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Sample records for alternative antidepressant treatment

  1. Treatment of Generalized Anxiety Disorder: A Comprehensive Review of the Literature for Psychopharmacologic Alternatives to Newer Antidepressants and Benzodiazepines

    OpenAIRE

    Huh, John; Goebert, Deborah; Takeshita, Junji; Lu, Brett Y.; Kang, Mark

    2011-01-01

    Objective: Generalized anxiety disorder (GAD) is common, chronic, and debilitating. Treatment with benzodiazepines and newer antidepressants is often inadequate. This article reviews the effectiveness of alternative and augmenting medications, such as older antidepressants, antipsychotics, anticonvulsants, and β-blockers.

  2. Pulse Intravenous Clomipramine as an alternative antidepressant treatment to ECT: A pilot study

    Directory of Open Access Journals (Sweden)

    Maj-Liz Persson

    2007-12-01

    Full Text Available Background and Objectives: The aim of the study was to examine the antidepressant effect of a single pulse dose of intravenous clomipramine (200 mg i.v. followed by oral administration as an alternative method to electroconvulsive therapy. Methods: Twenty-one inpatients (8 male, 13 female with major depression were included. Depression severity was measured by Montgomery Asberg Rating Scale (MADRS and Clinical Global Impression severity scale (CGI-S before the pulse dose and 1 week after. The day after the pulse dose, the patient was medicated with 75 mg of oral clomipramine and from day two with 150 mg clomipramine daily. Results: The MADRS score dropped with 39% ± 22% and the CGI score with 28% ± 19% in one week. The improvement of the MADRS score after one week was 13.1 (C.I.9.5-17.0. CGI-ratings dropped from a mean of 5.5 (SD 1.2 to 3.9 (SD 1.1, an improvement of 28% ± 19%.(C.I. 1.0-2.1. Both improvements were significant (p<000.1. Conclusions: Single pulse dose clomipramine administration ameliorates depressive symptoms, and may be an alternative to ECT.

  3. IC Treatment: Antidepressants

    Science.gov (United States)

    ... in Combined Federal Campaign ICA Resources for Donors Social Media ... you first hear the name antidepressant you may think of a medicine used to treat depression. Did you know that antidepressants are also effective ...

  4. Sleep deprivation and antidepressant treatment

    OpenAIRE

    Voderholzer, Ulrich

    2003-01-01

    The mood-improving effect of sleep deprivation (SD) in depression is even today still not fully understood. Despite the fact that mood and cognitive functions are lowered by prolonged sleep loss and despite convincing data that insomnia is a strong risk factor for subsequent depression, 1 acute SD for one night or even partial SD in the second half of the night improves mood in about 60% of depressed patients the day after. 2,3 In this respect, among alt types of antidepressant treatments, SD...

  5. Ketamine: stimulating antidepressant treatment?

    Science.gov (United States)

    Byrow, Yulisha; Cassidy, Frederick; Cipriani, Andrea; Demyttenaere, Koen; Frye, Mark A.; Gitlin, Michael; Kennedy, Sidney H.; Ketter, Terence A.; Lam, Raymond W.; McShane, Rupert; Mitchell, Alex J.; Ostacher, Michael J.; Rizvi, Sakina J.; Thase, Michael E.; Tohen, Mauricio

    2016-01-01

    Speaker’s Bureau payments): GlaxoSmithKline, and Sunovion Pharmaceuticals; royalties from American Psychiatric Publishing, Inc. Also, AstraZeneca Pharmaceuticals LP provided publication support to Parexel for preparation of a manuscript. Spouse employee and stockholder of Janssen Pharmaceuticals. R.W.L. Honoraria for speaking/advising/consulting, and/or received research funds: AstraZeneca, Brain Canada, Bristol Myers Squibb, Canadian Institutes of Health Research, Canadian Depression Research and Intervention Network, Canadian Network for Mood and Anxiety Treatments, Canadian Psychiatric Association, Coast Capital Savings, Johnson and Johnson, Lundbeck, Lundbeck Institute, Pfizer, Servier, St. Jude Medical, Takeda University, Health Network Foundation, and Vancouver Coastal Health Research Institute. R.M. Investigator Janssen trials of esketamine; ‘paid-for’ ketamine clinic operated by Oxford Health NHS Foundation Trust - fees used to support the Trust. M.J.O. Consultant: Sunovion and Acadia Pharmaceuticals. Full-time employee of U.S. Department of Veterans Affairs. M.E.T. Advisory/Consultant: Alkermes, Allergan, AstraZeneca, Bristol-Myers Squibb Company, Cerecor inc., Eli Lilly & Co., Forest Laboratories, Gerson Lehrman Group, Fabre-Kramer Pharmaceuticals, Inc., GlaxoSmithKline, Guidepoint Global, H. Lundbeck A/S, MedAvante Inc., Merck and Co. Inc. (formerly Schering Plough and Organon), Moksha8, Naurex Inc., Neuronetics Inc., Novartis, Ortho-McNeil Pharmaceuticals (Johnson & Johnson; Janssen), Otsuka, Pamlab, L.L.C. (Nestle), Pfizer (formerly Wyeth Ayerst Pharmaceuticals), Shire US Inc., Sunovion Pharmaceuticals Inc., Trius Therapeutical Inc. and Takeda. Grant support: Agency for Healthcare Research and Quality, Alkermes, AssureRx, Avanir, Forest Pharmaceuticals, Janssen, National Institute of Mental Health, and Otsuka Pharmaceuticals. Speakers Bureau: None since June, 2010. Equity Holdings: MedAvante, Inc. Royalties: American Psychiatric Foundation, Guilford

  6. Placebo and antidepressant treatment for major depression

    DEFF Research Database (Denmark)

    Hougaard, Esben

    2010-01-01

    Antidepressant medication is generally considered the primary treatment for major depressive disorders (MDD), but antidepressant treatment has recently approached a crisis with shrinking specific effects and growing placebo responses in current trials. The aim of the paper is to review the placebo...

  7. Extracorporeal treatment for tricyclic antidepressant poisoning

    DEFF Research Database (Denmark)

    Yates, Christopher; Galvao, Tais; Sowinski, Kevin M;

    2014-01-01

    The Extracorporeal Treatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatments (ECTR) in poisoning. Here, the workgroup presents its results for tricyclic antidepressants (TCAs). After an extensive literature search, using a predefined ...

  8. Fat cell-secreted adiponectin mediates physical exercise-induced hippocampal neurogenesis:an alternative anti-depressive treatment?

    Institute of Scientific and Technical Information of China (English)

    Suk Yu Yau; Ang Li; Aimin Xu; Kwok-fai So

    2015-01-01

    Psychological depression is drawing accumulating attention nowadays, due to the skyrocketing incidence worldwide and the enormous burdens it incurs. Physical exercise has been long recog-nized for its therapeutic effects on depressive disorders, although knowledge of the underlying mechanisms remains limited. Suppressed hippocampal neurogenesis in adult brains has been regarded, at least partly, contributive to depression, whereas physical exercise that restores neuro-genesis accordingly exerts the anti-depressive action. Several recent publications have suggested the potential role of adiponectin, a protein hormone secreted by peripheral mature adipocytes, in mediating physical exercise-triggered enhancement of hippocampal neurogenesis and alleviation of depression. Here, we brielfy review these novel ifndings and discuss the possibility of counter-acting depression by modulating adiponectin signaling in the hippocampus with interventions including physical exercise and administration of pharmacological agents.

  9. Exposure / Ritual Prevention Therapy Boosts Antidepressant Treatment of OCD

    Science.gov (United States)

    ... NIMH (99 items) Exposure / Ritual Prevention Therapy Boosts Antidepressant Treatment of OCD CBT Trumps Antipsychotic for Augmentation, ... Update A form of behavioral therapy can augment antidepressant treatment of obsessive compulsive disorder (OCD) better than ...

  10. Alternative Treatments

    Science.gov (United States)

    ... Find your chapter: search by state Home > Alzheimer's Disease > Treatments > Alternative Treatments Overview What Is Dementia? What Is Alzheimer's? Younger/Early Onset Facts and Figures Know the 10 Signs Stages Inside the Brain: ...

  11. Physiological Bases of Bulimia, and Antidepressant Treatment.

    Science.gov (United States)

    Getzfeld, Andrew R.

    This paper reviews the literature on the physiological causes of bulimia and investigates the rationale behind the usage of antidepressant medication in the treatment of bulimia nervosa. No definite conclusions can be stated regarding the physiology of bulimia, but a number of hypotheses are suggested. It appears that the hypothalamus is involved…

  12. [Neuroleptic malignant syndrome from treatment with antidepressives].

    Science.gov (United States)

    Heinemann, F; Assion, H J; Laux, G

    1997-05-01

    The neuroleptic malignant syndrome (NMS) is a rare complication in the treatment of neuroleptics. The pathophysiology is not fully known. A dopaminergic transmission block in the basal ganglia and the hypothalamus is thought to be the pathophysiological mechanism of NMS. There are some findings against the single role of dopamine receptor blockade: NMS is rare under neuroleptic treatment, although a strong dopamine receptor blockade is found even with a low dosis of neuroleptics. NMS can develop even after longterm treatment with neuroleptics and is not improved by dopamine agonists within the expected period. NMS may even develop when neuroleptics are reduced. Several cases have been reported of NMS precipitated by medication without a direct effect on dopaminergic system. Only rare case reports describe NMS under antidepressants. We report on all cases of NMS associated with antidepressants and present the different pathophysiological hypotheses on the precipitation of NMS. PMID:9235312

  13. Treatment of anorexia nervosa with antidepressants.

    Science.gov (United States)

    Hudson, J I; Pope, H G; Jonas, J M; Yurgelun-Todd, D

    1985-02-01

    Nine patients with anorexia nervosa were treated with antidepressant medications from three classes: tricyclics, monoamine oxidase inhibitors, and triazolopyridines. A tenth patient was treated with the combination of lithium carbonate and carbamazepine. With either the initial or a subsequent medication trial, four patients had displayed significant improvement in weight and in other anorexic and bulimic symptoms. Three additional patients had a marked or moderate improvement in bulimic symptoms, one with moderate and two without any weight gain. Two other patients had moderate weight gain. Side effects were a significant problem in many of the patients. These preliminary results suggest that antidepressants may be of benefit in the treatment of some patients with anorexia nervosa. PMID:3919068

  14. Antidepressants

    Science.gov (United States)

    Antidepressants are medicines that treat depression. Your doctor can prescribe them for you. They work to balance ... them to help. There are several types of antidepressants. You and your doctor may have to try ...

  15. Explanatory models of depression and treatment adherence to antidepressant medication

    DEFF Research Database (Denmark)

    Buus, Niels; Johannessen, Helle; Stage, Kurt Bjerregaard

    2012-01-01

    analysed thematically with "explanatory models" as the starting point. RESULTS: Patients had ambiguous experiences of depression and antidepressants. Patients explained their illness and the medical treatment in experience-near terms. Explanations of the reasons for depression were psychosocial and biology......BACKGROUND: Adherence to antidepressant medication is a challenging clinical issue, which reduces treatment efficacy: 30-60% of all patients commencing treatment with antidepressants are estimated to stop taking the medication within the first 12 weeks. Patients' personal beliefs about depression...... and antidepressants are regarded as central influences on adherence. OBJECTIVES: The aim was to gain detailed insight into patients' personal accounts of depression and use of antidepressant medication and to relate these accounts to the patients' self-reported level of adherence. METHODS: In-depth, qualitative...

  16. Listening Clearly: Alternative Treatments for Adolescent Depression

    Science.gov (United States)

    McGlasson, Terry D.

    2012-01-01

    For many years now, Cognitive Behavioral Therapy and anti-depressant medications have been the primary treatments for adolescent depression. However, there are many youth today with mild to moderate depressive symptoms for whom these treatments are not necessary. This article briefly summarizes several alternative therapeutic approaches for…

  17. Mechanisms Underlying the Antidepressant Response and Treatment Resistance

    Directory of Open Access Journals (Sweden)

    Marjorie Rose Levinstein

    2014-06-01

    Full Text Available Depression is a complex and heterogeneous disorder affecting millions of Americans. There are several different medications and other treatments that are available and effective for many patients with depression. However, a substantial percentage of patients fail to achieve remission with these currently available interventions, and relapse rates are high. Therefore, it is necessary to determine both the mechanisms underlying the antidepressant response and the differences between responders and non-responders to treatment. Delineation of these mechanisms largely relies on experiments that utilize animal models. Therefore, this review provides an overview of the various mouse models that are currently used to assess the antidepressant response, such as chronic mild stress, social defeat, and chronic corticosterone. We discuss how these mouse models can be used to advance our understanding of the differences between responders and non-responders to antidepressant treatment. We also provide an overview of experimental treatment modalities that are used for treatment-resistant depression, such as deep brain stimulation and ketamine administration. We will then review the various genetic polymorphisms and transgenic mice that display resistance to antidepressant treatment. Finally, we synthesize the published data to describe a potential neural circuit underlying the antidepressant response and treatment resistance.

  18. Antidepressants in the treatment of neuropathic pain

    DEFF Research Database (Denmark)

    Sindrup, Søren H.; Otto, Marit; Finnerup, Nanna Brix;

    2005-01-01

    options such as tramadol and oxycodone, whereas the serotonin noradrenaline reuptake inhibitor venlafaxine appears to be equally effective with these drugs and selective serotonin reuptake inhibitors apparently have lower efficacy. Head-to-head comparisons between antidepressants and the other analgesics...

  19. Antidepressant Treatment for Acute Bipolar Depression: An Update

    Directory of Open Access Journals (Sweden)

    Ben H. Amit

    2012-01-01

    Full Text Available While studies in the past have focused more on treatment of the manic phase of bipolar disorder (BD, recent findings demonstrate the depressive phase to be at least as debilitating. However, in contrast to unipolar depression, depression in bipolar patients exhibits a varying response to antidepressants, raising questions regarding their efficacy and tolerability. Methods. We conducted a MEDLINE and Cochrane Collaboration Library search for papers published between 2005 and 2011 on the subject of antidepressant treatment of bipolar depression. Sixty-eight articles were included in the present review. Results. While a few studies did advocate the use of antidepressants, most well-controlled studies failed to show a robust effect of antidepressants in bipolar depression, regardless of antidepressant class or bipolar subtype. There was no significant increase in the rate of manic/hypomanic switch, especially with concurrent use of mood stabilizers. Prescribing guidelines published in recent years rely more on atypical antipsychotics, especially quetiapine, as a first-line therapy. Conclusions. Antidepressants probably have no substantial role in acute bipolar depression. However, in light of conflicting results between studies, more well-designed trials are warranted.

  20. A genome-wide association study points to multiple loci predicting antidepressant treatment outcome in depression

    Science.gov (United States)

    Binder, Elisabeth B.; Bettecken, Thomas; Uhr, Manfred; Ripke, Stephan; Kohli, Martin A.; Hennings, Johannes M.; Horstmann, Sonja; Kloiber, Stefan; Menke, Andreas; Bondy, Brigitta; Rupprecht, Rainer; Domschke, Katharina; Baune, Bernhard T.; Arolt, Volker; Rush, A. John; Holsboer, Florian; Müller-Myhsok, Bertram

    2015-01-01

    Context Efficacy of antidepressant treatment in depression is unsatisfactory as one in three patients does not fully recover even after several treatment trials. Genetic factors and clinical characteristics contribute to the failure of a favorable treatment outcome. Objective To identify genetic and clinical determinants of antidepressant treatment outcome in depression. Design Genome-wide pharmacogenetic association study with two independent replication samples. Setting We performed a genome-wide association (GWA) study in patients from the Munich-Antidepressant-Response-Signature (MARS) project and in pooled DNA from an independent German replication sample. A set of 328 single nucleotide polymorphisms (SNPs) highly related to outcome in both GWA studies was genotyped in a sample of the Sequenced-Treatment-Alternatives-to-Relieve-Depression (STAR*D) study. Participants 339 inpatients suffering from a depressive episode (MARS sample), further 361 depressed inpatients (German replication sample), and 832 outpatients with major depression (STAR*D sample). Main Outcome Measures We generated a multi-locus genetic variable describing the individual number of alleles of the selected SNPs associated with beneficial treatment outcome in the MARS sample (“response” alleles) to evaluate additive genetic effects on antidepressant treatment outcome. Results Multi-locus analysis revealed a significant contribution of a binary variable categorizing patients as carriers of a high vs. low number of response alleles in predicting antidepressant treatment outcome in both samples, MARS and STAR*D. In addition, we observed that patients with a comorbid anxiety disorder in combination with a low number of response alleles showed the least favorable outcome. Conclusion Our results demonstrate the importance of multiple genetic factors in combination with clinical features to predict antidepressant treatment outcome underscoring the multifactorial nature of this trait. PMID

  1. Mechanisms underlying the antidepressant response and treatment resistance

    OpenAIRE

    Levinstein, Marjorie R.; Samuels, Benjamin A.

    2014-01-01

    Depression is a complex and heterogeneous disorder affecting millions of Americans. There are several different medications and other treatments that are available and effective for many patients with depression. However, a substantial percentage of patients fail to achieve remission with these currently available interventions, and relapse rates are high. Therefore, it is necessary to determine both the mechanisms underlying the antidepressant response and the differences between responders ...

  2. Mechanisms Underlying the Antidepressant Response and Treatment Resistance

    OpenAIRE

    Marjorie Rose Levinstein; Benjamin Adam Samuels

    2014-01-01

    Depression is a complex and heterogeneous disorder affecting millions of Americans. There are several different medications and other treatments that are available and effective for many patients with depression. However, a substantial percentage of patients fail to achieve remission with these currently available interventions, and relapse rates are high. Therefore, it is necessary to determine both the mechanisms underlying the antidepressant response and the differences between responders ...

  3. Combining antidepressants

    OpenAIRE

    Dunner, David L.

    2014-01-01

    Summary Treatment-resistant depression is a common problem encountered by psychiatrists. These patients are often difficult to treat effectively. Strategies for addressing patients with treatment-resistant depression include changing medications, adding another antidepressant (antidepressant polypharmacy), and augmenting treatment with a non-antidepressant.

  4. Combining clinical variables to optimize prediction of antidepressant treatment outcomes.

    Science.gov (United States)

    Iniesta, Raquel; Malki, Karim; Maier, Wolfgang; Rietschel, Marcella; Mors, Ole; Hauser, Joanna; Henigsberg, Neven; Dernovsek, Mojca Zvezdana; Souery, Daniel; Stahl, Daniel; Dobson, Richard; Aitchison, Katherine J; Farmer, Anne; Lewis, Cathryn M; McGuffin, Peter; Uher, Rudolf

    2016-07-01

    The outcome of treatment with antidepressants varies markedly across people with the same diagnosis. A clinically significant prediction of outcomes could spare the frustration of trial and error approach and improve the outcomes of major depressive disorder through individualized treatment selection. It is likely that a combination of multiple predictors is needed to achieve such prediction. We used elastic net regularized regression to optimize prediction of symptom improvement and remission during treatment with escitalopram or nortriptyline and to identify contributing predictors from a range of demographic and clinical variables in 793 adults with major depressive disorder. A combination of demographic and clinical variables, with strong contributions from symptoms of depressed mood, reduced interest, decreased activity, indecisiveness, pessimism and anxiety significantly predicted treatment outcomes, explaining 5-10% of variance in symptom improvement with escitalopram. Similar combinations of variables predicted remission with area under the curve 0.72, explaining approximately 15% of variance (pseudo R(2)) in who achieves remission, with strong contributions from body mass index, appetite, interest-activity symptom dimension and anxious-somatizing depression subtype. Escitalopram-specific outcome prediction was more accurate than generic outcome prediction, and reached effect sizes that were near or above a previously established benchmark for clinical significance. Outcome prediction on the nortriptyline arm did not significantly differ from chance. These results suggest that easily obtained demographic and clinical variables can predict therapeutic response to escitalopram with clinically meaningful accuracy, suggesting a potential for individualized prescription of this antidepressant drug. PMID:27089522

  5. Drug treatment episodes in pharmacoepidemiology - antidepressant use as a model

    NARCIS (Netherlands)

    Gardarsdottir, H.

    2009-01-01

    In the Netherlands, antidepressants are indicated for treating depression, generalized anxiety disorders, obsessive-compulsive disorders, social phobia, panic disorders, eating disorders, neuropathic pain and nocturnal enuresis. In addition, antidepressants are sometimes used for treating off-label

  6. Antidepressant treatment of the depressed patient with insomnia.

    Science.gov (United States)

    Thase, M E

    1999-01-01

    Sleep disturbances are an integral part of depressive disorder. As such, they are a part of all contemporary sets of diagnostic criteria for major depression and of all major symptom-based rating scales for depression. Insomnia is a particularly frequent complaint, and it is reported by more than 90% of depressed patients. Although the "kindling" or "illness transduction" model of depression remains hypothetical, there is evidence that people with recurrent depression have more pronounced abnormalities of sleep neurophysiology than those experiencing a single or initial episode. Therefore, early relief of insomnia in a depressed patient, in addition to alleviating other symptoms, may increase adherence to treatment and increase daytime performance and overall functioning, while complete relief of insomnia may improve prognosis. Stimulation of serotonin-2 (5-HT2) receptors is thought to underlie insomnia and changes in sleep architecture seen with selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). This is the reason why hypnotics or low-dose trazodone are commonly coprescribed at the initiation of the treatment with either the SSRIs or SNRIs. On the other hand, antidepressant drugs with 5-HT2 blocking properties, such as mirtazapine or nefazodone, alleviate insomnia and improve sleep architecture. In depressed patients, mirtazapine produces a significant shortening of sleep-onset latency, increases a total sleep time, and leads to a marked improvement in sleep efficiency. Antidepressants with preferential 5-HT2 blocking properties are therefore a good treatment option for depressed patients with marked insomnia. PMID:10446739

  7. Clinical application of antidepressants in the treatment of insomnia symptoms

    Directory of Open Access Journals (Sweden)

    WONG Iok-man

    2013-11-01

    Full Text Available Insomnia is one of the common complaints among all clinical departments. In recent years, some studies have demonstrated that insomnia symptoms can be improved or treated by some antidepressants. Based on literature search both at home and abroad, this paper summarized the effect of various antidepressants with different pharmacological properties on sleep, and the progress of clinical application of antidepressants in treating insomnia according to the classification of antidepressant drugs.

  8. Antidepressants in the treatment of attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Popper, C W

    1997-01-01

    Antidepressants differ in their effectiveness for treating attention-deficit/hyperactivity disorder (ADHD) in adults and children. None are as effective as psychostimulants for treating the attentional and cognitive symptoms, but they can help reduce impulsive and hyperactive behavior. Tricyclic antidepressants have well-demonstrated efficacy in treating behavioral symptoms, but desipramine should be avoided, at least in youths and adolescents (and perhaps adults), because safer tricyclics are available. Bupropion was effective in its few controlled trials, but tics and (especially in youth) skin rash limit its value. Venlafaxine appears effective, but controlled studies are needed. Serotonin selective reuptake inhibitors have not been tested in controlled trials, but they cause inconsistent changes, often aggravate ADHD symptoms, and can cause frontal apathy and disinhibition. Clonidine has not been adequately examined but seems to have small or uncertain effects. Psychostimulants remain the treatment of choice because of their unique effect on attention. Multimodal treatments (medications plus psychosocial) might not be more effective than medications alone. PMID:9418743

  9. Alternative disinfectant water treatments

    Science.gov (United States)

    Alternative disinfestant water treatments are disinfestants not as commonly used by the horticultural industry. Chlorine products that produce hypochlorous acid are the main disinfestants used for treating irrigation water. Chlorine dioxide will be the primary disinfestant discussed as an alternativ...

  10. Patients' perspectives on antidepressant treatment in consultations with physicians.

    Science.gov (United States)

    Fosgerau, Christina Fogtmann; Davidsen, Annette Sofie

    2014-05-01

    Patient perspectives on antidepressant treatment and physician attention, and responses toward these in consultations with patients diagnosed with depression, are rarely studied. We analyzed video-recorded consultations with general practitioners (GPs) and psychiatrists. We used conversation analysis and systemic functional linguistics and found that the perspectives patients expressed related to the possibility of achieving, and the inability to retain, a sense of agency. Patients also presented indirect expressions of shame and expressions suggesting alienation toward medical treatment. GPs attended to patient perspectives by talking about medication indirectly. When patients expressed their perspectives, GPs responded by being nonauthoritative but also without prompting patients to elaborate on their reflections. Psychiatrists responded authoritatively and never urged patients to reflect on their perspectives. Shared decision making did not take place because physicians did not explore patients' perspectives in depth or offer their expertise by taking these perspectives into consideration.

  11. Poor guideline adherence in the initiation of antidepressant treatment in children and adolescents in the Netherlands : choice of antidepressant and dose

    NARCIS (Netherlands)

    de Vries, Ymkje Anna; de Jonge, Peter; Kalverdijk, Luuk; Bos, Jens H J; Schuiling-Veninga, Catharina C M; Hak, Eelko

    2016-01-01

    The Dutch guideline for the treatment of depression in young people recommends initiating antidepressant treatment with fluoxetine, as the evidence for its efficacy is strongest and the risk of suicidality may be lower than with other antidepressants. Furthermore, low starting doses are recommended.

  12. Pharmacogenetics of antidepressant treatment in obsessive-compulsive disorder: an update and implications for clinicians.

    Science.gov (United States)

    Zai, Gwyneth; Brandl, Eva J; Müller, Daniel J; Richter, Margaret A; Kennedy, James L

    2014-06-01

    Obsessive-compulsive disorder (OCD) is a chronic neuropsychiatric disorder with high genetic influence. Antidepressants such as serotonin reuptake inhibitors, are widely accepted as the first-line medications for OCD; however, approximately 50% of OCD patients show poor response. Personalized medicine utilizing genetic testing has recently received much attention because the variability of antidepressant response and tolerability are partly due to an individual's genetic variations. This has led to researchers investigating the role of specific genetic factors on antidepressant response and utility of testing in the clinical realm. Genetic test panels are showing promise for guiding antidepressant treatment to improve outcomes in depression. This article will review the most recent findings in the pharmacogenetics of OCD and its related disorders. Promising results have been reported for several serotonergic and glutamatergic system genes and the cytochrome CYP450 liver enzyme genes, which appear to play an important role in OCD and antidepressant response.

  13. Triiodothyronine augmentation for the treatment of depression in substance misusers unresponsive to tricyclic antidepressants

    OpenAIRE

    Kan, CK; Ho, TP

    2001-01-01

    We report on two substance misusers with depression resistant to tricyclic antidepressant treatment who responded to triiodothyronine augmentation. The management of resistant depression, augmentation strategies with particular reference to triiodothyronine, and the possible mechanism of action of triiodothyronine are discussed.

  14. Antidepressants-Associated Sexual Dysfunction: Impact, Effects and Treatment

    OpenAIRE

    HIGGINS, AGNES; LYNCH, AILEEN MARIA; Nash, Michael

    2010-01-01

    PUBLISHED Sexual dysfunction is a common side effect of antidepressants and can have significant impact on the person?s quality of life, relationships, mental health, and recovery. The reported incidence of sexual dysfunction associated with antidepressant medication varies considerably between studies, making it difficult to estimate the exact incidence or prevalence. The sexual problems reported range from decreased sexual desire, decreased sexual excitement, diminished or...

  15. Persistence and compliance to antidepressant treatment in patients with depression: A chart review

    Directory of Open Access Journals (Sweden)

    Sawada Norifusa

    2009-06-01

    Full Text Available Abstract Background Adherence has recently been suggested to be divided into these two components: persistence (i.e., whether patients continue treatment or not and compliance (i.e., whether patients take doses as instructed. However, no study has yet assessed these two clinically relevant components at the same time in adherence to antidepressant treatment in the clinical outpatient setting. Methods In this retrospective chart-review, 6-month adherence to antidepressants was examined in 367 outpatients with a major depressive disorder (ICD-10 (170 males; mean ± SD age 37.6 ± 13.9 years, who started antidepressant treatment from April 2006 through March 2007. Additionally, we evaluated Medication Possession Rate (MPR, defined as the total days a medication was dispensed to patients divided by the treatment period. Results Only 161 patients (44.3% continued antidepressant treatment for 6 months. Among 252 patients who discontinued their initial antidepressant, 63.1% of these patients did so without consulting their physicians. Sertraline use was associated with a higher persistence rate at month 6 (odds ratio 2.59 in comparison with sulpiride, and the use of anxiolytic benzodiazepines had a positive effect on persistence to antidepressant treatment only at month 1 (odds ratio 2.14. An overall MPR was 0.77; 55.6% of patients were considered compliant (i.e., a MPR of ≥ 0.8. Conclusion Given a high rate of antidepressant discontinuation without consulting their physicians, closer communication between patients and their physicians should be encouraged. Although the use of anxiolytic benzodiazepines was associated with a higher persistence to antidepressant treatment at month 1, the use of these drugs should be avoided as a rule, given their well-known serious adverse effects.

