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Maciaszek J, Pawłowski T, Hadryś T, Misiak B. Baseline depressive symptoms as predictors of efficacy and tolerability of the treatment with duloxetine: a network analysis approach. Front Psychiatry 2023; 14:1210289. [PMID: 37398593 PMCID: PMC10312095 DOI: 10.3389/fpsyt.2023.1210289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 06/02/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Depression is considered one of the most prevalent and burdensome mental disorders. Only 50-60% of patients respond to first-line treatment. Individuals with depression might benefit from personalized treatment, tailored to the individual needs of the patient. In this study, we aimed to explore the baseline characteristics of depressive symptoms associated with a good response to duloxetine treatment using a network analysis. Additionally, the relationship between baseline psychopathological symptoms and treatment tolerability was assessed. Methods The sample of 88 drug-free patients with active depressive episode, who started monotherapy with increasing doses of duloxetine were evaluated. The Hamilton Depression Rating Scale (HAM-D) was used to assess depression severity and the UKU side effect rating scale to monitor adverse drug reactions (ADRs). A network analysis that explored interactions of specific baseline depression symptoms, treatment efficacy and tolerability was performed. Results The node representing duloxetine treatment efficacy was directly connected to the nodes representing the first HAM-D item ("depressed mood") (edge weight = 0.191) and duloxetine dose (edge weight = 0.144). The node representing ADRs was directly connected to only one node representing the baseline score of the HAM-D anxiety (psychic) item (edge weight = 0.263). Discussion Our findings indicate that individuals with depression presenting greater levels of depressed mood and lower levels of anxiety symptoms might better respond to the treatment with duloxetine in terms of efficacy and tolerability.
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Li B, Liu H, Luo X, Liu Y, Pan J, Yang M, Tian H, Hu C, Feng Y, Li C. Efficacy and safety of acupuncture for post-COVID-19 depression: a protocol for systematic review and meta-analysis. BMJ Open 2023; 13:e071169. [PMID: 37169492 PMCID: PMC10186080 DOI: 10.1136/bmjopen-2022-071169] [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] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION Post-COVID-19 depression (PCD) is a possible sequela of COVID-19. Some doctors have used acupuncture to treat PCD, but no systematic review or meta-analysis has yet evaluated its efficacy and safety for the treatment of PCD. The aim of this systematic review is to assess the efficacy and safety of acupuncture therapy for PCD. METHODS AND ANALYSIS Two reviewers will independently search the Cochrane Central Register of Controlled Trials (CENTRAL), Medline (PubMed), Excerpt Medica Database (EMBASE), China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Chinese Scientific Journal Database (VIP) and Wan-Fang Database from inception to 24 January 2023. Study selection, data extraction and assessment of study quality will be independently performed by two reviewers. If a meta-analysis is appropriate, Review Manager V.5.3 will be used for data synthesis; otherwise, a descriptive analysis will be conducted. Data will be synthesised using a fixed-effects or random-effects model, according to the results of a heterogeneity test. The results will be presented as risk ratios with 95% CIs for dichotomous data, and weighted mean differences or standardised mean differences with 95% CIs for continuous data. ETHICS AND DISSEMINATION The entire process used for this systematic review does not use private information, so ethical approval is not required. The results of this meta-analysis will be disseminated through publication in a peer-reviewed journal and/or conference presentations. PROSPERO REGISTRATION NUMBER CRD42022379312.
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Affiliation(s)
- Bei Li
- Zhijiang People's Hospital, Yichang, China
| | - Haijing Liu
- Yunnan University of Chinese Medicine, Kunming, China
| | - Xin Luo
- Yichun Hospital of Chinese Medicine, Yichun, China
| | - Yuhua Liu
- Zhijiang People's Hospital, Yichang, China
| | - Jin Pan
- Zhijiang Hospital of Chinese Medicine, Yichang, China
| | - Meidi Yang
- Zhijiang Hospital of Chinese Medicine, Yichang, China
| | | | - Chi Hu
- Zhijiang People's Hospital, Yichang, China
| | - Yang Feng
- Zhijiang People's Hospital, Yichang, China
| | - Cuiling Li
- Zhijiang People's Hospital, Yichang, China
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Stäuble CK, Lampert ML, Mikoteit T, Hatzinger M, Hersberger KE, Meyer zu Schwabedissen HE. Pharmacogenetic-Guided Antidepressant Selection as an Opportunity for Interprofessional Collaboration: A Case Report. Life (Basel) 2021; 11:673. [PMID: 34357045 PMCID: PMC8307172 DOI: 10.3390/life11070673] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 12/18/2022] Open
Abstract
In the herein reported case of a 42-year-old woman diagnosed with anxiety and depression, a long history of antidepressant ineffectiveness and adverse drug reactions was decisive for an in-depth medication review including pharmacogenetic panel testing. In detail, treatment attempts with paroxetine and escitalopram were ineffective and discontinued due to subjective gastrointestinal intolerance. Due to the worsening of the depression after the failed treatment attempts, admission to our clinic became necessary. Herein, owing to the collaboration of psychiatrists with clinical pharmacists, individualized incorporation of pharmacogenetic data into the process of antidepressant selection was enabled. We identified vortioxetine as a suitable therapeutic, namely for being most likely pharmacokinetically unaffected as predicted by pharmacogenetic panel testing and taking into account the current comedication, as well as for its favorable action profile. Herein, our collaborative effort proved to be successful and resulted in the patient's depression remission and clinic discharge with the interprofessionally selected pharmacotherapy. This exemplary case not only highlights the potential benefits and challenges of pre-emptive pharmacogenetic testing in antidepressant prescription, but also proposes an approach on how to put pharmacogenetics into practice.
