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Moulard M, Cosker E, Angioi-Duprez K, Laprévote V, Schwan R, Schwitzer T. Retinal markers of therapeutic responses in major depressive disorder: Effects of antidepressants on retinal function. J Psychiatr Res 2022; 154:71-79. [PMID: 35932524 DOI: 10.1016/j.jpsychires.2022.07.022] [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: 11/15/2021] [Revised: 06/28/2022] [Accepted: 07/04/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND One goal of research into major depressive disorder (MDD) is to develop markers to predict and monitor the response to psychotropic treatments. The retina is endowed with a complex neurotransmission system, composed of the main neurotransmitters involved in the pathophysiology of MDD. The retina is therefore a relevant site of investigation for the identification of reliable and robust markers. However, the effects of antidepressants on the human retina are poorly studied. Here, we seek to study the potential specific effects of various antidepressants on retinal function in MDD patients. METHODS We assessed retinal function using flash (fERG), pattern (PERG) and multifocal (mfERG) electroretinogram in 19 MDD patients treated using antidepressants at baseline and at weeks 4, 8 and 12. RESULTS We observed reduced b-wave amplitude of photopic fERG 3.0 in patients treated with Selective Serotonin Reuptake Inhibitor (SSRI) in comparison with patients treated with Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) or Tricyclic Antidepressant (TCAD). We also showed that SNRIs were associated both with a decrease in PERG P50 implicit time and an increase in fERG 3.0 b-wave amplitude. TCADs were associated with an increase in fERG flicker 3.0 a- and b-wave amplitude. CONCLUSIONS This is the first study in real-life conditions to show a specific effect of various antidepressants on retinal function evaluated by electroretinogram. Further investigations should be led to specify the effects of antidepressants on ERG in order to isolate reliable and reproducible markers for predicting and monitoring the response to antidepressants.
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Affiliation(s)
- Marie Moulard
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; Faculté de Médecine, Université de Lorraine, F-54500 Vandoeuvre-lès, Nancy, France
| | - Eve Cosker
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France
| | - Karine Angioi-Duprez
- Service d'Ophtalmologie, CHRU Nancy, Nancy, France; Faculté de Médecine, Université de Lorraine, F-54500 Vandoeuvre-lès, Nancy, France
| | - Vincent Laprévote
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; Faculté de Médecine, Université de Lorraine, F-54500 Vandoeuvre-lès, Nancy, France; INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France
| | - Raymund Schwan
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; Faculté de Médecine, Université de Lorraine, F-54500 Vandoeuvre-lès, Nancy, France; IADI INSERM U1254, Université de Lorraine, Nancy, France; Fondation FondaMental, Créteil, France
| | - Thomas Schwitzer
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; Faculté de Médecine, Université de Lorraine, F-54500 Vandoeuvre-lès, Nancy, France; IADI INSERM U1254, Université de Lorraine, Nancy, France; Fondation FondaMental, Créteil, France.
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Complete evaluation of retinal function in Major Depressive Disorder: From central slowdown to hyperactive periphery. J Affect Disord 2021; 295:453-462. [PMID: 34507226 DOI: 10.1016/j.jad.2021.08.054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/30/2021] [Accepted: 08/21/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Developing easy-to-access biomarkers is crucial in Major Depressive Disorder. The retina has already been suggested as relevant. However, there is a need for a global and local assessment of whole retinal function using a reproducible, standardized protocol allowing for comparison across studies. Our aim is to assess whole retinal function in patients with actual unipolar Major Depressive Episode (MDE) using pattern, flash and multifocal electroretinogram (ERG) according to the International Society for Clinical Electrophysiology of Vision standardized protocols. METHODS We assessed retinal function in 14 males and females with MDE, diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders, and in age- and sex-matched healthy controls. RESULTS Comparing the patients with the controls, we observed the following using multifocal ERG: a significant increase in N1 peak time in ring 3 and a decrease in P1 amplitude in ring 2; using pattern ERG: a significant increase in P50 peak time; using flash ERG: a decrease in a- and b-wave peak time and an increase in the b-wave amplitude in dark-adapted 3.0, a decrease in a- and b-wave peak time and an increase in both wave amplitudes in light-adapted 3.0, and a decrease in the b-wave peak time in light-adapted flicker. LIMITATIONS Sample size. Contribution of pharmacological treatments to the outcomes cannot be formally excluded. CONCLUSIONS Patients with MDE exhibit delayed signaling in the central retina and hyperreactivity to light in the periphery. Central retinal function may be a marker of psychomotor retardation and cognitive impairment in MDE.
