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Susantitapong K, Dilokpattanamongkol P, Sutherasan Y, Liamsombut S, Suthisisang C. Effects of gabapentin on slow-wave sleep period in critically ill adult patients: A randomized controlled trial. Clin Transl Sci 2024; 17:e13815. [PMID: 38803031 PMCID: PMC11130453 DOI: 10.1111/cts.13815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/11/2024] [Accepted: 04/18/2024] [Indexed: 05/29/2024] Open
Abstract
Sleep deprivation is a prevalent problem in critically ill patients, which leads to delayed recovery and delirium. Slow-wave sleep (SWS) is essential to energy restoration, tissue repair, and immune system strengthening. This study aimed to investigate the effects of gabapentin on SWS in critically ill patients. We performed a prospective open-label randomized controlled study to compare SWS and the clinical outcomes of gabapentin versus a control intervention in critically ill adult patients admitted to the intensive care unit (ICU) within 24 h. The patients' characteristics and sleep-related outcomes were recorded. The sleep-related outcomes, namely, bispectral analysis (BIS), the Richards-Campbell Sleep Questionnaire (RCSQ), and insulin-like growth factor-1 (IGF-1) levels, were evaluated. Furthermore, clinical outcomes and safety were assessed. Sixty patients from 348 cases were eligible for randomization. On day 3 of the study, patients in the gabapentin group had significantly increased SWS (66.79 vs. 0.00 min; p < 0.001), total sleep time (TST) (331.39 vs. 46.16 min; p = 0.001), RCSQ score (55.05 ± 20.18 vs. 32.80 ± 15.31; p < 0.001), and IGF-1 concentrations (84.33 ± 12.40 vs. 44.00 ± 10.20 ng/mL, p < 0.001) compared with the control group. Improvements in clinical outcomes, such as delirium, ICU-free days, and mechanical ventilator-free days, were observed; however, these differences did not reach statistically significant. Gabapentin at bedtime increased SWS, TST, and IGF-1 concentrations in critically ill patients. This regimen might be beneficial to critically ill patients for improving their sleep quality.
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Affiliation(s)
- Kanyarat Susantitapong
- Department of Pharmacy, Faculty of PharmacyMahidol UniversityBangkokThailand
- Pharmacy UnitKing Chulalongkorn Memorial HospitalBangkokThailand
| | | | - Yuda Sutherasan
- Department of Medicine, Faculty of Medicine, Ramathibodi HospitalMahidol UniversityBangkokThailand
| | - Somprasong Liamsombut
- Department of Medicine, Faculty of Medicine, Ramathibodi HospitalMahidol UniversityBangkokThailand
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Shi Y, Li W, Chen C, Yuan X, Yang Y, Wang S, Liu Z, Geng F, Wang J, Luo X, Wen X, Xia L, Liu H. Excessive Daytime Sleepiness and Insomnia Symptoms in Adolescents With Major Depressive Disorder: Prevalence, Clinical Correlates, and the Relationship With Psychiatric Medications Use. Psychiatry Investig 2023; 20:1018-1026. [PMID: 37997329 PMCID: PMC10678154 DOI: 10.30773/pi.2023.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/21/2023] [Accepted: 07/28/2023] [Indexed: 11/25/2023] Open
Abstract
OBJECTIVE Excessive daytime sleepiness (EDS) and insomnia symptoms are common in patients with major depressive disorder (MDD), which might lead to a poor prognosis and an increased risk of depression relapse. The current study aimed to investigate the prevalence, and sociodemographic and clinical correlates of EDS and insomnia symptoms among adolescents with MDD. METHODS The sample of this cross-sectional study included 297 adolescents (mean age=15.26 years; range=12-18 years; 218 females) with MDD recruited from three general and four psychiatric hospitals in five cities (Hefei, Bengbu, Fuyang, Suzhou, and Ma'anshan) in Anhui Province, China between January and August, 2021. EDS and insomnia symptoms, and clinical severity of depressive symptoms were assessed using Epworth sleepiness scale, Insomnia Severity Index, and Clinical Global Impression-Severity. RESULTS The prevalence of EDS and insomnia symptoms in adolescents with MDD was 39.7% and 38.0%, respectively. Binary logistic regression analyses showed that EDS symptoms were significantly associated with higher body mass index (odds ratio [OR]=1.097, 95% confidence interval [CI]=1.027-1.172), more severe depressive symptoms (OR=1.313, 95% CI=1.028-1.679), and selective serotonin reuptake inhibitors use (OR=2.078, 95% CI=1.199-3.601). And insomnia symptoms were positively associated with female sex (OR=1.955, 95% CI=1.052-3.633), suicide attempts (OR=1.765, 95% CI=1.037-3.005), more severe depressive symptoms (OR=2.031, 95% CI=1.523-2.709), and negatively associated with antipsychotics use (OR=0.433, 95% CI=0.196-0.952). CONCLUSION EDS and insomnia symptoms are common among adolescents with MDD. Considering their negative effects on the clinical prognosis, regular screening and clinical managements should be developed for this patient population.
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Affiliation(s)
- Yudong Shi
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui, China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui, China
| | - Wei Li
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Changhao Chen
- Department of Psychiatry, Suzhou Second People’s Hospital, Suzhou, Anhui, China
| | - Xiaoping Yuan
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yingying Yang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui, China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui, China
| | - Song Wang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui, China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui, China
| | - Zhiwei Liu
- Department of Psychiatry, Fuyang Third People’s Hospital, Fuyang, Anhui, China
| | - Feng Geng
- Department of Psychiatry, Hefei Fourth People’s Hospital, Hefei, Anhui, China
| | - Jiawei Wang
- Department of Psychiatry, Bozhou People’s Hospital, Bozhou, Anhui, China
| | - Xiangfen Luo
- Department of Psychiatry, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Xiangwang Wen
- Department of Psychiatry, Ma’anshan Fourth People’s Hospital, Ma’anshan, Anhui, China
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui, China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui, China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui, China
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Drabczyk AK, Kułaga D, Zaręba P, Tylińska W, Bachowski W, Archała A, Wnorowski A, Tzani A, Detsi A, Jaśkowska J. Eco-friendly synthesis of new olanzapine derivatives and evaluation of their anticancer potential. RSC Adv 2023; 13:20467-20476. [PMID: 37435368 PMCID: PMC10331126 DOI: 10.1039/d3ra03926a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 06/30/2023] [Indexed: 07/13/2023] Open
Abstract
New derivatives of the known antipsychotic drug olanzapine have been obtained as potential compounds with anticancer activity in two metabolically different breast cancer cell lines: MCF-7 and triple negative MDA-MB-231. The compounds were obtained under phase transfer catalysis (PTC) in the presence of microwave irradiation (MW) or ultrasound (")))"), evaluating the effect of solvents such as dimethylformamide, water, or choline chloride/urea (natural deep eutectic solvent, NaDES). In the best option, the compounds were obtained within 2 minutes with a yield of 57-86% in MW. Two of the obtained compounds which have a naphthalimide moiety and a pentyl (7) or hexyl chain (8) show pronounced cytotoxicity. Interestingly, neither olanzapine nor desmethylolanzapine (DOLA), which was one of the substrates for the synthesis reaction, showed any significant activity in the study.