  16. Reduced Treatment-Emergent Sexual Dysfunction as a Potential Target in the Development of New Antidepressants

    Directory of Open Access Journals (Sweden)

    David S. Baldwin

    2013-01-01

    Full Text Available Pleasurable sexual activity is an essential component of many human relationships, providing a sense of physical, psychological, and social well-being. Epidemiological and clinical studies show that depressive symptoms and depressive illness are associated with impairments in sexual function and satisfaction, both in untreated and treated patients. The findings of randomized placebo-controlled trials demonstrate that most of the currently available antidepressant drugs are associated with the development or worsening of sexual dysfunction, in a substantial proportion of patients. Sexual difficulties during antidepressant treatment often resolve as depression lifts but can endure over long periods and may reduce self-esteem and affect mood and relationships adversely. Sexual dysfunction during antidepressant treatment is typically associated with many possible causes, but the risk and type of dysfunction vary with differing compounds and should be considered when making decisions about the relative merits and drawbacks of differing antidepressants. A range of interventions can be considered when managing patients with sexual dysfunction associated with antidepressants, including the prescription of phosphodiesterase-5 inhibitors, but none of these approaches can be considered “ideal.” As treatment-emergent sexual dysfunction is less frequent with certain drugs, presumably related to differences in their pharmacological properties, and because current management approaches are less than ideal, a reduced burden of treatment-emergent sexual dysfunction represents a tolerability target in the development of novel antidepressants.

  17. Identification of primary care patients at risk of nonadherence to antidepressant treatment

    Directory of Open Access Journals (Sweden)

    Ann-Charlotte Åkerblad

    2009-01-01

    Full Text Available Ann-Charlotte Åkerblad1, Finn Bengtsson2, Margareta Holgersson3, Lars von Knorring1, Lisa Ekselius11Department of Neuroscience, Psychiatry, Uppsala University Hospital, Uppsala University, Uppsala, Sweden; 2Division of Clinical Pharmacology, Medicine and Care, Faculty of Health Sciences, Linköping University, Linköping, Sweden; 3Quintiles AB, Uppsala, SwedenIntroduction: Poor adherence to antidepressant treatment is common, and results in increased disability and costs. Several factors are thought to influence patients’ ability and willingness to adhere. So far, however, consensus is lacking regarding patient characteristics that predict nonadherence. The purpose of this study was to identify predictors of nonadherence to antidepressant treatment that can be ascertained at treatment start.Method: The present study used data from a randomized controlled trial with the main objective of studying the effect of two different compliance-enhancing programs on treatment adherence and treatment response in 1031 primary care patients with major depression. In this study, logistic regression analyses were performed to examine patient- and illness-related characteristics potentially associated with nonadherence.Results: Nonadherence to antidepressant treatment was predicted by age under 35 or over 64 years, presence of personality disorder, sensation-seeking personality traits, substance abuse, and absence of concomitant medications.Conclusion: Certain patient- and illness-related characteristics may imply an increased risk of nonadherence to antidepressant treatment. Giving special attention to subjects with such characteristics may improve adherence.Keywords: unipolar depression, antidepressant, adherence, compliance, SSRI, predictors

  18. Efficacy and safety of antidepressant's use in the treatment of depressive episodes in bipolar disorder - review of research.

    Science.gov (United States)

    Antosik-Wójcińska, Anna Zofia; Stefanowski, Bogdan; Święcicki, Łukasz

    2015-01-01

    The use of antidepressants in treatment of depression in course of bipolar disorders (BD) is controversial. In case of no improvement during monotherapy with mood stabilizer, the use of antidepressants is often necessary. The safety of this group (in context of phase change, mixed states and rapid cycling) is essential and is the subject of many research. In the paper, the authors review the literature concerning efficacy and safety of use of antidepressants in the treatment of affective disorders and long-term impact on the course of the disease. Selection of articles have been made by searching the Medline and Pubmed databases using keywords: antidepressant drugs, bipolar depression, bipolar disorder, efficacy, safety, mania, hypomania. The risk of mania is greater in bipolar disorder type I, than in type II or during treatment with Tricyclic antidepressants (TCAs) and treatment with venlafaxine. The use of SSRIs and bupropion is associated with a relatively small increase of phase change risk. There are different opinions concerning recommended duration of antidepressant treatment. Generally antidepressant use should end after 2-3 months of remission, the risk of recurrence of depression after discontinuation of antidepressants is, however, higher than in case of continuation. In BD type II or BD spectrum, antidepressant monotherapy is allowed in severe depression. In bipolar disorder type I and in case of phase change after antidepressants use in the past, use of antidepressants should be very cautious. Antidepressants are contraindicated in rapid cycling and in mixed episodes. Further work is needed to evaluate the efficacy and safety of antidepressants use. PMID:26909398

  19. Role of AC-cAMP-PKA Cascade in Antidepressant Action of Electroacupuncture Treatment in Rats

    Directory of Open Access Journals (Sweden)

    Jian-hua Liu

    2012-01-01

    Full Text Available Adenylyl cyclase (AC-cyclic adenosine monophosphate (cAMP-cAMP-dependent protein kinase A (PKA cascade is considered to be associated with the pathogenesis and treatment of depression. The present study was conducted to explore the role of the cAMP cascade in antidepressant action of electroacupuncture (EA treatment for chronic mild stress (CMS-induced depression model rats. The results showed that EA improved significantly behavior symptoms in depression and dysfunction of AC-cAMP-PKA signal transduction pathway induced by CMS, which was as effective as fluoxetine. Moreover, the antidepressant effects of EA rather than Fluoxetine were completely abolished by H89, a specific PKA inhibitor. Consequently, EA has a significant antidepressant treatment in CMS-induced depression model rats, and AC-cAMP-PKA signal transduction pathway is crucial for it.

  20. Vaginal dryness alternative treatments

    Science.gov (United States)

    ... a day. Soybeans contain plant-based substances called isoflavones. These substances have an effect on the body ... soy for vasomotor symptoms: the Herbal Alternatives for Menopause (HALT) Study. Menopause . 2008;15(1):51-58. ...

  1. Rhythms and blues: modulation of oscillatory synchrony and the mechanism of action of antidepressant treatments.

    Science.gov (United States)

    Leuchter, Andrew F; Hunter, Aimee M; Krantz, David E; Cook, Ian A

    2015-05-01

    Treatments for major depressive disorder (MDD) act at different hierarchical levels of biological complexity, ranging from the individual synapse to the brain as a whole. Theories of antidepressant medication action traditionally have focused on the level of cell-to-cell interaction and synaptic neurotransmission. However, recent evidence suggests that modulation of synchronized electrical activity in neuronal networks is a common effect of antidepressant treatments, including not only medications, but also neuromodulatory treatments such as repetitive transcranial magnetic stimulation. Synchronization of oscillatory network activity in particular frequency bands has been proposed to underlie neurodevelopmental and learning processes, and also may be important in the mechanism of action of antidepressant treatments. Here, we review current research on the relationship between neuroplasticity and oscillatory synchrony, which suggests that oscillatory synchrony may help mediate neuroplastic changes related to neurodevelopment, learning, and memory, as well as medication and neuromodulatory treatment for MDD. We hypothesize that medication and neuromodulation treatments may have related effects on the rate and pattern of neuronal firing, and that these effects underlie antidepressant efficacy. Elucidating the mechanisms through which oscillatory synchrony may be related to neuroplasticity could lead to enhanced treatment strategies for MDD.

  2. Ferulic acid chronic treatment exerts antidepressant-like effect: role of antioxidant defense system.

    Science.gov (United States)

    Lenzi, Juliana; Rodrigues, Andre Felipe; Rós, Adriana de Sousa; de Castro, Amanda Blanski; de Castro, Bianca Blanski; de Lima, Daniela Delwing; Magro, Débora Delwing Dal; Zeni, Ana Lúcia Bertarello

    2015-12-01

    Oxidative stress has been claimed a place in pathophysiology of depression; however, the details of the neurobiology of this condition remains incompletely understood. Recently, treatments employing antioxidants have been thoroughly researched. Ferulic acid (FA) is a phenolic compound with antioxidant and antidepressant-like effects. Herein, we investigated the involvement of the antioxidant activity of chronic oral FA treatment in its antidepressant-like effect using the tail suspension test (TST) and the forced swimming test (FST) in mice. The modulation of antioxidant system in blood, hippocampus and cerebral cortex was assessed after stress induction through TST and FST. Our results show that FA at the dose of 1 mg/kg has antidepressant-like effect without affecting locomotor activity. The stress induced by despair tests was able to decrease significantly the activities of superoxide dismutase (SOD) in the blood, catalase (CAT) in the blood and cerebral cortex and glutathione peroxidase (GSH-Px) in the cerebral cortex. Thiobarbituric acid-reactive substances (TBA-RS) levels were increased significantly in the cerebral cortex. Furthermore, the results show that FA was capable to increase SOD, CAT and GSH-Px activities and decrease TBA-RS levels in the blood, hippocampus and cerebral cortex. These findings demonstrated that FA treatment in low doses is capable to exert antidepressant-like effect with the involvement of the antioxidant defense system modulation.

  3. Decreased Total Antioxidant Activity in Major Depressive Disorder Patients Non-Responsive to Antidepressant Treatment

    Science.gov (United States)

    Baek, Song-Eun; Lee, Gyoung-Ja; Rhee, Chang-Kyu; Rho, Dae-Young; Kim, Do-Hoon; Huh, Sun

    2016-01-01

    Objective This study aimed to evaluate the total antioxidant activity (TAA) in patients with major depressive disorder (MDD) and the effect of antidepressants on TAA using a novel potentiometric method. Methods Twenty-eight patients with MDD and thirty-one healthy controls were enrolled in this study. The control group comprised 31 healthy individuals matched for gender, drinking and smoking status. We assessed symptoms of depression using the Hamilton Depression Rating Scale (HAMD) and the Beck Depression Inventory (BDI). We measured TAA using potentiometry. All measurements were made at baseline and four and eight weeks later. Results There was a significant negative correlation between BDI scores and TAA. TAA was significantly lower in the MDD group than in controls. When the MDD group was subdivided into those who showed clinical response to antidepressant therapy (response group) and those who did not (non-response group), only the non-response group showed lower TAA, while the response group showed no significant difference to controls at baseline. After eight weeks of antidepressant treatment, TAA in both the response and non-response groups was similar, and there was no significant difference among the three groups. Conclusion These results suggest that the response to antidepressant treatment in MDD patients might be predicted by measuring TAA. PMID:27081384

  4. Purine and pyrimidine metabolism: Convergent evidence on chronic antidepressant treatment response in mice and humans

    Science.gov (United States)

    Park, Dong Ik; Dournes, Carine; Sillaber, Inge; Uhr, Manfred; Asara, John M.; Gassen, Nils C.; Rein, Theo; Ising, Marcus; Webhofer, Christian; Filiou, Michaela D.; Müller, Marianne B.; Turck, Christoph W.

    2016-01-01

    Selective Serotonin Reuptake Inhibitors (SSRIs) are commonly used drugs for the treatment of psychiatric diseases including major depressive disorder (MDD). For unknown reasons a substantial number of patients do not show any improvement during or after SSRI treatment. We treated DBA/2J mice for 28 days with paroxetine and assessed their behavioral response with the forced swim test (FST). Paroxetine-treated long-time floating (PLF) and paroxetine-treated short-time floating (PSF) groups were stratified as proxies for drug non-responder and responder mice, respectively. Proteomics and metabolomics profiles of PLF and PSF groups were acquired for the hippocampus and plasma to identify molecular pathways and biosignatures that stratify paroxetine-treated mouse sub-groups. The critical role of purine and pyrimidine metabolisms for chronic paroxetine treatment response in the mouse was further corroborated by pathway protein expression differences in both mice and patients that underwent chronic antidepressant treatment. The integrated -omics data indicate purine and pyrimidine metabolism pathway activity differences between PLF and PSF mice. Furthermore, the pathway protein levels in peripheral specimens strongly correlated with the antidepressant treatment response in patients. Our results suggest that chronic SSRI treatment differentially affects purine and pyrimidine metabolisms, which may explain the heterogeneous antidepressant treatment response and represents a potential biosignature. PMID:27731396

  5. PCLO rs2522833 modulates HPA system response to antidepressant treatment in major depressive disorder.

    Science.gov (United States)

    Schuhmacher, Anna; Mössner, Rainald; Höfels, Susanne; Pfeiffer, Ute; Guttenthaler, Vera; Wagner, Michael; Schwab, Sibylle G; Maier, Wolfgang; Zobel, Astrid

    2011-03-01

    Variant rs2522833 of the Piccolo-encoding gene PCLO has recently been found to be associated with major depressive disorder (MDD). PCLO encodes a presynaptic cytomatrix protein which influences monoamine neurotransmitter release. Piccolo could therefore play an important role in treatment response to antidepressant therapy and the improvement of alterations in HPA system reactivity. We investigated the influence of the coding variant rs2522833 in the PCLO gene on treatment response in 205 in-patients with unipolar depression. Treatment response was measured (1) at the level of psychopathology using the Hamilton Depression Rating Scale (HAMD) and (2) with the combined dexamethasone/corticotropin-releasing hormone (Dex/CRH) test, which is a refined tool for showing dysregulation of the hypothalamic-pituitary-adrenocortical (HPA) system, a neurobiological finding in depression. While we did not find an association between variation in PCLO and HAMD scores, HPA dysregulation was less pronounced in carriers of the AA genotype than in carriers of one or two C alleles. HPA activity of individuals with the AA genotype only marginally changed during 4-wk antidepressant treatment, whereas C allele carriers showed a higher hormonal secretion at admission than carriers of the AA genotype but lower responsivity to the Dex/CRH challenge after 4 wk. Our results point to a moderating role of PCLO SNP rs2522833 on HPA regulation during antidepressant treatment, which may represent a neurobiological feature of stability of clinical response.

  6. Structural Imaging in Late Life Depression: Association with Mood and Cognitive Responses to Antidepressant Treatment

    Science.gov (United States)

    Marano, Christopher M.; Workman, Clifford I.; Lyman, Christopher H.; Munro, Cynthia A.; Kraut, Michael A.; Smith, Gwenn S.

    2014-01-01

    Objectives Recent positron emission tomography studies of cerebral glucose metabolism have identified the functional neural circuitry associated with mood and cognitive responses to antidepressant treatment in late life depression (LLD). The structural alterations in these networks are not well understood. The present study used magnetic resonance (MR) imaging and voxel-based morphometry (VBM) to evaluate the association between grey matter volumes and changes in mood symptoms and cognitive function with treatment with the antidepressant citalopram. Design Open label trial with baseline brain MR scan. Mood and cognitive assessments performed at baseline and during citalopram treatment. Setting Outpatient clinics of an academic medical center. Participants 17 previously unmedicated patients age 55 or older with a major depressive episode and 17 non-depressed comparison subjects. Intervention 12 week trial of flexibly dosed citalopram. Measurements Grey matter volumes, Hamilton Depression Rating Scale, California Verbal Learning Test, Delis–Kaplan Executive Function System™. Results In LLD, higher grey matter volumes in the cingulate gyrus, superior and middle frontal gyri, middle temporal gyrus and precuneus was associated with greater mood improvement. Higher grey matter volumes in primarily frontal areas were associated with greater improvement in verbal memory and verbal fluency performance. Conclusions Associations with antidepressant induced improvements in mood and cognition were observed in several brain regions previously correlated with normalization of glucose metabolism after citalopram treatment in LLD. Future studies will investigate molecular mechanisms underlying these associations (e.g. beta-amyloid, inflammation, glutamate). PMID:24238925

  7. Improvement of Glycemic Control in Insulin-Dependent Diabetics with Depression by Concomitant Treatment with Antidepressants.

    Science.gov (United States)

    Radojkovic, Jana; Sikanic, Natasa; Bukumiric, Zoran; Tadic, Marijana; Kostic, Nada; Babic, Rade

    2016-01-01

    BACKGROUND It is still disputable whether negative effects of comorbid depression in diabetics can be diminished by successful treatment of depression. The primary aim of this study was to assess whether addition of antidepressants to existing insulin treatment would further improve glycemic control in these patients. A secondary objective was to assess whether such treatment impairs their lipid and inflammatory status. MATERIAL AND METHODS Total of 192 patients with poorly controlled diabetes (defined as HbA1c ≥8%) in the absence of any uncontrolled medical condition entered the 6-month run-in phase with optimization of diabetic therapy. Depression status was screened at the end of this phase by BDI-II depression testing. Patients with BDI-II ≥14 and psychiatric confirmation of depression (58 patients) entered the 6-month interventional phase with SSRI class antidepressants. RESULTS Fifty patients completed the study. During the run-in phase, HbA1c dropped from 10.0±1.8% to 8.5±1.2% (pdepression scale and improvement in glycemic control was observed (R²=0.139, p=0.008). Lipid profile and inflammatory status did not change significantly during the interventional phase. CONCLUSIONS Patients with poorly controlled diabetes and comorbid depression might benefit from screening and treatment of depression with SSRI antidepressants by achieving an incremental effect on glycoregulation. This therapy did not have any adverse effects on lipid profile or inflammatory status. PMID:27329213

  8. Antidepressants and dementia

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Søndergård, Lars; Forman, Julie Lyng;

    2009-01-01

    BACKGROUND: It has been suggested that antidepressants may have neuroprotective abilities but it has newer been investigated lately whether treatment with antidepressants reduces the risk of dementia. METHOD: Linkage of registers of all prescribed antidepressants and diagnoses of dementia...... in Denmark during a period from 1995 to 2005. RESULTS: Persons who purchased antidepressants once (N=687,552) had an increased rate of dementia compared to persons unexposed to antidepressants (N=779,831). Nevertheless, the rate of dementia changed over time; thus during the initial prescription periods...... the rate increased with the number of prescriptions but continued long-term antidepressants treatment was associated with a reduction in the rate of dementia, however, not to the same level as the rate for the general population. This pattern was found for all classes of antidepressants (SSRIs, newer non...

  9. Antidepressants and dementia

    DEFF Research Database (Denmark)

    2009-01-01

    BACKGROUND: It has been suggested that antidepressants may have neuroprotective abilities but it has newer been investigated lately whether treatment with antidepressants reduces the risk of dementia. METHOD: Linkage of registers of all prescribed antidepressants and diagnoses of dementia in...... Denmark during a period from 1995 to 2005. RESULTS: Persons who purchased antidepressants once (N=687,552) had an increased rate of dementia compared to persons unexposed to antidepressants (N=779,831). Nevertheless, the rate of dementia changed over time; thus during the initial prescription periods the...... rate increased with the number of prescriptions but continued long-term antidepressants treatment was associated with a reduction in the rate of dementia, however, not to the same level as the rate for the general population. This pattern was found for all classes of antidepressants (SSRIs, newer non...

  10. Decreased sensitivity to paroxetine-induced inhibition of peripheral blood mononuclear cell growth in depressed and antidepressant treatment-resistant patients.

    Science.gov (United States)

    Rzezniczek, S; Obuchowicz, M; Datka, W; Siwek, M; Dudek, D; Kmiotek, K; Oved, K; Shomron, N; Gurwitz, D; Pilc, A

    2016-01-01

    Major depression disorder (MDD) is the most widespread mental disorder. Selective serotonin reuptake inhibitors (SSRIs) are used as first-line MDD treatment but are effective in resistant (TR) MDD patients are needed for prioritizing them for alternative therapeutics. SSRI-induced inhibition of the growth of peripheral blood mononuclear cells (PBMCs) is mediated via their target, the serotonin transporter (SERT). Here, we examined whether antidepressant drug-induced inhibition of the growth of PBMCs differed between MDD patients and healthy controls. PBMCs from well-characterized 33 treatment-sensitive (TS) and 33 TR MDD patients, and 24 healthy volunteers were studied. Dose-dependent inhibition of PBMCs growth was observed for both the non-SSRI antidepressant mirtazapine and the SSRI antidepressant paroxetine. Significantly lower sensitivities to 20 μm paroxetine were observed in MDD compared with control PBMCs prior to treatment onset (13% and 46%, respectively; Pdepression. A significantly lower expression of integrin beta-3 (ITGB3), a co-factor of the SERT, was observed in the PBMCs of MDD patients prior to treatment onset compared with healthy controls, and may explain their lower paroxetine sensitivity. Further studies with larger cohorts are required for clarifying the potential of reduced PBMCs paroxetine sensitivity and lower ITGB3 expression as MDD biomarkers. PMID:27244236

  11. Obesity and Its Potential Effects on Antidepressant Treatment Outcomes in Patients with Depressive Disorders: A Literature Review.

    Science.gov (United States)

    Woo, Young Sup; Seo, Hye-Jin; McIntyre, Roger S; Bahk, Won-Myong

    2016-01-12

    Accumulating evidence regarding clinical, neurobiological, genetic, and environmental factors suggests a bidirectional link between obesity and depressive disorders. Although a few studies have investigated the link between obesity/excess body weight and the response to antidepressants in depressive disorders, the effect of weight on treatment response remains poorly understood. In this review, we summarized recent data regarding the relationship between the response to antidepressants and obesity/excess body weight in clinical studies of patients with depressive disorders. Although several studies indicated an association between obesity/excess body weight and poor antidepressant responses, it is difficult to draw definitive conclusions due to the variability of subject composition and methodological differences among studies. Especially, differences in sex, age and menopausal status, depressive symptom subtypes, and antidepressants administered may have caused inconsistencies in the results among studies. The relationship between obesity/excess body weight and antidepressant responses should be investigated further in high-powered studies addressing the differential effects on subject characteristics and treatment. Moreover, future research should focus on the roles of mediating factors, such as inflammatory markers and neurocognitive performance, which may alter the antidepressant treatment outcome in patients with comorbid obesity and depressive disorder.

  12. Increased neuroplasticity and hippocampal microglia activation in a mice model of rapid antidepressant treatment.

    Science.gov (United States)

    Muzio, Luca; Brambilla, Valentina; Calcaterra, Lorenza; D'Adamo, Patrizia; Martino, Gianvito; Benedetti, Francesco

    2016-09-15

    The search for biomarkers of antidepressant effects focused on pathways regulating synaptic plasticity, and on activated inflammatory markers. Repeated Sleep Deprivation (SD) provides a model treatment to reverse-translate antidepressant effects from in vivo clinical psychiatry to model organisms. We studied the effects of repeated SD alone (ASD) or combined with exercise on a slow spinning wheel (SSW), in 116 C57BL/6J male mice divided in three groups (ASD, SSW, untreated). Forced Swimming Test (FST) was used to detect antidepressant-like effects. Unbiased evaluation of the transcriptional responses were obtained in the hippocampus by Illumina Bead Chip Array system, then confirmed with real time PCR. Spine densities in granular neurons of the dentate gyrus (DG) were assayed by standard Golgi staining. Activation of Microglial/Macrophages cells was evaluated by immunufluorescence analysis for Iba1. Rates of cell proliferation was estimated pulsing mice with the S-phase tracer 5-Iodo-2'-deoxyuridine (IdU). All SD procedures caused a decreasing of floating time at FST, and increased expression of the immediate early gene Arc/Arg3.1. In addition, SSW also increased expression of the Microglia/Macrophages genes Iba-1 and chemokine receptors Cx3cR1 and CxcR4, of the canonical Wnt signaling gene Wnt7a, and of dendritic spines in CA4 neurons of the DG. SSW up-regulated both the number of Iba1+ cells and rates of cell proliferation in the subgranular region of the DG. The antidepressant-like effects of SD dissociated both, from hippocampal neuroplasticity in the DG (not occurring after ASD), and from microglial activation (not preventing behavioral response when occurring). The increase in dendritic spine density in the DG after SD and exercise was associated with an up-regulation of Wnt 7a, and with activation of the innate immune system of the brain. Increased Arc/Arg3.1 suggests however increased neuroplasticity, which could be common to all fast-acting antidepressants

  13. Alternative pharmacological strategies for adult ADHD treatment: a systematic review.

    Science.gov (United States)

    Buoli, Massimiliano; Serati, Marta; Cahn, Wiepke

    2016-01-01

    Adult Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent psychiatric condition associated with high disability and frequent comorbidity. Current standard pharmacotherapy (methylphenidate and atomoxetine) improves ADHD symptoms in the short-term, but poor data were published about long-term treatment. In addition a number of patients present partial or no response to methylphenidate and atomoxetine. Research into the main database sources has been conducted to obtain an overview of alternative pharmacological approaches in adult ADHD patients. Among alternative compounds, amphetamines (mixed amphetamine salts and lisdexamfetamine) have the most robust evidence of efficacy, but they may be associated with serious side effects (e.g. psychotic symptoms or hypertension). Antidepressants, particularly those acting as noradrenaline or dopamine enhancers, have evidence of efficacy, but they should be avoided in patients with comorbid bipolar disorder. Finally metadoxine and lithium may be particularly suitable in case of comorbid alcohol misuse or bipolar disorder. PMID:26693882

  14. Utility of event-related potentials in predicting antidepressant treatment response: An iSPOT-D report

    NARCIS (Netherlands)

    Dinteren, R.J.R. van; Arns, M.W.; Kenemans, L.; Jongsma, M.L.; Kessels, R.P.C.; Fitzgerald, P.; Fallahpour, K.; DeBattista, C.; Gordon, E.; Williams, L.M.

    2015-01-01

    It is essential to improve antidepressant treatment of major depressive disorder (MDD) and one way this could be achieved is by reducing the number of treatment steps by employing biomarkers that can predict treatment outcome. This study investigated differences between MDD patients and healthy cont

  15. Does good leadership buffer effects of high emotional demands at work on risk of antidepressant treatment?

    DEFF Research Database (Denmark)

    Madsen, Ida E H; Hanson, Linda L Magnusson; Rugulies, Reiner Ernst;

    2014-01-01

    Emotionally demanding work has been associated with increased risk of common mental disorders. Because emotional demands may not be preventable in certain occupations, the identification of workplace factors that can modify this association is vital. This article examines whether effects of emoti......Emotionally demanding work has been associated with increased risk of common mental disorders. Because emotional demands may not be preventable in certain occupations, the identification of workplace factors that can modify this association is vital. This article examines whether effects...... of emotional demands on antidepressant treatment, as an indicator of common mental disorders, are buffered by good leadership....

  16. Antidepressant treatment with tianeptine reduces apoptosis in the hippocampal dentate gyrus and temporal cortex

    NARCIS (Netherlands)

    P.J. Lucassen; E. Fuchs; B. Czeh

    2004-01-01

    BACKGROUND: Recent clinical and preclinical studies suggest that major depression may be related to impairments of structural plasticity. Consequently, antidepressants may act by restoring altered rates of cell birth or death. Here, we investigated whether the antidepressant tianeptine would affect

  17. Relabeling the Medications We Call Antidepressants

    Directory of Open Access Journals (Sweden)

    David Antonuccio

    2012-01-01

    Full Text Available This paper raises the question about whether the data on the medications we call antidepressants justify the label of antidepressant. The authors argue that a true antidepressant should be clearly superior to placebo, should offer a risk/benefit balance that exceeds that of alternative treatments, should not increase suicidality, should not increase anxiety and agitation, should not interfere with sexual functioning, and should not increase depression chronicity. Unfortunately, these medications appear to fall short on all of these dimensions. Many of the “side effects” of these medications have larger effect sizes than the antidepressant effect size. To call these medications antidepressants may make sense from a marketing standpoint but may be misleading from a scientific perspective. Consumers deserve a label that more accurately reflects the data on the largest effects and helps them understand the range of effects from these medications. In other words, it may make just as much sense to call these medications antiaphrodisiacs as antidepressants because the negative effects on libido and sexual functioning are so common. It can be argued that a misleading label may interfere with our commitment to informed consent. Therefore, it may be time to stop calling these medications antidepressants.

  18. Convergent evidence from mouse and human studies suggests the involvement of zinc finger protein 326 gene in antidepressant treatment response.

    Directory of Open Access Journals (Sweden)

    Ying-Jay Liou

    Full Text Available OBJECTIVES: The forced swim test (FST is a commonly used model to predict antidepressant efficacy. Uncovering the genetic basis of the model may unravel the mechanism of antidepressant treatment. METHODS: FVB/NJ (FVB and C57BL/6J (B6 were first identified as the response and non-response strains to fluoxetine (a serotonin-specific reuptake inhibitor antidepressant treatment in the mouse FST. Simple-interval (SIM and composite-interval (CIM mappings were applied to map the quantitative trait loci (QTLs of the anti-immobility effect of fluoxetine in FST (FST(FLX in 865 male B6×FVB-F2 mice. The brain mRNA expressions of the gene with the maximum QTL-linkage signal for FST(FLX after the FST were compared between B6 and FVB mice and also compared between fluoxetine and saline treatment. The association of the variants in the human homologue of the mouse FST(FLX-QTL gene with major depressive disorder (MDD and antidepressant response were investigated in 1080 human subjects (MDD/control = 582/498. RESULTS: One linkage signal for FST(FLX-QTL was detected at an intronic SNP (rs6215396 of the mouse Zfp326 gene (maximal CIM-LOD = 9.36. The Zfp326 mRNA expression in the FVB thalamus was significantly down-regulated by fluoxetine in the FST, and the higher FVB-to-B6 Zfp326 mRNA expressions in the frontal cortex, striatum and hypothalamus diminished after fluoxetine treatment. Two coding-synonymous SNPs (rs2816881 and rs10922744 in the human homologue of Zfp326, ZNF326, were significantly associated with the 8-week antidepressant treatment response in the MDD patients (Bonferroni-corrected p = 0.004-0.028. CONCLUSIONS: The findings suggest the involvement of the Zfp326 and ZNF326 genes in antidepressant treatment response.

  19. Guideline recommendations for long-term treatment of depression with antidepressants in primary care-a critical review

    NARCIS (Netherlands)

    Piek, Ellen; van der Meer, Klaas; Nolen, Willem A.