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Affiliation(s)
- Céline K. Stäuble
- Biopharmacy, Department of Pharmaceutical Sciences, University of Basel, 4056 Basel, Switzerland;
- Pharmaceutical Care, Department of Pharmaceutical Sciences, University of Basel, 4001 Basel, Switzerland; (M.L.L.); (K.E.H.)
- Institute of Hospital Pharmacy, Solothurner Spitäler, 4600 Olten, Switzerland
| | - Markus L. Lampert
- Pharmaceutical Care, Department of Pharmaceutical Sciences, University of Basel, 4001 Basel, Switzerland; (M.L.L.); (K.E.H.)
- Institute of Hospital Pharmacy, Solothurner Spitäler, 4600 Olten, Switzerland
| | - Thorsten Mikoteit
- Psychiatric Services Solothurn, Solothurner Spitäler and Department of Medicine, University of Basel, 4503 Solothurn, Switzerland; (T.M.); (M.H.)
| | - Martin Hatzinger
- Psychiatric Services Solothurn, Solothurner Spitäler and Department of Medicine, University of Basel, 4503 Solothurn, Switzerland; (T.M.); (M.H.)
| | - Kurt E. Hersberger
- Pharmaceutical Care, Department of Pharmaceutical Sciences, University of Basel, 4001 Basel, Switzerland; (M.L.L.); (K.E.H.)
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Suryanto ME, Audira G, Uapipatanakul B, Hussain A, Saputra F, Siregar P, Chen KHC, Hsiao CD. Antidepressant Screening Demonstrated Non-Monotonic Responses to Amitriptyline, Amoxapine and Sertraline in Locomotor Activity Assay in Larval Zebrafish. Cells 2021; 10:cells10040738. [PMID: 33810553 PMCID: PMC8066259 DOI: 10.3390/cells10040738] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 12/15/2022] Open
Abstract
Antidepressants are well-known drugs to treat depression and major depressive disorder for humans. However, the misuse and abuse of antidepressants keep increasing with several side effects reported. The aim of this study was to assess the potential adverse effects of 18 antidepressants by monitoring zebrafish larval locomotor activity performance based on the total distance traveled, burst movement count, and total rotation count at four dark-light intercalated phases. In general, zebrafish larvae displayed sedative effects after antidepressant exposure by showing a significant reduction in all of the locomotor activity-related endpoints. However, three antidepressants i.e., amitriptyline, amoxapine, and sertraline were able to trigger a significantly high locomotor activity in zebrafish larvae during the light cycle. These differences might be due to the pharmacologic differences among the antidepressants. In addition, since each antidepressant possesses a different dosage range from the other, overdoses of these antidepressants might also be the causes of these differences. Furthermore, based on these results, a further study was conducted to observe the effect of these three antidepressants in lower concentrations. From the results, biphasic effects in terms of zebrafish larval locomotor activity were demonstrated by these drugs. Even though further studies are still required to validate the mechanism, these findings indicate that these antidepressants might share a common mechanism responsible for their effects on zebrafish larval locomotor activity although there were some differences in potency of these effects.
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Affiliation(s)
- Michael Edbert Suryanto
- Department of Bioscience Technology, Chung Yuan Christian University, Chung-Li 320314, Taiwan; (M.E.S.); (G.A.); (A.H.); (F.S.); (P.S.)
| | - Gilbert Audira
- Department of Bioscience Technology, Chung Yuan Christian University, Chung-Li 320314, Taiwan; (M.E.S.); (G.A.); (A.H.); (F.S.); (P.S.)