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Affiliation(s)
- Anna K Drabczyk
- Faculty of Chemical Engineering and Technology, Department of Chemical Technology and Environmental Analytics, Cracow University of Technology 24 Warszawska Street 31-155 Cracow Poland
| | - Damian Kułaga
- Faculty of Chemical Engineering and Technology, Department of Chemical Technology and Environmental Analytics, Cracow University of Technology 24 Warszawska Street 31-155 Cracow Poland
| | - Przemysław Zaręba
- Faculty of Chemical Engineering and Technology, Department of Organic Chemistry and Technology, Cracow University of Technology 24 Warszawska Street 31-155 Cracow Poland
| | - Wiktoria Tylińska
- Faculty of Chemical Engineering and Technology, Department of Chemical Technology and Environmental Analytics, Cracow University of Technology 24 Warszawska Street 31-155 Cracow Poland
| | - Wojciech Bachowski
- Faculty of Chemical Engineering and Technology, Department of Chemical Technology and Environmental Analytics, Cracow University of Technology 24 Warszawska Street 31-155 Cracow Poland
| | - Aneta Archała
- Department of Biopharmacy, Medical University of Lublin 4a Chodzki Street 20-059 Lublin Poland
| | - Artur Wnorowski
- Department of Biopharmacy, Medical University of Lublin 4a Chodzki Street 20-059 Lublin Poland
| | - Andromachi Tzani
- Laboratory of Organic Chemistry, Department of Chemical Sciences, School of Chemical Engineering, National Technical University of Athens 15780 Zografou Athens Greece
| | - Anastasia Detsi
- Laboratory of Organic Chemistry, Department of Chemical Sciences, School of Chemical Engineering, National Technical University of Athens 15780 Zografou Athens Greece
| | - Jolanta Jaśkowska
- Faculty of Chemical Engineering and Technology, Department of Chemical Technology and Environmental Analytics, Cracow University of Technology 24 Warszawska Street 31-155 Cracow Poland
- Laboratory of Organic Chemistry, Department of Chemical Sciences, School of Chemical Engineering, National Technical University of Athens 15780 Zografou Athens Greece
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Degraff Z, Souza GS, Santos NA, Shoshina II, Felisberti FM, Fernandes TP, Sigurdsson G. Brain atrophy and cognitive decline in bipolar disorder: Influence of medication use, symptomatology and illness duration. J Psychiatr Res 2023; 163:421-429. [PMID: 37276646 DOI: 10.1016/j.jpsychires.2023.05.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/02/2023] [Accepted: 05/25/2023] [Indexed: 06/07/2023]
Abstract
Bipolar disorder (BPD) is a chronic condition characterized by recurrent episodes of mania and depression. To date, the association of biological and psychopathological processes in BPD has not been extensively studied on a cognitive and cortical basis at the same time. We investigated whether brain atrophy (in prefrontal, temporal and occipital cortices) was associated with cognitive, biological and clinical processes in patients with BPD and healthy controls (HCs). A total of 104 participants (56 with BPD) completed tasks that measured attention, memory, information processing speed, inhibitory control, visuospatial working memory and cognitive flexibility. In addition, structural brain scans were obtained using high-resolution MRI. Outcomes of the measurements were examined using robust multiple mediation analyses. BPD patients showed greater cortical atrophy across all regions of interest when compared to HCs, linked to cognitive decline. BPD patients had slower reaction times and markedly increased errors of commission on the tasks. The outcomes were significantly influenced by medication use, symptomatology and illness duration. The findings showcase the complexity of brain structures and networks as well as the physiological mechanisms underlying diverse BPD symptomatology and endophenotypes. These differences were pronounced in patients with BPD, motivating further investigations of pathophysiological mechanisms involved in brain atrophy and cognitive decline.
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Affiliation(s)
- Zeke Degraff
- Svenskagier Neurologie, Stockholm, Sweden; Institute of Neurology, Belgium.
| | | | | | | | | | - Thiago P Fernandes
- Federal University of Para, Para, Brazil; Federal University of Paraiba, Paraiba, Brazil
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Owen NE, Barker RA, Voysey ZJ. Sleep Dysfunction in Huntington's Disease: Impacts of Current Medications and Prospects for Treatment. J Huntingtons Dis 2023; 12:149-161. [PMID: 37248911 PMCID: PMC10473096 DOI: 10.3233/jhd-230567] [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] [Accepted: 05/06/2023] [Indexed: 05/31/2023]
Abstract
Sleep dysfunction is highly prevalent in Huntington's disease (HD). Increasing evidence suggests that such dysfunction not only impairs quality of life and exacerbates symptoms but may even accelerate the underlying disease process. Despite this, current HD treatment approaches neither consider the impact of commonly used medications on sleep, nor directly tackle sleep dysfunction. In this review, we discuss approaches to these two areas, evaluating not only literature from clinical studies in HD, but also that from parallel neurodegenerative conditions and preclinical models of HD. We conclude by summarizing a hierarchical framework of current medications with regard to their impact on sleep, and by outlining key emerging sleep therapies.
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Affiliation(s)
- Natalia E. Owen
- Department of Clinical Neurosciences, John van Geest Centre for Brain Repair, University of Cambridge, Cambridge, UK
| | - Roger A. Barker
- Department of Clinical Neurosciences, John van Geest Centre for Brain Repair, University of Cambridge, Cambridge, UK
- Wellcome Trust-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK
| | - Zanna J. Voysey
- Department of Clinical Neurosciences, John van Geest Centre for Brain Repair, University of Cambridge, Cambridge, UK
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Luo H, Wang X, Zhang Y, Li J, Hu R, Zhang Z, Liao Q, Zhou X, Deng W, Yang J, Luo Q. Can circadian rhythm predict changes in neurocognitive functioning in bipolar disorder: protocol of a 12-month longitudinal cohort study based on research domain criteria. Ann Med 2023; 55:2240422. [PMID: 37506182 PMCID: PMC10392262 DOI: 10.1080/07853890.2023.2240422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
Introduction: Bipolar disorder (BD) is a prevalent and disabling mental disorder characterized by disrupted circadian rhythms and impaired neurocognitive features, both of which fall under the major domains of Research Domain Criteria (RDoC). However, there is limited evidence regarding the interaction between circadian rhythms and long-term neurocognitive functioning. Therefore, this longitudinal cohort study protocol aims to explore whether circadian rhythm can predict changes in neurocognitive functioning over time in patients with BD.Methods: This study adopts a longitudinal cohort design, aiming to recruit 100 BD patients in either depressive or remitted states. Participants will undergo evaluations from clinical, circadian rhythm, and neurocognitive perspectives at baseline, 6-month, and 12-month follow-ups, involving questionnaires, actigraphy, and computed neurocognitive tests. We will examine both cross-sectional and longitudinal associations between participants' circadian rhythm patterns and neurocognitive functioning. Statistical analyses will employ Spearman correlation and mixed regression models.Discussion: We anticipate that circadian rhythms may serve as predictors of neurocognitive functioning changes. The findings of this study could offer supplementary insights into BD pathophysiology, potential treatment targets, and prediction.Trial Registration: This study has been registered with the Chinese Clinical Trial Registry under the registration code ChiCTR2200064922 on 21st October 2022.
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Affiliation(s)
- Huirong Luo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xueqian Wang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yinlin Zhang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Junyao Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Renqin Hu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zheng Zhang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qian Liao
- Department of Laboratory Diagnostic, Chongqing KingMed Institute for Clinical Laboratory Co.LTD, Chongqing, China
| | - Xiaoxin Zhou
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wei Deng
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Jian Yang
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Luo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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7
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Nakagawa N, Suzuki M. Efficacy of Olanzapine for Symptom Relief in Cancer Patients. J Pain Palliat Care Pharmacother 2022; 36:216-222. [PMID: 36250742 DOI: 10.1080/15360288.2022.2126059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Olanzapine is an atypical antipsychotic and is widely used for prophylaxis of chemotherapy-induced nausea and vomiting in cancer patients. Previous studies have suggested its potential efficacy for the relief of various symptoms in cancer patients, especially gastrointestinal and psychiatric symptoms. We retrospectively reviewed the prescription of olanzapine to cancer patients at our hospital. Between 2008 and 2020, olanzapine was prescribed to 41 patients for relief of symptoms associated with cancer other than prophylaxis of chemotherapy-induced nausea and vomiting. Of those patients, symptom relief was seen in 53.7%. Notably, olanzapine was effective in 13 of 14 patients with chemotherapy-induced nausea and vomiting refractory to guideline-recommended prophylaxis. Of 16 patients in whom this symptom was not relieved by olanzapine, 13 (81.3%) continued taking olanzapine even after it was judged ineffective. No treatment-related adverse events were seen in this study. Our observation implies good efficacy of olanzapine for refractory chemotherapy-induced nausea and vomiting and a tendency to continue olanzapine even in those for whom it was ineffective.