    2010-01-01

    Background: Long-term treatment with antidepressants is considered effective in preventing recurrence of major depressive disorder (MDD). It is unclear whether this is true for primary care. Objectives: We investigated whether current guideline recommendations for long-term treatment with antidepres

  20. Mitochondrial plasticity of the hippocampus in a generic rat model of depression after antidepressant treatment

    DEFF Research Database (Denmark)

    Chen, Fenghua; Wegener, Gregers; Madsen, Torsten Meldgaard;

    2012-01-01

    volume of mitochondria in CA1 of the hippocampus in two different strains of rats, the Sprague-Dawley (SD) and Flinders rats, which display a genetic susceptibility to depressive behavior, the Flinders-sensitive line (FSL) and their corresponding controls, the Flinders-resistant line (FRL). Results......Depressive disorders and the treatment thereof have been associated with a number of neuroplastic events, such as neurogenesis and synaptic remodeling in discrete areas of the brain. The associations of these events in changes regarding the energy supply have not been investigated. Here, we...... investigated the changes in mitochondrial plasticity and its correlation to morphological alterations of neuroplasticity in the hippocampus, both associated with a depressive phenotype, and after treatment, with antidepressant imipramine. Design-based stereological methods were used to estimate the number and...

  1. Epigenetics and energetics in ventral hippocampus mediate rapid antidepressant action: Implications for treatment resistance.

    Science.gov (United States)

    Bigio, Benedetta; Mathé, Aleksander A; Sousa, Vasco C; Zelli, Danielle; Svenningsson, Per; McEwen, Bruce S; Nasca, Carla

    2016-07-12

    Although regulation of energy metabolism has been linked with multiple disorders, its role in depression and responsiveness to antidepressants is less known. We found that an epigenetic and energetic agent, acetyl-l-carnitine (LAC, oral administration), rapidly rescued the depressive- and central and systemic metabolic-like phenotype of LAC-deficient Flinders Sensitive Line rats (FSL). After acute stress during LAC treatment, a subset of FSL continued to respond to LAC (rFSL), whereas the other subset did not (nrFSL). RNA sequencing of the ventral dentate gyrus, a mood-regulatory region, identified metabolic factors as key markers predisposing to depression (insulin receptors Insr, glucose transporters Glut-4 and Glut-12, and the regulator of appetite Cartpt) and to LAC responsiveness (leptin receptors Lepr, metabotropic glutamate receptors-2 mGlu2, neuropeptide-Y NPY, and mineralocorticoid receptors MR). Furthermore, we found that stress-induced treatment resistance in nrFSL shows a new gene profile, including the metabolic regulator factors elongation of long chain fatty acids 7 (Elovl7) and cytochrome B5 reductase 2 (Cyb5r2) and the synaptic regulator NPAS4. Finally, while improving central energy regulation and exerting rapid antidepressant-like effects, LAC corrected a systemic hyperinsulinemia and hyperglicemia in rFSL and failed to do that in nrFSL. These findings establish CNS energy regulation as a factor to be considered for the development of better therapeutics. Agents such as LAC that regulate metabolic factors and reduce glutamate overflow could rapidly ameliorate depression and could also be considered for treatment of insulin resistance in depressed subjects. The approach here serves as a model for identifying markers and underlying mechanisms of predisposition to diseases and treatment responsiveness that may be useful in translation to human behavior and psychopathology. PMID:27354525

  2. Combination therapy with monoamine oxidase inhibitors and other antidepressants or stimulants: strategies for the management of treatment-resistant depression.

    Science.gov (United States)

    Thomas, Samantha J; Shin, Mirae; McInnis, Melvin G; Bostwick, Jolene R

    2015-04-01

    Treatment-resistant depression (TRD) is a major health concern. More than 40% of patients treated for major depressive disorder with an appropriate antidepressant dose for an adequate duration fail to respond. Further, approximately half of adults with major depressive disorder fail to achieve sustained remission despite various medication trials. The utilization of monoamine oxidase inhibitors (MAOIs) for the treatment of depression in clinical practice today is low due to their widely known adverse effects, some of which may be life threatening, and the risk for dietary and drug interactions. For these reasons, MAOIs are not recommended to be prescribed along with other antidepressants or certain prescription or nonprescription drugs. Pharmacologic options are limited for individuals with TRD, however, and there is a paucity of data on the efficacy of MAOIs in combination with other antidepressants for the management of TRD. We performed a search of the PubMed database (inception through January 25, 2015) to identify cases that illustrate the potential utility, as well as risks, of combination treatment with MAOIs and other antidepressants for the management of TRD; 18 articles met the criteria for our search. In addition, we performed a retrospective case series by reviewing the medical records of 29 adults treated for depression with an MAOI plus another psychotropic agent (an antidepressant or stimulant medication) between 2003 and 2012 at a large Midwestern teaching hospital. We compared the findings of the published experience with our local experience to allow for more informed decisions regarding pharmacotherapy in patients with TRD. We separated the local experience into two groups: 15 cases with the selective MAO type B inhibitor selegiline combined with medications presumed to increase the risk of serotonin syndrome and 14 cases with nonselective MAOIs (phenelzine and tranylcypromine) combined with other contraindicated medications. Although risks of

  3. Randomised controlled trial of counseling sessions, antidepressant medication, and combined treatment for major depression in primary care setting

    International Nuclear Information System (INIS)

    The study was made to determine whether counseling sessions using Egan's model combined with antidepressant medication is more effective than either treatment alone in the management of major depression in primary care. Patient aged 18 years and above with major depression on the research diagnostic criteria - a score of 13 or more on the 17 items. Hamilton rating scale for depression and a minimum duration of 4 weeks. Counseling sessions based on Egan's Model by research family physician or antidepressant medication or combination of both was performed. Hamilton rating scale for depression, Beck depression inventory, clinical interview schedule, and modified social adjustment schedule were used and assessed at 6 , 12 and 52 weeks. Patients in all groups showed a clear improvement after 12 weeks. The combination of counseling sessions and antidepressant medication is more effective than either treatment alone. Counseling sessions used by a trained family physician is an effective treatment for depressive disorders in primary care. The combination of this treatment with antidepressant medication is more effective than either treatment alone. (author)

  4. Alterations in leukocyte transcriptional control pathway activity associated with major depressive disorder and antidepressant treatment.

    Science.gov (United States)

    Mellon, S H; Wolkowitz, O M; Schonemann, M D; Epel, E S; Rosser, R; Burke, H B; Mahan, L; Reus, V I; Stamatiou, D; Liew, C-C; Cole, S W

    2016-01-01

    Major depressive disorder (MDD) is associated with a significantly elevated risk of developing serious medical illnesses such as cardiovascular disease, immune impairments, infection, dementia and premature death. Previous work has demonstrated immune dysregulation in subjects with MDD. Using genome-wide transcriptional profiling and promoter-based bioinformatic strategies, we assessed leukocyte transcription factor (TF) activity in leukocytes from 20 unmedicated MDD subjects versus 20 age-, sex- and ethnicity-matched healthy controls, before initiation of antidepressant therapy, and in 17 of the MDD subjects after 8 weeks of sertraline treatment. In leukocytes from unmedicated MDD subjects, bioinformatic analysis of transcription control pathway activity indicated an increased transcriptional activity of cAMP response element-binding/activating TF (CREB/ATF) and increased activity of TFs associated with cellular responses to oxidative stress (nuclear factor erythroid-derived 2-like 2, NFE2l2 or NRF2). Eight weeks of antidepressant therapy was associated with significant reductions in Hamilton Depression Rating Scale scores and reduced activity of NRF2, but not in CREB/ATF activity. Several other transcriptional regulation pathways, including the glucocorticoid receptor (GR), nuclear factor kappa-B cells (NF-κB), early growth response proteins 1-4 (EGR1-4) and interferon-responsive TFs, showed either no significant differences as a function of disease or treatment, or activities that were opposite to those previously hypothesized to be involved in the etiology of MDD or effective treatment. Our results suggest that CREB/ATF and NRF2 signaling may contribute to MDD by activating immune cell transcriptome dynamics that ultimately influence central nervous system (CNS) motivational and affective processes via circulating mediators. PMID:27219347

  5. Alterations in leukocyte transcriptional control pathway activity associated with major depressive disorder and antidepressant treatment

    Science.gov (United States)

    Mellon, S H; Wolkowitz, O M; Schonemann, M D; Epel, E S; Rosser, R; Burke, H B; Mahan, L; Reus, V I; Stamatiou, D; Liew, C -C; Cole, S W

    2016-01-01

    Major depressive disorder (MDD) is associated with a significantly elevated risk of developing serious medical illnesses such as cardiovascular disease, immune impairments, infection, dementia and premature death. Previous work has demonstrated immune dysregulation in subjects with MDD. Using genome-wide transcriptional profiling and promoter-based bioinformatic strategies, we assessed leukocyte transcription factor (TF) activity in leukocytes from 20 unmedicated MDD subjects versus 20 age-, sex- and ethnicity-matched healthy controls, before initiation of antidepressant therapy, and in 17 of the MDD subjects after 8 weeks of sertraline treatment. In leukocytes from unmedicated MDD subjects, bioinformatic analysis of transcription control pathway activity indicated an increased transcriptional activity of cAMP response element-binding/activating TF (CREB/ATF) and increased activity of TFs associated with cellular responses to oxidative stress (nuclear factor erythroid-derived 2-like 2, NFE2l2 or NRF2). Eight weeks of antidepressant therapy was associated with significant reductions in Hamilton Depression Rating Scale scores and reduced activity of NRF2, but not in CREB/ATF activity. Several other transcriptional regulation pathways, including the glucocorticoid receptor (GR), nuclear factor kappa-B cells (NF-κB), early growth response proteins 1–4 (EGR1–4) and interferon-responsive TFs, showed either no significant differences as a function of disease or treatment, or activities that were opposite to those previously hypothesized to be involved in the etiology of MDD or effective treatment. Our results suggest that CREB/ATF and NRF2 signaling may contribute to MDD by activating immune cell transcriptome dynamics that ultimately influence central nervous system (CNS) motivational and affective processes via circulating mediators. PMID:27187237

  6. Tricyclic Antidepressants

    Science.gov (United States)

    Schmidt, Gary J.

    The use of tricyclic antidepressant drugs is becoming increasingly prevalent for the treatment of depressed patients. It has been suggested that, analogous to many other drug substances, the tricyclic drugs exhibit clinical effectiveness within a defined therapeutic concentration range (1-10). Very recently, both Dito (11) and Orsulak and Schildkraut (12) have summarized the usefulness of measuring serum concentrations of these drugs. These authors suggest that knowledge of the plasma concentrations of these drugs aid the physician in determining patient compliance and initiating the best possible drug treatment.

  7. Amygdala response to explicit sad face stimuli at baseline predicts antidepressant treatment response to scopolamine in major depressive disorder.

    Science.gov (United States)

    Szczepanik, Joanna; Nugent, Allison C; Drevets, Wayne C; Khanna, Ashish; Zarate, Carlos A; Furey, Maura L

    2016-08-30

    The muscarinic antagonist scopolamine produces rapid antidepressant effects in individuals with major depressive disorder (MDD). In healthy subjects, manipulation of acetyl-cholinergic transmission modulates attention in a stimulus-dependent manner. This study tested the hypothesis that baseline amygdalar activity in response to emotional stimuli correlates with antidepressant treatment response to scopolamine and could thus potentially predict treatment outcome. MDD patients and healthy controls performed an attention shifting task involving emotional faces while undergoing functional magnetic resonance imaging (fMRI). We found that blood oxygenation level dependent (BOLD) signal in the amygdala acquired while MDD patients processed sad face stimuli correlated positively with antidepressant response to scopolamine. Amygdalar response to sad faces in MDD patients who did not respond to scopolamine did not differ from that of healthy controls. This suggests that the pre-treatment task elicited amygdalar activity that may constitute a biomarker of antidepressant treatment response to scopolamine. Furthermore, in MDD patients who responded to scopolamine, we observed a post-scopolamine stimulus processing shift towards a pattern demonstrated by healthy controls, indicating a change in stimulus-dependent neural response potentially driven by attenuated cholinergic activity in the amygdala. PMID:27366831

  8. Rapid and Longer-Term Antidepressant Effects of Repeated Ketamine Infusions in Treatment-Resistant Major Depression

    NARCIS (Netherlands)

    Murrough, James W.; Perez, Andrew M.; Pillemer, Sarah; Stern, Jessica; Parides, Michael K.; aan het Rot, Marije; Collins, Katherine A.; Mathew, Sanjay J.; Charney, Dennis S.; Iosifescu, Dan V.

    2013-01-01

    Background: Ketamine is reported to have rapid antidepressant effects; however, there is limited understanding of the time-course of ketamine effects beyond a single infusion. A previous report including 10 participants with treatment-resistant major depression (TRD) found that six ketamine infusion

  9. Augmenting Antidepressant Medication Treatment of Depressed Women with Emotionally Focused Therapy for Couples: A Randomized Pilot Study

    Science.gov (United States)

    Denton, Wayne H.; Wittenborn, Andrea K.; Golden, Robert N.

    2012-01-01

    This is the first study to evaluate adding emotionally focused therapy for couples (EFT) to antidepressant medication in the treatment of women with major depressive disorder and comorbid relationship discord. Twenty-four women and their male partners were randomized to 6 months of medication management alone (MM) or MM augmented with EFT (MM +…

  10. Randomized Trial of Behavioral Activation, Cognitive Therapy, and Antidepressant Medication in the Acute Treatment of Adults with Major Depression

    Science.gov (United States)

    Dimidjian, Sona; Hollon, Steven D.; Dobson, Keith S.; Schmaling, Karen B.; Kohlenberg, Robert J.; Addis, Michael E.; Gallop, Robert; McGlinchey, Joseph B.; Markley, David K.; Gollan, Jackie K.; Atkins, David C.; Dunner, David L.; Jacobson, Neil S.

    2006-01-01

    Antidepressant medication is considered the current standard for severe depression, and cognitive therapy is the most widely investigated psychosocial treatment for depression. However, not all patients want to take medication, and cognitive therapy has not demonstrated consistent efficacy across trials. Moreover, dismantling designs have…

  11. An endocrine perspective on the role of steroid hormones in the antidepressant treatment efficacy of transcranial magnetic stimulation

    NARCIS (Netherlands)

    Schutter, D.J.L.G.; Honk, E.J. van

    2010-01-01

    Evidence from recent meta-analyses indicates that transcranial magnetic stimulation (TMS) is moderately effective in the treatment of major depressive disorder (MDD). Individual differences in the susceptibility to TMS are suggested to underlie a significant portion of the variability in antidepress

  12. The antidepressant- and anxiolytic-like effects following co-treatment with escitalopram and risperidone in rats.

    Science.gov (United States)

    Kaminska, K; Rogoz, Z

    2016-06-01

    Several clinical reports have documented a beneficial effect of the addition of a low dose of risperidone to the ongoing treatment with antidepressants, in particular selective serotonin reuptake inhibitors (SSRI), in the treatment of drug-resistant depression and treatment-resistant anxiety disorders. In the present study, we investigated the effect of treatment with the antidepressant escitalopram (SSRI) given separately or jointly with a low dose of risperidone (an atypical antipsychotic) in the forced swim test and in the elevated plus-maze test in rats. The obtained results showed that escitalopram at doses of 2.5 or 5 mg/kg evoked antidepressant-like effect in the forced swim test. Moreover, risperidone at low doses (0.05 or 0.1 mg/kg) enhanced the antidepressant-like activity of escitalopram (1 mg/kg) in this test by increasing the swimming time and decreasing the immobility time in those animals. WAY 100635 (a serotonin 5-HT1A receptor antagonist) at a dose of 0.1 mg/kg abolished the antidepressant-like effect induced by co-administration of escitalopram and risperidone. The active behavior in that test did not reflect an increase in general activity, since the combined treatment with escitalopram and risperidone failed to enhance the exploratory activity of rats. In the following experiment, we showed that escitalopram (5 mg/kg) and mirtazapine (5 or 10 mg/kg) or risperidone (0.1 mg/kg) induced an anxiolytic-like effect in the elevated plus-maze test, and the combined treatment with an ineffective dose of risperidone (0.05 mg/kg) enhanced the anxiolytic-like effects of escitalopram (2.5 mg/kg) or mirtazapine (1 and 2.5 mg/kg) in this test. The obtained results suggest that risperidone applied at a low dose enhances the antidepressant-like activity of escitalopram in the forced swim test, and that 5-HT1A receptors may play some role in these effects. Moreover, a low dose of risperidone may also enhance the anxiolytic-like action of the studied

  13. The antidepressant- and anxiolytic-like effects following co-treatment with escitalopram and risperidone in rats.

    Science.gov (United States)

    Kaminska, K; Rogoz, Z

    2016-06-01

    Several clinical reports have documented a beneficial effect of the addition of a low dose of risperidone to the ongoing treatment with antidepressants, in particular selective serotonin reuptake inhibitors (SSRI), in the treatment of drug-resistant depression and treatment-resistant anxiety disorders. In the present study, we investigated the effect of treatment with the antidepressant escitalopram (SSRI) given separately or jointly with a low dose of risperidone (an atypical antipsychotic) in the forced swim test and in the elevated plus-maze test in rats. The obtained results showed that escitalopram at doses of 2.5 or 5 mg/kg evoked antidepressant-like effect in the forced swim test. Moreover, risperidone at low doses (0.05 or 0.1 mg/kg) enhanced the antidepressant-like activity of escitalopram (1 mg/kg) in this test by increasing the swimming time and decreasing the immobility time in those animals. WAY 100635 (a serotonin 5-HT1A receptor antagonist) at a dose of 0.1 mg/kg abolished the antidepressant-like effect induced by co-administration of escitalopram and risperidone. The active behavior in that test did not reflect an increase in general activity, since the combined treatment with escitalopram and risperidone failed to enhance the exploratory activity of rats. In the following experiment, we showed that escitalopram (5 mg/kg) and mirtazapine (5 or 10 mg/kg) or risperidone (0.1 mg/kg) induced an anxiolytic-like effect in the elevated plus-maze test, and the combined treatment with an ineffective dose of risperidone (0.05 mg/kg) enhanced the anxiolytic-like effects of escitalopram (2.5 mg/kg) or mirtazapine (1 and 2.5 mg/kg) in this test. The obtained results suggest that risperidone applied at a low dose enhances the antidepressant-like activity of escitalopram in the forced swim test, and that 5-HT1A receptors may play some role in these effects. Moreover, a low dose of risperidone may also enhance the anxiolytic-like action of the studied

  14. Antidepressant treatment reduces Fos-like immunoreactivity induced by swim stress in different columns of the periaqueductal gray matter.

    Science.gov (United States)

    Lino-de-Oliveira, Cilene; de Oliveira, Rúbia M W; Pádua Carobrez, Antonio; de Lima, Thereza C M; del Bel, Elaine Aparecida; Guimarães, Francisco Silveira

    2006-10-16

    Antidepressant treatment attenuates behavioral changes induced by uncontrollable stress. The periaqueductal gray matter (PAG) is proposed to be a brain site involved in the behavioral responses to uncontrollable stress and antidepressant effects. The main goal of the present study was to investigate the effect of antidepressant treatment on the pattern of neural activation of the PAG along its mediolateral and rostrocaudal subregions after a forced swim stress episode. Male Wistar rats were sub-acutely treated with desipramine (a selective noradrenaline re-uptake blocker, three injections of 10 mg/kg in 24 h) or clomipramine (a non-selective serotonin and noradrenaline re-uptake blocker, three injections of 10 mg/kg in 24 h) and submitted to the forced swimming test (FST). Two hours after the test their brain were removed for Fos immunohistochemistry. Fos-like immunoreactivity (FLI) in rostral, intermediate and caudal portions of dorsomedial (dmPAG), dorsolateral (dlPAG), lateral (lPAG) and ventrolateral (vlPAG) PAG were quantified by a computerized system. The FST session increased FLI in most parts of the PAG. Previous treatment with desipramine or clomipramine reduced FLI in all columns of the PAG. FLI in the PAG correlated positively with to the immobility time and negatively with to climbing behavior scored during the test. These results indicate that neurons in the PAG are activated by uncontrollable stress. Moreover, inhibitory action of antidepressants on this activity may be associated with the anti-immobility effects of these drugs in the FST.

  15. The effect of flexible cognitive-behavioural therapy and medical treatment, including antidepressants on post-traumatic stress disorder and depression in traumatised refugees

    DEFF Research Database (Denmark)

    Buhmann, Caecilie Böck; Nordentoft, Merete; Ekstrøm, Morten;

    2016-01-01

    BACKGROUND: Little evidence exists on the treatment of traumatised refugees. AIMS: To estimate treatment effects of flexible cognitive-behavioural therapy (CBT) and antidepressants (sertraline and mianserin) in traumatised refugees. METHOD: Randomised controlled clinical trial with 2 × 2 factorial...

  16. Radioactive cDNA microarray (II): Gene expression profiling of antidepressant treatment by human cDNA microarray

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Hye; Kang, Rhee Hun; Ham, Byung Joo; Lee, Min Su; Shin, Kyung Ho; Choe, Jae Gol; Kim, Meyoung Kon [College of Medicine, Univ. of Korea, Seoul (Korea, Republic of)

    2003-07-01

    Major depressive disorder is a prevalent psychiatric disorder in primary care, associated with impaired patient functioning and well-being. Fluoxetine is a selective serotonin-reuptake inhibitors (SSRIs) and is a commonly prescribed antidepressant compound. Its action is primarily attributed to selective inhibition of the reuptake of serotonin (5-hydroxytryptamine) in the central nervous system. Objectives ; the aims of this study were two-fold: (1) to determine the usefulness for investigation of the transcription profiles in depression patients, and (2) to assess the differences in gene expression profiles between positive response group and negative response groups by fluoxetine treatment. This study included 53 patients with major depression (26 in positive response group with antidepressant treatment, 27 in negative response group with antidepressant treatment), and 53 healthy controls. To examine the difference of gene expression profile in depression patients, radioactive complementary DNA microarrays were used to evaluate changes in the expression of 1,152 genes in total. Using 33p-labeled probes, this method provided highly sensitive gene expression profiles including brain receptors, drug metabolism, and cellular signaling. Gene transcription profiles were classified into several categories in accordance with the antidepressant gene-regulation. The gene profiles were significantly up-(22 genes) and down-(16 genes) regulated in the positive response group when compared to the control group. Also, in the negative response group, 35 genes were up-regulated and 8 genes were down-regulated when compared to the control group. Consequently, we demonstrated that radioactive human cDNA microarray is highly likely to be an efficient technology for evaluating the gene regulation of antidepressants, such as selective serotonin-reuptake inhibitors (SSRIs), by using high-throughput biotechnology.

  17. Reconsidering GHB: orphan drug or new model antidepressant?

    Science.gov (United States)

    Bosch, Oliver G; Quednow, Boris B; Seifritz, Erich; Wetter, Thomas C

    2012-05-01

    For six decades, the principal mode of action of antidepressant drugs is the inhibition of monoamine re-uptake from the synaptic cleft. Tricyclic antidepressants, selective serotonin re-uptake inhibitors (SSRIs) and the new generation of dual antidepressants all exert their antidepressant effects by this mechanism. In the early days of the monoaminergic era, other efforts have been made to ameliorate the symptoms of depression by pharmacological means. The gamma-aminobutyric acid (GABA) system was and possibly still is one of the main alternative drug targets. Gammahydroxybutyrate (GHB) was developed as an orally active GABA analogue. It was tested in animal models of depression and human studies. The effects on sleep, agitation, anhedonia and depression were promising. However, the rise of benzodiazepines and tricyclic antidepressants brought GHB out of the scope of possible treatment alternatives. GHB is a GABA(B) and GHB receptor agonist with a unique spectrum of behavioural, neuroendocrine and sleep effects, and improves daytime sleepiness in various disorders such as narcolepsy, Parkinson's disease and fibromyalgia. Although it was banned from the US market at the end of the 1990s because of its abuse and overdose potential, it later was approved for the treatment of narcolepsy. New research methods and an extended view on other neurotransmitter systems as possible treatment targets of antidepressant treatment brought GHB back to the scene. This article discusses the unique neurobiological effects of GHB, its misuse potential and possible role as a model substance for the development of novel pharmacological treatment strategies in depressive disorders.

  18. [Alternative treatment methods in ENT].

    Science.gov (United States)

    Friese, K H

    1997-08-01

    In this review, the most important complementary und alternative therapies are discussed, focusing particularly on their use in otorhinolaryngology. These therapies include balneology, Kneipp therapy, microbiological therapy, fasting, excretion therapy, different oxygen therapies, hydro-colon therapy, urine therapy, own-blood therapy, Bach therapy, orthomolecular therapy, order therapy, environmental medicine, phytotherapy, homeopathy, complex homeopathy, anthroposophy, neural therapy, electroaccupuncture according to Voll and similar therapies, nasal reflex therapy, reflex-zone massage, manual therapy, massage, lymph drainage, aroma therapy, thermotherapy, bioresonance, kinesiology, hopi candles, and dietetics. Some of these methods and regimens can be recommended, but others should be rejected. In universities, these methods are only represented to a minor extend, but are more accepted by otorhinolaryngologists in practice. This paper provides a guide to which alternative therapies are sensible and possible in otorhinolaryngology. The aim is to stimulate interest in these methods. It is necessary to discuss these alternative methods reasonably and credibly with patients. PMID:9378666

  19. Effect of antidepressant treatment on water load test and cortisol changes in patients with functional dyspepsia

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: It has been demonstrated that patients with functional dyspepsia have experiences social life stress events, and accompanied by psychological disorders, mainly manifested as depression and anxiety.Mental factors can lead to excessive gastrointestinal consensual reaction, and result in different brain-gut axis disturbance, and then cause the gastrointestinal sensorimotor abnormality and endocrine changes.OBJECTIVE: To observe the effect of antidepressant treatment on the changes of water load and serum cortisol in patients with functional dyspepsia, and analyze the therapeutic mechanism.DESIGN: A comparative observation.SETTING: The First Affiliated Hospital o Zhengzhou University.PARTICIPANTS: Forty-five patients with functional dyspepsia accompanied by depression were selected from the Department of Gastroenterology, the First Affiliated Hospital of Zhengzhou University from July 2004 to July 2006, and they were 25 - 65 years of age, and their disease courses ranged 1 - 10 years. They were all accorded with the diagnostic standards for Rome Ⅱ functional dyspepsia functional dyspepsia. As the patients' will, they were divided into treatment group (n =30, 12 males and 18 females) and control group (n =15, 6 males and 9 females), and there were no significant differences in the data between the two groups (P > 0.05). The programs were discussed and agreed by the committee of medical ethics of the First Affiliated Hospital of Zhengzhou University. Informed contents were obtained from all the patients.METHODS: In the treatment group, the patients were treated with venlafaxine sustained release capsule (75 mg per day), and those with sleep disorder were added by benzodiazepines (alprazolam). In the control group, the patients were given routine treatments of antacid, prokinetics, etc. Before and after 8-week treatment, the following examinations were performed: ① The gastrointestinal symptoms were assessed according to the symptoms; ② The severity of

  20. Antidepressant treatment and cultural differences - a survey of the attitudes of physicians and patients in Sweden and Turkey

    Directory of Open Access Journals (Sweden)

    McConnachie Alex

    2010-11-01

    Full Text Available Abstract Background The presenting symptoms of depression can be influenced by cultural differences. This study was conducted to compare the presenting symptoms and response to antidepressant medication of patients in Sweden and Turkey, two culturally different European countries. Methods Recruitment was triggered when adult patients were diagnosed with a depressive or anxiety disorder by a primary care physician and prescribed an antidepressant. Physicians and patients recorded presenting symptoms and completed relevant questionnaires just before and 8 weeks after starting treatment with an antidepressant. These included the Hospital Anxiety and Depression Scale (HADS, the Clinical Global Impressions (CGI scale, the Sheehan Disability Scale (SDS, and Likert scales gauging the importance of physical and psychological symptoms. Patients also rated severity of prominent symptoms (depression, anxiety, stress, sleep and pain from zero to ten. The outcomes were compared between patients from Sweden and Turkey using Fisher's Exact test and two-sample t-tests. Results The study was conducted in 460 patients (107, 23.3% in Sweden; 353, 76.7% in Turkey. Presenting symptoms differed between Sweden and Turkey, with Turkish patients more likely to present with physical symptoms, and report a higher number of physical symptoms (mean 2.4 vs. 1.4, p Conclusions The presenting symptoms of patients diagnosed with a depressive or anxiety disorder by a primary care physician and prescribed an antidepressant differ between Turkey and Sweden. Patients in Turkey were more likely to present with physical symptoms than patients in Sweden and present with more physical symptoms. After 8 weeks of antidepressant treatment, the improvement from baseline was greater in Turkish patients, and this was reflected in their improved functioning.