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Dmitrzak-Weglarz M, Banach E, Bilska K, Narozna B, Szczepankiewicz A, Reszka E, Jablonska E, Kapelski P, Skibinska M, Pawlak J. Molecular Regulation of the Melatonin Biosynthesis Pathway in Unipolar and Bipolar Depression. Front Pharmacol 2021; 12:666541. [PMID: 33981243 PMCID: PMC8107693 DOI: 10.3389/fphar.2021.666541] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/06/2021] [Indexed: 12/11/2022] Open
Abstract
Melatonin is a neurohormone that maintains the circadian rhythms of the body. By regulating the secretion of other hormones and neurotransmitters, it acts as a pleiotropic modulator that affects, for example, reproductive, immune, cardiovascular, sleep, and wake systems and mood. Thus, synthetic melatonin has become an essential component in the treatment of depressive disorders. Although we know the pathway of melatonin action in the brain, we lack comprehensive cross-sectional studies on the periphery of depressed patients. This study aimed to comprehensively analyze the differences between healthy control subjects (n = 84) and unipolar and bipolar depression patients (n = 94), including an analysis of the melatonin pathway at the level of the genes and serum biomarkers. An innovative approach is a pilot study based on gene expression profiling carried out on clinical and cell culture models using agomelatine and melatonin. We confirmed the melatonin biosynthesis pathway's molecular regulation dysfunctions, with a specific pattern for unipolar and bipolar depression, at the AANAT gene, its polymorphisms (rs8150 and rs3760138), and examined the serum biomarkers (serotonin, AANAT, ASMT, and melatonin). The biological pathway analysis uncovered pathways and genes that were uniquely altered after agomelatine treatment in a clinical model and melatonin treatment in a cell culture model. In both models, we confirmed the immunomodulatory effect of melatonin agents in depression.
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Affiliation(s)
| | - Ewa Banach
- Laboratory of Neurobiology, Department of Molecular and Cellular Neurobiology, Nencki Institute, Warsaw, Poland
| | - Karolina Bilska
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Beata Narozna
- Laboratory of Molecular and Cell Biology, Department of Pediatric Pulmonology, Allergy and Clinical Immunology, Poznan University of Medical Sciences, Poznan, Poland
| | - Aleksandra Szczepankiewicz
- Laboratory of Molecular and Cell Biology, Department of Pediatric Pulmonology, Allergy and Clinical Immunology, Poznan University of Medical Sciences, Poznan, Poland
| | - Edyta Reszka
- Department of Molecular Genetics and Epigenetics, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Ewa Jablonska
- Department of Molecular Genetics and Epigenetics, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Paweł Kapelski
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Maria Skibinska
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Joanna Pawlak
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
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Shin H, Seo H, Chung WG, Joo BJ, Jang J, Park JU. Recent progress on wearable point-of-care devices for ocular systems. LAB ON A CHIP 2021; 21:1269-1286. [PMID: 33704299 DOI: 10.1039/d0lc01317j] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The eye is a complex sensory organ that contains abundant information for specific diseases and pathological responses. It has emerged as a facile biological interface for wearable healthcare platforms because of its excellent accessibility. Recent advances in electronic devices have led to the extensive research of point-of-care (POC) systems for diagnosing and monitoring diseases by detecting the biomarkers within the eye. Among these systems, contact lenses, which make direct contact with the ocular surfaces, have been utilized as one of the promising candidates for non-invasive POC testing of various diseases. The continuous and long-term measurement from the sensor allows the patients to manage their symptoms in an effective and convenient way. Herein, we review the progress of contact lens sensors in terms of the materials, methodologies, device designs, and target biomarkers. The anatomical structure and biological mechanisms of the eye are also discussed to provide a comprehensive understanding of the principles of contact lens sensors. Intraocular pressure and glucose, which are the representative biomarkers found in the eyes, can be measured with the biosensors integrated with contact lenses for the diagnosis of glaucoma and diabetes. Furthermore, contact lens sensors for various general pathologies as well as other ocular diseases are also considered, thereby providing the prospects for further developments of smart contact lenses as a future POC system.
