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Agomelatine improves streptozotocin-induced diabetic nephropathy through melatonin receptors/SIRT1 signaling pathway. Int Immunopharmacol 2023; 115:109646. [PMID: 36587501 DOI: 10.1016/j.intimp.2022.109646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/17/2022] [Accepted: 12/24/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Diabetic nephropathy (DN) is a major cause of end-stage renal disease (ESRD). Agomelatine, a melatonin receptor agonist, has a potent anti-inflammatory activity. The current study aimed to determine the ameliorative anti-inflammatory effect of agomelatine against DN. METHODS We used 10 % fructose with streptozotocin (STZ) to induce DN in male Wistar rats. Diabetic rats were treated with agomelatine in presence or absence of melatonin receptor antagonist (luzindole) or Sirtuin1 (SIRT1) inhibitor (EX527). SIRT1 expression was measured by qRT-PCR and immunohistochemical analysis. The expression of nuclear factor kappa-light-chain-enhancer of activated B cells (NFκB), 5'adenosine monophosphate-activated protein kinase (AMPK), intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion protein-1 (VCAM-1), and monocyte chemoattractant protein-1 (MCP-1) were measured using ELISA. Histological assessment was performed using hematoxylin and eosin-stained renal sections. RESULTS Fructose and STZ treatment induced diabetes, insulin resistance, and renal damage accompanied by reduced SIRT1 expression, increased NFκB activation, and decreased AMPK phosphorylation in the kidney. Agomelatine treatment improved kidney histology and function and upregulated SIRT1 expression (2-fold). Inhibition of melatonin receptors and SIRT1 activity increased NFκB phosphorylation (2.13 and 1.98-folds, respectively), reduced AMPK activation (0.51 and 0.53-folds, respectively), increased inflammatory markers ICAM-1 (2.16 and 2.23-folds, respectively), VCAM-1 (2.19 and 2.26-folds, respectively), and MCP-1(2.84 and 3.12-folds, respectively), and inhibited the ameliorative effect of agomelatine on kidney structure and function. CONCLUSION Our findings reveal the ameliorative anti-inflammatory activity of agomelatine against STZ-induced DN and this effect is SIRT1- and melatonin receptor-dependent. Therefore, agomelatine may be beneficial to prevent the development of ESRD from diabetes mellitus.
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Zhang Z, Du Y, Chen L, Liu Y, Du B. Effects of the selective serotonin reuptake inhibitor fluoxetine on glucose metabolism: A systematic review. Asian J Psychiatr 2022; 73:103092. [PMID: 35430493 DOI: 10.1016/j.ajp.2022.103092] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 03/20/2022] [Accepted: 04/02/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVES The metabolic effects of antidepressants should be considered when prescribing antidepressants due to the increasing risk of diabetes, obesity and cardiovascular disease. This study aims to explore the effects of fluoxetine on glucose and lipid metabolism in human body. METHODS Studies of the effects of fluoxetine on glucose and lipid metabolism were collected from the PubMed, MEDLINE and Embase databases without limiting the research design. The retrieval spanned between inception and January 2021. The main outcome measures were fasting blood glucose, glycosylated hemoglobin (mainly HbA1c) and body weight. RESULTS A total of 24 studies were retrieved, including 20 randomized controlled trials (RCTs), 1 prospective study and 3 case reports. The meta-analysis showed that FBG and HbA1c levels were moderately decreased(MD-0.85[-1.75, -0.13], P = 0.02 and MD-0.55[-1.23, 0.13], P = 0.11 respectively) and body weight was significantly decreased (MD-3.01[-5.58, -0.44], P < 0.00001) with fluoxetine treatment compared with placebo. Both plasma triglyceride (TG) and total cholesterol (TC) levels decreased significantly (P < 0.00001). CONCLUSION Fluoxetine had a positive effect on improving blood glucose control in patients with disorders of glucose metabolism and was good for weight management in obese people despite significant heterogeneity between studies.
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Affiliation(s)
- Zizhen Zhang
- School of Pharmacy, Southwest Medical University, Luzhou 646000, China
| | - Yang Du
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China
| | - Lizhi Chen
- School of Pharmacy, Southwest Medical University, Luzhou 646000, China
| | - Ying Liu
- School of Pharmacy, North Sichuan Medical College, Nanchong 637000, China
| | - Biao Du
- Department of Pharmacy, Chongqing University Three Gorges Hospital, Chongqing 404000, China.