  1. Advanced oxidation treatment and photochemical fate of selected antidepressant pharmaceuticals in solutions of Suwannee River humic acid

    Energy Technology Data Exchange (ETDEWEB)

    Santoke, Hanoz, E-mail: hsantoke@uci.edu [Urban Water Research Center, Department of Civil and Environmental Engineering, University of California, Irvine, Irvine, CA 92697-2175 (United States); Song, Weihua, E-mail: wsong@uci.edu [Urban Water Research Center, Department of Civil and Environmental Engineering, University of California, Irvine, Irvine, CA 92697-2175 (United States); Department of Environmental Science and Engineering, Fudan University, Shanghai, 200433 (China); Cooper, William J., E-mail: wcooper@uci.edu [Urban Water Research Center, Department of Civil and Environmental Engineering, University of California, Irvine, Irvine, CA 92697-2175 (United States); Peake, Barrie M., E-mail: bpeake@chemistry.otago.ac.nz [Chemistry Department, University of Otago, P.O. Box 56, Dunedin 9054 (New Zealand)

    2012-05-30

    Highlights: Black-Right-Pointing-Pointer We elucidate the photochemical degradation of three antidepressant pharmaceuticals. Black-Right-Pointing-Pointer Hydroxyl radical is the most significant contributor to the degradation. Black-Right-Pointing-Pointer Excited state dissolved organic matter also plays a significant role for duloxetine. Black-Right-Pointing-Pointer Tentative reaction byproducts are identified. - Abstract: Antidepressant pharmaceuticals have recently been detected at low concentrations in wastewater and surface water. This work reports studies of the direct and indirect photochemical fate and treatment by advanced oxidation of three antidepressant compounds (duloxetine, venlafaxine and bupropion) in solutions of humic acid in order to elucidate their behavior in the natural environment prior to reaching a water treatment facility and potentially entering a potable water supply. Humic acid solution was prepared by adding to distilled water a known amount of organic matter as a photosensitizer. All three antidepressants react very rapidly with hydroxyl radicals ({center_dot}OH) and hydrated electrons (e{sup -}{sub aq}) with rate constants of {approx}10{sup 8} to 10{sup 10} M{sup -1} s{sup -1}, but significantly slower with singlet oxygen ({sup 1}{Delta}O{sub 2}) ({approx}10{sup 3} to 10{sup 5} M{sup -1} s{sup -1}). The steady-state concentrations of {center_dot}OH and {sup 1}{Delta}O{sub 2}, in a sample of humic acid solution were measured and used with the second order rate constants to show that the hydroxyl radical was an order of magnitude more effective than the singlet oxygen in the solar-induced photochemical degradation of the antidepressants. Excited state dissolved organic matter also accounted for a substantial portion of degradation of duloxetine, decreasing its half-life by 27% under solar irradiation. Several reaction pathways and by-products arising from the photodegradation were identified using gamma-irradiation followed by LC

  2. Advanced oxidation treatment and photochemical fate of selected antidepressant pharmaceuticals in solutions of Suwannee River humic acid

    International Nuclear Information System (INIS)

    Highlights: ► We elucidate the photochemical degradation of three antidepressant pharmaceuticals. ► Hydroxyl radical is the most significant contributor to the degradation. ► Excited state dissolved organic matter also plays a significant role for duloxetine. ► Tentative reaction byproducts are identified. - Abstract: Antidepressant pharmaceuticals have recently been detected at low concentrations in wastewater and surface water. This work reports studies of the direct and indirect photochemical fate and treatment by advanced oxidation of three antidepressant compounds (duloxetine, venlafaxine and bupropion) in solutions of humic acid in order to elucidate their behavior in the natural environment prior to reaching a water treatment facility and potentially entering a potable water supply. Humic acid solution was prepared by adding to distilled water a known amount of organic matter as a photosensitizer. All three antidepressants react very rapidly with hydroxyl radicals (·OH) and hydrated electrons (e−aq) with rate constants of ∼108 to 1010 M−1 s−1, but significantly slower with singlet oxygen (1ΔO2) (∼103 to 105 M−1 s−1). The steady-state concentrations of ·OH and 1ΔO2, in a sample of humic acid solution were measured and used with the second order rate constants to show that the hydroxyl radical was an order of magnitude more effective than the singlet oxygen in the solar-induced photochemical degradation of the antidepressants. Excited state dissolved organic matter also accounted for a substantial portion of degradation of duloxetine, decreasing its half-life by 27% under solar irradiation. Several reaction pathways and by-products arising from the photodegradation were identified using gamma-irradiation followed by LC–MS analysis.

  3. Stress, depression and antidepressant treatment options in patients suffering from multiple sclerosis.

    Science.gov (United States)

    Schumann, Robert; Adamaszek, Michael; Sommer, Norbert; Kirkby, Kenneth C

    2012-01-01

    Stress constitutes a risk factor for diseases where the immune system plays a significant role. Stress is recognized as a possible trigger for flare ups during the course of multiple sclerosis (MS). The disclosure to the patient of the diagnosis of MS, the commencement of immunomodulatory therapy, and the unpredictability and vagaries of disease progression are all sources of stress. Biological stress systems such as the hypothalamic-pituitary-adrenal system and the sympathetic nervous system may influence the pathogenesis and the disease course of MS. The ability to cope with stress may also be impaired, mediated for example by cognitive deficits or loss of abilities and resources as disease progresses or by the high prevalence of concurrent mood disturbances such as depression and chronic fatigue. Psychiatric comorbidities of MS disease or therapy as well as impairments of coping strategies are underrecognized in clinical practice. Treatment plans for depression among MS patients, as the most common psychiatric comorbidity, should be individualized with integrated approaches. Antidepressants are effective for the treatment of depression in MS patients although further clinical research into the neurobiological and psychological bases of depressive disorders in MS patients is clearly needed. In therapy, coping strategies can be enhanced through multidisciplinary assessment of the various challenges and restrictions imposed by the disease and assisting and supporting the patient in addressing these. Exercise, as a form of positive stress (eustress), also has a role in therapy.

  4. Nonnarcotic analgesics and tricyclic antidepressants for the treatment of chronic nonmalignant pain.

    Science.gov (United States)

    Richlin, D M

    1991-05-01

    Chronic nonmalignant pain is often characterized by multiple treatment failures, a pattern of maladaptive behavior, and depression. Often there is a history of inappropriate and excessive use of medications for pain. Prior and ongoing use of narcotics and sedatives acts to compound and aggravate the chronic pain syndrome. A first step in treatment is controlled withdrawal of these agents. Nonnarcotic analgesics, NSAIDs, and tricyclic antidepressants are commonly employed in patients with chronic pain. Effective use of these agents requires understanding of their pharmacokinetic and pharmacodynamic properties. Use of a fixed-time schedule is necessary to achieve an effective, sustained therapeutic response. Careful patient education and monitoring for side effects and toxicity are necessary, particularly in the elderly and patients with coexisting medical disorders. Incidence of side effects and toxicity may be reduced by choice of drug and modification of dosing regimen. Nonnarcotic analgesics, TCAs, and NSAIDs are seldom effective by themselves in resolving the pain and distress of patients with chronic nonmalignant pain. This is particularly true when maladaptive behavior coexists. A comprehensive multimodal pain management program encompassing additional pain-relieving strategies and behavior-modifying techniques should be considered and utilized in conjunction with medication.

  5. Efficacy and Safety of Antidepressant Augmentation With Lamotrigine in Patients With Treatment-Resistant Depression: A Randomized, Placebo-Controlled, Double-Blind Study

    OpenAIRE

    Santos, Milena Antunes; Rocha, Fábio Lopes; Hara, Cláudia

    2008-01-01

    Objective: This study reports a clinical trial evaluating lamotrigine safety and efficacy as an antidepressant augmentation agent in treatment-resistant depression, therefore adding more empirical evidence to the limited number of studies on the use of lamotrigine.

  6. Mitochondrial dynamics in the hippocampus is influenced by antidepressant treatment in a genetic rat model of depression

    DEFF Research Database (Denmark)

    Chen, F.; Wegener, Gregers; Madsen, T. M.;

    2013-01-01

    model of depression. The unbiased stereoloy methods were used to estimate the mitochondria numerical density, the number of mitochondria and the mean size and volume of mitochondria in CA1 stratum radiatum (CA1SR) of hippocampus. The results showed that the mitochondria numerical density and the number......Post-mortem, genetic, brain imaging, and peripheral cell studies showed that mitochondria may play an important role in the pathophysiology of depression and effects of antidepressant therapy. Here we investigated whether chronic antidepressant treatment on rats induce changes of the mitochondrial...... and SD-saline group. Impramine treatment can significantly increase the mitochondria numerical density and the number of mitochondria in FSL-imipramine group. Our results support the mitochondria plasticity hypothesis that depressive disorders may be related to impairments of mitochondria plasticity...

  7. The Strategy of Combining Antidepressants in the Treatment of Major Depression: Clinical Experience in Spanish Outpatients

    Directory of Open Access Journals (Sweden)

    Luis M. Martín-López

    2011-01-01

    The most frequent combinations are SSRIs and tricyclic antidepressants. The active principle most widely combined is fluoxetine. Conclusions. The prevalence of use of antidepressant combination therapy is 2.2% of the global sample and 8.3% of treated patients. Other than duration of the depressive episode, no clinical characteristics exclusive to patients who received combination rather than monotherapy were found. Our study found that the most frequent combination is SSRIs + TCAs, also being the most studied.

  8. Augmenting antidepressant medication treatment of depressed women with emotionally focused therapy for couples: A randomized pilot study

    OpenAIRE

    Denton, Wayne H.; Wittenborn, Andrea K; Golden, Robert N.

    2012-01-01

    This is the first study to evaluate adding emotionally focused therapy for couples (EFT) to antidepressant medication in the treatment of women with major depressive disorder and comorbid relationship discord. Twenty-four women and their male partners were randomized to six months of medication management alone (MM) or medication management augmented with EFT (MM+EFT). Medication management followed the Texas Medication Algorithm Project guidelines. Fifteen EFT sessions were...

  9. [The comparative study on the efficacy of the combination of serotonin reuptake inhibitor antidepressants and antipsychotics in the treatment of recurrent depressive disorders].

    Science.gov (United States)

    D'iakonov, A L; Lobanova, I V

    2012-01-01

    A combination of serotonin reuptake inhibitor antidepressants (prozac and stimulaton) with atypical antipsychotics (zyprexa and solian) reduced depression in patients with recurrent depressive disorders during 10 days. The effect was evenly distributed between 10, 20 and 40 days of treatment. Other symptoms had a peculiar dynamics depending on the therapy. By the end of the study, similar effects were achieved for all groups. The addition of antipsychotics to antidepressant treatment insignificantly increased the number of adverse events.

  10. Ozone oxidation of antidepressants in wastewater –Treatment evaluation and characterization of new by-products by LC-QToFMS

    OpenAIRE

    Lajeunesse André; Blais Mireille; Barbeau Benoît; Sauvé Sébastien; Gagnon Christian

    2013-01-01

    Abstract Background The fate of 14 antidepressants along with their respective N-desmethyl metabolites and the anticonvulsive drug carbamazepine was examined in a primary sewage treatment plant (STP) and following advanced treatments with ozone (O3). The concentrations of each pharmaceutical compound were determined in raw sewage, effluent and sewage sludge samples by LC-MS/MS analysis. The occurrence of antidepressant by-products formed in treated effluent after ozonation was also investigat...

  11. Obesity: Causes and Treatment Alternatives

    OpenAIRE

    Berrin Zuhal Bulucu Altunkaynak; Elvan Özbek

    2007-01-01

    Obesity is an important and chronic disease. It occurs due to more body fat accumulation than normal levels, it associates with many factor and it needs to medical treatment. Important risk factors of obesity are feeding habits, sexualty (Female), age, education, marriage, labor number and hereditary. Obesity, may be originated from hereditary factors and it progresses very fastly in developed and developing countries. More than 30 % percent of population is obese in Turkey (male %7,9 female ...

  12. 三环类抗抑郁药所致心肌损害的治疗%Treatment of myocardiac injury caused by tricyclic antidepressant

    Institute of Scientific and Technical Information of China (English)

    邢秀娟; 李美花; 吕伟

    2003-01-01

    @@ INTRODUCTION Tricyclic antidepressant has some toxic effect on heart, myocardicinjury is a common adverse effect which main characteristic areabnormality of EKG, change of T wave, deviation of ST segmentand prolongation of PR and Q-T interval. No self-conscious symp-toms is found in clinic. Compound Danshen dripping pill is thecommon drug in treatment of coronary heart disease and myocardiacinjury. We try to treat myocardiac injury caused by tricyclic an-tidepressant by compound Danshen dripping pill.

  13. Natural treatments for seasonal and non-seasonal depression: a review of literature and comparison of antidepressant responses

    Directory of Open Access Journals (Sweden)

    A. Putilov

    2013-02-01

    Full Text Available The symptoms of depression might be alleviated by such non-pharmacological interventions as sleep deprivation, bright light exposure, and physical exercise. Some strategies of non-drug treatment for seasonal and non-seasonal depression seem to be very effective, but the involvement of specific biological mechanisms in the observed beneficial response still remains to be clarified. A present literature review was combined with a brief summary of the results of a set of author’s investigations that provided a possibility to compare the antidepressant effects of several one-week treatments in 268 female subjects with either winter depression or non-seasonal depression or without depression (n=118, 64 and 86, respectively. It was demonstrated that a total night sleep deprivation failed to improve mood in non-depressed subjects, whereas in seasonally and non-seasonally depressed subjects the significant improvements of similar magnitudes were observed. Furthermore, any type of one-week treatment (i.e., 6 or 7 days of bright light, physical exercise, melatonin or placebo intake, and vocation in a south region administered either alone or in combination with one night of sleep deprivation produced a notable reduction of depression scores in both depressed and non-depressed subjects. Such treatments prevented relapse after sleep deprivation. Mood further improved after visual treatments, such as bright light and physical exercise, rather than after blind intake of ether melatonin or placebo. The studies of natural antidepressants highlighted the possibility that they often work as powerful placebos, and that, compared to the biology of depressives; their psychology is the most important mediator of clinical response. Further research might be aimed on testing the predictions based on evolutionary explanation of depression and antidepressant responses to natural treatments.

  14. Alternatives to Drug Treatment for Hyperactivity.

    Science.gov (United States)

    Den Houtter, Kathryn

    1980-01-01

    Results from recent studies on the effectiveness of Ritalin for "hyperactivity" show that this treatment is dubious at best. This article presents an alternative treatment approach, placing emphasis on devising an appropriate learning situation that meets the needs of the so-called hyperactive child. (Author)

  15. Prevalence of depression, quality of life and antidepressant treatment in the Danish General Suburban Population Study

    DEFF Research Database (Denmark)

    Ellervik, Christina; Kvetny, Jan; Christensen, Kaj Sparle;

    2014-01-01

    to describe the prevalence of antidepressants received by the respondents in the GESUS study and the correspondence to their subjective well-being on the WHO-5 questionnaire. METHODS: To evaluate the validity (scalability) of the MDI and the WHO-5 in the GESUS study we performed the non-parametric Mokken...

  16. Antidepressant-like activity of resveratrol treatment in the forced swim test and tail suspension test in mice: the HPA axis, BDNF expression and phosphorylation of ERK.

    Science.gov (United States)

    Wang, Zhen; Gu, Jianhua; Wang, Xueer; Xie, Kai; Luan, Qinsong; Wan, Nianqing; Zhang, Qun; Jiang, Hong; Liu, Dexiang

    2013-11-01

    Resveratrol is a natural polyphenol enriched in Polygonum cuspidatum and has diverse biological activities. There is only limited information about the antidepressant-like effect of resveratrol. The present study assessed whether resveratrol treatment (20, 40 and 80mg/kg, i.p., 21days) has an antidepressant-like effect on the forced swim test (FST) and tail suspension test (TST) in mice and examined what its molecular targets might be. The results showed that resveratrol administration produced antidepressant-like effects in mice, evidenced by the reduced immobility time in the FST and TST, while it had no effect on the locomotor activity in the open field test. Resveratrol treatment significantly reduced serum corticosterone levels, which had been elevated by the FST and TST. Moreover, resveratrol increased brain-derived neurotrophic factor (BDNF) protein and extracellular signal-regulated kinase (ERK) phosphorylation levels in the prefrontal cortex and hippocampus. All of these antidepressant-like effects of resveratrol were essentially similar to those observed with the clinical antidepressant, fluoxetine. These results suggest that the antidepressant-like effects of resveratrol in the FST and TST are mediated, at least in part, by modulating hypothalamic-pituitary-adrenal axis, BDNF and ERK phosphorylation expression in the brain region of mice.

  17. Brain functional changes in facial expression recognition in patients with major depressive disorder before and after antidepressant treatment A functional magnetic resonance imaging study

    Institute of Scientific and Technical Information of China (English)

    Wenyan Jiang; Zhongmin Yin; Yixin Pang; Feng Wu; Lingtao Kong; Ke Xu

    2012-01-01

    Functional magnetic resonance imaging was used during emotion recognition to identify changes in functional brain activation in 21 first-episode, treatment-naive major depressive disorder patients before and after antidepressant treatment. Following escitalopram oxalate treatment, patients exhibited decreased activation in bilateral precentral gyrus, bilateral middle frontal gyrus, left middle temporal gyrus, bilateral postcentral gyrus, left cingulate and right parahippocampal gyrus, and increased activation in right superior frontal gyrus, bilateral superior parietal lobule and left occipital gyrus during sad facial expression recognition. After antidepressant treatment, patients also exhibited decreased activation in the bilateral middle frontal gyrus, bilateral cingulate and right parahippocampal gyrus, and increased activation in the right inferior frontal gyrus, left fusiform gyrus and right precuneus during happy facial expression recognition. Our experimental findings indicate that the limbic-cortical network might be a key target region for antidepressant treatment in major depressive disorder.

  18. Chronic treatment with antidepressant drugs and the analgesia induced by 5-methoxy-N,N-dimethyltryptamine: attenuation by desipramine.

    Science.gov (United States)

    Danysz, W; Minor, B G; Post, C; Archer, T

    1986-08-01

    The effect of chronic and acute oral or intraperitoneal treatment with the antidepressant drugs, desipramine, amitriptyline, alaproclate and iprindole, upon pain thresholds in the tail flick, hot plate and shock titration tests of nociception in saline- and 5-MeODMT-treated rats was studied. Chronic desipramine treatment increased the pre-test tail flick latencies. In the saline-treated rats, chronic oral desipramine treatment increased tail flick latencies, whereas chronic oral amitriptyline treatment decreased tail flick latencies. In 5-MeODMT-treated rats, chronic oral desipramine treatment attenuated the effects of 5-MeODMT (1 mg/kg) in all three tests of nociception, whereas chronic amitriptyline caused a potentiation in the tail flick and hot plate tests. Chronic oral iprindole treatment attenuated 5-MeODMT-induced analgesia in the hot plate test. Chronic intraperitoneal desipramine treatment attenuated 5-MeODMT analgesia in the tail flick and shock titration tests. In a different chronic treatment experiment, oral desipramine treatment attenuated 5-MeODMT analgesia in the tail flick test and zimeldine did for both the tail flick and hot plate tests, whereas mianserin potentiated 5-MeODMT-induced analgesia in both the tail flick and hot plate tests. In the saline-treated rats, acute treatment with all four drugs, desipramine, amitriptyline, iprindole and alaproclate, elevated the shock thresholds, whereas in 5-MeODMT-treated rats, desipramine and amitriptyline elevated shock thresholds. Two main conclusions can be drawn: chronic desipramine caused a quite consistent attenuation of 5-MeODMT-induced analgesia and the effects of acute treatment differed strongly from that of the chronic treatment. The effects of chronic administration with these antidepressants were compared with other findings using different measures of behavioural and receptor function. PMID:3776549

  19. Cardiovascular Effects of Antidepressants and Mood Stabilizers

    Directory of Open Access Journals (Sweden)

    Shahin Akhondzadeh

    2007-08-01

    Full Text Available Depression is a serious disorder in today’s society, with the estimates of lifetime prevalence being as high as 21% of the general population in some developed countries. As defined by the American Psychiatric Association, depression is a heterogeneous disorder often manifested with symptoms at the psychological, behavioral, and physiological levels. Such patients are often reluctant to take synthetic antidepressants in their appropriate doses due to their anticipated side effects including inability to drive a car, dry mouth, constipation, and sexual dysfunction. As a therapeutic alternative, effective herbal drugs may offer advantages in terms of safety and tolerability, possibly also improving patient compliance. The advent of the first antidepressants, Monoamine Oxidase Inhibitors (MAOIs and Tricyclic Antidepressants (TCAs, in the 1950s and 1960s represented a dramatic leap forward in the clinical management of depression. The subsequent development of the Selective Serotonin Reuptake Inhibitors (SSRIs and the Serotonin Norepinephrine Reuptake Inhibitor (SNRI venlafaxine in the past decade and a half has greatly enhanced the treatment of depression by offering patients medications that are as effective as the older agents but are generally more tolerable and safer in an overdose. The introduction of atypical antidepressants, such as bupropion, nefazadone, and mirtazapine, has added substantially to the available pharmacopoeia for depression. Nonetheless, rates of remission tend to be low and the risk of relapse and recurrence remains high. One of the concerns regarding the safety of antidepressant is its potential risk of cardiotoxicity and cardiovascular side effects. In this review, we will focus on the cardiovascular side effects of different types of antidepressants.

  20. Acute Treatment with a Novel TRPC4/C5 Channel Inhibitor Produces Antidepressant and Anxiolytic-Like Effects in Mice.

    Directory of Open Access Journals (Sweden)

    Li-Ping Yang

    Full Text Available Transient receptor potential canonical (TRPC channels are widely expressed in brain and involved in various aspects of brain function. Both TRPC4 and TRPC5 have been implicated in innate fear function, which represents a key response to environmental stress. However, to what extent the TRPC4/C5 channels are involved in psychiatric disorders remains unexplored. Here, we tested the antidepressant and anxiolytic-like effects of a newly identified TRPC4/C5 inhibitor, M084. We show that a single intraperitoneal administration of M084 at 10 mg/kg body weight to C57BL/6 male mice significantly shortened the immobility time in forced swim test and tail suspension test within as short as 2 hours. The M084-treated mice spent more time exploring in illuminated and open areas in light/dark transition test and elevated plus maze test. In mice subjected to chronic unpredictable stress, M084 treatment reversed the enhanced immobility time in forced swim test and decreased the latency to feed in novelty suppressed feeding test. The treatment of M084 increased BDNF expression in both mRNA and protein levels, as well as phosphorylation levels of AKT and ERK, in prefrontal cortex. Our results indicate that M084 exerts rapid antidepressant and anxiolytic-like effects at least in part by acting on BDNF and its downstream signaling. We propose M084 as a lead compound for further druggability research.

  1. Suicide Behavior Before and After the Start with Antidepressants : A High Persistent Risk in the First Month of Treatment Among the Young

    NARCIS (Netherlands)

    Termorshuizen, Fabian; Palmen, Saskia Jm; Heerdink, Eibert R

    2015-01-01

    BACKGROUND: A causal relationship between antidepressants (ADs) and a high risk of suicidal behavior at a young age has been suggested. We analyzed the rates of suicide attempts during treatment with AD in comparison with the rates before treatment initiation for different ages. METHODS: Claims of i

  2. Antipsychotics as antidepressants.

    Science.gov (United States)

    Roberts, Rona Jeannie; Lohano, Kavita K; El-Mallakh, Rif S

    2016-09-01

    Three second-generation antipsychotic (SGA) agents have received FDA approval for adjunctive treatment, to antidepressant, of major depressive disorder: quetiapine, aripiprazole, and olanzapine. Additionally, quetiapine and lurasidone have been approved for the treatment of bipolar depression. There are data suggesting that quetiapine is effective for major depressive disorder as monotherapy. These agents are effective for depression only at subantipsychotic doses. Receptor profiles predict that all SGA will have anxiolytic effects as subantipsychotic doses but that all will be dysphorogenic at full antipsychotic doses (i.e., produce a depression-like clinical picture). The antidepressant effect appears to be unique to some agents, with direct evidence of insignificant antidepressant action for ziprasidone. Three general principles can guide the use of antipsychotics as antidepressants: (i) All SGAs may have anxiolytic effects; (ii) full antipsychotic doses are dysphorogenic, and therefore, subantipsychotic doses are to be used; and (iii) SGAs do not have a general antidepressant effect, rather, this appears to be unique to quetiapine and aripiprazole, and possibly lurasidone. PMID:25963405

  3. Ketamine: A New Antidepressant?

    Directory of Open Access Journals (Sweden)

    Feride Karacaer

    2015-03-01

    Full Text Available Standart antidepressants are needed for the many individuals with major depressive disorder. However they do not respond adequately to treatment and because of a delay of weeks before the emergence of therapeutic effects. Recent studies show that subanesthetic dose of ketamine is efficacy and safety for the treatment of depression. Antidepressant effects of ketamine have been found to be short-lived and its psychotomimetic properties may limit the use of ketamine to depressive patients. Future research studies should focus on identifying predictors of response (pharmalogical and clinical , investigating application of different doses and routes of administration and maintaining antidepressant effect. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(1: 30-40

  4. Alternative Systemic Treatments for Vitiligo: A Review.

    Science.gov (United States)

    Cohen, Brandon E; Elbuluk, Nada; Mu, Euphemia W; Orlow, Seth J

    2015-12-01

    Vitiligo is a common, acquired disorder of skin pigmentation that can significantly impact quality of life. It often represents a therapeutic challenge, which has resulted in interest in alternative treatments such as herbal and vitamin supplements. In this review, we provide an overview of the most commonly studied complementary agents, describe proposed mechanisms of action, identify potential adverse effects, and discuss the primary evidence supporting their use. Our discussion focuses on L-phenylalanine, Polypodium leucotomos, khellin, Ginkgo biloba, and vitamins and minerals, including vitamins B12, C, and E, folic acid, and zinc used as monotherapy or in combination with other treatments for the management of vitiligo. PMID:26329814

  5. Treatment Technology and Alternative Water Resources

    Science.gov (United States)

    Chapman, M. J.

    2014-12-01

    At this point in our settlement of the planet Earth, with over seven billion human inhabitants, there are very few unallocated sources of fresh water. We are turning slowly toward "alternatives" such as municipal and industrial wastewater, saline groundwater, the sea, irrigation return flow, and produced water that comes up with oil and gas deposits from deep beneath the surface of the earth. Slowly turning, not because of a lack in technological ability, but because it takes a large capital investment to acquire and treat these sources to a level at which they can be used. The regulatory system is not geared up for alternative sources and treatment processes. Permitting can be circular, contradictory, time consuming, and very expensive. The purpose for the water, or the value of the product obtained using the water, must be such that the capital and ongoing expense seem reasonable. There are so many technological solutions for recovering water quality that choosing the most reliable, economical, and environmentally sound technology involves unraveling the "best" weave of treatment processes from a tangled knot of alternatives. Aside from permitting issues, which are beyond the topic for this presentation, the "best" weave of processes will be composed of four strands specifically fitted to the local situation: energy, pretreatment, driving force for separation processes, and waste management. A range of treatment technologies will be examined in this presentation with a focus on how the quality of the feed water, available power sources, materials, and waste management opportunities aid in choosing the best weave of treatment technologies, and how innovative use of a wide variety of driving forces are increasing the efficiency of treatment processes.

  6. Successful treatment of cataplexy in patients with early-infantile Niemann-Pick disease type C: use of tricyclic antidepressants.

    Science.gov (United States)

    Cak, Halime Tuna; Haliloğlu, Göknur; Düzgün, Gökçen; Yüce, Aysel; Topçu, Meral

    2014-11-01

    Cataplexy is a brief episode of bilateral loss of muscle tone with intact consciousness, triggered by a variety of strong emotions such as anger, laugh, humor or surprise and it is considered to represent the physiologic atonia of rapid eye movement sleep. On the other hand, Niemann-Pick type C is a neurodegenerative lysosomal storage disease, characterized by the accumulation of cholesterol and glycosphingolipids. Cataplexy is a relatively specific and common neurologic sign seen in almost 50% of all patients with Niemann-Pick type C. The aim of this report is to demonstrate the successful treatment of cataplexy with the use of a tricyclic antidepressant imipiramine, in two patients between the ages 6-9, with mild to moderate mental retardation, molecularly diagnosed as Niemann-Pick type C 1 and currently under miglustat treatment and to discuss the possible mechanisms of drug action in the light of cataplexy and Niemann-Pick type C pathophysiology. PMID:25139345

  7. Use of antidepressants in the treatment of major depressive disorder in primary care during a period of economic crisis

    Directory of Open Access Journals (Sweden)

    Sicras-Mainar A

    2015-12-01

    Full Text Available Antoni Sicras-Mainar,1 Ruth Navarro-Artieda2 1Research Unit, Badalona Serveis Assistencials SA, 2Medical Documentation Unit, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain Objective: To describe antidepressant (AD use in the treatment of major depressive disorder during a period of economic crisis.Patients and methods: This was a retrospective, observational study using population-based databases. Two periods were considered: 1 2008–2009, precrisis, and 2 2012–2013, economic crisis. Certain inclusion/exclusion criteria were taken into account for the study (initiation of AD treatment. Patients were followed up for 12 months. The main measures were use (defined daily doses, epidemiologic measures, strategies used and treatment persistence, referrals, and use of resources. Statistical significance was set at P<0.05.Results: In the precrisis period, 3,662 patients were enrolled, and 5,722 were enrolled in the period of economic crisis. Average age was 58.8 years and 65.4% were women. Comparing the two periods, major depressive disorder prevalence was 5.4% vs 8.1%, P<0.001. During the period of economic crisis, AD use rose by 35.2% and drug expenditures decreased by 38.7%. Defined daily dose per patient per day was 10.0 mg vs 13.5 mg, respectively, P<0.001. At 12-month follow-up, the majority of patients (60.8% discontinued the treatment or continued on the same medication as before, and in 23.3% a change of AD was made.Conclusion: Primary health care professionals are highly involved in the management of the illness; in addition, during the period of economic crisis, patients with major depressive disorder showed higher rates of prevalence of the illness, with increased use of AD drugs. Keywords: consumption, antidepressants, economic crisis

  8. Wastewater Treatment in Kathmandu : Management, Treatment and Alternative

    OpenAIRE

    Regmi, Shakil

    2013-01-01

    Main aim of this thesis was to understand the wastewater situation in Kathmandu, Nepal and its impact in natural water stream, how it is managed and treated. After understanding the scenario of wastewater treatment in Kathmandu, a suitable alternative wastewater treatment system is recommended for future use. Technical as well as managerial problem exists in Kathmandu, thus from my experience in Mikkeli, Finland I came up with the model that is handled by the municipality itself because skill...