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Affiliation(s)
- Natsuki Nakagawa
- Department of Respiratory Medicine, Kanto Central Hospital, Tokyo, Japan
| | - Masaru Suzuki
- Department of Respiratory Medicine, Kanto Central Hospital, Tokyo, Japan
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8
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Shoshina II, Almeida NL, Oliveira MEC, Trombetta BNT, Silva GM, Fars J, Santos NA, Fernandes TP. Serum levels of olanzapine are associated with acute cognitive effects in bipolar disorder. Psychiatry Res 2022; 310:114443. [PMID: 35286918 DOI: 10.1016/j.psychres.2022.114443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 02/03/2022] [Accepted: 02/12/2022] [Indexed: 11/16/2022]
Abstract
Bipolar (BPD) patients have deficits in cognition, but there are still controversies about the effects of some medications on their cognitive performance. Here, we investigated the relationship between cognition in terms of executive functions, memory, and attention in both first-episode medication-naive BPD patients and BPD patients taking olanzapine. Forty-one healthy controls, 40 unmedicated drug-naive BPD patients, and 34 BPD patients who took only olanzapine were recruited for the study. Cognitive performance was assessed using the Flanker test, Stroop test, and Corsi-block test. Bayesian multivariate regression analysis was run considering maximum robustness to avoid bias and to predict the outcomes. Our results revealed that unmedicated medication-naive BPD patients performed worse than healthy controls and the olanzapine group in some tasks. Additionally, BPD patients who took olanzapine had better cognitive performance than healthy controls and unmedicated BPD patients. The acute cognitive effects were predicted by olanzapine dosage and serum levels (i.e., large effects). The potential pro-cognitive effects of olanzapine in BPD patients should be carefully interpreted by considering various other clinical variables. We expect that our findings will contribute to further research in this area, with the goal of helping other researchers, patients, and the population.
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Affiliation(s)
- Irina I Shoshina
- Pavlov Institute of Physiology, RAS, Laboratory of Vision Physiology, Saint-Petersburg, Russia; St. Petersburg State University, Institute for Cognitive Research, Saint-Petersburg, Russia
| | - Natalia L Almeida
- Department of Psychology, Federal University of Paraiba, Joao Pessoa, Brazil; Perception, Neuroscience and Behaviour Laboratory, Federal University of Paraiba, Brazil
| | - Milena E C Oliveira
- Department of Psychology, Federal University of Paraiba, Joao Pessoa, Brazil; Perception, Neuroscience and Behaviour Laboratory, Federal University of Paraiba, Brazil
| | - Bianca N T Trombetta
- Department of Psychology, Federal University of Paraiba, Joao Pessoa, Brazil; Perception, Neuroscience and Behaviour Laboratory, Federal University of Paraiba, Brazil
| | - Gabriella M Silva
- Department of Psychology, Federal University of Paraiba, Joao Pessoa, Brazil; Perception, Neuroscience and Behaviour Laboratory, Federal University of Paraiba, Brazil
| | - Julien Fars
- Department of Ophthalmology, University Hospital Erlangen, Erlangen, Germany
| | - Natanael A Santos
- Department of Psychology, Federal University of Paraiba, Joao Pessoa, Brazil; Perception, Neuroscience and Behaviour Laboratory, Federal University of Paraiba, Brazil
| | - Thiago P Fernandes
- Department of Psychology, Federal University of Paraiba, Joao Pessoa, Brazil; Perception, Neuroscience and Behaviour Laboratory, Federal University of Paraiba, Brazil.
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Chen WY, Liu HC, Cheng YC, Li H, Huang CC, Ding YW, Huang MC, Chiu CC, Tu YK, Kuo PH. Effect of Pharmacological and Neurostimulation Interventions for Cognitive Domains in Patients with Bipolar Disorder: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Clin Epidemiol 2021; 13:1039-1049. [PMID: 34744458 PMCID: PMC8565895 DOI: 10.2147/clep.s335584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/20/2021] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION The priority of interventions to alleviate cognitive deficits in patients with bipolar disorder (BD) is inconclusive. We systematically evaluate the efficacy of pharmacological or neurostimulation interventions for cognitive function in BD through a network meta-analysis. METHODS The PubMed, PsycINFO, Embase, and Cochrane Library databases were searched from database inception to September 30, 2021. Following PRISMA guidelines, all eligible studies were randomized controlled trials of adult bipolar patients that provided detailed cognitive outcomes. Studies were excluded if participants limited to comorbid substance use disorder or the intervention was a psychotherapy. Network meta-analysis comparing different interventions was conducted for 8 cognitive domains. Partially ordered set with Hasse diagram was used to resolve conflicting rankings between outcomes. The study was preregistered on PROSPERO database (CRD42020152044). RESULTS Total 21 RCTs including 42 tests for assessing intervention effects on cognition were retrieved. Adjunctive erythropoietin (SMD = 0.61, 95% CI = 0.00-1.23), Withania somnifera (SMD = 0.58, 95% CI = 0.03-1.13), and galantamine (SMD = 1.22, 95% CI = 0.10-2.35) was more beneficial for attention, working memory, and verbal learning in euthymic BD patients than treatment as usual, respectively. Hasse diagram suggested ranking of choice when multiple domains were combined. CONCLUSION Considerable variability in measurements of cognitive domains in BD was observed, and no intervention resulted in superior benefits across all domains. We suggested interventions priority can be tailored according to individual patients' cognitive deficits. As current findings from relatively small and heterogeneous dataset, future trials with consensus should be applied for building further evidence.
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Affiliation(s)
- Wen-Yin Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Hsing-Cheng Liu
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ying-Chih Cheng
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan
| | - Hua Li
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chi-Chieh Huang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yu-Wei Ding
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ming-Chyi Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chih-Chiang Chiu
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Po-Hsiu Kuo
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
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Gibson JS, Claassen DO. State-of-the-art pharmacological approaches to reduce chorea in Huntington's disease. Expert Opin Pharmacother 2021; 22:1015-1024. [PMID: 33550875 PMCID: PMC8222076 DOI: 10.1080/14656566.2021.1876666] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/12/2021] [Indexed: 02/07/2023]
Abstract
Introduction Chorea is a common motor manifestation of Huntington's disease (HD). Two vesicular monoamine transporter type 2 (VMAT-2) inhibitors have been approved by the FDA for treatment of HD chorea, and a third is currently being assessed in a phase 3 trial. Antipsychotic therapies are used off-label for treatment of chorea and can treat comorbid psychiatric symptoms. There is considerable clinical equipoise regarding the safe and effective treatment of chorea and comorbid symptoms in HD.Areas covered: The authors review existing medications used to treat HD chorea in the United States of America (USA). Implications for common comorbid symptoms (e.g. psychiatric, metabolic) are also discussed. Available therapies vary widely in cost, dosing frequency, and off -target effects, both beneficial or negative.Expert opinion: Treatment considerations for chorea should account for patient comorbidities. The authors recommend prospective, observational clinical effectiveness studies which can evaluate the long-term comparative effectiveness and safety of VMAT-2 inhibitors and antipsychotics in HD. Data regarding safety of dual therapy is another critical need. This is especially timely given the changing landscape of HD therapies which may increase cost burden and possibly extend both asymptomatic and symptomatic years for HD patients.
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Affiliation(s)
| | - Daniel O. Claassen
- Department of Neurology, Division of Behavioral and Cognitive Neurology, Vanderbilt University Medical Center
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11
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Herrero Babiloni A, Beetz G, Bruneau A, Martel MO, Cistulli PA, Nixdorf DR, Conway JM, Lavigne GJ. Multitargeting the sleep-pain interaction with pharmacological approaches: A narrative review with suggestions on new avenues of investigation. Sleep Med Rev 2021; 59:101459. [PMID: 33601274 DOI: 10.1016/j.smrv.2021.101459] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 12/21/2022]
Abstract
The multimorbidity formed by sleep disturbances and pain conditions is highly prevalent and has a significant impact in global health and in the socioeconomic system. Although different approaches have been directed toward its management, evidence regarding an optimal treatment is lacking, and pharmacological options are often preferred. Health professionals (e.g., pain and sleep clinicians) tend to focus on their respective expertise, targeting a single symptom with a single drug. This may increase polypharmacy and the risk of drug interactions, adverse events, and mortality. Hence, the use of medications that can directly or indirectly improve sleep, pain, and other possible accompanying conditions without exacerbating them becomes especially relevant. The objectives of this comprehensive review are to: a) describe the beneficial or deleterious effects that some commonly used medications to manage pain have on sleep and sleep disorders; and b) describe the beneficial or deleterious effects that frequently prescribed medications for sleep may have on pain. Moreover, medications targeting some specific sleep-pain interactions will be suggested and future directions for improving sleep and alleviating pain of these patients will be provided with clinical and research perspectives.
