features intact. Facilitation of DA release promotes the activational aspects of motivated behavior. In this review, we discuss cholinergic and DA regulation of motivated behaviors. We place emphasis on effort-choice processes and the ability of effort-choice tasks to examine and dissociate changes of motivated behavior in the context of substance use and mood disorders. Furthermore, we consider how altered cholinergic transmission impacts motivated behavior across disease states, and the possible role of cholinergic dysregulation in the etiology of these illnesses. Finally, we suggest that treatments targeting cholinergic activity may be useful in ameliorating motivational disruptions associated with substance use and comorbid substance use and mood disorders.
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Affiliation(s)
- Eric J. Nunes
- Department of Psychiatry, Yale School of Medicine,Yale Tobacco Center of Regulatory Science, Yale School of Medicine
| | - Nardos Kebede
- Department of Psychiatry, Yale School of Medicine,Yale Tobacco Center of Regulatory Science, Yale School of Medicine
| | - Deniz Bagdas
- Department of Psychiatry, Yale School of Medicine,Yale Tobacco Center of Regulatory Science, Yale School of Medicine
| | - Nii A. Addy
- Department of Psychiatry, Yale School of Medicine,Yale Tobacco Center of Regulatory Science, Yale School of Medicine,Department of Cellular and Molecular Physiology, Yale School of Medicine,Interdepartmental Neuroscience Program, Yale University,Wu Tsai Institute, Yale University
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5
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Recto P, Champion JD. Psychosocial Factors Associated with Paternal Perinatal Depression in the United States: A Systematic Review. Issues Ment Health Nurs 2020; 41:608-623. [PMID: 32286093 DOI: 10.1080/01612840.2019.1704320] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Paternal perinatal depression can occur in approximately one out of ten fathers. However, research within this population is limited. A previous systematic review suggested that United States had higher rates of paternal perinatal depression compared to other countries. Therefore, this systematic review identified psychosocial factors for depression during the perinatal period in fathers who live in the United States. A literature search was conducted from multiple databases using keywords and MeSH terms to retrieve articles up to the year 2019. Twenty five articles were included in this review. A social-ecological framework was applied to identify psychosocial factors associated with paternal depression. Individual factors include prior history of depression, having maladaptive cognitive coping styles, fathers who self-identified as African-American or Hispanic, parenting stress, substance use, and history of criminal conviction. Interpersonal factors include lack of social support, quality of relationship with the mother of the baby, coparenting conflict, quality of current and childhood relationships with their own parents, and maternal depression. Community factors include frequent daily experiences with racism, and limited access to transportation and housing. These findings underscore the importance of assessing depression and developing father-inclusive interventions that address the psychological needs of fathers.
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Affiliation(s)
- Pamela Recto
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Jane Dimmitt Champion
- Lee and Joseph D. Jamail Endowed Professorship in Nursing, School of Nursing, University of Texas at Austin, Austin, Texas, USA
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Abstract
Drug addiction is a worldwide societal problem and public health burden, and results from recreational drug use that develops into a complex brain disorder. The opioid system, one of the first discovered neuropeptide systems in the history of neuroscience, is central to addiction. Recently, opioid receptors have been propelled back on stage by the rising opioid epidemics, revolutions in G protein-coupled receptor research and fascinating developments in basic neuroscience. This Review discusses rapidly advancing research into the role of opioid receptors in addiction, and addresses the key questions of whether we can kill pain without addiction using mu-opioid-receptor-targeting opiates, how mu- and kappa-opioid receptors operate within the neurocircuitry of addiction and whether we can bridge human and animal opioid research in the field of drug abuse.
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Affiliation(s)
- Emmanuel Darcq
- Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Brigitte Lina Kieffer
- Douglas Mental Health Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada. .,Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM, Centre National de la Recherche Scientifique and University of Strasbourg, Strasbourg, France.