- Department of Chemistry, Chung Yuan Christian University, Chung-Li 320314, Taiwan
| | - Boontida Uapipatanakul
- Department of Chemistry, Faculty of Science and Technology, Rajamangala University of Technology Thanyaburi, Thanyaburi 12110, Thailand;
| | - Akhlaq Hussain
- Department of Bioscience Technology, Chung Yuan Christian University, Chung-Li 320314, Taiwan; (M.E.S.); (G.A.); (A.H.); (F.S.); (P.S.)
| | - Ferry Saputra
- Department of Bioscience Technology, Chung Yuan Christian University, Chung-Li 320314, Taiwan; (M.E.S.); (G.A.); (A.H.); (F.S.); (P.S.)
| | - Petrus Siregar
- Department of Bioscience Technology, Chung Yuan Christian University, Chung-Li 320314, Taiwan; (M.E.S.); (G.A.); (A.H.); (F.S.); (P.S.)
| | - Kelvin H.-C. Chen
- Department of Applied Chemistry, National Pingtung University, Pingtung 900391, Taiwan
- Correspondence: (K.H.-C.C.); (C.-D.H.)
| | - Chung-Der Hsiao
- Department of Bioscience Technology, Chung Yuan Christian University, Chung-Li 320314, Taiwan; (M.E.S.); (G.A.); (A.H.); (F.S.); (P.S.)
- Department of Chemistry, Chung Yuan Christian University, Chung-Li 320314, Taiwan
- Center for Nanotechnology, Chung Yuan Christian University, Chung-Li 320314, Taiwan
- Correspondence: (K.H.-C.C.); (C.-D.H.)
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Li M, Niu J, Yan P, Yao L, He W, Wang M, Li H, Cao L, Li X, Shi X, Liu X, Yang K. The effectiveness and safety of acupuncture for depression: An overview of meta-analyses. Complement Ther Med 2019; 50:102202. [PMID: 32444032 DOI: 10.1016/j.ctim.2019.102202] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/19/2019] [Accepted: 09/28/2019] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To provide an overview of existing meta-analysis (MAs) on the efficacy and safety of acupuncture for depression, and assess the methodological quality and the strength of evidence of the included MAs. METHODS We searched MAs of randomized trials that have evaluated the effects of acupuncture on depression in three international and three Chinese databases from their inception until August 2019. The methodological quality of included MAs was evaluated with the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), and the strength of evidence with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). We used the intra-class correlation coefficient (ICC) to assess reviewer agreement in the pre-experiment. RESULTS We included 31 MAs and 59 RCTs. The results of included MAs were conflicting, our meta-analyses found that acupuncture may confer small benefit in reducing the severity of depression by end of treatment than no treatment/wait list/treatment as usual(SMD -0.74, 95% CI -1.06 to -0.41, eight trials, 624 participants), control acupuncture (invasive, non-invasive sham controls) (SMD 0.27, 95% CI -0.51 to -0.04, 20 trials, 1055 participants), antidepressants(Selective serotonin reuptake inhibitors (SSRI)/ Tetracyclic antidepressants(TCAs)) (SMD -0.28, 95% CI -0.46 to -0.10, 30 trials, 3068 participants), acupuncture plus antidepressants versus antidepressants(SSRI/TCAs) (SMD -0.99, 95% CI -1.37 to -0.61, 17 trials, 1110 participants). Subgroup analyses showed that there was no difference between electro-acupuncture and invasive control (P = 0.37), electro-acupuncture and non-invasive control (P = 0.90), manual acupuncture and Tetracyclic antidepressants (P = 0.57), electro-acupuncture and Tetracyclic antidepressants (P = 0.07). Six MAs concluded that acupuncture reduced the incidence of adverse events compared with antidepressants. The evaluation with AMSTAR-2 showed that the quality of included MAs was low or critically low. The results of the GRADE evaluation showed that the strength of evidence was low to very low for most outcomes. CONCLUSIONS Although acupuncture appears to be more effective and safer than no treatment, control acupuncture and antidepressants, the quality of the available evidence was very low. Further methodologically rigorous and adequately powered primary studies are needed to confirm the effectiveness of acupuncture for depression.
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Affiliation(s)
- Meixuan Li
- School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Junqiang Niu
- The First Hospital of Lanzhou University, Lanzhou, 730000, China
| | - Peijing Yan
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Institute of Clinical Research and Evidence Based Medicine, The Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Liang Yao
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, L8S4L8, Canada
| | - Wenbo He
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Meng Wang
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Huijuan Li
- School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Liujiao Cao
- School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Xiuxia Li
- School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Xiue Shi
- Institute of Evidence Based Rehabilitation Medicine of Gansu Province, Lanzhou, 730000, China
| | - Xingrong Liu
- School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China.
| | - Kehu Yang
- School of Public Health, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence Based Social Science Research Center, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China; Institute of Clinical Research and Evidence Based Medicine, The Gansu Provincial Hospital, Lanzhou, 730000, China.