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Affiliation(s)
- Alberto Herrero Babiloni
- Division of Experimental Medicine, McGill University, Montreal, Québec, Canada; Center for Advanced Research in Sleep Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal (CIUSSS du Nord de-l'Île-de-Montréal), Québec, Canada; Faculty of Dental Medicine, Université de Montréal, Québec, Canada.
| | - Gabrielle Beetz
- Center for Advanced Research in Sleep Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal (CIUSSS du Nord de-l'Île-de-Montréal), Québec, Canada
| | - Alice Bruneau
- Division of Experimental Medicine, McGill University, Montreal, Québec, Canada
| | - Marc O Martel
- Division of Experimental Medicine, McGill University, Montreal, Québec, Canada; Faculty of Dentistry & Department of Anesthesia, McGill University, Canada
| | - Peter A Cistulli
- Sleep Research Group, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Centre for Sleep Health and Research, Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Donald R Nixdorf
- Division of TMD and Orofacial Pain, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA; Department of Neurology, Medical School, University of Minnesota, Minneapolis, MN, USA; HealthPartners Institute for Education and Research, Bloomington, MN, USA
| | | | - Gilles J Lavigne
- Division of Experimental Medicine, McGill University, Montreal, Québec, Canada; Center for Advanced Research in Sleep Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal (CIUSSS du Nord de-l'Île-de-Montréal), Québec, Canada; Faculty of Dental Medicine, Université de Montréal, Québec, Canada
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12
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Abstract
OPINION STATEMENT Olanzapine has become a major drug in the management of chemotherapy-induced nausea and vomiting as a prophylactic agent. In addition, a recent randomized trial has demonstrated its benefits in treating nausea and vomiting associated with advanced cancer. The added benefit to olanzapine is that it also stimulates appetite. As a result, since it treats multiple symptoms associated with advanced cancer, it is likely to become the antiemetic of choice in palliative care at least in the USA. The added benefit of treating insomnia and the avoidance of benzodiazepines should place olanzapine in at the top of the list of drugs to use for patients who do complain of insomnia. There is no good evidence that it potentiates the respiratory depression of opioids unlike benzodiazepines. The evidence is weak that olanzapine in as an adjuvant analgesic. Hopefully, future trials will explore this in greater depth. The benefits of adding olanzapine to potent opioids are that it may reduce craving, drug cues, and opioid misuse. Other symptoms like anxiety and depression may be addressed by the addition of olanzapine to standard antidepressants.
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Affiliation(s)
- Mellar P Davis
- Geisinger Medical Center, 100 N Academy Ave, Danville, PA, 17822, USA.
| | - Gareth J Sanger
- Blizard Institute and National Bowel Research Centre, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, England
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13
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Semyachkina-Glushkovskaya O, Postnov D, Penzel T, Kurths J. Sleep as a Novel Biomarker and a Promising Therapeutic Target for Cerebral Small Vessel Disease: A Review Focusing on Alzheimer's Disease and the Blood-Brain Barrier. Int J Mol Sci 2020; 21:ijms21176293. [PMID: 32878058 PMCID: PMC7504101 DOI: 10.3390/ijms21176293] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/14/2020] [Accepted: 08/26/2020] [Indexed: 12/12/2022] Open
Abstract
Cerebral small vessel disease (CSVD) is a leading cause of cognitive decline in elderly people and development of Alzheimer’s disease (AD). Blood–brain barrier (BBB) leakage is a key pathophysiological mechanism of amyloidal CSVD. Sleep plays a crucial role in keeping health of the central nervous system and in resistance to CSVD. The deficit of sleep contributes to accumulation of metabolites and toxins such as beta-amyloid in the brain and can lead to BBB disruption. Currently, sleep is considered as an important informative platform for diagnosis and therapy of AD. However, there are no effective methods for extracting of diagnostic information from sleep characteristics. In this review, we show strong evidence that slow wave activity (SWA) (0–0.5 Hz) during deep sleep reflects glymphatic pathology, the BBB leakage and memory deficit in AD. We also discuss that diagnostic and therapeutic targeting of SWA in AD might lead to be a novel era in effective therapy of AD. Moreover, we demonstrate that SWA can be pioneering non-invasive and bed–side technology for express diagnosis of the BBB permeability. Finally, we review the novel data about the methods of detection and enhancement of SWA that can be biomarker and a promising therapy of amyloidal CSVD and CSVD associated with the BBB disorders.
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Affiliation(s)
- Oxana Semyachkina-Glushkovskaya
- Department of Human and Animal Physiology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (D.P.); (T.P.); (J.K.)
- Physics Department, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany
- Correspondence: ; Tel.: +7-927-115-5157
| | - Dmitry Postnov
- Department of Human and Animal Physiology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (D.P.); (T.P.); (J.K.)
| | - Thomas Penzel
- Department of Human and Animal Physiology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (D.P.); (T.P.); (J.K.)
- Advanced Sleep Research GmbH, 12489 Berlin, Germany
- Charité-Universitätsmedizin Berlin, Sleep Medicine Center, Charitéplatz 1, 10117 Berlin, Germany
| | - Jürgen Kurths
- Department of Human and Animal Physiology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (D.P.); (T.P.); (J.K.)
- Physics Department, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany
- Potsdam Institute for Climate Impact Research, Telegrafenberg A31, 14473 Potsdam, Germany
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14
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Eugene AR. Association of sleep among 30 antidepressants: a population-wide adverse drug reaction study, 2004-2019. PeerJ 2020; 8:e8748. [PMID: 32201646 PMCID: PMC7071824 DOI: 10.7717/peerj.8748] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 02/14/2020] [Indexed: 01/08/2023] Open
Abstract
Background Sleep is one of the most essential processes required to maintain a healthy human life, and patients experiencing psychiatric illness often experience an inability to sleep. The aim of this study is to test the hypothesis that antidepressant compounds with strong binding affinities for the serotonin 5-HT2C receptor, histamine H1 receptors, or norepinephrine transporter (NET) will be associated with the highest odds of somnolence. Methods Post-marketing cases of patient adverse drug reactions were obtained from the United States Food and Drug Administration Adverse Events Reporting System (FAERS) during the reporting window of January 2004 to September 2019. Disproportionality analyses of antidepressants reporting somnolence were calculated using the case/non-case method. The reporting odds-ratios (ROR) and corresponding 95% confidence interval (95% CI) were computed and all computations and graphing conducted in R. Results There were a total of 69,196 reported cases of somnolence out of a total of 7,366,864 cases reported from January 2004 to September 2019. Among the 30 antidepressants assessed, amoxapine (n = 16) reporting odds-ratio (ROR) = 7.1 (95% confidence interval [CI] [4.3–11.7]), atomoxetine (n = 1,079) ROR = 6.6 (95% CI [6.2–7.1]), a compound generally approved for attention deficit hyperactivity disorder (ADHD), and maprotiline (n = 18) ROR = 6.3 (95% CI, 3.9–10.1) were the top three compounds ranked with the highest reporting odds of somnolence. In contrast, vortioxetine (n = 52) ROR = 1.3 (95% CI [1.0–1.8]), milnacipran (n = 58) ROR = 2.1 (95% CI [1.7–2.8]), and bupropion (n = 1,048) ROR = 2.2 (95% CI [2.1–2.4]) are least significantly associated with somnolence. Moreover, levomilnacipran (n = 1) ROR = 0.4 (95% CI [0.1–2.9]) was not associated with somnolence. Conclusion Among the thirty tested antidepressants, consistent with the original hypothesis, amoxepine has strongest 5-HT2C receptor binding affinity and has the highest reporting odds of somnolence. Atomoxetine, ranked second in reporting odds of somnolence overall, binds to the NET with with the strongest binding affinity among the thirty compounds. Mirtazapine, a tetracyclic antidepressant, was ranked 11th in reporting odds of somnolence and had the strongest H1 receptor binding affinity. This study provides an informative ranking of somnolence among thirty antidepressant compounds with an already wide array of clinical indications as well as provides insight into potential drug repurposing in psychopharmacology.