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Srisurapanont M, Suttajit S, Kosachunhanun N, Likhitsathian S, Suradom C, Maneeton B. Antidepressants for depressed patients with type 2 diabetes mellitus: A systematic review and network meta-analysis of short-term randomized controlled trials. Neurosci Biobehav Rev 2022; 139:104731. [PMID: 35691471 DOI: 10.1016/j.neubiorev.2022.104731] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 10/18/2022]
Abstract
This network meta-analysis compared the short-term treatment effects of different antidepressants on depression severity and HbA1c in depressed patients with type 2 diabetes mellitus (T2DM). We searched 8- to 24-week randomized-controlled trials (RCTs) in PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, and Clinicaltrials.gov on November 22, 2021. We included 12 RCTs (N = 792) studying agomelatine, citalopram, escitalopram, fluoxetine, nortriptyline, no treatment, paroxetine, sertraline, vortioxetine, and placebo. Compared to placebo, the standardized mean differences and 95% confidence intervals (SMD, 95%CIs) for depression severity reduction revealed that escitalopram ranked first (-2.93, -3.92 to -1.94), followed by agomelatine (-0.68, -1.15 to -0.20). Compared to placebo, the mean differences (MDs, 95%CIs) for HbA1c reduction suggested that vortioxetine ranked first (-2.35, -4.13 to -0.57), followed by escitalopram (-1.00, -1.42 to -0.57) and agomelatine (-0.79, -1.16 to -0.42). Limited evidence from short-term trials in depressed patients with T2DM suggests that escitalopram and agomelatine may have a favorable profile in reducing depression and controlling glycemic goals, but more trials are required.
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Affiliation(s)
- Manit Srisurapanont
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Thailand.
| | - Sirijit Suttajit
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Thailand
| | | | | | - Chawisa Suradom
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Thailand
| | - Benchalak Maneeton
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Thailand
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Circadian Rhythms in Mood Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1344:153-168. [PMID: 34773231 DOI: 10.1007/978-3-030-81147-1_9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Altered behavioral rhythms are a fundamental diagnostic feature of mood disorders. Patients report worse subjective sleep and objective measures confirm this, implicating a role for circadian rhythm disruptions in mood disorder pathophysiology. Molecular clock gene mutations are associated with increased risk of mood disorder diagnosis and/or severity of symptoms, and mouse models of clock gene mutations have abnormal mood-related behaviors. The mechanism by which circadian rhythms contribute to mood disorders remains unknown, however, circadian rhythms regulate and are regulated by various biological systems that are abnormal in mood disorders and this interaction is theorized to be a key component of mood disorder pathophysiology. A growing body of evidence has begun defining how the interaction of circadian and neurotransmitter systems influences mood and behavior, including the role of current antidepressants and mood stabilizers. Additionally, the hypothalamus-pituitary-adrenal (HPA) axis interacts with both circadian and monoaminergic systems and may facilitate the contribution of environmental stressors to mood disorder pathophysiology. The central role of circadian rhythms in mood disorders has led to the development of chronotherapeutics, which are treatments designed specifically to target circadian rhythm regulators, such as sleep, light, and melatonin, to produce an antidepressant response.