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Affiliation(s)
- Haein Shin
- Nano Science Technology Institute, Department of Materials Science and Engineering, Yonsei University, Seoul, 03722, Republic of Korea.
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Could Agomelatine Play a Role to Treat Anhedonia in Heroin Dependence? ADDICTIVE DISORDERS & THEIR TREATMENT 2021. [DOI: 10.1097/adt.0000000000000245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cosker E, Schwan R, Angioi-Duprez K, Laprévote V, Schwitzer T. New insights on the role of the retina in diagnostic and therapeutic strategies in major depressive disorder. Neurosci Biobehav Rev 2020; 113:262-272. [PMID: 32147530 DOI: 10.1016/j.neubiorev.2020.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 02/26/2020] [Accepted: 03/04/2020] [Indexed: 12/11/2022]
Abstract
Major depressive disorder (MDD) affects people worldwide. MDD treatments include antidepressants, which involve a delayed onset of action, long-term treatment, side effects and, frequently, only partial efficacy. The lack of access to the living brain, and the complex and still poorly elucidated pathophysiology of MDD, hinders treatment development. There is not only a need for new treatment strategies, but also for new approaches to investigating the pathophysiology of MDD. Light therapy is a well-established treatment acting through the retina. Since the retina is part of the central nervous system, it has been suggested as a useful area for investigating mental illness. In this article, we will first set out the evidence that MDD affects the retina's structure and function. We will then review studies evaluating the efficacy of light therapy in unipolar non-seasonal MDD. Finally, we discuss the disruption of melatoninergic pathways in MDD, its assessment through the retina and the treatment of this disruption with light therapy.
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Affiliation(s)
- Eve Cosker
- Pôle Hospitalo-Universitaire De Psychiatrie d'Adultes et d'Addictologie Du Grand Nancy, Centre Psychothérapique De Nancy, Laxou, France; INSERM U1114, Fédération De Médecine Translationnelle De Strasbourg, Pôle De Psychiatrie, Centre Hospitalier Régional Universitaire De Strasbourg, Strasbourg, France
| | - Raymund Schwan
- Pôle Hospitalo-Universitaire De Psychiatrie d'Adultes et d'Addictologie Du Grand Nancy, Centre Psychothérapique De Nancy, Laxou, France; INSERM U1114, Fédération De Médecine Translationnelle De Strasbourg, Pôle De Psychiatrie, Centre Hospitalier Régional Universitaire De Strasbourg, Strasbourg, France; Faculté de Médecine, Université de Lorraine, Nancy, France
| | | | - Vincent Laprévote
- Pôle Hospitalo-Universitaire De Psychiatrie d'Adultes et d'Addictologie Du Grand Nancy, Centre Psychothérapique De Nancy, Laxou, France; INSERM U1114, Fédération De Médecine Translationnelle De Strasbourg, Pôle De Psychiatrie, Centre Hospitalier Régional Universitaire De Strasbourg, Strasbourg, France; Faculté de Médecine, Université de Lorraine, Nancy, France
| | - Thomas Schwitzer
- Pôle Hospitalo-Universitaire De Psychiatrie d'Adultes et d'Addictologie Du Grand Nancy, Centre Psychothérapique De Nancy, Laxou, France; INSERM U1114, Fédération De Médecine Translationnelle De Strasbourg, Pôle De Psychiatrie, Centre Hospitalier Régional Universitaire De Strasbourg, Strasbourg, France; Faculté de Médecine, Université de Lorraine, Nancy, France.
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Halder SK, Matsunaga H, Ueda H. Experimental evidence for the involvement of F 0/F 1 ATPase and subsequent P2Y 12 receptor activation in prothymosin alpha-induced protection of retinal ischemic damage. J Pharmacol Sci 2020; 143:127-131. [PMID: 32156464 DOI: 10.1016/j.jphs.2020.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/07/2020] [Accepted: 01/22/2020] [Indexed: 11/18/2022] Open
Abstract
The inhibition of retinal ischemia-induced damage by post-ischemic prothymosin alpha (ProTα) was not affected in toll-like receptor 4 knockout (TLR4-/-) mice but blocked by the pretreatment with antibody against F0/F1 ATPase α- or β-subunit, novel candidate for ProTα-receptor. In addition to the previous observation of ProTα-induced ATP release from cells, the present study showed a ProTα-induced enhancement of ATP hydrolysis activity of recombinant ATP5A1/5B complex. As the protection of retinal function by post-ischemic ProTα was abolished by anti-P2Y12 antibody, the activation of F0/F1 ATPase and subsequent P2Y12 receptor system may play roles in beneficial actions by post-ischemic ProTα.