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Affiliation(s)
- Andy R Eugene
- Independent Researcher, Kansas, United States of America.,Independent Neurophysiology Unit, Department of Psychiatry, Medical University of Lublin, Lublin, Poland
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15
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Light exposure at night and sleep quality in bipolar disorder: The APPLE cohort study. J Affect Disord 2019; 257:314-320. [PMID: 31302520 DOI: 10.1016/j.jad.2019.07.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 06/09/2019] [Accepted: 07/04/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Sleep disturbance in bipolar disorder (BD) is common and is associated with a risk for mood episode recurrence. Thus, it is important to identify factors that are related to sleep disturbance in BD. This cross-sectional study investigated the association between exposure to light at night (LAN) and sleep parameters in patients with BD. METHODS The sleep parameters of 175 outpatients with BD were recorded using actigraphy at their homes for seven consecutive nights and were evaluated using the Insomnia Severity Index (ISI). The average LAN intensity in the bedroom during bedtime and rising time was measured using a portable photometer, and the participants were divided into two groups: "Light" (≥5 lx) and "Dark" (<5 lx). The association between LAN and sleep parameters was tested with multivariable analysis by adjusting for potential confounder such as age, gender, current smoker, mood state, day length, daytime light exposure, and sedative medications. RESULTS After adjusting for potential confounder, the actigraphy sleep parameters showed significantly lower sleep efficiency (mean, 80.1%vs. 83.4%; p = 0.01), longer log-transformed sleep onset latency (2.9 vs. 2.6 min; p = 0.01), and greater wake after sleep onset (51.4 vs. 41.6 min; p = 0.02) in the Light group than in the Dark group. Whereas, there were no significant differences in the ISI scores between the groups. LIMITATIONS This was a cross-sectional study; therefore, the results do not necessarily imply that LAN causes sleep disturbance. CONCLUSIONS Reducing LAN exposure may contribute to improved sleep quality in patients with BD.
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16
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Donovan LM, Malte CA, Spece LJ, Griffith MF, Feemster LC, Zeliadt SB, Au DH, Hawkins EJ. Center Predictors of Long-Term Benzodiazepine Use in Chronic Obstructive Pulmonary Disease and Post-traumatic Stress Disorder. Ann Am Thorac Soc 2019; 16:1151-1157. [PMID: 31113231 PMCID: PMC6812159 DOI: 10.1513/annalsats.201901-048oc] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 05/15/2019] [Indexed: 02/04/2023] Open
Abstract
Rationale: Symptoms of insomnia and anxiety are common among patients with chronic obstructive pulmonary disease (COPD), especially among patients with comorbid mental health disorders such as post-traumatic stress disorder (PTSD). Benzodiazepines provide temporary relief of these symptoms, but guidelines discourage routine use of benzodiazepines because of the serious risks posed by these medications. A more thorough understanding of guideline-discordant benzodiazepine use will be critical to reduce potentially inappropriate prescribing and its associated risks.Objectives: Examine the national prevalence, variability, and center correlates of long-term benzodiazepine prescriptions for patients with COPD and comorbid PTSD.Methods: We identified patients with COPD and PTSD between 2010 and 2012 who received care within the Department of Veterans Affairs. We used a mixed-effects logistic regression model to assess center predictors of long-term benzodiazepine prescriptions (≥90 d), while accounting for patient characteristics.Results: Of 43,979 patients diagnosed with COPD and PTSD at 129 centers, 24.4% were prescribed benzodiazepines long term, with use varying from 9.5% to 49.4% by medical center. Patients with long-term prescriptions were more likely to be white (90.1% vs. 80.7%) and have other mental health comorbidities, including generalized anxiety disorder (31.3% vs. 16.5%). Accounting for patient mix and characteristics, long-term benzodiazepine use was associated with lower patient-reported access to mental health care (odds ratio, 0.54; 95% confidence interval, 0.37-0.80).Conclusions: Long-term benzodiazepine prescribing is common among patients at high risk for complications, although this practice varies substantially from center to center. Poor access to mental health care is a potential driver of this guideline inconsistent use.
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Affiliation(s)
- Lucas M. Donovan
- Center for Veteran-Centered and Value-Driven Care, Health Services Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
- Division of Pulmonary, Critical Care, and Sleep Medicine
| | - Carol A. Malte
- Center for Veteran-Centered and Value-Driven Care, Health Services Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
| | - Laura J. Spece
- Center for Veteran-Centered and Value-Driven Care, Health Services Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
- Division of Pulmonary, Critical Care, and Sleep Medicine
| | - Matthew F. Griffith
- Center for Veteran-Centered and Value-Driven Care, Health Services Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
- Division of Pulmonary, Critical Care, and Sleep Medicine
| | - Laura C. Feemster
- Center for Veteran-Centered and Value-Driven Care, Health Services Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
- Division of Pulmonary, Critical Care, and Sleep Medicine
| | - Steven B. Zeliadt
- Center for Veteran-Centered and Value-Driven Care, Health Services Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
- Department of Health Services and
| | - David H. Au
- Center for Veteran-Centered and Value-Driven Care, Health Services Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
- Division of Pulmonary, Critical Care, and Sleep Medicine
| | - Eric J. Hawkins
- Center for Veteran-Centered and Value-Driven Care, Health Services Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
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17
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Wilson S, Anderson K, Baldwin D, Dijk DJ, Espie A, Espie C, Gringras P, Krystal A, Nutt D, Selsick H, Sharpley A. British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: An update. J Psychopharmacol 2019; 33:923-947. [PMID: 31271339 DOI: 10.1177/0269881119855343] [Citation(s) in RCA: 149] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This British Association for Psychopharmacology guideline replaces the original version published in 2010, and contains updated information and recommendations. A consensus meeting was held in London in October 2017 attended by recognised experts and advocates in the field. They were asked to provide a review of the literature and identification of the standard of evidence in their area, with an emphasis on meta-analyses, systematic reviews and randomised controlled trials where available, plus updates on current clinical practice. Each presentation was followed by discussion, aiming to reach consensus where the evidence and/or clinical experience was considered adequate, or otherwise to flag the area as a direction for future research. A draft of the proceedings was circulated to all speakers for comments, which were incorporated into the final statement.
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Affiliation(s)
- Sue Wilson
- 1 Centre for Psychiatry, Imperial College London, London, UK
| | - Kirstie Anderson
- 2 Regional Sleep Service, Freeman Hospital, Newcastle Upon Tyne, UK
| | - David Baldwin
- 3 Clinical and Experimental Sciences, University of Southampton, Southampton, UK
| | - Derk-Jan Dijk
- 4 Sleep Research Centre, University of Surrey, Guildford, UK
| | - Audrey Espie
- 5 Psychology Department, NHS Fife, Dunfermline, UK
| | - Colin Espie
- 6 Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Paul Gringras
- 7 Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Andrew Krystal
- 8 Psychiatry and Behavioral Science, University of California, San Francisco, CA, USA
| | - David Nutt
- 1 Centre for Psychiatry, Imperial College London, London, UK
| | - Hugh Selsick
- 9 Royal London Hospital for Integrated Medicine, London, UK
| | - Ann Sharpley
- 10 Department of Psychiatry, University of Oxford, Oxford, UK
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18
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Zhang Y, Gruber R. Can Slow-Wave Sleep Enhancement Improve Memory? A Review of Current Approaches and Cognitive Outcomes. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2019; 92:63-80. [PMID: 30923474 PMCID: PMC6430170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Slow-wave sleep (SWS) is involved in the overnight consolidation of declarative memories. Recent efforts using auditory stimulation, slow-oscillatory transcranial direct current stimulation (so-tDCS), and pharmacological agents have targeted sleep slow-waves as a method for enhancing cognitive performance. However, no studies thus far have integrated current evidence to provide a preliminary review of the effects of SWS enhancement on memory and other cognitive outcomes. The objective of this review was to synthesize the results of recent experimental studies that have used auditory stimulation, electrical, and pharmacological methods to boost both SWS and cognitive performance. A systematic review was done to identify and consolidate all currently existing empirical studies in this area. We found that each stimulation method could enhance slow-wave power and/or SWS duration in human subjects. Closed-loop, in-phase auditory stimulation enhanced verbal declarative memory in healthy adults. Electrical stimulation using so-tDCS showed some efficacy in promoting verbal declarative memory, picture recognition memory, and location memory. Interleukin-6 and sodium oxybate enhanced declarative verbal memory, while tiagabine and sodium oxybate improved some non-memory measures of cognitive performance. There is some evidence that so-tDCS can also improve certain cognitive outcomes in clinical populations. Overall, future studies should recruit larger sample sizes drawn from more diverse populations, and determine clinical significance and effect sizes of each enhancement methodology.