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Wang S, Xu Q, Qu K, Wang J, Zhou Z. CYP1A2 polymorphism may contribute to agomelatine-induced acute liver injury: Case report and review of the literature. Medicine (Baltimore) 2021; 100:e27736. [PMID: 34766583 PMCID: PMC10545369 DOI: 10.1097/md.0000000000027736] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/16/2021] [Accepted: 10/22/2021] [Indexed: 11/27/2022] Open
Abstract
RATIONALE Liver function monitoring is recommended when agomelatine is prescribed, although liver enzymes are not considered predictive biomarkers. Most patients present with acute liver injury, with only a few presenting with levels of liver enzymes that are over 30 times the upper limit of normal. The patient-specific risk factors that are associated with liver injury remain unclear. Thus, this report provides new insights into the mechanism of agomelatine-induced acute hepatocellular injury based on cytochrome P450 family 1 subfamily A member 2 (CYP1A2) polymorphism. PATIENT CONCERNS We present a case of acute hepatocellular injury in a 75-year-old man who was taking agomelatine at a dose of 50 mg/qn. All hepatitis virus test results were negative. No history of liver disease was observed. As CYP1A2 is the main metabolic enzyme of agomelatine, CYP1A2 AA (rs762551) genetic polymorphism was analyzed. DIAGNOSIS The patient's transaminases level exceeded the critical value on day 72 after starting oral agomelatine. INTERVENTIONS The patient received intravenous magnesium isoglycyrrhizinate, a liver cell-protecting agent, followed by the withdrawal of agomelatine. OUTCOMES There was an improvement in the levels of the liver enzymes and no subsequent organ dysfunction was observed. LESSONS Here, we report a case of acute hepatocellular injury characterized by a very high aspartate aminotransferase level. Periodic liver function testing throughout the treatment period can help in the rapid and appropriate diagnosis of acute liver injury, particularly in the absence of typical clinical manifestations. Agomelatine hepatic toxicity might be related to an idiosyncratic metabolic reaction that depends on individual patient differences. As it is the main metabolic enzyme of agomelatine, CYP1A2 genetic polymorphism may contribute to liver injury by affecting its metabolites.
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Affiliation(s)
- Shushan Wang
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Department of Pharmacy, Binhu District, Wuxi City, Jiangsu Province, China
| | - Qing Xu
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Department of Psychiatry, Binhu District, Wuxi City, Jiangsu Province, China
| | - Kankan Qu
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Department of Pharmacy, Binhu District, Wuxi City, Jiangsu Province, China
| | - Jun Wang
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Department of Psychiatry, Binhu District, Wuxi City, Jiangsu Province, China
| | - Zhenhe Zhou
- The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Department of Psychiatry, Binhu District, Wuxi City, Jiangsu Province, China
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Agomelatine might be more appropriate for elderly, depressed, type 2 diabetes mellitus patients than paroxetine/fluoxetine. Aging (Albany NY) 2021; 13:22934-22946. [PMID: 34610580 PMCID: PMC8544326 DOI: 10.18632/aging.203586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/20/2021] [Indexed: 12/16/2022]
Abstract
Agomelatine was a novel and melatonergic antidepressant. The present study was conducted to find out whether age was an important factor for agomelatine in treating depressed type 2 diabetes mellitus (T2DM) patients. In total, 193 depressed T2DM patients were included. There were 84 patients ranged from 27 years old to 49 years old (age phase I) (n = 44 receiving agomelatine, n = 40 receiving paroxetine or fluoxetine), and 109 patients ranged from 50 years old to 70 years old (age phase II) (n = 56 receiving agomelatine, n = 53 receiving paroxetine or fluoxetine). The Hamilton Depression Rating Scale (HDRS) score, Hamilton Anxiety Rating Scale (HARS) score, fasting plasma glucose (FPG), hemoglobin A1c (HbA1c) level and body mass index (BMI) were assessed after 12 weeks treatment. After treatment, we found that among patients in age phase I, there were no significant differences in final average HDRS score, HARS score, FPG, HbA1c level, BMI, response rate and remission rate between the two groups. However, among patients in age phase II, compared to patients receiving paroxetine or fluoxetine, patients receiving agomelatine had the significantly lower average HDRS score, HARS score, HbA1c level and BMI, and significantly higher response rate and remission rate. The incidence of treatment-related adverse events was similar between the two groups in both age phases. These results suggested that age was an important factor for agomelatine in treating depressed T2DM patients. Compared to paroxetine/fluoxetine, agomelatine might be more appropriate for elderly depressed T2DM patients.