  9. Amygdala Reactivity to Emotional Faces in the Prediction of General and Medication-Specific Responses to Antidepressant Treatment in the Randomized iSPOT-D Trial.

    Science.gov (United States)

    Williams, Leanne M; Korgaonkar, Mayuresh S; Song, Yun C; Paton, Rebecca; Eagles, Sarah; Goldstein-Piekarski, Andrea; Grieve, Stuart M; Harris, Anthony W F; Usherwood, Tim; Etkin, Amit

    2015-09-01

    Although the cost of poor treatment outcomes of depression is staggering, we do not yet have clinically useful methods for selecting the most effective antidepressant for each depressed person. Emotional brain activation is altered in major depressive disorder (MDD) and implicated in treatment response. Identifying which aspects of emotional brain activation are predictive of general and specific responses to antidepressants may help clinicians and patients when making treatment decisions. We examined whether amygdala activation probed by emotion stimuli is a general or differential predictor of response to three commonly prescribed antidepressants, using functional magnetic resonance imaging (fMRI). A test-retest design was used to assess patients with MDD in an academic setting as part of the International Study to Predict Optimized Treatment in Depression. A total of 80 MDD outpatients were scanned prior to treatment and 8 weeks after randomization to the selective serotonin reuptake inhibitors escitalopram and sertraline and the serotonin-norepinephrine reuptake inhibitor, venlafaxine-extended release (XR). A total of 34 matched controls were scanned at the same timepoints. We quantified the blood oxygen level-dependent signal of the amygdala during subliminal and supraliminal viewing of facial expressions of emotion. Response to treatment was defined by ⩾50% symptom improvement on the 17-item Hamilton Depression Rating Scale. Pre-treatment amygdala hypo-reactivity to subliminal happy and threat was a general predictor of treatment response, regardless of medication type (Cohen's d effect size 0.63 to 0.77; classification accuracy, 75%). Responders showed hypo-reactivity compared to controls at baseline, and an increase toward 'normalization' post-treatment. Pre-treatment amygdala reactivity to subliminal sadness was a differential moderator of non-response to venlafaxine-XR (Cohen's d effect size 1.5; classification accuracy, 81%). Non-responders to

  10. Preferential reduction of binding of sup 125 I-iodopindolol to beta-1 adrenoceptors in the amygdala of rat after antidepressant treatments

    Energy Technology Data Exchange (ETDEWEB)

    Ordway, G.A.; Gambarana, C.; Tejani-Butt, S.M.; Areso, P.; Hauptmann, M.; Frazer, A. (Veterans Affairs Medical Center, Philadelphia, PA (USA))

    1991-05-01

    This study utilized quantitative receptor autoradiography to examine the effects of repeated administration of antidepressants to rats on the binding of the beta adrenoceptor antagonist, {sup 125}I-iodopindolol ({sup 125}I-IPIN) to either beta-1 or beta-2 adrenoceptors in various regions of brain. Antidepressants were selected to represent various chemical and pharmacological classes including tricyclic compounds (desipramine and protriptyline), monoamine oxidase inhibitors (clorgyline, phenelzine and tranylcypromine), atypical antidepressants (mianserin and trazodone) and selective inhibitors of the uptake of serotonin (citalopram and sertraline). Additionally, rats were treated with various psychotropic drugs that lack antidepressant efficacy (cocaine, deprenyl, diazepam and haloperidol). Repeated treatment of rats with desipramine, protriptyline, clorgyline, phenelzine, tranylcypromine or mianserin reduced the binding of {sup 125}I-IPIN to beta-1 adrenoceptors in many brain areas. Only in the basolateral and lateral nuclei of the amygdala did all six of these antidepressants significantly reduce {sup 125}I-IPIN binding to beta-1 adrenoceptors. In these amygdaloid nuclei, the magnitude of the reduction in the binding of {sup 125}I-IPIN caused by each of these drugs was comparable to or greater than the reduction in binding produced in any other region of brain. Reductions of binding of {sup 125}I-IPIN after antidepressant treatments were not consistently observed in the cortex, the area of brain examined most often in homogenate binding studies. Only the monoamine oxidase inhibitors caused reductions in the binding of {sup 125}I-IPIN to beta-2 adrenoceptors, and this effect was generally localized to the amygdala and hypothalamus.

  11. [Switching and combining strategies of antidepressant medications].

    Science.gov (United States)

    Charpeaud, Thomas; Moliere, Fanny; Bubrovszky, Maxime; Haesebaert, Frédéric; Allaïli, Najib; Bation, Rémy; Nieto, Isabel; Richieri, Raphaëlle; Saba, Ghassen; Bellivier, Frank; Bennabi, Djamila; Holtzmann, Jérôme; Camus, Vincent; Courtet, Philippe; Courvoisier, Pierre; d'Amato, Thierry; Doumy, Olivier; Garnier, Marion; Bougerol, Thierry; Lançon, Christophe; Haffen, Emmanuel; Leboyer, Marion; Llorca, Pierre-Michel; Vaiva, Guillaume; El-Hage, Wissam; Aouizerate, Bruno

    2016-03-01

    Switching antidepressant medication may be helpful in depressed patients having no benefit from the initial antidepressant treatment. Before considering switching strategy, the initial antidepressant treatment should produce no therapeutic effect after at least 4 weeks of administration at adequate dosage. Choosing an antidepressant of pharmacologically distinct profile fails to consistently demonstrate a significant superiority in terms of effectiveness over the switching to another antidepressant within the same pharmacological class. Augmenting SSRI/SNRIs with mirtazapine/mianserin has become the most recommended strategy of antidepressant combinations. Augmenting SSRI with tricyclic drugs is now a less recommended strategy of antidepressant combinations given the increased risk for the occurrence of pharmacokinetic drug-drug interactions and adverse effects.

  12. Betaine enhances antidepressant-like, but blocks psychotomimetic effects of ketamine in mice.

    Science.gov (United States)

    Lin, Jen-Cheng; Lee, Mei-Yi; Chan, Ming-Huan; Chen, Yi-Chyan; Chen, Hwei-Hsien

    2016-09-01

    Ketamine is emerging as a new hope against depression, but ketamine-associated psychotomimetic effects limit its clinical use. An adjunct therapy along with ketamine to alleviate its adverse effects and even potentiate the antidepressant effects might be an alternative strategy. Betaine, a methyl derivative of glycine and a dietary supplement, has been shown to have antidepressant-like effects and to act like a partial agonist at the glycine site of N-methyl-D-aspartate receptors (NMDARs). Accordingly, betaine might have potential to be an adjunct to ketamine treatment for depression. The antidepressant-like effects of ketamine and betaine were evaluated by forced swimming test and novelty suppressed feeding test in mice. Both betaine and ketamine produced antidepressant-like effects. Furthermore, we determined the effects of betaine on ketamine-induced antidepressant-like and psychotomimetic behaviors, motor incoordination, hyperlocomotor activity, and anesthesia. The antidepressant-like responses to betaine combined with ketamine were stronger than their individual effects. In contrast, ketamine-induced impairments in prepulse inhibition, novel object recognition test, social interaction, and rotarod test were remarkably attenuated, whereas ketamine-induced hyperlocomotion and loss of righting reflex were not affected by betaine. These findings revealed that betaine could enhance the antidepressant-like effects, yet block the psychotomimetic effects of ketamine, suggesting that betaine can be considered as an add-on therapy to ketamine for treatment-resistant depression and suitable for the treatment of depressive symptoms in patients with schizophrenia. PMID:27363702

  13. Contacts to general practice and antidepressant treatment initiation after screening for anxiety and depression in patients with heart disease

    DEFF Research Database (Denmark)

    Larsen, Karen Kjær; Vestergaard, Claus Høstrup; Schougaard, Liv Marit Valen;

    2016-01-01

    Introduction Anxiety and depression are found in 20-30% of all persons with heart disease, and depression is known to impact mortality. This paper aimed to describe the effect of systematic screening of this population in terms of use of general practice, psychological therapy and antidepressant...... treatment. Methods A population-based cohort study was conducted in 2011-2013 comprising 1,658 people with heart disease treated at a Danish regional hospital. Collected data were based on Danish national registers and patient questionnaires. Results Patients with heart disease and anxiety or depressive...... symptoms had more general practitioner (GP) contact rates than patients without anxiety or depressive symptoms both before and after the screening. Furthermore, patients with depressive symptoms increased their GP contact rate significantly in the first month after the screening, while this was not the...

  14. Antidepressive and BDNF effects of enriched environment treatment across ages in mice lacking BDNF expression through promoter IV

    Science.gov (United States)

    Jha, S; Dong, B E; Xue, Y; Delotterie, D F; Vail, M G; Sakata, K

    2016-01-01

    Reduced promoter IV-driven expression of brain-derived neurotrophic factor (BDNF) is implicated in stress and major depression. We previously reported that defective promoter IV (KIV) caused depression-like behavior in young adult mice, which was reversed more effectively by enriched environment treatment (EET) than antidepressants. The effects of promoter IV-BDNF deficiency and EET over the life stages remain unknown. Since early-life development (ED) involves dynamic epigenetic processes, we hypothesized that EET during ED would provide maximum antidepressive effects that would persist later in life due to enhanced, long-lasting BDNF induction. We tested this hypothesis by determining EET effects across three life stages: ED (0–2 months), young adult (2–4 months), and old adult (12–14 months). KIV mice at all life stages showed depression-like behavior in the open-field and tail-suspension tests compared with wild-type mice. Two months of EET reduced depression-like behavior in ED and young adult, but not old adult mice, with the largest effect in ED KIV mice. This effect lasted for 1 month after discontinuance of EET only in ED mice. BDNF protein induction by EET in the hippocampus and frontal cortex was also the largest in ED mice and persisted only in the hippocampus of ED KIV mice after discontinuance of EET. No gender-specific effects were observed. The results suggest that defective promoter IV causes depression-like behavior, regardless of age and gender, and that EET during ED is particularly beneficial to individuals with promoter IV-BDNF deficiency, while additional treatment may be needed for older adults. PMID:27648918

  15. Antidepressive and BDNF effects of enriched environment treatment across ages in mice lacking BDNF expression through promoter IV.

    Science.gov (United States)

    Jha, S; Dong, B E; Xue, Y; Delotterie, D F; Vail, M G; Sakata, K

    2016-01-01

    Reduced promoter IV-driven expression of brain-derived neurotrophic factor (BDNF) is implicated in stress and major depression. We previously reported that defective promoter IV (KIV) caused depression-like behavior in young adult mice, which was reversed more effectively by enriched environment treatment (EET) than antidepressants. The effects of promoter IV-BDNF deficiency and EET over the life stages remain unknown. Since early-life development (ED) involves dynamic epigenetic processes, we hypothesized that EET during ED would provide maximum antidepressive effects that would persist later in life due to enhanced, long-lasting BDNF induction. We tested this hypothesis by determining EET effects across three life stages: ED (0-2 months), young adult (2-4 months), and old adult (12-14 months). KIV mice at all life stages showed depression-like behavior in the open-field and tail-suspension tests compared with wild-type mice. Two months of EET reduced depression-like behavior in ED and young adult, but not old adult mice, with the largest effect in ED KIV mice. This effect lasted for 1 month after discontinuance of EET only in ED mice. BDNF protein induction by EET in the hippocampus and frontal cortex was also the largest in ED mice and persisted only in the hippocampus of ED KIV mice after discontinuance of EET. No gender-specific effects were observed. The results suggest that defective promoter IV causes depression-like behavior, regardless of age and gender, and that EET during ED is particularly beneficial to individuals with promoter IV-BDNF deficiency, while additional treatment may be needed for older adults. PMID:27648918

  16. Association of FKBP51 with priming of autophagy pathways and mediation of antidepressant treatment response: evidence in cells, mice, and humans.

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    Nils C Gassen

    2014-11-01

    Full Text Available BACKGROUND: FK506 binding protein 51 (FKBP51 is an Hsp90 co-chaperone and regulator of the glucocorticoid receptor, and consequently of stress physiology. Clinical studies suggest a genetic link between FKBP51 and antidepressant response in mood disorders; however, the underlying mechanisms remain elusive. The objective of this study was to elucidate the role of FKBP51 in the actions of antidepressants, with a particular focus on pathways of autophagy. METHODS AND FINDINGS: Established cell lines, primary neural cells, human blood cells of healthy individuals and patients with depression, and mice were treated with antidepressants. Mice were tested for several neuroendocrine and behavioral parameters. Protein interactions and autophagic pathway activity were mainly evaluated by co-immunoprecipitation and Western blots. We first show that the effects of acute antidepressant treatment on behavior are abolished in FKBP51 knockout (51KO mice. Autophagic markers, such as the autophagy initiator Beclin1, were increased following acute antidepressant treatment in brains from wild-type, but not 51KO, animals. FKBP51 binds to Beclin1, changes decisive protein interactions and phosphorylation of Beclin1, and triggers autophagic pathways. Antidepressants and FKBP51 exhibited synergistic effects on these pathways. Using chronic social defeat as a depression-relevant stress model in combination with chronic paroxetine (PAR treatment revealed that the stress response, as well as the effects of antidepressants on behavior and autophagic markers, depends on FKBP51. In human blood cells of healthy individuals, FKBP51 levels correlated with the potential of antidepressants to induce autophagic pathways. Importantly, the clinical antidepressant response of patients with depression (n = 51 could be predicted by the antidepressant response of autophagic markers in patient-derived peripheral blood lymphocytes cultivated and treated ex vivo (Beclin1/amitriptyline: r

  17. Progress in Treatment of Irritable Bowel Syndrome with Antidepressants%抗抑郁药治疗肠易激综合征的研究进展

    Institute of Scientific and Technical Information of China (English)

    向虹

    2011-01-01

    Current studies have demonstrated that psychosocial factor plays an important role in the pathogenesis of irritable bowel syndrome (IBS), more and more attenlion have been paid to the treatment of IBS with antidepressants. Selective serotonin reuptake inhibitors (SSRIs), tricycbc antidepressants (TCAs), serotonin-norepinephrine reuptake inhibitors (SNRIs) are the commonly used antidepressants. This article reviewed the progress in treatment of IBS with antidepressants in recent years.%目前研究发现精神心理因素在肠易激综合征(IBS)的发病中起重要作用,抗抑郁药在治疗IBS中的作用已受到越来越多的关注.常用的抗抑郁药包括选择性5-羟色胺再摄取抑制剂(SSRIs)、三环类抗抑郁药(TCAs)、5-羟色胺和去甲肾上腺素再摄取抑制剂(SNRIs)等.本文就近年抗抑郁药治疗IBS的研究进展作一综述.

  18. Antidepressant-like activity of sildenafil following acute and subchronic treatment in the forced swim test in mice: effects of restraint stress and monoamine depletion.

    Science.gov (United States)

    Socała, Katarzyna; Nieoczym, Dorota; Pieróg, Mateusz; Szuster-Ciesielska, Agnieszka; Wyska, Elżbieta; Wlaź, Piotr

    2016-10-01

    Sildenafil is a highly effective oral agent for the treatment of erectile dysfunction of multiple etiologies. Although in clinical practice sildenafil is often used in depressed patients, its influence on the pathophysiology of depression remains unclear. The aim of the present study was to evaluate the antidepressant-like activity following acute and subchronic treatment with sildenafil in naïve mice as well as in mice with reserpine- and restraint stress-induced depressive-like behavior. Since corticosterone is released in response to acute stress, we also aimed to assess the influence of sildenafil on serum corticosterone level in non-stressed and stressed animals. The antidepressant activity of sildenafil was assessed in the forced swim test. Corticosterone serum level was determined by using ELISA method, while brain and serum sildenafil level via HPLC method. Sildenafil administered acutely exerted an antidepressant-like effect. Subchronic (14 days) administration of sildenafil resulted only in a weak antidepressant-like effect when evaluated 24 h after the last dose. Acute but not subchronic sildenafil administration reversed the reserpine- and stress-induced immobility in the forced swim test. The lack of effects of sildenafil after subchronic treatment could have been related to its complete elimination from the brain within 24 h from the last injection. Interestingly, acute administration of sildenafil produced a marked increase in serum corticosterone level in both non-stressed and stressed animals. Sildenafil exerts differential effects in the forced swim test after acute and subchronic administration. Further studies on the antidepressant activity of sildenafil are required.

  19. VGF, a New Player in Antidepressant Action?

    OpenAIRE

    Malberg, Jessica E.; Monteggia, Lisa M.

    2008-01-01

    Recent studies have identified adaptations of intracellular signaling pathways and target genes that could contribute or modulate the action of antidepressant drugs, as well as exercise-mediated antidepressant responses. Understanding these adaptations, particularly those changes that are common to diverse antidepressant treatments, is important for the development of more potent and specific treatments of depression. There is growing evidence that growth factors may be important mediators of...

  20. Neuroimmune endocrine effects of antidepressants

    OpenAIRE

    Antonioli M; Rybka J; Carvalho LA

    2012-01-01

    Marco Antonioli, Joanna Rybka, LA CarvalhoPsychoimmunology Translational Laboratory, Health Science Research Centre, Roehampton University, London, UKAbstract: Antidepressant pharmacotherapy is to date the most often used treatment for depression, but the exact mechanism of action underlying its therapeutic effect is still unclear. Many theories have been put forward to account for depression, as well as antidepressant activity, but none of them is exhaustive. Neuroimmune endocrine impairment...

  1. A retrospective study of predictive factors for effective aripiprazole augmentation of antidepressant therapy in treatment-resistant depression

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    Sugawara H

    2016-05-01

    Full Text Available Hiroko Sugawara,1,2 Kaoru Sakamoto,1 Tsuyoto Harada,3 Satoru Shimizu,4 Jun Ishigooka1 1Department of Psychiatry, Tokyo Women’s Medical University, 2Support Center for Women Health Care Professionals and Researchers, Tokyo Women’s Medical University, Shinjuku-ku, 3Department of Psychiatry, Tokyo Women’s Medical University Medical Center East, Arakawa-ku, 4Department of Research, Medical Research Institute, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan Background: Several studies have evaluated the efficacy and tolerability of aripiprazole for augmentation of antidepressant therapy for treatment-resistant depression (TRD. Here, we investigated the efficacy of aripiprazole augmentation for TRD including both major depressive disorder and bipolar disorder and the clinical predictors of treatment efficacy in a Japanese population.  Methods: Eighty-five depressed Japanese patients who underwent aripiprazole augmentation therapy after failing to respond satisfactorily to antidepressant monotherapy were included in the study. Treatment responses were evaluated based on Clinical Global Impression Improvement scores assessed 8 weeks after initiation of aripiprazole administration. We compared demographic and diagnostic variables, psychiatric medication variables, and clinical variables between remission and nonremission groups.  Results: The aripiprazole augmentation remission rate was 36.5%. Multiple logistic regression analysis indicated that aripiprazole augmentation was significantly more effective for bipolar depression than for major depressive disorder, and both absence of comorbid anxiety disorders and current episode duration >3 months were significantly associated with the efficacy of aripiprazole augmentation.  Conclusion: Polarity of depression, comorbidity of anxiety disorders, and current episode duration may predict the efficacy of aripiprazole augmentation for TRD including both major depressive disorder and

  2. Effectiveness and cost-effectiveness of antidepressants in primary care: a multiple treatment comparison meta-analysis and cost-effectiveness model.

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    Joakim Ramsberg

    Full Text Available OBJECTIVE: To determine effectiveness and cost-effectiveness over a one-year time horizon of pharmacological first line treatment in primary care for patients with moderate to severe depression. DESIGN: A multiple treatment comparison meta-analysis was employed to determine the relative efficacy in terms of remission of 10 antidepressants (citalopram, duloxetine escitalopram, fluoxetine, fluvoxamine mirtazapine, paroxetine, reboxetine, sertraline and venlafaxine. The estimated remission rates were then applied in a decision-analytic model in order to estimate costs and quality of life with different treatments at one year. DATA SOURCES: Meta-analyses of remission rates from randomised controlled trials, and cost and quality-of-life data from published sources. RESULTS: The most favourable pharmacological treatment in terms of remission was escitalopram with an 8- to 12-week probability of remission of 0.47. Despite a high acquisition cost, this clinical effectiveness translated into escitalopram being both more effective and having a lower total cost than all other comparators from a societal perspective. From a healthcare perspective, the cost per QALY of escitalopram was €3732 compared with venlafaxine. CONCLUSION: Of the investigated antidepressants, escitalopram has the highest probability of remission and is the most effective and cost-effective pharmacological treatment in a primary care setting, when evaluated over a one year time-horizon. Small differences in remission rates may be important when assessing costs and cost-effectiveness of antidepressants.

  3. Ozone oxidation of antidepressants in wastewater –Treatment evaluation and characterization of new by-products by LC-QToFMS

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    Lajeunesse André

    2013-01-01

    Full Text Available Abstract Background The fate of 14 antidepressants along with their respective N-desmethyl metabolites and the anticonvulsive drug carbamazepine was examined in a primary sewage treatment plant (STP and following advanced treatments with ozone (O3. The concentrations of each pharmaceutical compound were determined in raw sewage, effluent and sewage sludge samples by LC-MS/MS analysis. The occurrence of antidepressant by-products formed in treated effluent after ozonation was also investigated. Results Current primary treatments using physical and chemical processes removed little of the compounds (mean removal efficiency: 19%. Experimental sorption coefficients (Kd of each studied compounds were also calculated. Sorption of venlafaxine, desmethylvenlafaxine, and carbamazepine on sludge was assumed to be negligible (log Kd ≤ 2, but higher sorption behavior can be expected for sertraline (log Kd ≥ 4. Ozonation treatment with O3 (5 mg/L led to a satisfactory mean removal efficiency of 88% of the compounds. Screening of the final ozone-treated effluent samples by high resolution-mass spectrometry (LC-QqToFMS did confirm the presence of related N-oxide by-products. Conclusion Effluent ozonation led to higher mean removal efficiencies than current primary treatment, and therefore represented a promising strategy for the elimination of antidepressants in urban wastewaters. However, the use of O3 produced by-products with unknown toxicity.

  4. Association analysis between variants of the interleukin-1β and the interleukin-1 receptor antagonist gene and antidepressant treatment response in major depression

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    André Tadic

    2008-03-01

    Full Text Available André Tadic1, Dan Rujescu2, Matthias J Müller3, Ralf Kohnen4, Hans H. Stassen5, Armin Szegedi6, Norbert Dahmen11Department of Psychiatry, University of Mainz, Germany; 2Department of Psychiatry, University of Munich, Germany; 3Clinic for Psychiatry and Psychotherapy, Marburg-Sued, Germany, and Clinic for Psychiatry and Psychotherapy, Giessen, Germany; 4IMEREM, Nuernberg, Germany; 5Department of Psychiatry, University of Zurich, Switzerland; 6Organon, Roseland, NJ, USAAbstract: This study investigated the possible association of the interleukin-1 beta (IL-1β C-511T promoter polymorphism and the interleukin-1 receptor antagonist (IL-1Ra (86bpn variable number of tandem repeats (VNTR polymorphism with antidepressant response to paroxetine and mirtazapine treatment. The study group consisted of 101 patients suffering from DSM-IV major depression participating in a randomized double-blind controlled clinical trial. Patients homozygous for the IL-1β-511T allele had a significantly faster and more pronounced response to paroxetine treatment than IL-1β-511C allele carriers. No association was found for the IL-1β C-511T polymorphism with mirtazapine treatment response. The IL-1Ra VNTR showed neither an association with paroxetine nor with mirtazapine treatment response. Our results provide further suggestive evidence that time course of response and antidepressant efficacy of paroxetine, but not of mirtazapine, is influenced in a clinically relevant manner by the IL-1β C-511T gene variant. Our data do not support the hypothesis that the IL-1Ra (86bpn VNTR affects antidepressant treatment response to paroxetine or mirtazapine. An independent replication of our finding is needed. If replicated, the IL-1β C-511T promoter polymorphism could be considered useful for prospective confirmatory pharmacogenetic trials in patients with major depression.Keywords: major depression, antidepressive agents, treatment outcome, interleukin-1 beta, interleukin-1

  5. Dopaminergic challenges in social anxiety disorder: evidence for dopamine D3 desensitisation following successful treatment with serotonergic antidepressants.

    Science.gov (United States)

    Hood, S D; Potokar, J P; Davies, S J C; Hince, D A; Morris, K; Seddon, K M; Nutt, D J; Argyropoulos, S V

    2010-05-01

    Serotonergic antidepressants (SSRIs) are first-line treatments for social anxiety disorder [SAnD], though there is evidence of dopaminergic system dysfunction. Twenty subjects with DSM-IV SAnD, untreated (n = 10) and SSRI-remitted DSM-IV SAnD (n = 10), were administered a single dose of 1) a dopamine agonist (pramipexole 0.5 mg) and 2) a dopamine antagonist (sulpiride 400 mg), followed by anxiogenic challenges (verbal tasks and autobiographical scripts) in a double-blind crossover design, the two test days being one week apart. Anxiety symptoms were measured by self-reported changes in Visual Analogue Scales, specific SAnD scales and anxiety questionnaires. Plasma levels of prolactin were obtained. Untreated SAnD subjects experienced significant increases in anxiety symptoms following behavioural challenges after either sulpiride or pramipexole. Following remission with SSRIs, the socially anxiogenic effect of behavioural provocation was significantly attenuated under pramipexole, whereas under sulpiride effects remained significantly elevated. There appears to be instability of the dopamine system under behavioural stress in social anxiety subjects that is only partly rectified by successful treatment with an SSRI, which may induce a desensitisation of postsynaptic dopamine D(3) receptors. PMID:18838500

  6. Homeopathy as an alternative for asthma treatment

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    Andreas Sebastian Loureiro Mendez

    2011-09-01

    Full Text Available Background: Asthma is a chronic inflammatory disease characterized by a reversible obstruction and hyperactivity of inferior aerial treat [1]. It is responsible for lifestyle modification and, considering its high frequency, it became an important issue in the budget of health services around the world. Aspects like the lack of definitive results and presence of adverse effects, observed for traditional therapy, as well as the search for better quality of life have increased patients’ interest for complementary and alternative medicines (CAM, being homeopathy one of the most cited [2]. In 2001, asthma was between the 10 diagnostics most treated by homeopaths in USA [3]. Aims: In this work, a qualitative research was made focusing the evaluation of the real contribution that homeopathy can represent for asthma patients and the role of pharmacist in this therapy. Methodology: databases such as Medline, Sciencedirect and Bireme were used to find scientific articles, applying the expressions “asthma”, “homeopathy” and “complementary and alternative medicine”. Results: At least six works demonstrate successful applications of homeopathic treatment in children or adults with asthma. The main benefits cited are the decrease of frequency and gravity of the crises, besides of some cure cases. Conclusions: Data available are still scanty about asthma homeopathic treatment. The few works found showed this kind of therapy is very adequate, mainly because of the emotional component of the disease, but also because it represents to be away from the adverse effects commonly related to the traditional therapy (e. g. corticoids. To ensure a correct therapy is being made, the pharmacist must be present and active in the patients’ identification and documentation, giving them right orientations about the use and storage of homeopathic medicines

  7. COMPLIANCE TO LONG-TERM TREATMENT OF CARDIOLOGIC PATIENTS WITH MILD TO MODERATE DEPRESSION: INEFFECTIVENESS OF ANTIDEPRESSIVE THERAPY WITH PIRLINDOL IN RANDOMIZED STUDY

    Directory of Open Access Journals (Sweden)

    E. V. Strokova

    2015-12-01

    Full Text Available Aim. To evaluate the influence of antidepressant therapy with pirlindol on compliance to the long-term treatment and quality of life in patients with cardiovascular diseases and mild to moderate depression. Material and methods. 61 patients with cardiovascular diseases and mild to moderate depression (according to Beck depression scale were randomized into two groups. Patients of intervention group received pirlindol, while patients of control group did not receive this drug. Compliance to cardiovascular and antidepressant treatment were estimated in 3 and 6 months. Adverse reactions and patients self-assessment of their well-being and global satisfaction in treatmen were also registered.  Results. 24 (75%, 2 (6% and 0 patients of intervention group continue pirlindol treatment in 1, 3 and 6 months, respectively. In 3 months of observation patients of intervention group took drugs for cardiovascular diseases more often than these in control group (81% vs 72%, respectively , р<0.05, they also less frequently showed adverse reactions (56% vs 72%, respectively ,p=0.01 and more often — improvement of their well-being (65% vs 50%, respectively , р=0.03. Compliance to cardiovascular therapy did not differ significantly in patients of both groups by the end the study.  Conclusion. Antidepressant therapy with pirlindol did not influence compliance to long-term cardiovascular treatment in patients with cardiovascular diseases and mild to moderate depression, apparently because of low compliance to pirlindol therapy.