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Affiliation(s)
- Yujie Zhang
- Department of Psychology, McGill University, Montréal, QC, Canada
| | - Reut Gruber
- Department of Psychiatry, McGill University, Montréal, QC, Canada,To whom all correspondence should be addressed: Reut Gruber, PhD Psychologist; Department of Psychiatry, Faculty of Medicine, McGill University; Director of Attention Behavior and Sleep Lab, Douglas Mental Health University Institute; 6875 LaSalle Blvd, Montréal, QC, Canada H4H 1R3; Tel: 5147616131 ext. 3476;
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19
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Kiwan N, Mahfoud Z, Ghuloum S, Yehya A, Hammoudeh S, Hani Y, Chamali R, Amro I, Mook-Kanamori D, Al-Amin H. Relationships between sleep patterns and metabolic profile in patients maintained on antipsychotics: a cross-sectional comparative study. Neuropsychiatr Dis Treat 2019; 15:2035-2047. [PMID: 31410007 PMCID: PMC6650465 DOI: 10.2147/ndt.s207987] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 06/10/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Disturbances in sleep duration and quality have been associated with obesity and other metabolic changes. Patients with mental disorders (MD) are known to have more sleep problems, and antipsychotics (AP), used in the treatment of these patients, can also cause weight gain. This study aimed to compare the self-reported sleep patterns between psychiatric patients (on or off AP) and controls. We also evaluated the associations between the clinical and metabolic profiles with short or long sleep duration. METHODS A total of 339 subjects was recruited: Mentally ill patients maintained on AP for at least six months (MD+AP, n=112), patients not taking AP for at least the last six months before enrollment (MD/noAP, n=101), and non-psychiatry controls (HC, n=126). Multinomial regression analysis was applied to find the predictors of irregular sleep duration in this sample. RESULTS More mentally ill patients (MD+AP and MD/noAP) reported a sleep duration of >8 hrs than HC. Patients from MD/noAP showed more insomnia than HC. Sleep disturbances were significantly more frequent in MD+AP than HC. Participants who reported sleeping >8 hrs had higher body mass index and waist circumference than those who slept <7 hrs. CONCLUSION Female gender, central obesity and being mentally ill were independently associated with long sleep duration (>8h) in the population of Qatar.
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Affiliation(s)
- Nancy Kiwan
- Department of Research, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Ziyad Mahfoud
- Department of Health Policy and Research, Weill Cornell Medicine - Qatar, Doha, Qatar.,Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA
| | | | - Arij Yehya
- Department of Research, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Samer Hammoudeh
- Department of Research, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Yahya Hani
- Psychiatry Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Rifka Chamali
- Department of Research, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Iman Amro
- Department of Research, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Dennis Mook-Kanamori
- Department of Physiology and Biophysics, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Hassen Al-Amin
- Department of Psychiatry, Weill Cornell Medicine - Qatar, Doha, Qatar
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20
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Hein M, Senterre C, Lanquart JP, Montana X, Loas G, Linkowski P, Hubain P. Hyperarousal during sleep in untreated, major depressed subjects with prodromal insomnia: A polysomnographic study. Psychiatry Res 2017; 258:387-395. [PMID: 28860016 DOI: 10.1016/j.psychres.2017.08.061] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 08/22/2017] [Accepted: 08/23/2017] [Indexed: 12/22/2022]
Abstract
In primary insomnia, specific dynamics of hyperarousal are evident during the night. Similarly, in major depression, many elements also favor of the presence of hyperarousal. Thus, it would be interesting to investigate if hyperarousal presents the same dynamic in major depression. Polysomnographic data from 30 healthy controls, 66 patients with major depression and prodromal insomnia, and 86 primary insomnia sufferers recruited from the sleep laboratory database were studied for whole night and thirds of the night. Insomnia sufferers and patients with depression exhibit a similar polysomnographic pattern both for whole night (increased sleep latency and WASO and reduced SWS and REM) and thirds of night (increased WASO at first and last thirds, reduced SWS in first third, and reduced in REM in first and last third). No alterations were detected during the second third of the night. Just as in primary insomnia, the hyperarousal phenomenon is found mainly in major depression with prodromal insomnia during the sleep-onset period and the first and last thirds of the night, but lesser during the second third of the night. These specific dynamics of hyperarousal may aid in the understanding of the particular relationship between insomnia and depression.
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Affiliation(s)
- Matthieu Hein
- Erasme hospital, Department of Psychiatry and Sleep Laboratory, Université Libre de Bruxelles, ULB, Brussels, Belgium.
| | - Christelle Senterre
- School of Public Health SPU-ESP, Department of Biostatistics, Université Libre de Bruxelles, ULB, Brussels, Belgium
| | - Jean-Pol Lanquart
- Erasme hospital, Department of Psychiatry and Sleep Laboratory, Université Libre de Bruxelles, ULB, Brussels, Belgium
| | - Xavier Montana
- Erasme hospital, Department of Psychiatry and Sleep Laboratory, Université Libre de Bruxelles, ULB, Brussels, Belgium
| | - Gwénolé Loas
- Erasme hospital, Department of Psychiatry and Sleep Laboratory, Université Libre de Bruxelles, ULB, Brussels, Belgium
| | - Paul Linkowski
- Erasme hospital, Department of Psychiatry and Sleep Laboratory, Université Libre de Bruxelles, ULB, Brussels, Belgium
| | - Philippe Hubain
- Erasme hospital, Department of Psychiatry and Sleep Laboratory, Université Libre de Bruxelles, ULB, Brussels, Belgium
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21
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Ronai KZ, Szentkiralyi A, Lazar AS, Ujszaszi A, Turanyi C, Gombos F, Mucsi I, Bodizs R, Molnar MZ, Novak M. Depressive Symptoms Are Associated With Objectively Measured Sleep Parameters in Kidney Transplant Recipients. J Clin Sleep Med 2017; 13:557-564. [PMID: 28162142 PMCID: PMC5359332 DOI: 10.5664/jcsm.6542] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 10/06/2016] [Accepted: 11/30/2016] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Both depression and sleep complaints are very prevalent among kidney transplant (kTx) recipients. However, details of the complex relationship between sleep and depression in this population are not well documented. Thus, we investigated the association between depressive symptoms and sleep macrostructure parameters among prevalent kTx recipients. METHODS Ninety-five kTx recipients participated in the study (54 males, mean ± standard devation age 51 ± 13 years, body mass index 26 ± 4 kg/m2, estimated glomerular filtration rate 53 ± 19 ml/min/1.73 m2). Symptoms of depression were assessed by the Center for Epidemiologic Studies - Depression Scale (CES-D). After 1-night polysomnography each recording was visually scored and sleep macrostructure was analyzed. RESULTS The CES-D score was significantly associated with the amount of stage 2 sleep (r = 0.20, P < .05), rapid eye movement (REM) latency (r = 0.21, P < .05) and REM percentage (r = -0.24, P < .05), but not with the amount of slow wave sleep (r = -0.12, P > .05). In multivariable linear regression models the CES-D score was independently associated with the amount of stage 2 sleep (β: 0.205; confidence interval: 0.001-0.409; P = .05) and REM latency (β: 0.234; confidence interval: 0.001-0.468; P = .05) after adjustment for potential confounders. CONCLUSIONS Depressive symptoms among kTx recipients are associated with increased amount of stage 2 sleep and prolonged REM latency. Further studies are needed to confirm our findings and understand potential clinical implications.