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Veronesi VB, Pioli MR, de Souza DN, Teixeira CJ, Murata GM, Santos-Silva JC, Hecht FB, Vicente JM, Bordin S, Anhê GF. Agomelatine reduces circulating triacylglycerides and hepatic steatosis in fructose-treated rats. Biomed Pharmacother 2021; 141:111807. [PMID: 34120066 DOI: 10.1016/j.biopha.2021.111807] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/28/2021] [Accepted: 06/07/2021] [Indexed: 11/16/2022] Open
Abstract
Agomelatine (AGO) is an antidepressant drug with agonistic activity at melatonin receptor 1 (MT1) and MT2 and with neutral antagonistic activity at serotonin receptor 5-HT2C. Although experimental studies show that melatonin reduces hypertriglyceridemia and hepatic steatosis induced by excessive fructose intake, no studies have tested if AGO exerts similar actions. To address this issue we have treated male Wistar rats with fructose (15% in the drinking water) and/or AGO (40 mg/kg/day) for two weeks. AGO reduced body weight gain, feeding efficiency and hepatic lipid levels without affecting caloric intake in fructose-treated rats. AGO has also decreased very low-density lipoprotein (VLDL) production and circulating TAG levels after an oral load with olive oil. Accordingly, treatment with AGO reduced the hepatic expression of fatty acid synthase (Fasn), a limiting step for hepatic de novo lipogenesis (DNLG). The expression of apolipoprotein B (Apob) and microsomal triglyceride transfer protein (Mttp) in the ileum, two crucial proteins for intestinal lipoprotein production, were also downregulated by treatment with AGO. Altogether, the present data show that AGO mimics the metabolic benefits of melatonin when used in fructose-treated rats. This study also suggests that it is relevant to evaluate the potential of AGO to treat metabolic disorders in future clinical trials.
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Affiliation(s)
- Vanessa Barbosa Veronesi
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, 105 Alexander Flemming St., Zip Code: 13083-881, Campinas, SP, Brazil
| | - Mariana Rodrigues Pioli
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, 105 Alexander Flemming St., Zip Code: 13083-881, Campinas, SP, Brazil
| | - Dailson Nogueira de Souza
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, 105 Alexander Flemming St., Zip Code: 13083-881, Campinas, SP, Brazil
| | - Caio Jordão Teixeira
- Department of Physiology and Biophysics, Institute of Biomedical Science, University of Sao Paulo, 1524 Prof. Lineu Prestes Ave., ICB 1, Zip Code: 05508-000, Sao Paulo, SP, Brazil
| | - Gilson Masahiro Murata
- Department of Physiology and Biophysics, Institute of Biomedical Science, University of Sao Paulo, 1524 Prof. Lineu Prestes Ave., ICB 1, Zip Code: 05508-000, Sao Paulo, SP, Brazil
| | - Junia Carolina Santos-Silva
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, 105 Alexander Flemming St., Zip Code: 13083-881, Campinas, SP, Brazil
| | - Fernanda Ballerini Hecht
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, 105 Alexander Flemming St., Zip Code: 13083-881, Campinas, SP, Brazil
| | - Julia Modesto Vicente
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, 105 Alexander Flemming St., Zip Code: 13083-881, Campinas, SP, Brazil
| | - Silvana Bordin
- Department of Physiology and Biophysics, Institute of Biomedical Science, University of Sao Paulo, 1524 Prof. Lineu Prestes Ave., ICB 1, Zip Code: 05508-000, Sao Paulo, SP, Brazil
| | - Gabriel Forato Anhê
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, 105 Alexander Flemming St., Zip Code: 13083-881, Campinas, SP, Brazil.
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van der Feltz‐Cornelis C, Allen SF, Holt RIG, Roberts R, Nouwen A, Sartorius N. Treatment for comorbid depressive disorder or subthreshold depression in diabetes mellitus: Systematic review and meta-analysis. Brain Behav 2021; 11:e01981. [PMID: 33274609 PMCID: PMC7882189 DOI: 10.1002/brb3.1981] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/02/2020] [Accepted: 11/16/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To provide an estimate of the effect of interventions on comorbid depressive disorder (MDD) or subthreshold depression in type 1 and type 2 diabetes. METHODS Systematic review and meta-analysis. We searched PubMed, PsycINFO, Embase, and the Cochrane Library for randomized controlled trials evaluating the outcome of depression treatments in diabetes and comorbid MDD or subthreshold symptoms published before August 2019 compared to care as usual (CAU), placebo, waiting list (WL), or active comparator treatment as in a comparative effectiveness trial (CET). Primary outcomes were depressive symptom severity and glycemic control. Cohen's d is reported. RESULTS Forty-three randomized controlled trials (RCTs) were selected, and 32 RCTs comprising 3,543 patients were included in the meta-analysis. Our meta-analysis showed that, compared to CAU, placebo or WL, all interventions showed a significant effect on combined outcome 0,485 (95% CI 0.360; 0.609). All interventions showed a significant effect on depression. Pharmacological treatment, group therapy, psychotherapy, and collaborative care had a significant effect on glycemic control. High baseline depression score was associated with a greater reduction in HbA1 c and depressive outcome. High baseline HbA1 c was associated with a greater reduction in HbA1 c. CONCLUSION All treatments are effective for comorbid depression in type 1 diabetes and type 2 diabetes. Over the last decade, new interventions with large effect sizes have been introduced, such as group-based therapy, online treatment, and exercise. Although all interventions were effective for depression, not all treatments were effective for glycemic control. Effective interventions in comorbid depressive disorder may not be as effective in comorbid subthreshold depression. Baseline depression and HbA1 c scores modify the treatment effect. Based on the findings, we provide guidance for treatment depending on patient profile and desired outcome, and discuss possible avenues for further research.