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Wang G, Lei C, Tian Y, Wang Y, Zhang L, Zhang R. Rb1, the Primary Active Ingredient in Panax ginseng C.A. Meyer, Exerts Antidepressant-Like Effects via the BDNF-Trkb-CREB Pathway. Front Pharmacol 2019; 10:1034. [PMID: 31572200 PMCID: PMC6753202 DOI: 10.3389/fphar.2019.01034] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/14/2019] [Indexed: 12/18/2022] Open
Abstract
Panax ginseng C.A. Meyer (Araliaceae), a popular tonic and dietetic herbal medicine, has been traditionally prescribed in China and other countries to treat affective disorders. The medicinal parts of ginseng, the roots and flower buds, have become increasingly popular as dietary supplements due to the current holistic healthcare trend. We have investigated for the first time the antidepressive actions of the different medicinal parts, namely, the main roots, fibrous roots, and flower buds (in water extract and powder), of garden-cultivated ginseng through behavioral and drug-induced tests in mice. The water extracts, but not the powders of ginseng fibrous roots, flower buds, and main roots (1.5 g of crude drug per kilogram, p.o.), significantly reduced the immobility time in the forced swim test (FST) and tail suspension test (TST); moreover, the water extracts enhanced the 5-hydroxytryptophan (5-HTP)-induced head-twitch response and antagonized the action of reserpine in the mouse. We then explored the antidepressive mechanism of action of the ginsenoside Rb1 (Rb1) related to the brain-derived neurotrophic factor (BDNF) and its downstream proteins in mice exposed to chronic unpredictable mild stress (CUMS). Treatment with Rb1 (20 mg/kg, p.o.) for 21 days significantly attenuated the CUMS-induced decrease in the activities of BDNF, tropomyosin-related kinase B (TrkB), protein kinase B (AKT), extracellular regulatory protein kinase (ERK), and cyclic adenosine monophosphate (cAMP) response element binding protein (CREB) in the mouse hippocampal CA3 region and prefrontal cortex (PFC). Interestingly, treatment with the novel TrkB antagonist ANA-12 (0.5 mg/kg, i.p.) did not alter the level of BDNF but significantly blocked the antidepressive effects of Rb1 on proteins downstream of BDNF in CUMS-treated mice. These results suggest that BDNF–TrkB–CREB signaling may be involved in the antidepressive mechanism of the action of Rb1.
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Affiliation(s)
- Guoli Wang
- College of Pharmacy, Jinan University, Guangzhou, China.,College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun, China
| | - Cong Lei
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Ya Tian
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Yingping Wang
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun, China
| | - Lianxue Zhang
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun, China
| | - Ronghua Zhang
- College of Pharmacy, Jinan University, Guangzhou, China
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Kang SH, Kim BY, Kwon HI, Kim HM, Cho SH, Park JS, Han HD, Shin BC. PLGA Microsphere Addition to 1‐Hydroxy‐2‐napthoic Acid Enhances the Sustained Release of Escitalopram. B KOREAN CHEM SOC 2019. [DOI: 10.1002/bkcs.11822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Seok Hee Kang
- Bio/Drug Discovery DivisionKorea Research Institute of Chemical Technology Daejeon 305‐060 South Korea
- Medicinal Chemistry and PharmacologyUniversity of Science and Technology Yuseong 305‐350 South Korea
| | - Bo Yeon Kim
- Bio/Drug Discovery DivisionKorea Research Institute of Chemical Technology Daejeon 305‐060 South Korea
| | - Hyuk Il Kwon
- Bio/Drug Discovery DivisionKorea Research Institute of Chemical Technology Daejeon 305‐060 South Korea
- College of PharmacyChungnam National University Daejeon 305‐764 South Korea
| | - Hye Min Kim
- Bio/Drug Discovery DivisionKorea Research Institute of Chemical Technology Daejeon 305‐060 South Korea
- College of PharmacyChungnam National University Daejeon 305‐764 South Korea
| | - Sun Hang Cho
- Bio/Drug Discovery DivisionKorea Research Institute of Chemical Technology Daejeon 305‐060 South Korea
| | - Jeong Sook Park
- College of PharmacyChungnam National University Daejeon 305‐764 South Korea
| | - Hee Dong Han
- Department of Immunology, School of MedicineKonkuk University Chungju 380‐701 South Korea
| | - Byung Cheol Shin
- Bio/Drug Discovery DivisionKorea Research Institute of Chemical Technology Daejeon 305‐060 South Korea
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