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Affiliation(s)
- Katalin Z. Ronai
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Andras Szentkiralyi
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - Alpar S. Lazar
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Akos Ujszaszi
- Institute of Pathophysiology, Semmelweis University, Budapest, Hungary
| | - Csilla Turanyi
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Ferenc Gombos
- Department of General Psychology, Pázmány Péter Catholic University, Budapest, Hungary
| | - Istvan Mucsi
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
- Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Canada
| | - Robert Bodizs
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
- Department of General Psychology, Pázmány Péter Catholic University, Budapest, Hungary
| | - Miklos Z. Molnar
- Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Tennessee
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Marta Novak
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
- Centre for Mental Health, University Health Network and Department of Psychiatry, University of Toronto, Toronto, Canada
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22
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Attali V, Straus C, Pottier M, Buzare MA, Morélot-Panzini C, Arnulf I, Similowski T. Normal sleep on mechanical ventilation in adult patients with congenital central alveolar hypoventilation (Ondine's curse syndrome). Orphanet J Rare Dis 2017; 12:18. [PMID: 28115003 PMCID: PMC5256543 DOI: 10.1186/s13023-017-0569-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 01/11/2017] [Indexed: 01/13/2023] Open
Abstract
Background The purpose of this study was to describe the sleep structure (especially slow wave sleep) in adults with congenital central hypoventilation syndrome (CCHS), a rare genetic disease due to mutations in the PHOX2B gene. Fourteen patients aged 23 (19.0; 24.8) years old (median [1rst-3rd quartiles]) with CCHS underwent a sleep interview and night-time attended polysomnography with their ventilatory support. Their sleep variables were compared to those collected in 15 healthy control subjects matched for age, sex and body mass index. Results The latency to N3 sleep was shorter in patients (26.3 min [24.0; 30.1]) than in controls (49.5 min [34.3; 66.9]; P = 0.005), and sleep onset latency tended to be shorter in patients (14.0 min [7.0; 20.5]) than in controls (33.0 min [18.0; 49.0]; P = 0.052). Total sleep time, sleep stage percentages, sleep fragmentation as well as respiratory and movement index were within normal ranges and not different between groups. Conclusions Normal sleep in adult patients with CCHS and adequate ventilator support indicates that the PHOX2 gene mutations do not affect brain sleep networks. Consequently, any complaint of disrupted sleep should prompt clinicians to look for the usual causes of sleep disorders, primarily inadequate mechanical ventilation. Shorter N3 latency may indicate a higher need for slow wave sleep, to compensate for the abnormal respiratory-related cortical activity during awake quiet breathing observed in patients with CCH.
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Affiliation(s)
- Valérie Attali
- Sorbonne Universités, UPMC Université Paris 06, INSERM, UMRS1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France. .,Service des Pathologies du Sommeil, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75651, Paris, Cedex 13, France. .,Branche "Adultes" du Centre de Référence du Syndrome d'Ondine, F-75013, Paris, France.
| | - Christian Straus
- Sorbonne Universités, UPMC Université Paris 06, INSERM, UMRS1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France.,Branche "Adultes" du Centre de Référence du Syndrome d'Ondine, F-75013, Paris, France.,Service d'Explorations Fonctionnelles Respiratoires de l'Exercice et de la Dyspnée EFRED, F-75013, Paris, France
| | - Michel Pottier
- Service des Pathologies du Sommeil, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75651, Paris, Cedex 13, France
| | - Marie-Annick Buzare
- Service des Pathologies du Sommeil, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75651, Paris, Cedex 13, France
| | - Capucine Morélot-Panzini
- Sorbonne Universités, UPMC Université Paris 06, INSERM, UMRS1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France.,Unité ambulatoire d'Assistance Respiratoire à Domicile, F-75013, Paris, France.,Service de Pneumologie et Réanimation Médicale, Département R3S, Hopitaux Universitaires Pitié-Salpêtrière Charles Foix, AP-HP, F-75013, Paris, France
| | - Isabelle Arnulf
- Service des Pathologies du Sommeil, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75651, Paris, Cedex 13, France.,Branche "Adultes" du Centre de Référence du Syndrome d'Ondine, F-75013, Paris, France.,Brain Research Institute-UPMC Paris 6 Univ Inserm U 1127, CNRS UMR 7225, Paris, France
| | - Thomas Similowski
- Sorbonne Universités, UPMC Université Paris 06, INSERM, UMRS1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France.,Branche "Adultes" du Centre de Référence du Syndrome d'Ondine, F-75013, Paris, France.,Service de Pneumologie et Réanimation Médicale, Département R3S, Hopitaux Universitaires Pitié-Salpêtrière Charles Foix, AP-HP, F-75013, Paris, France
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23
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Robillard R, Oxley C, Hermens DF, White D, Wallis R, Naismith SL, Whitwell B, Southan J, Scott EM, Hickie IB. The relative contributions of psychiatric symptoms and psychotropic medications on the sleep-wake profile of young persons with anxiety, depression and bipolar disorders. Psychiatry Res 2016; 243:403-6. [PMID: 27449011 DOI: 10.1016/j.psychres.2016.06.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 05/29/2016] [Accepted: 06/16/2016] [Indexed: 12/13/2022]
Abstract
This study investigated the relative contribution of psychiatric symptoms and psychotropic medications on the sleep-wake cycle. Actigraphy and clinical assessments (Brief Psychiatric Rating Scale) were conducted in 146 youths with anxiety, depression or bipolar disorders. Independently of medications, mania symptoms were predictive of lower circadian amplitude and rhythmicity. Independently of diagnosis and symptoms severity: i) antipsychotics were related to longer sleep period and duration, ii) serotonin-norepinephrine reuptake inhibitors to longer sleep period, and iii) agomelatine to earlier sleep onset. Manic symptoms and different subclasses of medications may have independent influences on the sleep-wake cycle of young people with mental disorders.
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Affiliation(s)
- Rébecca Robillard
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Camperdown, NSW 2050, Australia.
| | - Cristal Oxley
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Camperdown, NSW 2050, Australia
| | - Daniel F Hermens
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Camperdown, NSW 2050, Australia
| | - Django White
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Camperdown, NSW 2050, Australia
| | - Ryan Wallis
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Camperdown, NSW 2050, Australia
| | - Sharon L Naismith
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Camperdown, NSW 2050, Australia; School of Psychology, University of Sydney, Camperdown, NSW 2050, Australia
| | - Bradley Whitwell
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Camperdown, NSW 2050, Australia
| | - James Southan
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Camperdown, NSW 2050, Australia
| | - Elizabeth M Scott
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Camperdown, NSW 2050, Australia
| | - Ian B Hickie
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Camperdown, NSW 2050, Australia.
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24
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Monti JM. The effect of second-generation antipsychotic drugs on sleep parameters in patients with unipolar or bipolar disorder. Sleep Med 2016; 23:89-96. [PMID: 27692282 DOI: 10.1016/j.sleep.2016.04.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 04/07/2016] [Accepted: 04/11/2016] [Indexed: 11/28/2022]
Abstract
Sleep disturbances predominantly take the form of insomnia in patients with unipolar disorder, while patients with bipolar disorder show a decreased need for sleep. Sleep impairment in these patients is a risk factor for the development of a major depressive episode and suicidal behavior. Administration of second-generation antipsychotics (SGAs) olanzapine, quetiapine, and ziprasidone as augmentation therapy or monotherapy to unipolar and bipolar disorder patients, respectively, has been shown to improve sleep continuity and sleep architecture. Thus, their use by these patients could ameliorate their sleep disorder.
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Affiliation(s)
- Jaime M Monti
- Department of Pharmacology and Therapeutics, School of Medicine, Clinics Hospital, Montevideo, Uruguay.
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25
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Hori H, Koga N, Hidese S, Nagashima A, Kim Y, Higuchi T, Kunugi H. 24-h activity rhythm and sleep in depressed outpatients. J Psychiatr Res 2016; 77:27-34. [PMID: 26978182 DOI: 10.1016/j.jpsychires.2016.02.022] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 02/19/2016] [Accepted: 02/29/2016] [Indexed: 11/19/2022]
Abstract
Disturbances in sleep and circadian rest-activity rhythms are key features of depression. Actigraphy, a non-invasive method for monitoring motor activity, can be used to objectively assess circadian rest-activity rhythms and sleep patterns. While recent studies have measured sleep and daytime activity of depressed patients using wrist-worn actigraphy, the actigraphic 24-h rest-activity rhythm in depression has not been well documented. We aimed to examine actigraphically measured sleep and circadian rest-activity rhythms in depressed outpatients. Twenty patients with DSM-IV major depressive episode and 20 age- and sex-matched healthy controls participated in this study. Participants completed 7 consecutive days of all-day actigraphic activity monitoring while engaging in usual activities. For sleep parameters, total sleep time, wake after sleep onset, and sleep fragmentation index were determined. Circadian rhythms were estimated by fitting individual actigraphy data to a cosine curve of a 24-h activity rhythm using the cosinor method, which generated three circadian activity rhythm parameters, i.e., MESOR (rhythm-adjusted mean), amplitude, and acrophase. Subjective sleep was also assessed using a sleep diary and the Pittsburgh Sleep Quality Index. Patients showed significantly lower MESOR and more dampened amplitude along with significant sleep disturbances. Logistic regression analysis revealed that lower MESOR and more fragmented sleep emerged as the significant predictors of depression. Correlations between subjectively and actigraphically measured parameters demonstrated the validity of actigraphic measurements. These results indicate marked disturbances in sleep and circadian rest-activity rhythms of depression. By simultaneously measuring sleep and rest-activity rhythm parameters, actigraphy might serve as an objective diagnostic aid for depression.