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Affiliation(s)
| | - Sarah F. Allen
- Department of Health SciencesHull York Medical SchoolUniversity of YorkYorkUK
| | - Richard I. G. Holt
- Human Development and HealthFaculty of MedicineUniversity of SouthamptonSouthamptonUK
| | - Richard Roberts
- Department of Family Medicine & Community HealthUniversity of WisconsinMadisonWIUSA
| | - Arie Nouwen
- Department of PsychologyMiddlesex UniversityLondonUK
| | - Norman Sartorius
- Association for the Improvement of Mental Health ProgrammesGenevaSwitzerland
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Gonzalez Heredia T, González-Ramírez LP, Hernández-Corona DM, Maciel-Hernández EA. Anxious depression in patients with Type 2 Diabetes Mellitus and its relationship with medication adherence and glycemic control. Glob Public Health 2020; 16:460-468. [PMID: 32841093 DOI: 10.1080/17441692.2020.1810735] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A relationship between anxious depression has been proposed in patients with diabetes, which may contribute to the lack of medication adherence. The aim of this study was to investigate if there is a relationship between depression and / or anxiety with medication adherence and glycemic control in patients with type 2 Diabetes Mellitus (DM2). An analytical, cross-sectional study was carried out in the internal medicine outpatient clinic of a Hospital in Mexico. Patients with DM2 participated over a period from November 2015 to January 2016. The Morisky scale for medication adherence, and the Goldberg anxiety and depression scale were conducted for each patient. Data was collected from a total of 179 patients. There was a significant difference between anxious depression and medication adherence (p < 0.001) using logistic regression with an R2 of 0.136. There was also a significant difference between anxiety and glycemic control (p < 0.001) with an R2 of 0.175, however no significant difference was found between glycemic control and anxious depression. Our findings demonstrate that patients who suffer from anxious depression also tend to have reduced medication adherence, and anxiety was associated with poor glycemic control in patients with DM2 within the Mexican population.
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Affiliation(s)
- Tonatiuh Gonzalez Heredia
- Department of Biomedical Science, Health Sciences Division, Tonala University Campus, University of Guadalajara, Guadalajara, Mexico
| | | | - Diana Mercedes Hernández-Corona
- Department of Biomedical Science, Health Sciences Division, Tonala University Campus, University of Guadalajara, Guadalajara, Mexico
| | - Eugenio Alejandro Maciel-Hernández
- Physician specializing in Internal Medicine, Clinical Coordination of Medicine, Mexican Institute of Social Security, Guadalajara, México
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Wang H, Chen H, Gao Y, Wang S, Wang X, Tang X, Fang W, Shi X, Yao J, Chen Q. The effect of wuling capsule on depression in Type 2 diabetic patients. Biosci Rep 2020; 40:BSR20191260. [PMID: 31894843 PMCID: PMC7029151 DOI: 10.1042/bsr20191260] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 12/03/2019] [Accepted: 12/19/2019] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE Depression is a common complication in Type 2 diabetes mellitus (T2DM); however, it has long been underrecognized and undertreated. In the present study, we aimed to evaluate the clinical effects of Wuling capsule, a compound traditional Chinese herbal medicine, on T2DM complicated with depression. METHOD 66 patients were enrolled and randomly divided into Wuling capsule treatment group and placebo group, and finally 64 cases finished the present study. The levels of FPG, 2hPG, HbAlc, TNF-α, IL-6, SOD, MDA, Cor, ACTH, HOMA-β, HOMA-IR and ISI of patients were evaluated and compared. The HAMD scale for patients were recorded. RESULT After 12-week treatment, the HAMD scale decreased in both groups, and was lower in Wuling capsule group. The level of FPG in Wuling capsule group was significantly lower than in placebo group; however, no obvious changes of 2hPG and HbA1c were found. The levels of IL-6 and TNF-α were significantly decreased in both groups, and more obviously in Wuling capsule group. The level of SOD was increased while the level of MDA was decreased significantly in both groups, and the changes were more obviously in Wuling capsule group. The levels of Cor and ACTH were significantly decreased in both groups; however, there was no statistically significance between the two groups. Besides, the comparisons of HOMA-β, HOMA-IR and ISI between the two groups were not statistically significant. CONCLUSION Our results suggested that Wuling capsule ameliorated the depression in patients with T2DM, and also improved the state of inflammation and oxidative stress state. These results also strongly indicated the ability of clinical transformation of Wuling capsule in patients with T2DM in the future.