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Affiliation(s)
- Sebok Kumar Halder
- Department of Pharmacology and Therapeutic Innovation, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8521, Japan; San Diego Biomedical Research Institute, 10865 Road to the Cure #100, San Diego, CA 92121, USA
| | - Hayato Matsunaga
- Department of Pharmacology and Therapeutic Innovation, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8521, Japan; Department of Medical Pharmacology, Nagasaki University of Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan
| | - Hiroshi Ueda
- Department of Pharmacology and Therapeutic Innovation, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8521, Japan; Department of Molecular Pharmacology, Kyoto University Graduate School of Pharmaceutical Sciences, Kyoto 606-8501, Japan.
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Youssef P, Nath S, Chaimowitz GA, Prat SS. Electroretinography in psychiatry: A systematic literature review. Eur Psychiatry 2019; 62:97-106. [PMID: 31553929 DOI: 10.1016/j.eurpsy.2019.09.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 09/07/2019] [Indexed: 02/01/2023] Open
Abstract
This review aims to consolidate the available information on use of electroretinography as a diagnostic tool in psychiatry. The electroretinogram (ERG) has been found to have diagnostic utility in cocaine withdrawal (reduced light-adapted b-wave response), major depressive disorder (reduced contrast gain in pattern ERG), and schizophrenia (reduced a- and b-wave amplitudes). This review examines these findings as well as the applicability of ERG to substance use disorder, Alzheimer's disease, autism spectrum disorder, panic disorder, eating disorders, attention deficit hyperactivity disorder, and medication use. While there have been promising results, current research suffers from a lack of specificity. Further research that quantifies anomalies in ERG present in psychiatric illness is needed.
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Affiliation(s)
- Peter Youssef
- Bachelor of Health Sciences Program, McMaster University, Hamilton, Ontario, Canada
| | - Siddharth Nath
- MD/PhD Program, McMaster University, Hamilton, Ontario, Canada
| | - Gary A Chaimowitz
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Sebastien S Prat
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada; Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.
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Effect of agomelatine treatment on C-reactive protein levels in patients with major depressive disorder: an exploratory study in "real-world," everyday clinical practice. CNS Spectr 2017; 22:342-347. [PMID: 27702411 DOI: 10.1017/s1092852916000572] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Agomelatine is a newer antidepressant but, to date, no studies have been carried out investigating its effects on C-reactive protein (CRP) levels in major depressive disorder (MDD) before and after treatment. The present study aimed (i) to investigate the effects of agomelatine treatment on CRP levels in a sample of patients with MDD and (ii) to investigate if CRP variations were correlated with clinical improvement in such patients. METHODS 30 adult outpatients (12 males, 18 females) with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) diagnosis of MDD were recruited in "real-world," everyday clinical practice and treated with a flexible dose of agomelatine for 12 weeks. The Hamilton Rating Scale for Depression (HAM-D) and the Snaith-Hamilton Pleasure Scale (SHAPS) were used to evaluate depressive symptoms and anhedonia, respectively. Moreover, serum CRP was measured at baseline and after 12 weeks of treatment. RESULTS Agomelatine was effective in the treatment of MDD, with a significant reduction in HAM-D and SHAPS scores from baseline to endpoint. CRP levels were reduced in the whole sample, with remitters showing a significant difference in CRP levels after 12 weeks of agomelatine. A multivariate stepwise linear regression analysis showed that higher CRP level variation was associated with higher baseline HAM-D scores, controlling for age, gender, smoking, BMI, and agomelatine dose. CONCLUSIONS Agomelatine's antidepressant properties were associated with a reduction in circulating CRP levels in MDD patients who achieved remission after 12 weeks of treatment. Moreover, more prominent CRP level variation was associated with more severe depressive symptoms at baseline.