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7
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Kaufling J. Alterations and adaptation of ventral tegmental area dopaminergic neurons in animal models of depression. Cell Tissue Res 2019; 377:59-71. [PMID: 30848354 DOI: 10.1007/s00441-019-03007-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 02/11/2019] [Indexed: 01/01/2023]
Abstract
Depression is one of the most prevalent psychiatric diseases, affecting the quality of life of millions of people. Ventral tegmental area (VTA) dopaminergic (DA) neurons are notably involved in evaluating the emotional and motivational value of a stimulus, in detecting reward prediction errors, in motivated learning, or in the propensity to initiate or withhold an action. DA neurons are thus involved in psychopathologies associated with perturbations of emotional and motivational states, such as depression. In this review, we focus on adaptations/alterations of the VTA, particularly of the VTA DA neurons, in the three most frequently used animal models of depression: learned helplessness, chronic mild stress and chronic social defeat.
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Affiliation(s)
- Jennifer Kaufling
- Centre National de la Recherche Scientifique, Institut des Neurosciences Cellulaires et Intégratives, 8 Allée du Générale Rouvillois, 67000, Strasbourg, France.
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Drug addiction: a curable mental disorder? Acta Pharmacol Sin 2018; 39:1823-1829. [PMID: 30382181 DOI: 10.1038/s41401-018-0180-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 09/29/2018] [Indexed: 02/06/2023] Open
Abstract
Drug addiction is a chronic, relapsing brain disorder. Multiple neural networks in the brain including the reward system (e.g., the mesocorticolimbic system), the anti-reward/stress system (e.g., the extended amygdala), and the central immune system, are involved in the development of drug addiction and relapse after withdrawal from drugs of abuse. Preclinical and clinical studies have demonstrated that it is promising to control drug addiction by pharmacologically targeting the addiction-related systems in the brain. Here we review the pharmacological targets within the dopamine system, glutamate system, trace amine system, anti-reward system, and central immune system, which are of clinical interests. Furthermore, we discuss other potential therapies, e.g., brain stimulation, behavioral treatments, and therapeutic gene modulation, which could be effective to treat drug addiction. We conclude that, although drug addiction is a complex disorder that involves complicated neural mechanisms and psychological processes, this mental disorder is treatable and may be curable by therapies such as gene modulation in the future.
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9
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Ruda-Kucerova J, Zanda MT, Amchova P, Fratta W, Fattore L. Sex and Feeding Status Differently Affect Natural Reward Seeking Behavior in Olfactory Bulbectomized Rats. Front Behav Neurosci 2018; 12:255. [PMID: 30425627 PMCID: PMC6218565 DOI: 10.3389/fnbeh.2018.00255] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 10/11/2018] [Indexed: 02/01/2023] Open
Abstract
Substance abuse and depression are common psychiatric disorders with a high rate of comorbidity. Both conditions affect differently men and women and preclinical research has showed many sex differences in drug addiction and depression. The most common approach for modeling depression-addiction comorbidity is the combination of the intravenous drug self-administration and the olfactory bulbectomy (OBX) models in rats. Such a combination has revealed enhanced drug-taking and drug-seeking behaviors in OBX rats, but no study has investigated so far potential sex differences in operant responding and motivation for natural reinforcers in OBX rats. This study investigated for the first time operant self-administration of palatable food pellets in male and female OBX rats under different feeding status, i.e., ad libitum vs. restricted food, and schedules of reinforcement, i.e., a continuous ratio schedule fixed ratio 1 (FR1) vs. a complex (FR5(x)) second order schedule of reinforcement. In the FR1 experiment, OBX rats of both sexes exhibited lower operant responding and intake of palatable food pellets than sham-operated controls, with food restriction leading to increased operant responding in both OBX and SHAM groups. Female rats showed higher responding than males but this effect was abolished by the OBX lesion. Similarly, in the (FR5(x)) second order schedule of reinforcement both male and female OBX rats showed lower responding and food intake, with SHAM and OBX females showing higher operant responding than corresponding male groups. Overall, our findings showed that: (i) responding for food was lower in OBX than in SHAM rats under both FR1 and (FR5(x)) schedules of reinforcement; (ii) sex and food restriction affect operant responding for palatable food; and (iii) the suppressing effect of OBX lesion on food intake was consistently present in both sexes and represents the most robust factor in the analysis. This may represent anhedonia which is associated with depressive-like phenotype and palatable food self-administration may serve as a robust behavioral index of anhedonia in the OBX model.