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Affiliation(s)
- Huanping Wang
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, China
| | - Huizhen Chen
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, China
| | - Yang Gao
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, China
| | - Shengju Wang
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, China
| | - Xian Wang
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, China
| | - Xiaomei Tang
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, China
| | - Wei Fang
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, China
| | - Xiaoyan Shi
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, China
| | - Jia Yao
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, China
| | - Qiu Chen
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, China
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Simayi A, Mohemaiti P. Risk and protective factors of co-morbid depression in patients with type 2 diabetes mellitus: a meta analysis. Endocr J 2019; 66:793-805. [PMID: 31178523 DOI: 10.1507/endocrj.ej18-0579] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The aim from this paper is to identify the main influencing factors of co-morbid depression among T2DM (Type 2 Diabetes Mellitus) patients and to provide reliable evidence for relative researches. A systematic review and meta-analysis of risk factors for co-morbid depression in T2DM was performed on all retrieved studies through an observational research of network database. Data were analyzed by Review Manager 5.3 from the extracted results, the heterogeneity index of the studies was determined using Chi-squared I2 tests and on the basis of heterogeneity, a fixed or random effect model was used to estimates the pooled effect of each influencing factor. Fourteen observational studies containing total of 82,239,298 cases that have been identified. Diabetic complications (OR = 2.91; 95%CI, 1.76-4.82, p < 0.0001), insulin use (OR = 1.71; 95%CI, 1.18-2.48, p = 0.005), education status (OR = 1.91; 95%CI, 1.30-2.81, p = 0.001) were confirmed as risk factors, while regular exercising (OR = 0.51; 95%CI, 0.27-0.96, p = 0.04), gender (OR = 0.56; 95%CI, 0.47-0.65, p < 0.0001), marital status (OR = 0.53; 95%CI, 0.34-0.83, p = 0.005), current social status (OR = 0.64; 95%CI, 0.47-0.88, p = 0.006) were confirmed as protective factors of co-morbid depression in the patients with T2DM. Subgroup analysis claimed age (≥60 years) was a risk factor and smoking was protective factor for co-morbid depression in the patients with T2DM. Being female, have diabetic complications, insulin use, education level less than secondary are risk factors. However, doing regular exercise, being married and on work are protective factors of co-morbid depression in patients with T2DM. As to the other influencing factors should be further studied.
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Affiliation(s)
- Aidibai Simayi
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Patamu Mohemaiti
- School of Public Health, Xinjiang Medical University, Urumqi, China
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Abstract
INTRODUCTION Agomelatine is an antidepressant with unique pharmacological actions; it is both a melatonin agonist and selective serotonin antagonist. Both actions combined are necessary for antidepressant efficacy. Effects on melatonin receptors enable resynchronisation of disrupted circadian rhythms with beneficial effects on sleep patterns. Areas covered: The issue of use of an antidepressant for depression co-morbid with somatic disorders is covered by the authors. A review of the literature from 2000 to August 2018 was undertaken using Scopus and Web of Science with the key words: agomelatine, depression, medical illness. Depression in Parkinson's disease, cardiovascular illness and type II diabetes is reviewed with evidence of efficacy. Bipolar depression and seasonal affective disorder may also react favourably. Agomelatine may have specific efficacy on symptoms of anhedonia. Expert opinion: Despite approval in some major jurisdictions, the drug has failed to gain registration in the United States. A defining issue may be questions about longer term efficacy: unequivocal effectiveness in placebo-controlled relapse prevention studies has not always been demonstrated. Continuation studies suggest maintenance of clinical responsiveness. A major disadvantage of the drug is its' potential hepatotoxicity and the need for repeated clinical laboratory tests.