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Hébert M, Mérette C, Paccalet T, Gagné AM, Maziade M. Electroretinographic anomalies in medicated and drug free patients with major depression: Tagging the developmental roots of major psychiatric disorders. Prog Neuropsychopharmacol Biol Psychiatry 2017; 75:10-15. [PMID: 28007463 DOI: 10.1016/j.pnpbp.2016.12.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 11/01/2016] [Accepted: 12/05/2016] [Indexed: 11/17/2022]
Abstract
The retina is tagged as an approachable part of the brain due to its common embryonic origin and appears as a promising site of investigation for psychiatric disorders. Retinal function is assessed best with the electroretinogram (ERG), which was obtained in a large sample of patients with major depressive disorder and matched controls. ERG cone and rod luminance response functions were recorded in non-dilated eyes in 100 major depressive disorder patients (MDD) and 100 controls, (mean age of 42.8 and 40.9y. o. respectively). Amongst MDD patients, 17 were drug free (mean age 41.2y. o). In medicated patients, at the cone level, a prolonged b-wave was observed (p≤0.01). In drug free patients a prolonged b-wave was discovered only when averaging the implicit time of the 3 highest b-wave amplitudes of the photopic hill. For the medicated patients, the mixed rods/cones a-wave was reduced (p=0.01) whereas a trend (p=0.06) was observed for the pure rod b-wave (reduced) and the mixed rods/cones (reduced and prolonged; p=0.05). In drug free patients, a similar pattern could be observed in terms of effect sizes. Overall, medicated and drug free MDD patients shared some deficits suggesting that some anomalies are present above and beyond the effect of medication. Of interest, the prolonged cone and reduced rod amplitude were reported by our group in schizophrenia patients, suggesting a common neurodevelopmental root of major psychiatric disorders.
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Affiliation(s)
- Marc Hébert
- Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada; Département d'ophtalmologie et ORL - chirurgie cervico-faciale, Université Laval, Québec, Canada.
| | - Chantal Mérette
- Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada; Département de psychiatrie et neurosciences, Université Laval, Québec, Canada
| | - Thomas Paccalet
- Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada
| | - Anne-Marie Gagné
- Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada
| | - Michel Maziade
- Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada; Département de psychiatrie et neurosciences, Université Laval, Québec, Canada
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Komaram RB, Nukala S, Palla J, Nambaru LR, Kasturi SM. A Comparative Study of Efficacy and Safety of Agomelatine and Escitalopram in Major Depressive Disorder. J Clin Diagn Res 2015; 9:VC05-VC08. [PMID: 26266196 DOI: 10.7860/jcdr/2015/12371.6092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 04/29/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a mental disorder characterized by episodes of depressed mood, loss of interest or pleasure, feeling of guilt or low self-esteem, loss of energy, altered sleep patterns and difficulty in concentration. OBJECTIVE This study was carried out to compare the efficacy and safety of Agomelatine with Escitalopram in the treatment of major depressive disorder. DESIGN AND SETTING This is a prospective study conducted at Outpatient Department of Psychiatry, GSL Medical College & General hospital, Rajahmundry, India. MATERIALS AND METHODS Patients with newly diagnosed major depressive disorder (DSM-IV-TR) with minimum score of 20 in Hamilton depression rating scale were randomly assigned Agomelatine (25-50 mg/day) or Escitalopram (10-20 mg/day) for a period of 8 weeks. The main efficacy outcome considered was the mean change of HAM-D17 score from baseline to end of therapy. Secondary outcome measures were Clinical Global Impressions-improvement (CGI) and severity (CGI-S) rating scales. STATISTICAL ANALYSIS Student t-test was used for comparing the groups and chi-square test was used for assessing the qualitative variables. For all statistical analysis p<0.05 was considered statistically significant. RESULTS The drugs under study effectively reduced depressive symptoms at all the time points. The percentage of responders at 8weeks (last post baseline value) was 65.38% with Agomelatine and 57.40% with Escitalopram. The difference between the drugs was statistically not significant in all evaluations (p>0.05). The mean CGI-S and CGI-I scores were decreased in both the groups (p<0.05) and there was no statistically significant difference between the groups at any assessment during the study period. Both the treatment groups showed favourable safety profile. CONCLUSION The study results supported that Agomelatine is therapeutically similar to Escitalopram in terms of antidepressant effect.