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Affiliation(s)
- Jana Ruda-Kucerova
- Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Mary Tresa Zanda
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato, Italy
| | - Petra Amchova
- Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Walter Fratta
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato, Italy.,Center of Excellence "Neurobiology of Addiction", University of Cagliari, Monserrato, Italy
| | - Liana Fattore
- Center of Excellence "Neurobiology of Addiction", University of Cagliari, Monserrato, Italy.,CNR Institute of Neuroscience-Cagliari, National Research Council, Rome, Italy
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Strong C, Kabbaj M. On the safety of repeated ketamine infusions for the treatment of depression: Effects of sex and developmental periods. Neurobiol Stress 2018; 9:166-175. [PMID: 30450382 PMCID: PMC6236511 DOI: 10.1016/j.ynstr.2018.09.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/23/2018] [Accepted: 09/04/2018] [Indexed: 12/16/2022] Open
Abstract
In this review, we will discuss the safety of repeated treatments with ketamine for patients with treatment-resistant depression (TRD), a condition in which patients with major depression do not show any clinical improvements following treatments with at least two antidepressant drugs. We will discuss the effects of these treatments in both sexes at different developmental periods. Numerous small clinical studies have shown that a single, low-dose ketamine infusion can rapidly alleviate depressive symptoms and thoughts of suicidality in patients with TRD, and these effects can last for about one week. Interestingly, the antidepressant effects of ketamine can be prolonged with intermittent, repeated infusion regimens and produce more robust therapeutic effects when compared to a single infusion. The safety of such repeated treatments with ketamine has not been thoroughly investigated. Although more studies are needed, some clinical and preclinical reports indicated that repeated infusions of low doses of ketamine may have addictive properties, and suggested that adolescent and adult female subjects may be more sensitive to ketamine's addictive effects. Additionally, during ketamine infusions, many TRD patients report hallucinations and feelings of dissociation and depersonalization, and therefore the effects of repeated treatments of ketamine on cognition must be further examined. Some clinical reports indicated that, compared to women, men are more sensitive to the psychomimetic effects of ketamine. Preclinical studies extended these findings to both adolescent and adult male rodents and showed that male rodents at both developmental periods are more sensitive to ketamine's cognitive-altering effects. Accordingly, in this review we shall focus our discussion on the potential addictive and cognitive-impairing effects of repeated ketamine infusions in both sexes at two important developmental periods: adolescence and adulthood. Although more work about the safety of ketamine is warranted, we hope this review will bring some answers about the safety of treating TRD with repeated ketamine infusions.
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Affiliation(s)
| | - Mohamed Kabbaj
- Corresponding author. Florida State University, 3300-H, 1115 W. Call St, Tallahassee, FL, 32306, USA.
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11
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Wright KN, Kabbaj M. Sex differences in sub-anesthetic ketamine's antidepressant effects and abuse liability. Curr Opin Behav Sci 2018; 23:36-41. [PMID: 30038955 DOI: 10.1016/j.cobeha.2018.02.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Sub-anesthetic ketamine produces rapid antidepressant effects in patients with bipolar and unipolar major depression where conventional monoaminergic-based antidepressant drugs have been ineffective or ridden with side effects. A single ketamine infusion can produce antidepressant effects lasting up to two weeks, and multiple ketamine infusions prolong this effect. Pre-clinical studies are underway to uncover ketamine's mechanisms of action, but there are still many questions unanswered regarding the safety of its long-term use. Abuse liability is one area of concern, as recreational ketamine use is an ongoing issue in many parts of the world. Another understudied area is sex differences in responsivity to ketamine. Women are twice as likely as men to be diagnosed with depression, and they progress through stages of drug addiction more rapidly than their male counterparts. Despite this, preclinical studies in ketamine's antidepressant and addictive-like behaviors in females are limited. These intersecting factors in recent clinical and pre-clinical studies are reviewed to characterize ketamine's therapeutic potential, its limitations, and its potential mechanisms of action.