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Affiliation(s)
- Trevor R Norman
- a Department of Psychiatry , University of Melbourne, Austin Hospital , Heidelberg , Australia
| | - James S Olver
- a Department of Psychiatry , University of Melbourne, Austin Hospital , Heidelberg , Australia
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Sivolap YP. [Antidepressants: the goals and possibilities of therapy]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 118:120-124. [PMID: 30698571 DOI: 10.17116/jnevro2018118121120] [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: 11/17/2022]
Abstract
Antidepressants are among the most commonly prescribed drugs due to their effectivenes in treating depression and anxiety disorders. One of the reasons for early discontinuation of taking antidepressants are side-effects. Agomelatine is a relatively novel antidepressant with high efficacy and good tolerance. Clinical effects of agomelatine include a reduction in symptoms of depression, anti-anxiety and hypnotic effects, as well as the rapid elimination of anhedonia, which determines high adherence to therapy, restoration of normal social functioning, and complete remission of disease.
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Affiliation(s)
- Yu P Sivolap
- Sechenov First Moscow State Medical University, Moscow, Russia
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Wan TJ, Yu YC, Zhao XG, Tang P, Gong YS. Efficacy of betahistine plus cognitive behavioral therapy on residual dizziness after successful canalith repositioning procedure for benign paroxysmal positional vertigo. Neuropsychiatr Dis Treat 2018; 14:2965-2971. [PMID: 30464481 PMCID: PMC6223332 DOI: 10.2147/ndt.s182809] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Some patients still complain of residual dizziness after successful canalith repositioning procedure (CRP) for benign paroxysmal positional vertigo (BPPV). Previous study found that compared to the low-dose betahistine, the high-dose betahistine could yield better efficacy in treating residual dizziness. Therefore, this study was conducted to assess whether the addition of cognitive behavioral therapy (CBT) could make low-dose betahistine produce similar results to high-dose betahistine in treating residual dizziness. METHODS The recruited patients were randomly assigned to receive either low-dose betahistine (6 mg/time, three times/day) or high-dose betahistine (12 mg/time, three times/day). Patients in the low-dose group also received CBT (twice a week, 1 hour per time). The treatment was continued for 4 weeks. The duration of residual dizziness, 25-item Dizziness Handicap Inventory (DHI), Hamilton Anxiety Rating Scale (HARS), and Hamilton Depression Rating Scale (HDRS) were recorded and analyzed. The duration of residual dizziness and DHI score were the primary outcomes, and the HARS and HDRS scores were the secondary outcomes. RESULTS Each group had 50 patients. After treatment, the average DHI scores, HDRS scores, and HARS scores were significantly decreased in both groups. The duration of residual dizziness and average DHI score were nonsignificantly different (P=0.08; P=0.06) between the two groups, although they were lower in the low-dose group. Compared to the high-dose group, the low-dose group had the significantly lower average HDRS score (P=0.007) and HARS score (P=0.02). Meanwhile, four patients in the high-dose group experienced intolerable stomach upset. CONCLUSION These results demonstrated that the addition of CBT could make low-dose beta-histine produce similar results to high-dose betahistine in treating residual dizziness. Moreover, the low-dose betahistine plus CBT showed some advantages over high-dose betahistine in relieving depressive and anxiety symptoms and should be further explored.
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Affiliation(s)
- Tian-Ju Wan
- Department of Emergency, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Yi-Chuan Yu
- Department of Emergency, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Xiao-Gang Zhao
- Department of Emergency, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Ping Tang
- Department of Emergency, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Yong-Shu Gong
- Department of Pediatrics, Yongchuan Hospital of Chongqing Medical University, Chongqing, China,
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