  8. Burnout as a risk factor for antidepressant treatment - a repeated measures time-to-event analysis of 2936 Danish human service workers

    DEFF Research Database (Denmark)

    Madsen, Ida E H; Lange, Theis; Borritz, Marianne;

    2015-01-01

    Burnout is a state of emotional exhaustion, feelings of reduced personal accomplishment, and withdrawal from work thought to occur as a consequence of prolonged occupational stress. The condition is not included in the diagnostic classifications, but is considered likely to develop into depressive...... disorder in some cases. We examined the prospective association between burnout and antidepressant treatment, as an indicator of clinically significant mental disorder. We further investigated potential effect-modifiers of the association, to identify factors that may prevent this progression of burnout...... modeling, examining the risk of entering antidepressant treatment in relation to the level of work-related burnout measured by the Copenhagen Burnout inventory. As effect-modifiers we examined both sociodemographic factors and a range of psychosocial work environment factors. The level of burnout predicted...

  9. Elevated stress-hemoconcentration in major depression is normalized by antidepressant treatment: secondary analysis from a randomized, double-blind clinical trial and relevance to cardiovascular disease risk.

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    Ma-Li Wong

    Full Text Available BACKGROUND: Major depressive disorder (MDD is an independent risk factor for cardiovascular disease (CVD; the presence of MDD symptoms in patients with CVD is associated with a higher incidence of cardiac complications following acute myocardial infarction (MI. Stress-hemoconcentration, a result of psychological stress that might be a risk factor for the pathogenesis of CVD, has been studied in stress-challenge paradigms but has not been systematically studied in MDD. METHODS: Secondary analysis of stress hemoconcentration was performed on data from controls and subjects with mild to moderate MDD participating in an ongoing pharmacogenetic study of antidepressant treatment response to desipramine or fluoxetine. Hematologic and hemorheologic measures of stress-hemoconcentration included blood cell counts, hematocrit, hemoglobin, total serum protein, and albumin, and whole blood viscosity. FINDINGS: Subjects with mild to moderate MDD had significantly increased hemorheologic measures of stress-hemoconcentration and blood viscosity when compared to controls; these measures were correlated with depression severity. Measures of stress-hemoconcentration improved significantly after 8 weeks of antidepressant treatment. Improvements in white blood cell count, red blood cell measures and plasma volume were correlated with decreased severity of depression. CONCLUSIONS: Our secondary data analyses support that stress-hemoconcentration, possibly caused by decrements in plasma volume during psychological stress, is present in Mexican-American subjects with mild to moderate MDD at non-challenged baseline conditions. We also found that after antidepressant treatment hemorheologic measures of stress-hemoconcentration are improved and are correlated with improvement of depressive symptoms. These findings suggest that antidepressant treatment may have a positive impact in CVD by ameliorating increased blood viscosity. Physicians should be aware of the potential

  10. Cost-effectiveness of collaborative care including PST and an antidepressant treatment algorithm for the treatment of major depressive disorder in primary care; a randomised clinical trial

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    Beekman Aartjan TF

    2007-03-01

    Full Text Available Abstract Background Depressive disorder is currently one of the most burdensome disorders worldwide. Evidence-based treatments for depressive disorder are already available, but these are used insufficiently, and with less positive results than possible. Earlier research in the USA has shown good results in the treatment of depressive disorder based on a collaborative care approach with Problem Solving Treatment and an antidepressant treatment algorithm, and research in the UK has also shown good results with Problem Solving Treatment. These treatment strategies may also work very well in the Netherlands too, even though health care systems differ between countries. Methods/design This study is a two-armed randomised clinical trial, with randomization on patient-level. The aim of the trial is to evaluate the treatment of depressive disorder in primary care in the Netherlands by means of an adapted collaborative care framework, including contracting and adherence-improving strategies, combined with Problem Solving Treatment and antidepressant medication according to a treatment algorithm. Forty general practices will be randomised to either the intervention group or the control group. Included will be patients who are diagnosed with moderate to severe depression, based on DSM-IV criteria, and stratified according to comorbid chronic physical illness. Patients in the intervention group will receive treatment based on the collaborative care approach, and patients in the control group will receive care as usual. Baseline measurements and follow up measures (3, 6, 9 and 12 months are assessed using questionnaires and an interview. The primary outcome measure is severity of depressive symptoms, according to the PHQ9. Secondary outcome measures are remission as measured with the PHQ9 and the IDS-SR, and cost-effectiveness measured with the TiC-P, the EQ-5D and the SF-36. Discussion In this study, an American model to enhance care for patients with a

  11. Arterial Blood Gas Analysis and the Outcome of Treatment in Tricyclic Antidepressants Poisoned Patients with Benzodiazepine Coingestion

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    Ahmad Yaraghi

    2015-01-01

    Full Text Available Background. Poisoning with tricyclic antidepressants (TCAs is still a major concern for emergency physicians and intensivists. Concomitant ingestion of other psychoactive drugs especially benzodiazepines with TCAs may make this clinical situation more complex. This study aimed to compare the arterial blood gas (ABG values and the outcome of treatment in patients with coingestion of TCA and benzodiazepine (TCA + BZD poisoning and TCA poisoning alone. Methods. In this cross-sectional study which was carried out in a tertiary care university hospital in Iran, clinical and paraclinical characteristics of one hundred forty TCA only or TCA + BZD poisoned patients (aged 18–40 years were evaluated. ABG analysis was done on admission in both groups. Outcomes were considered as survival with or without complication (e.g., intubation and the frequency of TCA poisoning complications. Results. Arterial pH was significantly lower in TCA + BZD poisoning group compared with TCA only poisoning group (7.34 ± 0.08 and 7.38 ± 0.08, resp.; P=0.02. However, other complications such as seizure, and the need for the endotracheal intubation were not significantly different. All patients in both groups survived. Conclusions. Concomitant TCA plus BZD poisoning may make the poisoned patients prone to a lower arterial pH level on hospital admission which may potentially increases the risk of cardiovascular complications in TCA poisoning.

  12. Role of anti-depressant fluoxetine in the puva treatment of psoriasis vulgaris

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    Mitra A

    2001-11-01

    Full Text Available Severity of psoriasis vulgaris is known to be modified by psychological stress. The objective of this study was to evaluate the role of fluoxetine in the PU VA treatment of psoriasis. Twenty patients with progressive disease having more than thirty per cent body area involvement were included in a randomized, double blinded, placebo- controlled, age and sex matched study. All patients were on PUVA treatment, half of patients were given fluoxetine 20 mgs daily whereas the ten were given placebo. Assessment was done by Psoriasis Area and Severity Index (PASI scoring after every 5 exposures of PUVA treatment till 20 treatments. All ten patients who took fluoxetine along with PUVA treatment showed better response and quicker remission. Fluoxetine may be used as an adjuvant in PUVA treatment of psoriasis.

  13. Role of anti-depressant fluoxetine in the puva treatment of psoriasis vulgaris

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    Mitra A

    2003-03-01

    Full Text Available Severity of Psoriasis Vulgaris is known to be modified by psychological stress. The objective of this study was to evaluate the role of Fluoxetine in the PUVA treatment of Psoriasis. Twenty patients with progressive disease having more than thirty per cent body area involvement were included in a randomized, double blinded, placebo-controlled, age and sex matched study. All patients were on PUVAtreatment; half of the patients were given Fluoxetine 20 mgms daily whereas the other ten were given placebo. Assessment was done by Psoriasis Area and Severity Index (PASI scoring after every 5 exposures of PUVA treatment till 20 treatments. All ten patients who took Fluoxetine along with PUVA treatment showed better response and quicker remission. Fluoxetine may be used as an adjuvant in PUVA treatment of Psoriasis.

  14. Regulation of brain-derived neurotrophic factor (BDNF) in the chronic unpredictable stress rat model and the effects of chronic antidepressant treatment

    DEFF Research Database (Denmark)

    Larsen, Marianne H; Mikkelsen, Jens D; Hay-Schmidt, Anders;

    2010-01-01

    swim test in stressed rats. Present evidence suggests a role for brain-derived neurotrophic factor (BDNF) in depression. BDNF mRNA levels in the ventral and dorsal hippocampus were assessed by in situ hybridization. Exposure to CUS was not correlated with a decrease but rather with an increase in BDNF...... mRNA expression in both the dentate gyrus of the dorsal hippocampus and the CA3 region of the ventral hippocampus indicating that there is no simple link between depression-like behaviors per se and brain BDNF levels in rats. However, a significant increase in BDNF mRNA levels in the dentate gyrus...... of the dorsal hippocampus correlated with chronic antidepressant treatment emphasizing a role for BDNF in the mechanisms underlying antidepressant activity....

  15. Childhood trauma predicts antidepressant response in adults with major depression: data from the randomized international study to predict optimized treatment for depression.

    Science.gov (United States)

    Williams, L M; Debattista, C; Duchemin, A-M; Schatzberg, A F; Nemeroff, C B

    2016-01-01

    Few reliable predictors indicate which depressed individuals respond to antidepressants. Several studies suggest that a history of early-life trauma predicts poorer response to antidepressant therapy but results are variable and limited in adults. The major goal of the present study was to evaluate the role of early-life trauma in predicting acute response outcomes to antidepressants in a large sample of well-characterized patients with major depressive disorder (MDD). The international Study to Predict Optimized Treatment for Depression (iSPOT-D) is a randomized clinical trial with enrollment from December 2008 to January 2012 at eight academic and nine private clinical settings in five countries. Patients (n=1008) meeting DSM-IV criteria for MDD and 336 matched healthy controls comprised the study sample. Six participants withdrew due to serious adverse events. Randomization was to 8 weeks of treatment with escitalopram, sertraline or venlafaxine with dosage adjusted by the participant's treating clinician per routine clinical practice. Exposure to 18 types of traumatic events before the age of 18 was assessed using the Early-Life Stress Questionnaire. Impact of early-life stressors-overall trauma 'load' and specific type of abuse-on treatment outcomes measures: response: (⩾50% improvement on the 17-item Hamilton Rating Scale for Depression, HRSD17 or on the 16-item Quick Inventory of Depressive Symptomatology-Self-Rated, QIDS_SR16) and remission (score ⩽7 on the HRSD17 and ⩽5 on the QIDS_SR16). Trauma prevalence in MDD was compared with controls. Depressed participants were significantly more likely to report early-life stress than controls; 62.5% of MDD participants reported more than two traumatic events compared with 28.4% of controls. The higher rate of early-life trauma was most apparent for experiences of interpersonal violation (emotional, sexual and physical abuses). Abuse and notably abuse occurring at ⩽7 years of age predicted poorer outcomes

  16. Complementary and Alternative Medicine (CAM) Treatments and Pediatric Psychopharmacology

    Science.gov (United States)

    Rey, Joseph M.; Walter, Garry; Soh, Nerissa

    2008-01-01

    Children and adolescents often use complementary and alternative medicine (CAM) treatments outside their indications, particularly to lose weight. Some of the herbal remedies and dietary supplements that may of relevance for psychopharmacological practice are discussed with respect to CAM treatments.

  17. Mechanisms of antidepressant resistance

    Directory of Open Access Journals (Sweden)

    Wissam eEl Hage

    2013-11-01

    Full Text Available Depression is one of the most frequent and severe mental disorder. Since the discovery of antidepressant properties of the imipramine and then after of other tricyclic compounds, several classes of psychotropic drugs have shown be effective in treating major depressive disorder. However, there is a wide range of variability in response to antidepressants that might lead to non response or partial response or in increased rate of relapse or recurrence. The mechanisms of response to antidepressant therapy are poorly understood, and few biomarkers are available than can predict response to pharmacotherapy. Here, we will first review markers that can be used to predict response to pharmacotherapy, such as markers of drug metabolism or blood-brain barrier function, the activity of specific brain areas or neurotransmitter systems, hormonal dysregulations or plasticity, and related molecular targets. We will describe both clinical and preclinical studies and describe factors that might affect the expression of these markers, including environmental or genetic factors and comorbidities. This information will permit us to suggest practical recommendations and innovative treatment strategies to improve therapeutic outcomes.

  18. Rethinking psychopharmacotherapy: The role of treatment context and brain plasticity in antidepressant and antipsychotic interventions.

    Science.gov (United States)

    Rief, W; Barsky, A J; Bingel, U; Doering, B K; Schwarting, R; Wöhr, M; Schweiger, U

    2016-01-01

    Emerging evidence indicates that treatment context profoundly affects psychopharmacological interventions. We review the evidence for the interaction between drug application and the context in which the drug is given both in human and animal research. We found evidence for this interaction in the placebo response in clinical trials, in our evolving knowledge of pharmacological and environmental effects on neural plasticity, and in animal studies analyzing environmental influences on psychotropic drug effects. Experimental placebo research has revealed neurobiological trajectories of mechanisms such as patients' treatment expectations and prior treatment experiences. Animal research confirmed that "enriched environments" support positive drug effects, while unfavorable environments (low sensory stimulation, low rates of social contacts) can even reverse the intended treatment outcome. Finally we provide recommendations for context conditions under which psychotropic drugs should be applied. Drug action should be steered by positive expectations, physical activity, and helpful social and physical environmental stimulation. Future drug trials should focus on fully controlling and optimizing such drug×environment interactions to improve trial sensitivity and treatment outcome. PMID:26616735

  19. Milnacipran: a unique antidepressant?

    Directory of Open Access Journals (Sweden)

    Siegfried Kasper

    2010-08-01

    Full Text Available Siegfried Kasper, Gerald PailDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, AustriaAbstract: Tricyclic antidepressants (TCAs are among the most effective antidepressants available, although their poor tolerance at usual recommended doses and toxicity in ­overdose make them difficult to use. While selective serotonin reuptake inhibitors (SSRIs are ­better tolerated than TCAs, they have their own specific problems, such as the aggravation of sexual dysfunction, interaction with coadministered drugs, and for many, a discontinuation syndrome. In addition, some of them appear to be less effective than TCAs in more severely depressed patients. Increasing evidence of the importance of norepinephrine in the etiology of depression has led to the development of a new generation of antidepressants, the serotonin and ­norepinephrine reuptake inhibitors (SNRIs. Milnacipran, one of the pioneer SNRIs, was designed from theoretic considerations to be more effective than SSRIs and better tolerated than TCAs, and with a simple pharmacokinetic profile. Milnacipran has the most balanced potency ratio for reuptake inhibition of the two neurotransmitters compared with other SNRIs (1:1.6 for milnacipran, 1:10 for duloxetine, and 1:30 for venlafaxine, and in some studies milnacipran has been shown to inhibit norepinephrine uptake with greater potency than serotonin (2.2:1. Clinical studies have shown that milnacipran has efficacy comparable with the TCAs and is superior to SSRIs in severe depression. In addition, milnacipran is well tolerated, with a low potential for pharmacokinetic drug–drug interactions. Milnacipran is a first-line therapy suitable for most depressed patients. It is frequently successful when other treatments fail for reasons of efficacy or tolerability.Keywords: milnacipran, SNRI, antidepressant efficacy, tolerability

  20. Personality test and prediction of antidepressive treatment effect in mental illness

    DEFF Research Database (Denmark)

    Thorleifsson, Ari; Holst, Klaus; Diaz, Marta;

    2010-01-01

    INTRODUCTION: The STAR*D project showed that standard treatment of patients with major depression with citalopram resulted in a 36.8% remission in a group of patients. A switch to or supplementing with cognitive therapy substantially increased the remission rate. It would be desirable to identify...

  1. No interactions between genetic polymorphisms and stressful life events on outcome of antidepressant treatment

    DEFF Research Database (Denmark)

    Bukh, Jens Drachmann; Bock, Camilla; Vinberg, Maj;

    2009-01-01

    in the genes encoding the serotonin transporter, brain derived neurotrophic factor, catechol-O-methyltransferase, angiotensin converting enzyme, tryptophan hydroxylase, and the serotonin receptors 1A, 2A, and 2C. We found no evidence that the effects of the genetic polymorphisms on treatment outcome were...

  2. Early discontinuation of antidepressant treatment and suicide risk among persons aged 50 and over

    DEFF Research Database (Denmark)

    Erlangsen, Annette; Agerbo, Esben; Hawton, Keith;

    2009-01-01

    ratio=0.98 [CI-95%: 0.78-1.23]. The suicide rate in women who discontinued treatment was 52 per 100,000 compared with 74 per 100,000 in those who continued refilling; hazard ratio=0.72 [CI-95%: 0.55-0.94]. Although people with previous psychiatric hospitalizations had greater risk of suicide than those...

  3. The effect of prolonged duration of untreated depression on antidepressant treatment outcome

    DEFF Research Database (Denmark)

    Bukh, Jens Otto Drachmann; Bock, Camilla; Vinberg, Maj;

    2013-01-01

    The duration of untreated illness has been considered a likely predictor of the course of psychotic disorders. However, there is only sparse data concerning the influence of treatment delay on the outcome of mood disorders. The present study aimed to assess the effect of prolonged untreated...

  4. Inflammatory Biomarkers as Differential Predictors of Antidepressant Response

    Directory of Open Access Journals (Sweden)

    Kenji Hashimoto

    2015-04-01

    Full Text Available Although antidepressants are generally effective in the treatment of major depressive disorder (MDD, it can still take weeks before patients feel the full antidepressant effects. Despite the efficacy of standard treatments, approximately two-thirds of patients with MDD fail to respond to pharmacotherapy. Therefore, the identification of blood biomarkers that can predict the treatment response to antidepressants would be highly useful in order to improve this situation. This article discusses inflammatory molecules as predictive biomarkers for antidepressant responses to several classes of antidepressants, including the N-methyl-d-aspartate (NMDA receptor antagonist ketamine.

  5. Evaluation of antidepressant polypharmacy and other interventions for treatment-resistant depression

    OpenAIRE

    Peng,Daihui; Fang, Yiru

    2014-01-01

    Summary There is on-going controversy about the definition and sub-classification of treatment-resistant depression (TRD) that makes it difficult to assess the effectiveness of different proposed strategies for treating this chronic, often disabling condition. Sub-classification of TRD in terms of symptom severity and in terms of demographic and clinical characteristics may help in the recognition of homogeneous TRD subgroups and in the development of subgroup-specific interventions.

  6. Neuroimmune endocrine effects of antidepressants

    Directory of Open Access Journals (Sweden)

    Antonioli M

    2012-02-01

    Full Text Available Marco Antonioli, Joanna Rybka, LA CarvalhoPsychoimmunology Translational Laboratory, Health Science Research Centre, Roehampton University, London, UKAbstract: Antidepressant pharmacotherapy is to date the most often used treatment for depression, but the exact mechanism of action underlying its therapeutic effect is still unclear. Many theories have been put forward to account for depression, as well as antidepressant activity, but none of them is exhaustive. Neuroimmune endocrine impairment is found in depressed patients; high levels of circulating corticosteroids along with hyperactivation of the immune system, high levels of proinflammatory cytokines, low levels of melatonin in plasma and urine, and disentrainment of circadian rhythms have been demonstrated. Moreover, antidepressant treatment seems to correct or at least to interfere with these alterations. In this review, we summarize the complex neuroimmune endocrine and chronobiological alterations found in patients with depression and how these systems interact with each other. We also explain how antidepressant therapy can modify these systems, along with some possible mechanisms of action shown in animal and human models.Keywords: antidepressant agents, biological markers, human, cytokines, neuroinflammation, psychoneuroimmunology, endophenotype

  7. [Antidepressives and antidepressive interactions with other drugs].

    Science.gov (United States)

    Zavrsnik, Davorka; Spirtović, Selma; Becić, Fahir

    2006-01-01

    During the therapy with antidepressive agents, for the reason of its duration, numerous drug-drug interactions may occur. Antidepressive agents inhibit P450 enzyme activity and interfere with other drug metabolism. Many interactions are acceptable from the clinical point of view, and some are seriously dangerous indicating a need for their better knowledge. The aim of this work is to point out the possible interactions between antidepressive agents and other drugs. PMID:16425539

  8. The Pharmacopsychometric Triangle to Illustrate the Effectiveness of T-PEMF Concomitant with Antidepressants in Treatment Resistant Patients

    DEFF Research Database (Denmark)

    Bech, P; Gefke, Maria; Lunde, M;

    2011-01-01

    . The antidepressive medication which the patients were resistant to was kept unchanged during the five weeks of active versus sham T-PEMF. Results. In total 21, patients received active T-PEMF, and 19 patients received sham T-PEMF. The effect size was 1.02 and 0.90, respectively, on HAM-D(6) and HAM...

  9. Provide optimized antidepressant monotherapy with multiple drugs before considering antidepressant polypharmacy

    OpenAIRE

    SAAH, Tammy; Garlow, Steven J.; Rapaport, Mark H.

    2014-01-01

    Summary Many patients with chronic or recurring major depressive disorder have suboptimal responses to the wide range of antidepressant medications available. When confronted with these patients, clinicians may augment the original antidepressant with other medications, including adjunctive treatment with a second or third antidepressant. Although it is a widely-used practice among psychiatrists and primary care physicians in high-income countries, evidence for the benefits of this type of an...

  10. Agomelatine Treatment with Adolescents with ADHD

    Science.gov (United States)

    Niederhofer, Helmut

    2012-01-01

    Objective: Antidepressants, in particular Atomextine, along with stimulants have demonstrated benefit in the treatment of ADHD. Agomelatine is a new antidepressant with additional affinities to the melatonergic system. As ADHD has been associated with sleep disorders, it is assumed that Agomelatiine might serve as a therapeutic alternative to…

  11. Endometriosis: alternative methods of medical treatment

    Science.gov (United States)

    Muñoz-Hernando, Leticia; Muñoz-Gonzalez, Jose L; Marqueta-Marques, Laura; Alvarez-Conejo, Carmen; Tejerizo-García, Álvaro; Lopez-Gonzalez, Gregorio; Villegas-Muñoz, Emilia; Martin-Jimenez, Angel; Jiménez-López, Jesús S

    2015-01-01

    Endometriosis is an inflammatory estrogen-dependent disease defined by the presence of endometrial glands and stroma at extrauterine sites. The main purpose of endometriosis management is alleviating pain associated to the disease. This can be achieved surgically or medically, although in most women a combination of both treatments is required. Long-term medical treatment is usually needed in most women. Unfortunately, in most cases, pain symptoms recur between 6 months and 12 months once treatment is stopped. The authors conducted a literature search for English original articles, related to new medical treatments of endometriosis in humans, including articles published in PubMed, Medline, and the Cochrane Library. Keywords included “endometriosis” matched with “medical treatment”, “new treatment”, “GnRH antagonists”, “Aromatase inhibitors”, “selective progesterone receptor modulators”, “anti-TNF α”, and “anti-angiogenic factors”. Hormonal treatments currently available are effective in the relief of pain associated to endometriosis. Among new hormonal drugs, association to aromatase inhibitors could be effective in the treatment of women who do not respond to conventional therapies. GnRH antagonists are expected to be as effective as GnRH agonists, but with easier administration (oral). There is a need to find effective treatments that do not block the ovarian function. For this purpose, antiangiogenic factors could be important components of endometriosis therapy in the future. Upcoming researches and controlled clinical trials should focus on these drugs. PMID:26089705

  12. ALTERNATIVE DISINFECTION FOR DRINKING WATER TREATMENT

    Science.gov (United States)

    During a one-yr study at Jefferson Parish, La., the chemical, microbiological, and mutagenic effects os using the major drinkgin water disinfectants (chlorine, chlorine dioxide, chloramine, ozone) were evaluated. Tests were performed on samples collected from various treatment s...

  13. Endometriosis: alternative methods of medical treatment

    Directory of Open Access Journals (Sweden)

    Muñoz-Hernando L

    2015-06-01

    Full Text Available Leticia Muñoz-Hernando,1 Jose L Muñoz-Gonzalez,1 Laura Marqueta-Marques,1 Carmen Alvarez-Conejo,1 Álvaro Tejerizo-García,1 Gregorio Lopez-Gonzalez,1 Emilia Villegas-Muñoz,2 Angel Martin-Jimenez,3 Jesús S Jiménez-López1 1Endometriosis Unit, Service of Obstetrics and Gynecology, Hospital Universitario 12 de Octubre, Madrid, Spain; 2Endometriosis Unit, Service of Obstetrics and Gynecology, Hospital Carlos Haya, Malaga, Spain; 3Endometriosis Unit, Service of Obstetrics and Gynecology, Hospital Son Llatzer, Palma de Mallorca, Spain Abstract: Endometriosis is an inflammatory estrogen-dependent disease defined by the presence of endometrial glands and stroma at extrauterine sites. The main purpose of endometriosis management is alleviating pain associated to the disease. This can be achieved surgically or medically, although in most women a combination of both treatments is required. Long-term medical treatment is usually needed in most women. Unfortunately, in most cases, pain symptoms recur between 6 months and 12 months once treatment is stopped. The authors conducted a literature search for English original articles, related to new medical treatments of endometriosis in humans, including articles published in PubMed, Medline, and the Cochrane Library. Keywords included “endometriosis” matched with “medical treatment”, “new treatment”, “GnRH antagonists”, “Aromatase inhibitors”, “selective progesterone receptor modulators”, “anti-TNF α”, and “antiangiogenic factors”. Hormonal treatments currently available are effective in the relief of pain associated to endometriosis. Among new hormonal drugs, association to aromatase inhibitors could be effective in the treatment of women who do not respond to conventional therapies. GnRh antagonists are expected to be as effective as GnRH agonists, but with easier administration (oral. There is a need to find effective treatments that do not block the ovarian function

  14. Sleep and cognition at baseline and the effects of REM sleep diminution after 1 week of antidepressive treatment in patients with depression.

    Science.gov (United States)

    Göder, Robert; Seeck-Hirschner, Mareen; Stingele, Karoline; Huchzermeier, Christian; Kropp, Cornelia; Palaschewski, Milena; Aldenhoff, Josef; Koch, Jakob

    2011-12-01

    It has been hypothesized that non-rapid eye movement (NREM) sleep facilitates declarative memory consolidation, and rapid eye movement (REM) sleep is particularly important in promoting procedural learning. The aim of this study was to examine the effects of pharmacological REM sleep suppression on performance in different neuropsychological tasks. For our baseline, we chose 41 moderately depressed patients (age range 19-44 years), who were not taking antidepressants. In the morning after polysomnography, we tested memory recall and cognitive flexibility by assessment of verbal and figural fluency, a shift of attention task and the Trail Making Test B. After recording baseline values, patients were assigned randomly to one of three treatment groups: medication with citalopram; medication with reboxetine; or exclusive treatment with psychotherapy. Retesting took place 1 week after onset of treatment. The main results were: (1) an association of slow-wave sleep with verbal memory performance at baseline; (2) a suppression of REM sleep in patients taking citalopram and reboxetine; (3) no differences regarding neuropsychological performance within the treatment groups; and (4) no association of REM sleep diminution with decreases in memory performance or cognitive flexibility in patients treated with citalopram or reboxetine. In line with other studies, our results suggest that there are no negative effects of a decrease in REM sleep on memory performance in patients taking antidepressants.