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Affiliation(s)
- Katherine N Wright
- Florida State University, Department of Biomedical Sciences, Program in Neuroscience, Tallahassee, FL
| | - Mohamed Kabbaj
- Florida State University, Department of Biomedical Sciences, Program in Neuroscience, Tallahassee, FL
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12
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Beaulieu T, Ti L, Milloy MJ, Nosova E, Wood E, Hayashi K. Major depressive disorder and access to health services among people who use illicit drugs in Vancouver, Canada. Subst Abuse Treat Prev Policy 2018; 13:3. [PMID: 29351757 PMCID: PMC5775557 DOI: 10.1186/s13011-018-0142-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 01/12/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND People who use illicit drugs (PWUD) are commonly diagnosed with major depressive disorder (MDD). However, little is known about whether PWUD living with MDD experience additional barriers to accessing health services compared to those without MDD. We sought to identify whether MDD symptoms were associated with perceived barriers to accessing health services among people who use illicit drugs (PWUD) in Vancouver, Canada. METHODS Data were collected through prospective cohorts of PWUD in Vancouver, Canada between 2005 and 2016. Using multiple logistic regression, we examined the relationship between MDD symptoms, defined as a Centre for Epidemiologic Studies Depression (CES-D) scale total score of ≥16, and barriers to access health services. We also used descriptive statistics to examine common barriers among participants who reported any barriers. RESULTS Among a total of 1529 PWUD, including 521 (34.1%) females, 415 (27.1%) reported barriers to accessing health services, and 956 (62.5%) reported MDD symptoms at baseline. In multiple logistic regression analyses, after adjusting for a range of potential confounders, MDD symptoms (adjusted odds ratio [AOR] = 1.40; 95% confidence interval [CI]: 1.03-1.92) were positively and significantly associated with barriers to accessing health services. Among those who reported MDD symptoms and barriers to access, commonly reported barriers included: long wait lists/times (38.1%); and treated poorly by health care professionals (30.0%). CONCLUSION These findings show that the likelihood of experiencing barriers to accessing health services was higher among PWUD with MDD symptoms compared to their counterparts. Policies and interventions tailored to address these barriers are urgently needed for this subpopulation of PWUD.
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Affiliation(s)
- Tara Beaulieu
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Lianping Ti
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada
| | - M-J Milloy
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- British Columbia Centre on Substance Use, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada
| | - Ekaterina Nosova
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- British Columbia Centre on Substance Use, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Evan Wood
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- British Columbia Centre on Substance Use, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
- Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada
| | - Kanna Hayashi
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
- British Columbia Centre on Substance Use, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
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Nobrega JN, Hedayatmofidi PS, Lobo DS. Strong interactions between learned helplessness and risky decision-making in a rat gambling model. Sci Rep 2016; 6:37304. [PMID: 27857171 PMCID: PMC5114549 DOI: 10.1038/srep37304] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 10/27/2016] [Indexed: 01/22/2023] Open
Abstract
Risky decision-making is characteristic of depression and of addictive disorders, including pathological gambling. However it is not clear whether a propensity to risky choices predisposes to depressive symptoms or whether the converse is the case. Here we tested the hypothesis that rats showing risky decision-making in a rat gambling task (rGT) would be more prone to depressive-like behaviour in the learned helplessness (LH) model. Results showed that baseline rGT choice behaviour did not predict escape deficits in the LH protocol. In contrast, exposure to the LH protocol resulted in a significant increase in risky rGT choices on retest. Unexpectedly, control rats subjected only to escapable stress in the LH protocol showed a subsequent decrease in riskier rGT choices. Further analyses indicated that the LH protocol affected primarily rats with high baseline levels of risky choices and that among these it had opposite effects in rats exposed to LH-inducing stress compared to rats exposed only to the escape trials. Together these findings suggest that while baseline risky decision making may not predict LH behaviour it interacts strongly with LH conditions in modulating subsequent decision-making behaviour. The suggested possibility that stress controllability may be a key factor should be further investigated.
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Affiliation(s)
- José N Nobrega
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Departments of Psychology and Pharmacology &Toxicology, University of Toronto, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | - Daniela S Lobo
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada
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