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Affiliation(s)
- Hiroaki Hori
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, 187-8502, Japan; Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan.
| | - Norie Koga
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, 187-8502, Japan
| | - Shinsuke Hidese
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, 187-8502, Japan
| | - Anna Nagashima
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, 187-8502, Japan
| | - Yoshiharu Kim
- Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan
| | - Teruhiko Higuchi
- National Center of Neurology and Psychiatry, Tokyo, 187-8502, Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, 187-8502, Japan
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26
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A Case of Chronic Peduncular Hallucinosis in a 90-Year-Old Woman Successfully Treated With Olanzapine. J Clin Psychopharmacol 2016; 36:285-6. [PMID: 27043125 DOI: 10.1097/jcp.0000000000000497] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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27
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Chakrabarty T, Hadjipavlou G, Lam RW. Cognitive Dysfunction in Major Depressive Disorder: Assessment, Impact, and Management. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2016; 14:194-206. [PMID: 31975803 PMCID: PMC6519654 DOI: 10.1176/appi.focus.20150043] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Cognitive dysfunction is increasingly being recognized as an important clinical dimension in major depressive disorder. This review summarizes the existing data on the epidemiology, assessment, and treatment of cognitive dysfunction among nonelderly adults with the disorder. Overall, cognitive dysfunction is prevalent, persists through periods of symptom remission, and may be independently associated with functional outcomes. However, although the evidence increasingly suggests that clinicians should be heedful of their patients' cognitive functioning, there is as yet no consensus on how best to monitor cognition clinically. In addition, although most studies have reported improved cognition with antidepressant medications, psychotherapy, and neuromodulation, the clinical significance of these improvements is unclear, and high-level evidence to guide decision making is limited. Nonetheless, given the important functional implications, clinicians should assess and monitor cognition and optimize both medication and psychological treatments to mitigate cognitive dysfunction among patients with major depressive disorder.
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Affiliation(s)
- Trisha Chakrabarty
- The authors are with the Department of Psychiatry, University of British Columbia, and the Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada. Send correspondence to Dr. Lam (e-mail: )
| | - George Hadjipavlou
- The authors are with the Department of Psychiatry, University of British Columbia, and the Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada. Send correspondence to Dr. Lam (e-mail: )
| | - Raymond W Lam
- The authors are with the Department of Psychiatry, University of British Columbia, and the Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada. Send correspondence to Dr. Lam (e-mail: )
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28
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Sachdeva A, Kumar K, Anand KS. Non Pharmacological Cognitive Enhancers - Current Perspectives. J Clin Diagn Res 2015; 9:VE01-VE06. [PMID: 26393186 DOI: 10.7860/jcdr/2015/13392.6186] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 05/23/2015] [Indexed: 02/02/2023]
Abstract
Cognition refers to the mental processes involved in thinking, knowing, remembering, judging, and problem solving. Cognitive dysfunctions are an integral part of neuropsychiatric disorders as well as in healthy ageing. Cognitive Enhancers are molecules that help improve aspects of cognition like memory, intelligence, motivation, attention and concentration. Recently, Non Pharmacological Cognitive Enhancers have gained popularity as effective and safe alternative to various established drugs. Many of these Non Pharmacological Cognitive Enhancers seem to be more efficacious compared to currently available Pharmacological Cognitive Enhancers. This review describes and summarizes evidence on various Non Pharmacological Cognitive Enhancers such as physical exercise, sleep, meditation and yoga, spirituality, nutrients, computer training, brain stimulation, and music. We also discuss their role in ageing and different neuro-psychiatric disorders, and current status of Cochrane database recommendations. We searched the Pubmed database for the articles and reviews having the terms 'non pharmacological and cognitive' in the title, published from 2000 till 2014. A total of 11 results displayed, out of which 10 were relevant to the review. These were selected and reviewed. Appropriate cross-references within the articles along with Cochrane reviews were also considered and studied.
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Affiliation(s)
- Ankur Sachdeva
- Senior Resident, Department of Psychiatry and Drug De-addiction, Post Graduate Institute of Medical Education and Research, Dr Ram Manohar Lohia Hospital , New Delhi, India
| | - Kuldip Kumar
- Associate Professor, Department of Psychiatry, Vardhman Mahavir Medical College and Safdarjang Hospital , New Delhi, India
| | - Kuljeet Singh Anand
- Professor, Head of the Department, Department of Neurology, Post Graduate Institute of Medical Education and Research, Dr Ram Manohar Lohia Hospital , New Delhi, India
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29
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Makhani A, Akbaryan F, Cernak I. Cognitive performance improvement in Canadian Armed Forces personnel during deployment. JOURNAL OF MILITARY, VETERAN AND FAMILY HEALTH 2015. [DOI: 10.3138/jmvfh.2014-04] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction: Chronic stress can decrease resilience and diminish cognitive adaptability; thus, operational stressors related to military deployment can pose significant risks to cognitive functioning. Numerous studies have aimed to assess the effects of deployment on cognitive functioning on the basis of cognitive performance measures administered before and after deployment. However, to the best of our knowledge, no studies have measured neurocognitive performance of military personnel while they were deployed to a combat zone. Methods: Canadian Armed Forces military troops ( N = 85) were tested during pre-deployment training and during deployment in Afghanistan. At both time points, the participants completed a detailed demographic form and performed touch-screen neurocognitive tests using the Cambridge Neuropsychological Test Automated Battery (CANTAB). The CANTAB measurements included executive function (Attention Switching Task [AST] and Spatial Working Memory [SWM] test), decision making and response control (Stop Signal Task [SST]), and attention (Reaction Time [RTI] test). Two-tailed, paired t-tests were used to compare pre-deployment and deployment CANTAB results. Results: On average, all participants significantly improved their performance on all neurocognitive tests during deployment compared with pre-deployment. At both pre-deployment and deployment time points, the participants demonstrated excellent performance on the AST and RTI test and less-than-optimal performance on the SWM test and SST. Discussion: The influence of training, social factors, and emotional status, among many others, on cognitive adaptability should be taken into account to fully understand soldiers’ capability to improve and maintain high cognitive functioning during deployment.
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Affiliation(s)
- Asad Makhani
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Farzad Akbaryan
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Ibolja Cernak
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
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30
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Du X, Pang TY. Is Dysregulation of the HPA-Axis a Core Pathophysiology Mediating Co-Morbid Depression in Neurodegenerative Diseases? Front Psychiatry 2015; 6:32. [PMID: 25806005 PMCID: PMC4353372 DOI: 10.3389/fpsyt.2015.00032] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 02/16/2015] [Indexed: 01/19/2023] Open
Abstract
There is increasing evidence of prodromal manifestation of neuropsychiatric symptoms in a variety of neurodegenerative diseases such as Parkinson's disease (PD) and Huntington's disease (HD). These affective symptoms may be observed many years before the core diagnostic symptoms of the neurological condition. It is becoming more apparent that depression is a significant modifying factor of the trajectory of disease progression and even treatment outcomes. It is therefore crucial that we understand the potential pathophysiologies related to the primary condition, which could contribute to the development of depression. The hypothalamic-pituitary-adrenal (HPA)-axis is a key neuroendocrine signaling system involved in physiological homeostasis and stress response. Disturbances of this system lead to severe hormonal imbalances, and the majority of such patients also present with behavioral deficits and/or mood disorders. Dysregulation of the HPA-axis is also strongly implicated in the pathology of major depressive disorder. Consistent with this, antidepressant drugs, such as the selective serotonin reuptake inhibitors have been shown to alter HPA-axis activity. In this review, we will summarize the current state of knowledge regarding HPA-axis pathology in Alzheimer's, PD and HD, differentiating between prodromal and later stages of disease progression when evidence is available. Both clinical and preclinical evidence will be examined, but we highlight animal model studies as being particularly useful for uncovering novel mechanisms of pathology related to co-morbid mood disorders. Finally, we purpose utilizing the preclinical evidence to better inform prospective, intervention studies.
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Affiliation(s)
- Xin Du
- Mental Health Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne , Melbourne, VIC , Australia
| | - Terence Y Pang
- Behavioural Neurosciences Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne , Melbourne, VIC , Australia
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