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Affiliation(s)
- Ravi Babu Komaram
- Associate Professor, Department of Pharmacology, GSL Medical college & General Hospital , Rajahmundry, Andhra Pradesh, India
| | - Srikrishna Nukala
- Associate Professor, Department of Psychiatry, GSL Medical college & General Hospital , Rajahmundry, Andhra Pradesh, India
| | - Jayasree Palla
- Postgraduate Student, Department of Community Medicine, GSL Medical college & General Hospital , Rajahmundry, Andhra Pradesh, India
| | - Lakshmana Rao Nambaru
- Assistant Professor in statistics, Department of Community Medicine, RIMS , Ongole, Andhra Pradesh, India
| | - Satyanarayana Murthy Kasturi
- Professor & HOD, Department of Pharmacology, GSL Medical college & General Hospital , Rajahmundry, Andhra Pradesh, India
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De Berardis D, Fornaro M, Serroni N, Campanella D, Rapini G, Olivieri L, Srinivasan V, Iasevoli F, Tomasetti C, De Bartolomeis A, Valchera A, Perna G, Mazza M, Di Nicola M, Martinotti G, Di Giannantonio M. Agomelatine beyond borders: current evidences of its efficacy in disorders other than major depression. Int J Mol Sci 2015; 16:1111-30. [PMID: 25569089 PMCID: PMC4307293 DOI: 10.3390/ijms16011111] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 12/23/2014] [Indexed: 12/14/2022] Open
Abstract
Agomelatine, a melatonergic antidepressant with a rapid onset of action, is one of the most recent drugs in the antidepressant category. Agomelatine's antidepressant actions are attributed to its sleep-promoting and chronobiotic actions mediated by MT1 and MT2 receptors present in the suprachiasmatic nucleus, as well as to its effects on the blockade of 5-HT2c receptors. Blockade of 5-HT2c receptors causes release of both noradrenaline and dopamine at the fronto-cortical dopaminergic and noradrenergic pathways. The combined actions of agomelatine on MT1/MT2 and 5-HT2c receptors facilitate the resynchronization of altered circadian rhythms and abnormal sleep patterns. Agomelatine appeared to be effective in treating major depression. Moreover, evidence exists that points out a possible efficacy of such drug in the treatment of bipolar depression, anxiety disorders, alcohol dependence, migraines etc. Thus, the aim of this narrative review was to elucidate current evidences on the role of agomelatine in disorders other than major depression.
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Affiliation(s)
- Domenico De Berardis
- National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, 64100 Teramo, Italy.
| | - Michele Fornaro
- Department of "Scienze della Formazione", University of Catania, 95121 Catania, Italy.
| | - Nicola Serroni
- Department of Neuroscience and Imaging, University "G. D'Annunzio", 66013 Chieti, Italy.
| | - Daniela Campanella
- Department of Neuroscience and Imaging, University "G. D'Annunzio", 66013 Chieti, Italy.
| | - Gabriella Rapini
- Department of Neuroscience and Imaging, University "G. D'Annunzio", 66013 Chieti, Italy.
| | - Luigi Olivieri
- National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, 64100 Teramo, Italy.
| | - Venkataramanujam Srinivasan
- Sri Sathya Sai Medical Educational and Research Foundation, Medical Sciences Research Study Center, Prasanthi Nilayam, 40-Kovai Thirunagar Coimbatore-641014, 641014 Tamilnadu, India
| | - Felice Iasevoli
- Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", 80131 Naples, Italy.
| | - Carmine Tomasetti
- Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", 80131 Naples, Italy.
| | - Andrea De Bartolomeis
- Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", 80131 Naples, Italy.
| | - Alessandro Valchera
- Hermanas Hospitalarias, FoRiPsi, Villa S. Giuseppe Hospital, 63100 Ascoli Piceno, Italy.
| | - Giampaolo Perna
- Hermanas Hospitalarias, FoRiPsi, Department of Clinical Neurosciences, Villa San Benedetto Menni, Albese con Cassano, 22032 Como, Italy.
| | - Monica Mazza
- National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, 64100 Teramo, Italy.
| | - Marco Di Nicola
- National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, 64100 Teramo, Italy.
| | - Giovanni Martinotti
- Department of Neuroscience and Imaging, University "G. D'Annunzio", 66013 Chieti, Italy.
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