  15. Irradiation as an alternative post harvest treatment

    International Nuclear Information System (INIS)

    This current world population has significantly added to the pressures placed upon our finite resources and our resulting ability to feed ourselves. In order to cope with current and future demands, the two established lines of action, that is, reduced population growth and expansion of agricultural production, must be supplemented with the parallel activity of reducing food losses during and after harvest. For developing countries in particular, enormous post-harvest losses result from spillage, contamination, pests and physiological deterioration during storage. Studies in these countries indicate that post-harvest losses are enormous and amount to tens of millions of tons per year valued at billions of dollars. Programs to reduce post-harvest losses, if applied properly, can result in realistic yield increases between 10 and 30%, which can be directly converted into increased consumption for humans. Post-harvest losses vary greatly and are a function of the crop variety, pest combinations in the environment, climate, the system of harvesting, storage, handling, marketing, and even the social and cultural environment. Pests are among the most criticals of these factors. Because of the disastrous potential consequences of such pests, quarantine regulations prohibit the entrance of plants or products which might hide the unwanted pest from countries where it is known to exist. Quarantine treatments are can be chemical, physical or ionizing radiation treatment. Numerous investigations on the use of ionizing radiation for the disinfestation of fresh plant materials indicate that rather low dosages will control fruit-fly problems, thus making it well suited for quarantine treatment. The effectiveness of the irradiation as a broad spectrum quarantine treatment of fresh fruits and vegetables was recognized by the several plant protection organizations around the world. Currently, some 40 countries have approved one or more irradiated food items or groups of food

  16. Irradiation as an alternative post harvest treatment

    Energy Technology Data Exchange (ETDEWEB)

    Satin, M. [Agricultural Industries and Post-harvest Management Service, FAO, Rome (Italy); Loaharanu, P. [Head, Food Preservation Section, Joint FAO/ IAEA Division of Nuclear Techniques in Food and Agriculture, Wagramerstr. 5, A-1400, Vienna (Austria)

    1997-12-31

    This current world population has significantly added to the pressures placed upon our finite resources and our resulting ability to feed ourselves. In order to cope with current and future demands, the two established lines of action, that is, reduced population growth and expansion of agricultural production, must be supplemented with the parallel activity of reducing food losses during and after harvest. For developing countries in particular, enormous post-harvest losses result from spillage, contamination, pests and physiological deterioration during storage. Studies in these countries indicate that post-harvest losses are enormous and amount to tens of millions of tons per year valued at billions of dollars. Programs to reduce post-harvest losses, if applied properly, can result in realistic yield increases between 10 and 30%, which can be directly converted into increased consumption for humans. Post-harvest losses vary greatly and are a function of the crop variety, pest combinations in the environment, climate, the system of harvesting, storage, handling, marketing, and even the social and cultural environment. Pests are among the most criticals of these factors. Because of the disastrous potential consequences of such pests, quarantine regulations prohibit the entrance of plants or products which might hide the unwanted pest from countries where it is known to exist. Quarantine treatments are can be chemical, physical or ionizing radiation treatment. Numerous investigations on the use of ionizing radiation for the disinfestation of fresh plant materials indicate that rather low dosages will control fruit-fly problems, thus making it well suited for quarantine treatment. The effectiveness of the irradiation as a broad spectrum quarantine treatment of fresh fruits and vegetables was recognized by the several plant protection organizations around the world. Currently, some 40 countries have approved one or more irradiated food items or groups of food

  17. Study protocol for a randomized controlled trial comparing mindfulness-based cognitive therapy with maintenance anti-depressant treatment in the prevention of depressive relapse/recurrence: the PREVENT trial

    Directory of Open Access Journals (Sweden)

    Hayes Rachel

    2010-10-01

    Full Text Available Abstract Background Depression is a common and distressing mental health problem that is responsible for significant individual disability and cost to society. Medication and psychological therapies are effective for treating depression and maintenance anti-depressants (m-ADM can prevent relapse. However, individuals with depression often express a wish for psychological help that can help them recover from depression in the long-term. We need to develop psychological therapies that prevent depressive relapse/recurrence. A recently developed treatment, Mindfulness-based Cognitive Therapy (MBCT, see http://www.mbct.co.uk shows potential as a brief group programme for people with recurring depression. In two studies it has been shown to halve the rates of depression recurring compared to usual care. This trial asks the policy research question, is MBCT superior to m-ADM in terms of: a primary outcome of preventing depressive relapse/recurrence over 24 months; and, secondary outcomes of (a depression free days, (b residual depressive symptoms, (c antidepressant (ADM usage, (d psychiatric and medical co-morbidity, (e quality of life, and (f cost effectiveness? An explanatory research question asks is an increase in mindfulness skills the key mechanism of change? Methods/Design The design is a single blind, parallel RCT examining MBCT vs. m-ADM with an embedded process study. To answer the main policy research question the proposed trial compares MBCT plus ADM-tapering with m-ADM for patients with recurrent depression. Four hundred and twenty patients with recurrent major depressive disorder in full or partial remission will be recruited through primary care. Depressive relapse/recurrence over two years is the primary outcome variable. The explanatory question will be addressed in two mutually informative ways: quantitative measurement of potential mediating variables pre/post-treatment and a qualitative study of service users' views and experiences

  18. Suicidality: risk factors and the effects of antidepressants. The example of parallel reduction of suicidality and other depressive symptoms during treatment with the SNRI, milnacipran

    Directory of Open Access Journals (Sweden)

    Philippe Courtet

    2010-08-01

    Full Text Available Philippe CourtetCHRU Montpellier, Inserm U888, University of Montpellier I, Montpellier, FranceAbstract: Suicidal behavior (SB represents a major public health issue. Clinical and basic research suggests that SB is a specific entity in psychiatric nosology involving a combination of personality traits, genetic factors, childhood abuse and neuroanatomical abnormalities. The principal risk factor for suicide is depression. More than 60% of patients who complete suicide are depressed at the time of suicide, most of them untreated. There has been a controversy concerning a possible increased risk of SB in some depressed patients treated with antidepressants. Most recent evidence suggests, however, that treatment of depressed patients is associated with a favorable benefit-risk ratio. A recent study has determined the effects of 6 weeks of antidepressant treatment with the serotonin and norepinephrine reuptake inhibitor, milnacipran, on suicidality in a cohort of 30 patients with mild to moderate depression. At baseline, mild suicidal thoughts were present in 46.7% of patients. Suicidal thoughts decreased progressively throughout the study in parallel with other depressive symptoms and were essentially absent at the end of the study. At no time during treatment was there any indication of an increased suicidal risk. Retardation and psychic anxiety decreased in parallel possibly explaining the lack of any “activation syndrome” in this study.Keywords: suicide, milnacipran, SNRI, activation syndrome

  19. Chronic treatment with zinc and antidepressants induces enhancement of presynaptic/extracellular zinc concentration in the rat prefrontal cortex

    OpenAIRE

    Sowa-Kućma, Magdalena; Kowalska, Magdalena; Szlósarczyk, Marek; Gołembiowska, Krystyna; Opoka, Włodzimierz; Baś, Bogusław; Pilc, Andrzej; Nowak, Gabriel

    2010-01-01

    Zinc exhibits antidepressant-like activity in preclinical tests/models. Moreover, zinc homeostasis is implicated in the pathophysiology of affective disorders. The aim of the present study was to examine the effect of chronic zinc, citalopram and imipramine intraperitoneal administration on the presynaptic and extracellular zinc concentration in the rat prefrontal cortex and hippocampus. We used two methods: zinc–selenium histochemistry (which images the pool of presynaptic-vesicle zinc) and ...

  20. [Prospective evaluation of antidepressant discontinuation].

    Science.gov (United States)

    Mourad, I; Lejoyeux, M; Adès, J

    1998-01-01

    The authors prospectively assessed symptoms induced by the interruption of antidepressants in 16 patients (11 women and 5 men), aged from 33 to 85 years (mean = 52.4 +/- 16.4), treated with antidepressants since at least two weeks. All patients were free of alcohol abuse or dependence disorder and of other dependence to psychoactive substances. None of them presented medical illness. Diagnosis were made by separate evaluations by two authors and confirmed with a semistructered assessment instrument: the Schedule for Affective Disorders and Schizophrenia (Lifetime Version). All patients were submitted to a brutal discontinuation of their antidepressant agent. Patients were assessed twice, before the interruption of the antidepressant, and 72 hours later. Effects of antidepressant interruption were assessed by several means. Modification of anxiety and depression were evaluated using the Montgomery Asberg Depression Rating Scale (MADRS) and the Hamilton Anxiety Scale. Symptoms of withdrawal were assessed with Cassano and al.'s scale SESSH including an evaluation of anxiety, agitation, irritability, anergy, difficulty on concentrating, depersonalization, sleep and appetite disorders, muscle pains, nausea, tremor, sweating, altered taste, hyperosmia, paresthesias, photophobia, motor incoordination, dizziness, hyperacousia pain, delirium. Fourteen of the 16 patients (87.5%) presented modifications of their somatic or psychic state 3 days after the interruption of the antidepressant treatment. Most frequent symptoms were: increase in anxiety (31%), increase in irritability (25%), sleep disorders (19%), decrease of anergia and fatigue (19%). Mean scores of anxiety and depression were not significantly modified by the withdrawal. Following TCAs interruption (7 patients) most frequent symptoms were sleep disorders; increase in anxiety, nausea. Among patients withdrawn from SSRIs (6 patients), most frequent symptoms were increase in anxiety, increase in irritability

  1. In the rat forced swimming test, NA-system mediated interactions may prevent the 5-HT properties of some subacute antidepressant treatments being expressed.

    Science.gov (United States)

    Rénéric, Jean-Philippe; Bouvard, Manuel; Stinus, Luis

    2002-04-01

    In the rat forced swimming test (FST), reuptake inhibitors selective of either serotonin (5-HT) or noradrenaline (NA) decrease immobility duration, and increase, respectively, swimming and climbing behaviour. In this study, an almost total 6-OHDA-induced NA-depletion prevented the behavioural effects of desipramine, but not fluoxetine. Interestingly, the serotonin/noradrenaline-reuptake-inhibitor milnacipran, as well as a (desipramine+fluoxetine) combination, could produce both swimming and climbing behaviour in NA-lesioned rats, but not in non-lesioned. The new antidepressant mirtazapine, which enhances both 5-HT and NA transmissions, supposedly through the antagonizing of alpha(2)-adrenoreceptors, dose-dependently reduced immobility and increased climbing behaviour. Interestingly, a (mirtazapine+fluoxetine) combination treatment resulted in additive anti-immobility effects and in the summation of fluoxetine-induced swimming with mirtazapine-induced climbing. Taken together, these data suggest that the NA system mediates presynaptic inhibiting interactions on the 5-HT system, that may involve alpha(2)-receptors, and that may limit the efficacy of mixed serotonin/noradrenaline reuptake inhibition in subacute antidepressant treatments.

  2. Alternative Technical Summary Report: Electrometallurgical Treatment Variant

    Energy Technology Data Exchange (ETDEWEB)

    Gray, L.W.

    1995-11-30

    Immobilization is the fixation of the surplus fissile materials in an acceptable matrix such as glass or ceramics to create an environmentally benign form for disposal in a repository. In addition to the traditional characteristics required of an immobilization form to achieve isolation of the fissile material from the biosphere over geologic times, the immobilization form for the Fissile Materials Disposition Program (FMDP) must also possess the property that it is inherently as unattractive and inaccessible as the fissile material from commercial spent fuel. This latter requirement is similar to the wording of the ''spent fuel standard'' invoked in the National Academy of Sciences (NAS) study on plutonium disposition. High-level wastes (HLW) or separated cesium ({sup 137}Cs), can be added with the fissile material into the waste form to create a radiation field that increases the proliferation resistance and decreases reuse by the host nation in the following ways: (1) Plutonium will be diluted with elements that must be removed by extensive chemical processing to return it to weapons-usable purity; (2) The immobilized plutonium canisters will contain approximately 2 tonnes (2000 kg; 2.2 tons) of mass, thereby forcing the use of heavy equipment to move the canisters; (3) A gamma radiation barrier will be added to the immobilized plutonium canisters; the present concept is to add a radiation barrier that is greater than 1 Gy (100 rad) per hour at 1 m (3 ft) 30 years after fabrication; (4) These canisters will then be sealed in casks and emplaced into drifts in a federal repository where they will be monitored for 100 years before the repository is sealed. This immobilization process is shown conceptually in Figure 1. In the electrometallurgical treatment (ET) variant, plutonium-rich residues are shipped to existing Argonne National Laboratory-West (ANL-W) facilities where the plutonium is converted to plutonium chloride, dissolved in a molten

  3. Heart rate variability in major depressive disorder and after antidepressant treatment with agomelatine and paroxetine: Findings from the Taiwan Study of Depression and Anxiety (TAISDA).

    Science.gov (United States)

    Yeh, Ta-Chuan; Kao, Lien-Cheng; Tzeng, Nian-Sheng; Kuo, Terry B J; Huang, San-Yuan; Chang, Chuan-Chia; Chang, Hsin-An

    2016-01-01

    Evidence from previous studies suggests that heart rate variability (HRV) is reduced in major depressive disorder (MDD). However, whether this reduction is attributable to the disorder per se or to medication, since antidepressants may also affect HRV, is still debated. There is a dearth of information regarding the effects of agomelatine, a novel antidepressant, on HRV. Here, we investigated whether HRV is reduced in MDD and compared the effects of agomelatine and paroxetine on HRV. We recruited 618 physically healthy unmedicated patients with MDD and 506 healthy volunteers aged 20-65 years. Frequency-domain measures of resting HRV were obtained at the time of enrollment for all participants. For patients with MDD, these measures were obtained again after 6 weeks of either agomelatine or paroxetine monotherapy. Compared with healthy subjects, unmedicated patients with MDD exhibited significantly lower variance (total HRV), low frequency (LF), and high frequency (HF) HRV, and a higher LF/HF ratio. Depression severity independently contributed to decreased HRV and vagal tone. Fifty-six patients completed the open-label trial (n=29 for agomelatine, n=27 for paroxetine). Between-group analyses showed a significant group-by-time interaction for LF-HRV and HF-HRV, driven by increases in LF-HRV and HF-HRV only after agomelatine treatment. Within the paroxetine-treated group, there were no significant changes in mean R-R intervals or any HRV indices. We therefore concluded that MDD is associated with reduced HRV, which is inversely related to depression severity. Compared with paroxetine, agomelatine has a more vagotonic effect, suggesting greater cardiovascular safety. Clinicians should consider HRV effects while selecting antidepressants especially for depressed patients who already have decreased cardiac vagal tone.

  4. Alternative Methods for Treatment of TRISO Fuels

    International Nuclear Information System (INIS)

    The current treatment technologies of spent TRISO fuel have been review. The proposed innovative technologies such as thermal shock breaching and EMS-CC processes were found to be promising. A schematic flow sheet has been constructed by using thermal shock, EMS-CC process and separation of breached fines. The heating and fracture behavior of SiC powder by RF heating was investigated. Hoop stress was calculated for breaching of coating layers by inter fission gas pressure at elevated temperature. Electrolytic molten salt cell was installed in glove box and preliminary test was performed. EMS-CC reaction was realized by using glassy carbon and CVD SiC. The morphology of the sample was observed after EMS-CC test. Cyclic voltammogram was constructed by using SiC in order to check the effect of magnesium as a reductant. Investigation of fracture behavior of TRISO coating layers by using thermal shock : 1500 .deg. C of temperature gradient was applied. Macro, microstructure and crystal structure were investigated by using XRD and SEM. Vicker hardness was measured before and after experiment. Innovative gas-solid reaction method beside RF heating and EMS-CC was proposed. This process was also evaluated as a promising to decrease secondary waste. Construction of cyclone separator and optimization : ZrO2(kernel), SiC and graphite powders as surrogate of TRISO were used for the process optimization of fluidization separator equipped with cyclone. The optimum condition was found to be 1.5cm/s of fluidization velocity and 99.9% of separation efficiency was achieved. Literature survey of FP recovery : Recovery technologies of fission products such as I, Kr/Xe, 14C and tritium which are released during the breaching process were surveyed, and its flow sheet was constructed

  5. Comparative efficacy and acceptability of first-generation and second-generation antidepressants in the acute treatment of major depression: protocol for a network meta-analysis

    Science.gov (United States)

    Salanti, Georgia; Atkinson, Lauren Z; Leucht, Stefan; Ruhe, Henricus G; Turner, Erick H; Chaimani, Anna; Ogawa, Yusuke; Takeshima, Nozomi; Hayasaka, Yu; Imai, Hissei; Shinohara, Kiyomi; Suganuma, Aya; Watanabe, Norio; Stockton, Sarah; Geddes, John R

    2016-01-01

    Introduction Many antidepressants are indicated for the treatment of major depression. Two network meta-analyses have provided the most comprehensive assessments to date, accounting for both direct and indirect comparisons; however, these reported conflicting interpretation of results. Here, we present a protocol for a systematic review and network meta-analysis aimed at updating the evidence base and comparing all second-generation as well as selected first-generation antidepressants in terms of efficacy and acceptability in the acute treatment of major depression. Methods and analysis We will include all randomised controlled trials reported as double-blind and comparing one active drug with another or with placebo in the acute phase treatment of major depression in adults. We are interested in comparing the following active agents: agomelatine, amitriptyline, bupropion, citalopram, clomipramine, desvenlafaxine, duloxetine, escitalopram, fluoxetine, fluvoxamine, levomilnacipran, milnacipran, mirtazapine, nefazodone, paroxetine, reboxetine, sertraline, trazodone, venlafaxine, vilazodone and vortioxetine. The main outcomes will be the proportion of patients who responded to or dropped out of the allocated treatment. Published and unpublished studies will be sought through relevant database searches, trial registries and websites; all reference selection and data extraction will be conducted by at least two independent reviewers. We will conduct a random effects network meta-analysis to synthesise all evidence for each outcome and obtain a comprehensive ranking of all treatments. To rank the various treatments for each outcome, we will use the surface under the cumulative ranking curve and the mean ranks. We will employ local as well as global methods to evaluate consistency. We will fit our model in a Bayesian framework using OpenBUGS, and produce results and various checks in Stata and R. We will also assess the quality of evidence contributing to network

  6. Reviewing efficacy of alternative water treatment techniques.

    Science.gov (United States)

    Hambidge, A

    2001-06-01

    synergistic effect in the inactivation of coliphage MS-2 and poliovirus. Other techniques: There are a number of other techniques. We have conducted trials of most of these in the control of Legionella sp., but these fall out of the scope of this article, and as such less emphasis has been placed on them here. Ozonation: Ozone [O3] is an oxidising gas, generated electrically from oxygen [O2]. L. pneumophila can be killed at ozone [Edelstien et al 1982]. Muraca et al [1987] found that 1-2 mg/L of continuous ozone over a six hour contact time, produced a 5 logarithm decrease of L. pneumophila. The effectiveness of ozone treatment against a range of bacteria and coliphages has been studied Botzenhart et al [1993]. E. coli was least resistant to ozone, followed by MS 2-coliphage and PhiX 174-coliphage, with L. pneumophila and Bacillus subtilis spores being the most resistant. (ABSTRACT TRUNCATED)

  7. Antidepressant chronotherapeutics for bipolar depression

    OpenAIRE

    Benedetti, Francesco

    2012-01-01

    Chronotherapeutics refers to treatments based on the principles of circadian rhythm organization and sleep physiology, which control the exposure to environmental stimuli that act on biological rhythms, in order to achieve therapeutic effects in the treatment of psychiatric conditions. It includes manipulations of the sleep-wake cycle such as sleep deprivation and sleep phase advance, and controlled exposure to light and dark. The antidepressant effects of chronotherapeutics are evident in di...

  8. Antidepressant and neurocognitive effects of isoflurane anesthesia versus electroconvulsive therapy in refractory depression.

    Directory of Open Access Journals (Sweden)

    Howard R Weeks

    Full Text Available BACKGROUND: Many patients have serious depression that is nonresponsive to medications, but refuse electroconvulsive therapy (ECT. Early research suggested that isoflurane anesthesia may be an effective alternative to ECT. Subsequent studies altered drug, dose or number of treatments, and failed to replicate this success, halting research on isoflurane's antidepressant effects for a decade. Our aim was to re-examine whether isoflurane has antidepressant effects comparable to ECT, with less adverse effects on cognition. METHOD: Patients with medication-refractory depression received an average of 10 treatments of bifrontal ECT (n = 20 or isoflurane (n = 8 over 3 weeks. Depression severity (Hamilton Rating Scale for Depression-24 and neurocognitive responses (anterograde and retrograde memory, processing speed and verbal fluency were assessed at Pretreatment, Post all treatments and 4-week Follow-up. RESULTS: Both treatments produced significant reductions in depression scores at Post-treatment and 4-week Follow-up; however, ECT had modestly better antidepressant effect at follow-up in severity-matched patients. Immediately Post-treatment, ECT (but not isoflurane patients showed declines in memory, fluency, and processing speed. At Follow-up, only autobiographical memory remained below Pretreatment level for ECT patients, but isoflurane patients had greater test-retest neurocognitive score improvement. CONCLUSIONS: Our data reconfirm that isoflurane has an antidepressant effect approaching ECT with less adverse neurocognitive effects, and reinforce the need for a larger clinical trial.

  9. Evaluation of the Effectiveness of a Psychoeducational Intervention in Treatment-Naïve Patients with Antidepressant Medication in Primary Care: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    R. Casañas

    2015-01-01

    Full Text Available Background. There is evidence supporting the effectiveness of psychoeducation (PE in patients with symptoms of depression in primary care (PC, but very few studies have assessed this intervention in antidepressant-naïve patients. The aim of this study is to assess the effectiveness of a PE program in these patients, since the use of antidepressant (AD medication may interfere with the effects of the intervention. Methods. 106 participants were included, 50 from the PE program (12 weekly 1.5-hour sessions and 56 from the control group (CG that received the usual care. Patients were assessed at baseline and at 3, 6, and 9 months. The main outcome measures were the Beck Depression Inventory (BDI and remission based on the BDI. The analysis was carried out on an intention-to-treat basis. Results. The PE program group showed remission of symptoms of 40% (P=0.001 posttreatment and 42% (P=0.012 at 6 months. The analysis only showed significant differences in the BDI score posttreatment (P=0.008; effect size Cohen’s d′=0.55. Conclusions. The PE intervention is an effective treatment in the depressive population not treated with AD medication. Before taking an AD, psychoeducational intervention should be considered.

  10. Antidepressant effects of ketamine: mechanisms underlying fast-acting novel antidepressants

    Directory of Open Access Journals (Sweden)

    Caroline Ann Browne

    2013-12-01

    Full Text Available Newer antidepressants are needed for the many individuals with major depressive disorder that do not respond adequately to treatment and because of a delay of weeks before the emergence of therapeutic effects. Recent evidence from clinical trials shows that the NMDA antagonist ketamine is a revolutionary novel antidepressant because it acts rapidly and is effective for treatment-resistant patients. A single infusion of ketamine alleviates depressive symptoms in treatment-resistant depressed patients within hours and these effects may be sustained for up to 2 weeks. Although the discovery of ketamine’s effects has reshaped drug discovery for antidepressants, the psychotomimetic properties of this compound limit the use of this therapy to the most severely ill patients. In order to develop additional antidepressants like ketamine, adequate preclinical behavioral screening paradigms for fast-acting antidepressants need to be established and used to identify the underlying neural mechanisms. This review examines the preclinical literature attempting to model the antidepressant-like effects of ketamine. Acute administration of ketamine has produced effects in behavioral screens for antidepressants like the forced swim test, novelty suppression of feeding and in rodent models for depression. Protracted behavioral effects of ketamine have been reported to appear after a single treatment that last for days. This temporal pattern is similar to its clinical effects and may serve as a new animal paradigm for rapid antidepressant effects in humans. In addition, protracted changes in molecules mediating synaptic plasticity have been implicated in mediating the antidepressant-like behavioral effects of ketamine. Current preclinical studies are examining compounds with more specific pharmacological effects at glutamate receptors and synapses in order to develop additional rapidly acting antidepressants without the hallucinogenic side effects or abuse

  11. Relationship between depressive symptoms and miRNA expression level in monocytes of patients with depression before and after antidepressant treatment

    Directory of Open Access Journals (Sweden)

    Qiao-li ZHANG

    2015-04-01

    Full Text Available Objective To explore the correlation of depressive symptoms to the microRNA (miRNA expression level in monocytes of patients with depression before and after antidepressant treatment. Methods Eighty-one patients with depression, admitted to the 102 Hospital of PLA from Aug. 2012 to Oct. 2013, having not received antidepressants treatment and meeting the criteria as listed in Diagnostic and Statistical Manual 4th edition (DSM-IV, were selected as case group. Eighty-one normal individuals served as control group. With Affymetrix Expression Array, 26 miRNAs were identified from 3 individuals from each group as candidate miRNA, and among them 9 miRNAs (miR-146b, miR-1972, miR-26b, miR-29b, miR-338, miR-4485, miR-4498, miR-4743 and miR-874 in monocytes were selected for quantitative real-time reverse transcription polymerase chain reaction (RTPCR assessment. Twenty patients from the case group were selected for the assessment of miRNA expression levels, and the clinical symptoms and treatment effect were evaluated using Hamilton Depression Scale (HAMD and Clinical Global Impression (CGI, before and 6 weeks after antidepressant (venlafaxine, sertraline, mirtazapine, etc. treatment. Results Compared with the control group, the expression levels of miRNA-26b, miRNA-4743, miRNA-4498, miRNA-4485 and miRNA-1972 of the case group were significantly up-regulated (P<0.05. The variance of expression level of miRNA-4743, miRNA-4498, miRNA-4485 and miRNA-1972 was respectively positively correlated with improvement in retardation factors (P<0.05, meanwhile the variance of expression level of miRNA-26b was negatively correlated with the improvement of day and night change factors (P<0.05. Logistic regression analysis demonstrated that the alteration of miRNA-4485 expression may account 28.8% of retardation variance (P<0.05. Conclusion  The miRNA-4743, miRNA-4498, miRNA-4485, miRNA-1972 and miRNA-26b in monocytes may serve as the biomarkers for the

  12. Influence of antidepressants on hemostasis.

    Science.gov (United States)

    Halperin, Demian; Reber, Guido

    2007-01-01

    Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are widely used for the treatment of depression and anxious disorders. The observation that depression is an independent risk factor for cardiovascular mortality and morbidity in patients with ischemic heart disease, the assessment of the central role of serotonin in pathophysiological mechanisms of depression, and reports of cases of abnormal bleeding associated with antidepressant therapy have led to investigations of the influence of antidepressants on hemostasis markers. In this review, we summarize data regarding modifications of these markers, drawn from clinical studies and case reports. We observed an association between the type of antidepressant drug and the number of abnormal bleeding case reports, with or without modifications of hemostasis markers. Drugs with the highest degree of serotonin reuptake inhibition--fluoxetine, paroxetine, and sertraline--are more frequently associated with abnormal bleeding and modifications of hemostasis markers. The most frequent hemostatic abnormalities are decreased platelet aggregability and activity, and prolongation of bleeding time. Patients with a history of coagulation disorders, especially suspected or documented thrombocytopenia or platelet disorder, should be monitored in case of prescription of any serotonin reuptake inhibitor (SRI). Platelet dysfunction, coagulation disorder, and von Willebrand disease should be sought in any case of abnormal bleeding occurring during treatment with an SRI. Also, a non-SSRI antidepressant should be favored over an SSRI or an SRI in such a context. Considering the difficulty in performing platelet aggregation tests, which are the most sensitive in SRI-associated bleeding, and the low sensitivity of hemostasis tests when performed in case of uncomplicated bleeding in the general population, establishing guidelines for the assessment of SRI-associated bleeding complications remains a challenge. PMID

  13. Is exercise an alternative treatment for chronic insomnia?

    Directory of Open Access Journals (Sweden)

    Giselle Soares Passos

    2012-01-01

    Full Text Available The purposes of this systematic/critical review are: 1 to identify studies on the effects of exercise on chronic insomnia and sleep complaints in middle-aged and older adults and to compare the results of exercise with those obtained with hypnotic medications and 2 to discuss potential mechanisms by which exercise could promote sleep in insomniac patients. We identified studies from 1983 through 2011 using MEDLINE, SCOPUS and Web of Science. For systematic analyses, only studies assessing the chronic effects of exercise on sleep in people with sleep complaints or chronic insomnia were considered. We used the following keywords when searching for articles: insomnia, sleep, sleep complaints, exercise and physical activity. For a critical review, studies were selected on the effects of exercise and possible mechanisms that may explain the effects of exercise on insomnia. We identified five studies that met our inclusion criteria for systematic review. Exercise training is effective at decreasing sleep complaints and insomnia. Aerobic exercise has been more extensively studied, and its effects are similar to those observed after hypnotic medication use. Mechanisms are proposed to explain the effects of exercise on insomnia. There is additional documented evidence on the antidepressant and anti-anxiety effects of exercise. Exercise is effective to decrease sleep complaints and to treat chronic insomnia. Exercise presented similar results when compared with hypnotics; however, prospective studies comparing the effects of exercise with medical and non-medical treatments are warranted before including exercise as a first-line treatment for chronic insomnia are necessary.

  14. Nanofibers Offer Alternative Ways to the Treatment of Skin Infections

    Directory of Open Access Journals (Sweden)

    T. D. J. Heunis

    2010-01-01

    Full Text Available Injury to the skin causes a breach in the protective layer surrounding the body. Many pathogens are resistant to antibiotics, rendering conventional treatment less effective. This led to the use of alternative antimicrobial compounds, such as silver ions, in skin treatment. In this review nanofibers, and the incorporation of natural antimicrobial compounds in these scaffolds, are discussed as an alternative way to control skin infections. Electrospinning as a technique to prepare nanofibers is discussed. The possibility of using these structures as drug delivery systems is investigated.

  15. Bacteriocins - exploring alternatives to antibiotics in mastitis treatment.

    Science.gov (United States)

    Pieterse, Reneé; Todorov, Svetoslav D

    2010-07-01

    Mastitis is considered to be the most costly disease affecting the dairy industry. Management strategies involve the extensive use of antibiotics to treat and prevent this disease. Prophylactic dosages of antibiotics used in mastitis control programmes could select for strains with resistance to antibiotics. In addition, a strong drive towards reducing antibiotic residues in animal food products has lead to research in finding alternative antimicrobial agents. In this review we have focus on the pathogenesis of the mastitis in dairy cows, existing antibiotic treatments and possible alternative for application of bacteriocins from lactic acid bacteria in the treatment and prevention of this disease.

  16. Bacteriocins: exploring alternatives to antibiotics in mastitis treatment

    Directory of Open Access Journals (Sweden)

    Reneé Pieterse

    2010-10-01

    Full Text Available Mastitis is considered to be the most costly disease affecting the dairy industry. Management strategies involve the extensive use of antibiotics to treat and prevent this disease. Prophylactic dosages of antibiotics used in mastitis control programmes could select for strains with resistance to antibiotics. In addition, a strong drive towards reducing antibiotic residues in animal food products has lead to research in finding alternative antimicrobial agents. In this review we have focus on the pathogenesis of the mastitis in dairy cows, existing antibiotic treatments and possible alternative for application of bacteriocins from lactic acid bacteria in the treatment and prevention of this disease.

  17. Effects of BDNF Polymorphisms on Antidepressant Action

    OpenAIRE

    Tsai, Shih-Jen; Hong, Chen-Jee; Liou, Ying-Jay

    2010-01-01

    Evidence suggests that the down-regulation of the signaling pathway involving brain-derived neurotrophic factor (BDNF), a molecular element known to regulate neuronal plasticity and survival, plays an important role in the pathogenesis of major depression. The restoration of BDNF activity induced by antidepressant treatment has been implicated in the antidepressant therapeutic mechanism. Because there is variability among patients with major depressive disorder in terms of response to antidep...

  18. Chronic mild stress and antidepressant treatment alter 5-HT1A receptor expression by modifying DNA methylation of a conserved Sp4 site.

    Science.gov (United States)

    Le François, Brice; Soo, Jeremy; Millar, Anne M; Daigle, Mireille; Le Guisquet, Anne-Marie; Leman, Samuel; Minier, Frédéric; Belzung, Catherine; Albert, Paul R

    2015-10-01

    The serotonin 1A receptor (5-HT1A), a critical regulator of the brain serotonergic tone, is implicated in major depressive disorder (MDD) where it is often found to be dys-regulated. However, the extent to which stress and antidepressant treatment impact 5-HT1A expression in adults remains unclear. To address this issue, we subjected adult male BALB/c mice to unpredictable chronic mild stress (UCMS) to induce a depression-like phenotype that was reversed by chronic treatment with the antidepressant imipramine. In prefrontal cortex (PFC) and midbrain tissue, UCMS increased 5-HT1A RNA and protein levels, changes that are expected to decrease the brain serotonergic activity. The stress-induced increase in 5-HT1A expression was paralleled by a specific increase in DNA methylation of the conserved -681 CpG promoter site, located within a Sp1-like element. We show that the -681 CpG site is recognized and repressed by Sp4, the predominant neuronal Sp1-like factor and that Sp4-induced repression is attenuated by DNA methylation, despite a stress-induced increase in PFC Sp4 levels. These results indicate that adult life stress induces DNA methylation of a conserved promoter site, antagonizing Sp4 repression to increase 5-HT1A expression. Chronic imipramine treatment fully reversed the UCMS-induced increase in methylation of the -681 CpG site in the PFC but not midbrain of stressed animals and also increased 5-HT1A expression in the PFC of control animals. Incomplete reversal by imipramine of stress-induced changes in 5-HT1A methylation and expression indicates a persistence of stress vulnerability, and that sustained reversal of behavioral impairments may require additional pathways. PMID:26188176

  19. Complementary and alternative medicine approaches in the treatment of PTSD.

    Science.gov (United States)

    Wynn, Gary H

    2015-08-01

    Complementary and alternative medicine is a diverse set of practices and treatments that has seen a significant increase among Americans over the past decade. These approaches have been applied to a myriad of medical and mental health disorders with varying levels of efficacy. Recent years have seen an increased interest in the use of complementary and alternative medicine to address the growing numbers of individuals suffering from post-traumatic stress disorder and other trauma-related disorders. These approaches include pharmacologic and non-pharmacologic modalities. This article will review some of the most widely used non-pharmacologic complementary and alternative medicine practices used to treat post-traumatic stress disorder such as recreational therapy, animal-assisted therapy, yoga, and acupuncture as well as alternative delivery methods for psychotherapy. PMID:26073362

  20. [Reimbursement for alternative medical treatment in the Netherlands, incomprehensible].

    NARCIS (Netherlands)

    Hoogen, M.W.F. van den; Popa, C.; Elving, L.D.; Meer, J.W.M. van der

    2012-01-01

    It is remarkable that, at a time when not only doctors but also the Health Care Inspectorate (IGZ) and the health insurance companies are paying increasing attention to the quality of conventional medicine, many alternative methods of treatments without a scientific basis are accepted in the Netherl

  1. 40 CFR 142.46 - Alternative treatment techniques.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Alternative treatment techniques. 142.46 Section 142.46 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS IMPLEMENTATION Variances Issued by the Administrator Under Section 1415(a) of the Act §...

  2. Treatment response in relation to subthreshold bipolarity in patients with major depressive disorder receiving antidepressant monotherapy: a post hoc data analysis (KOMDD study

    Directory of Open Access Journals (Sweden)

    Park YM

    2016-05-01

    Full Text Available Young-Min Park,1 Bun-Hee Lee2 1Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, 2Department of Psychiatry, Seoul Eunpyeong Hospital, Seoul, Republic of Korea Background: The aim of this observational study was to determine whether subthreshold bipolarity affects treatment response and remission in patients with major depressive disorder receiving antidepressant (AD monotherapy over a 6-month follow-up period. Methods: Seventy-eight patients with major depressive disorder were stratified into two subgroups according to the presence of subthreshold bipolarity, identified using the Korean version of the Mood Disorder Questionnaire (K-MDQ, which classifies patients as positive for a screening of bipolarity based on the cutoff for the total K-MDQ score (ie, 7 points. They received AD monotherapy such as escitalopram, sertraline, paroxetine, or tianeptine for 6 months. The Beck Depression Inventory (BDI, Hamilton Depression Rating Scale (HAMD, Hamilton Anxiety Scale, and Beck Scale for Suicide Ideation were applied at baseline, 1 week, 3 weeks, 2 months, 3 months, and 6 months. Results: The mean HAMD, BDI, and Beck Scale for Suicide Ideation scores were higher in the bipolarity group than in the nonbipolarity group at 3 weeks. The mean BDI score was also higher in the bipolarity group than in the nonbipolarity group at 6 months. Evaluation of the ratio of improvement for each scale revealed different patterns of percentage changes between the two groups over the 6-month follow-up period. Furthermore, the response and remission rates (as assessed using BDI and HAMD scores were higher in the nonbipolarity group than in the bipolarity group, with the exception of HAMD scores at the 3-week follow-up time point. Conclusion: The findings of this study showed that depressed patients with bipolarity had a worse response to AD monotherapy than did those without bipolarity. Keywords: subthreshold bipolarity

  3. Application of antidepressants in the treatment of bipolar affective disorder%抗抑郁药物在双相情感障碍治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    王立伟

    2012-01-01

    Antidepressants in the treatment of bipolar affective disorder remain a clinical hot topic. It is effective to use antidepressants in the acute treatment of bipolar depression. However, the patients switch to manic episode easily sometimes. The long-term preventive efficacy has not been demonstrated. Based on medical point of view, this review discusses the efficacy of antidepressants in the acute and maintenance treatment of bipolar affective disorder including the risk of switching to manic episode. It also describes the importance and necessity in rational use of antidepressants.%抗抑郁药物在双相情感障碍中的应用备受关注.抗抑郁药物治疗双相抑郁急性期疗效较为肯定,但有转躁等问题;长期治疗的预防效果尚有待进一步研究.本文从循证医学角度,综述抗抑郁药物在双相情感障碍(主要是双相抑郁)急性期和维持期治疗中的疗效以及转躁情况,阐述双相情感障碍治疗中抗抑郁药物合理使用的重要性和必要性.

  4. The effects of antidepressants on gastric ulcer

    Directory of Open Access Journals (Sweden)

    Mehmet Latif Güneş

    2013-12-01

    Full Text Available In their daily practice, psychiatrists often experience gastriccomplaints in patients beside psychiatric disorders.Peptic ulcer is one of the diseases, which accompanyto psychiatric disorders including mainly depression. Itis shown that antidepressants can inflame the bleedingsincluding gastrointestinal (GI bleedings, while they havepositive effect on ulcer healing. In this review, studies,which conducted about the positive or negative effects ofantidepressant drugs on ulcer treatment were examined.Accordingly; it was found that opipramol, amitriptyline,imipramine that of tricyclic antidepressants was found tobe helpful in healing of the ulcer. It was stated that SelectiveSerotonin Reuptake Inhibitors generally inflamedulcers, exceptionally fluvoxamine and fluoxetine reducedulcer; moclobemide that of monoamine-oxidase inhibitorand tianeptine and mirtazapine that of atypical antidepressantshad positive effect in ulcer healing. To be carefulin choosing the appropriate antidepressant in psychiatricpatients with gastric ulcer is important in the prognosisof both ulcer and depression.Key words: peptic ulcer; depression; antidepressant drugs

  5. New generation of antidepressants in pregnant women

    Directory of Open Access Journals (Sweden)

    Ladan Kashani

    2007-03-01

    Full Text Available Although pregnancy was once thought to protect against psychiatric disorders, gravid and non gravid women have similar risks for major depression, at 10% to 15%. Both depression and antidepressant treatment during pregnancy have been associated with risks. Few medications have been proved unequivocally safe during pregnancy. Although certain antidepressants have not been linked with an increased risk of birth defects or impaired development including bupropion, citalopram, escitalopram and venlafaxine, the latest studies aren't necessarily reassuring. As researchers continue to learn more about antidepressants, the risks and benefits of taking the drugs during pregnancy must be weighed carefully on a case-by-case basis. This review discusses about the use of new generation of antidepressants in pregnancy

  6. Sodium-Bearing Waste Treatment Alternatives Implementation Study

    Energy Technology Data Exchange (ETDEWEB)

    Charles M. Barnes; James B. Bosley; Clifford W. Olsen

    2004-07-01

    The purpose of this document is to discuss issues related to the implementation of each of the five down-selected INEEL/INTEC radioactive liquid waste (sodium-bearing waste - SBW) treatment alternatives and summarize information in three main areas of concern: process/technical, environmental permitting, and schedule. Major implementation options for each treatment alternative are also identified and briefly discussed. This report may touch upon, but purposely does not address in detail, issues that are programmatic in nature. Examples of these include how the SBW will be classified with respect to the Nuclear Waste Policy Act (NWPA), status of Waste Isolation Pilot Plant (WIPP) permits and waste storage availability, available funding for implementation, stakeholder issues, and State of Idaho Settlement Agreement milestones. It is assumed in this report that the SBW would be classified as a transuranic (TRU) waste suitable for disposal at WIPP, located in New Mexico, after appropriate treatment to meet transportation requirements and waste acceptance criteria (WAC).

  7. Second-tier natural antidepressants: review and critique.

    Science.gov (United States)

    Iovieno, Nadia; Dalton, Elizabeth D; Fava, Maurizio; Mischoulon, David

    2011-05-01

    The use of Complementary and Alternative Medicine (CAM) for physical and mental problems has increased significantly in the US over the past two decades, and depression is one of the leading indications for the use of CAM. This article reviews some of the lesser-known natural products with potential psychiatric applications that are starting to emerge with some scientific and clinical evidence and may constitute a next wave of natural antidepressants: Rhodiola rosea, chromium, 5-Hydroxytryptophan (5-HTP) and inositol. Background information, efficacy data, proposed mechanisms of action, recommended doses, side effects, and precautions are reviewed. We found some encouraging data for the use of these natural products in specific populations of depressed patients. R. rosea is an adaptogen plant that can be especially helpful in treating asthenic or lethargic depression, and may be combined with conventional antidepressants to alleviate some of their common side effects. Chromium has a beneficial effect on eating-related atypical symptoms of depression, and may be a valuable agent in treating atypical depression and seasonal affective disorder. Inositol may be useful in the treatment of bipolar depression when combined with mood stabilizers. Evidence for the clinical efficacy of 5-HTP is also promising but still preliminary. Although more well-designed and larger controlled studies are needed before any substantive conclusions can be drawn, the available evidence is compelling and these natural products deserve further investigation as a possibly significant addition to the antidepressant armamentarium. PMID:20579741

  8. Assessment of alternatives to correct inventory difference statistical treatment deficiencies

    International Nuclear Information System (INIS)

    This document presents an analysis of alternatives to correct deficiencies in the statistical treatment of inventory differences in the NRC guidance documents and licensee practice. Pacific Northwest Laboratory's objective for this study was to assess alternatives developed by the NRC and a panel of safeguards statistical experts. Criteria were developed for the evaluation and the assessment was made considering the criteria. The results of this assessment are PNL recommendations, which are intended to provide NRC decision makers with a logical and statistically sound basis for correcting the deficiencies

  9. Paroxetine versus other anti-depressive agents for depression

    OpenAIRE

    Cipriani, Andrea; Furukawa, Toshi A.; Veronese, Antonio; Watanabe, Norio; Churchill, Rachel; McGuire, Hugh; Barbui, Corrado

    2007-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To determine the efficacy of paroxetine in comparison with other anti-depressive agents in alleviating the acute symptoms of major depressive disorder.To review acceptability of treatment with paroxetine in comparison with other anti-depressive agents.To investigate the adverse effects of paroxetine in comparison with other anti-depressive agents.

  10. An algorithm to identify antidepressant users with a diagnosis of depression from prescription data.

    NARCIS (Netherlands)

    Gardarsdottir, H.; Egberts, T.C.G.; Dijk, L. van; Sturkenboom, M.; Heerdink, E.R.

    2008-01-01

    Background: Investigating depression treatment outcomes in prescription databases is problematic when information on indication for antidepressant prescriptions is unavailable. Objectives: To develop and validate an algorithm using prescription data to identify antidepressant drug users who suffer f

  11. Alternative methods for the treatment of post-menopausal troubles [Alternative Methoden zur Behandlung postmenopausaler Beschwerden

    OpenAIRE

    Wasem, Jürgen; Aidelsburger, Pamela; Schauer, Svenja; Grabein, Kristin

    2012-01-01

    Background Menopause is described as the transition from the reproductive phase of a women to the non reproductive. Changes in hormone levels might lead to complaints and health consequences especially during peri- and postmenopause. Hormone therapy has a potential damaging health risk profile and is recommended for temporal limited therapy for acute vasomotor symptoms only. Objective The present HTA-report aims to assess the effectiveness and the cost-effectiveness of alternative treatment m...

  12. Increased use of antidepressants and decreasing suicide rates

    DEFF Research Database (Denmark)

    Erlangsen, Annette; Canudas-Romo, V; Conwell, Y

    2008-01-01

    OBJECTIVE: The objective of the present study was to examine if the change in the suicide rate is associated with individuals' use of antidepressants as has been suggested by ecological studies. DESIGN: Decomposition of suicide rates by antidepressant treatment group. SETTING: Population......-based record linkage. PARTICIPANTS: All individuals aged 50 years and older living in Denmark between 1 January 1996 and 31 December 2000 (N = 2,100,808). MAIN OUTCOME MEASURES: Suicide rates are calculated according to current antidepressant treatment status (no treatment, tricyclic antidepressants (TCA......), selective serotonin reuptake inhibitors (SSRI), other antidepressants). The change in the suicide rate during 1996-2000 was decomposed by treatment group. RESULTS: Only one in five older adults dying by suicide was in treatment at the time of death. Whereas the male suicide rate declined by 9.7 suicides per...

  13. Outcome measures of antidepressive therapy.

    Science.gov (United States)

    Rosenberg, R

    2000-01-01

    A variety of outcome measures assessing antidepressive therapy are available. However, in randomized clinical trials, the Hamilton Rating Scale for Depression (HAM-D) is often the primary outcome measure. Results from factor analysis and Rasch item analysis indicate that the HAM-D is heterogeneous and that the sum of items scores may not be an adequate measure of the severity of depression. A Melancholia Scale of 11 items has been suggested as a more valid measure of the core symptoms of affective syndrome. Other global outcome measures, focusing on health-related quality of life issues and on social functioning as well as macro-economic analyses are also used in depression. Applying stringent and well-documented outcome measures in randomized clinical trials of antidepressants may give the clinician a better indication of the most appropriate drug for treatment of the individual patient.

  14. Synergistic interaction between ketoconazole and several antidepressant drugs with allopregnanolone treatments in ovariectomized Wistar rats forced to swim.

    Science.gov (United States)

    Molina-Hernández, Miguel; Tellez-Alcántara, Norma Patricia; García, Julían Pérez; Lopez, Jorge Ivan Olivera; Jaramillo, M Teresa

    2004-12-01

    This article was aimed to investigate the interest of the combination allopregnanolone plus ketoconazole in depression with the time-sampling method in the forced swimming task. Dose-response curves for fluoxetine (0.5, 1.0 or 2.0 mg/kg, twice day, during 2 weeks; i.p.), desipramine (0.5, 1.0 or 2.14 mg/kg, twice a day, during 2 weeks; i.p.), ketoconazole (6.25, 12.5, 25.0 and 37.5 mg/kg, once a day, during 2 weeks; i.p.) and allopregnanolone (0.5, 1.5, 2.0 mg/kg; once a day, during 2 weeks; s.c.) were established. Fluoxetine (1.0 mg/kg, p swimming, highlighting a serotonergic mechanism while desipramine (1.0 mg/kg, p climbing behavior highlighting noradrenergic or dopaminergic effects. Subthreshold doses of fluoxetine (p immobility by increasing climbing. In conclusion, fluoxetine, desipramine, ketoconazole and allopregnanolone produced differential antidepressant-like actions in ovariectomized rats forced to swim. Ketoconazole, fluoxetine or desipramine synergized with allopregnanolone.

  15. Pharmacogenetics of antidepressant response: An update

    Directory of Open Access Journals (Sweden)

    Drago Antonio

    2009-04-01

    Full Text Available Abstract The past few decades have witnessed much progress in the field of pharmacogenetics. The identification of the genetic background that regulates the antidepressant response has benefited from these advances. This review focuses on the pharmacogenetics of the antidepressant response through the analysis and discussion of the most compelling evidence in this line of research. Online databases (Medline and PsycINFO have been searched and the most replicated association findings relating to the genetics of the antidepressant response have been reported and discussed. Some replicated findings in the literature have suggested the serotonin transporter promoter (5-HTTLPR, serotonin receptor 1A (HTR1A, serotonin receptor 2A (HTR2A, brain derived neurotrophic factor (BDNF, corticotropin releasing hormone receptor 1 (CRHR1 and FK506 binding protein 5 (FKBP5 as putative regulators of the antidepressant response. A high rate of failure of replication has also been reported. Pharmacogenetics will hopefully provide the basis for personalised antidepressant treatment that is able to maximise the probability of a good response and to minimise side effects; however, this goal is not achievable at the moment. The extent of the validity of the replicated findings and the reasons for the poor results obtained from studies of the pharmacogenetics of the antidepressant response are discussed.

  16. Increased use of antidepressants at the end of life

    DEFF Research Database (Denmark)

    Hansen, Dorte Gilså; Rosholm, Jens-Ulrik; Gichangi, Anthony;

    2007-01-01

    BACKGROUND: The new antidepressants are generally effective and safe for older people, but may have serious side-effects. The use has been rapidly increasing, but focus on upper age groups has been limited. The pattern of antidepressant use as death approaches has never been analysed. OBJECTIVE......: The use of antidepressants among 65+ year-olds increases with age and proximity to death to very high levels. Future studies may clarify the problems and diagnoses giving rise to the use of antidepressants for such a large proportion of older people, and especially the problems giving rise to treatment...

  17. Sensitivity to changes during antidepressant treatment: a comparison of unidimensional subscales of the Inventory of Depressive Symptomatology (IDS-C) and the Hamilton Depression Rating Scale (HAMD) in patients with mild major, minor or subsyndromal depression.

    Science.gov (United States)

    Helmreich, Isabella; Wagner, Stefanie; Mergl, Roland; Allgaier, Antje-Kathrin; Hautzinger, Martin; Henkel, Verena; Hegerl, Ulrich; Tadić, André

    2012-06-01

    In the efficacy evaluation of antidepressant treatments, the total score of the Hamilton Depression Rating Scale (HAMD) is still regarded as the 'gold standard'. We previously had shown that the Inventory of Depressive Symptomatology (IDS) was more sensitive to detect depressive symptom changes than the HAMD17 (Helmreich et al. 2011). Furthermore, studies suggest that the unidimensional subscales of the HAMD, which capture the core depressive symptoms, outperform the full HAMD regarding the detection of antidepressant treatment effects. The aim of the present study was to compare several unidimensional subscales of the HAMD and the IDS regarding their sensitivity to changes in depression symptoms in a sample of patients with mild major, minor or subsyndromal depression (MIND). Biweekly IDS-C28 and HAMD17 data from 287 patients of a 10-week randomised, placebo-controlled trial comparing the effectiveness of sertraline and cognitive-behavioural group therapy in patients with MIND were converted to subscale scores and analysed during the antidepressant treatment course. We investigated sensitivity to depressive change for all scales from assessment-to-assessment, in relation to depression severity level and placebo-verum differences. The subscales performed similarly during the treatment course, with slight advantages for some subscales in detecting treatment effects depending on the treatment modality and on the items included. Most changes in depressive symptomatology were detected by the IDS short scale, but regarding the effect sizes, it performed worse than most subscales. Unidimensional subscales are a time- and cost-saving option in judging drug therapy outcomes, especially in antidepressant treatment efficacy studies. However, subscales do not cover all facets of depression (e.g. atypical symptoms, sleep disturbances), which might be important for comprehensively understanding the nature of the disease depression. Therefore, the cost-to-benefit ratio must be

  18. The Clinical and Cost Effectiveness of Vortioxetine for the Treatment of a Major Depressive Episode in Patients With Failed Prior Antidepressant Therapy: A Critique of the Evidence.

    Science.gov (United States)

    Lomas, James; Llewellyn, Alexis; Soares, Marta; Simmonds, Mark; Wright, Kath; Eastwood, Alison; Palmer, Stephen

    2016-09-01

    The National Institute for Health and Care Excellence (NICE) invited the manufacturer of vortioxetine (Lundbeck) to submit clinical and cost-effectiveness evidence for vortioxetine for the treatment of major depressive episodes (MDEs), as part of the Institute's Single Technology Appraisal (STA) process. The Centre for Reviews and Dissemination and Centre for Health Economics at the University of York were commissioned to act as the independent Evidence Review Group (ERG). This article provides a description of the company submission, the ERG review and the resulting NICE guidance TA367 issued in November 2015. The ERG critically reviewed the evidence presented in the manufacturer's submission and identified areas requiring clarification, for which the manufacturer provided additional evidence. Two phase III randomised controlled trials for a second-line population involving vortioxetine were identified-REVIVE and TAK318. These two trials represent only 972 of over 7000 patients included in trials of vortioxetine. In REVIVE, there was a statistically significant difference in depression scores favouring vortioxetine compared with agomelatine [mean Montgomery-Åsberg Depression Rating Scale (MADRS) score difference of 2.16 points; 95 % confidence interval 0.81-3.51]. The ERG concluded that, based on all the evidence, rather than the substantially restricted subset of evidence originally considered by the manufacturer, vortioxetine is likely to be similar in efficacy to other analysed antidepressants [citalopram, sertraline, escitalopram and venlafaxine extended release (XR)], and may be more efficacious than agomelatine and inferior to duloxetine. The ERG concluded that vortioxetine may be more tolerable than other analysed antidepressants (sertraline, venlafaxine XR and bupropion), although the limited data prevent firm conclusions. The base-case incremental cost-effectiveness ratio (ICER) of vortioxetine reported by the manufacturer was £378 per quality

  19. SCIENTIFIC BASED OF ACUPUNCTURE AS ALTERNATIVE TREATMENT OF DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Koosnadi Saputra

    2012-11-01

    Full Text Available Background: Acupuncture its traditional form is based upon the stimulation of well defined points on the body by insertion of metal needles, such needling is considered necessary influenced biological mechanism by intrinsic and extrinsic activation after acupuncture points stimulation. Many clinical report therapeutic effect acupuncture treatment of Diabetes Mellitus especially Non Insulin dependent, the effectiveness of mild or middle type of disease is better that severe one and accompanying With controlling diet and doing more exercise will contribute recovery. Methods: Modem research indicates that acupuncture treatment can control blood sugar level, mainly by adjusting insulin molecular level, enhance insulin secretion and recontrol insulin by regulating central nervous system. Of the all, the improved function of the receptor of insulin target cells is probably the most important one. Results: The basic research approach to animal laboratory (rabbit,rat and mice by electro stimulation, streptozotocin and alloxan monohydrate injection visualizing correlation 13 cell pancreas inorphofunction, insulin receptor and electrical profile of specific pancreas point in body surface. Conclusion: Relationship between biophysical, morphology and physiological study of acupuncture points in diabetic animal and diabetic patient tobase acupuncture model as alternative treatment to diabetes mellitus. Key words: acupuncture, alternative treatment, diabetes mellitus

  20. An Alternative Surgical Method for Treatment of Osteoid Osteoma

    Science.gov (United States)

    Gökalp, Mehmet Ata; Gözen, Abdurrahim; Ünsal, Seyyid Şerif; Önder, Haci; Güner, Savaş

    2016-01-01

    Background An osteoid osteoma is a benign bone tumor that tends to be osteoma can be treated with various conservative and surgical methods, but these have some risks and difficulties. The purpose of the present study was to present an alternative treatment method for osteoid osteoma and the results we obtained. Material/Methods In the period from 2010 to 2014, 10 patients with osteoid osteoma underwent nidus excision by using a safe alternative method in an operating room (OR) with no computed tomography (CT). The localization of the tumor was determined by use of a CT-guided Kirschner wire in the radiology unit, then, in the OR the surgical intervention was performed without removing the Kirschner wire. Results Following the alternative intervention, all the patients were completely relieved of pain. In the follow-up, no recurrence or complication occurred. Conclusions The presented alternative method for treating osteoid osteoma is an efficient and practical procedure for surgeons working in clinics that lack specialized equipment. PMID:26898923

  1. Treatment of Diabetic Gastroparesis by Complementary and Alternative Medicines

    Directory of Open Access Journals (Sweden)

    Hao Liu

    2015-08-01

    Full Text Available Gastroparesis is a common gastrointestinal complication in diabetes, induced by hyperglycemia and characterized by delayed gastric emptying and upper abdominal symptoms, such asnausea, vomiting, early satiety, bloating and epigastric pain. Diabetic gastroparesis (DGP affects life quality and glycemic control, and is a challenge to treat in both Western and Eastern medicine. Routine treatment in Western medicine includes gastric emptying promoted by prokinetic agents, gastric pacemaking, or surgery combined with lifetime hormono-therapy, all of which have unavoidable side effects and limitations, and are very expensive. Complementary and alternative medical treatments like acupuncture, moxibustion, and massage are becoming more and more attractive because of their effectiveness, fewer side effects, and reliable safety. This article aims to introduce representative methods of complementary and alternative medicine to treat DGP, which were searched in English through Pubmed and in Chinese through CNKI (China Knowledge Resource Integrated Database. Several lines of evidence demonstrated the effects of single or combined complementary alternative therapies on DGP outcomes; however, the mechanisms were rarely investigated. Randomized controlled trials are undoubtedly required in future studies.

  2. Efficacy of antidepressants on orofacial pain: a systematic review

    NARCIS (Netherlands)

    W.J.J.M. Martin; R.S.G.M. Perez; D.B. Tuinzing; T. Forouzanfar

    2012-01-01

    Orofacial pain is a common complaint with multiple diagnoses. There is controversy about the effectiveness of antidepressants for the management of orofacial pain disorders. In order to be able to make a best evidence choice between available antidepressants for the treatment of orofacial pain, a sy

  3. Mindfulness-based cognitive therapy vs. psycho-education for patients with major depression who did not achieve remission following antidepressant treatment.

    Science.gov (United States)

    Chiesa, Alberto; Castagner, Vittoria; Andrisano, Costanza; Serretti, Alessandro; Mandelli, Laura; Porcelli, Stefano; Giommi, Fabio

    2015-04-30

    Mindfulness-based cognitive therapy (MBCT) showed efficacy for currently depressed patients. However, most of the available studies suffer from important methodological shortcomings, including the lack of adequate control groups. The present study aims to compare MBCT with a psycho-educational control group designed to be structurally equivalent to the MBCT program but excluding the main putative "active ingredient" of MBCT (i.e., mindfulness meditation practice) for the treatment of patients with major depression (MD) who did not achieve remission following at least 8 weeks of antidepressant treatment. Out of 106 screened subjects, 43 were randomized to receive MBCT or psycho-education and were prospectively followed for 26 weeks. MD severity was assessed with the Hamilton Rating Scale for Depression (HAM-D) and the Beck Depression Inventory-II (BDI-II). Measures of anxiety, mindfulness, and quality of life were also included. All assessments were performed at baseline, 4, 8, 17 and 26-weeks. Both HAM-D and BDI scores, as well as quality of life and mindfulness scores, showed higher improvements, which were particularly evident over the long-term period, in the MBCT group than in the psycho-education group. Although limited by a small sample size, the results of this study suggest the superiority of MBCT over psycho-education for non-remitted MD subjects.

  4. Single treatments that have lasting effects: some thoughts on the antidepressant effects of ketamine and botulinum toxin and the anxiolytic effect of psilocybin.

    Science.gov (United States)

    Young, Simon N

    2013-03-01

    Recent clinical trials suggest that 3 single biological treatments have effects that persist. Based on research showing that the muscles involved in facial expressions can feed back to influence mood, a single trial diminishing glabella frown lines with botulinum toxin demonstrated a significant antidepressant effect for 16 weeks. Based primarily on research with animal models of depression suggesting that glutamate may be involved in depression, the N-methyl-D-aspartate antagonist ketamine has been tested in several trials. A single dose decreased depression for up to a week. The reported effects of the use of mushrooms containing psilocybin by a number of cultures around the world has stimulated several trials showing beneficial effects of a single dose of psilocybin for over a year in healthy people, and for up to 3 months in patients with anxiety disorders who have advanced cancer. This article discusses these studies, their rationale, their possible mechanisms of action, the future clinical research required to establish these therapies and the basic research required to optimize single treatments that have lasting effects.

  5. Complementary and Alternative Medicine Treatment Options for Otitis Media

    Science.gov (United States)

    Marom, Tal; Marchisio, Paola; Tamir, Sharon Ovnat; Torretta, Sara; Gavriel, Haim; Esposito, Susanna

    2016-01-01

    Abstract Otitis media (OM) has numerous presentations in children. Together with conventional medical therapies aimed to prevent and/or treat OM, a rising number of complementary and alternative medicine (CAM) treatment options can be offered. Since OM is common in children, parents may ask healthcare professionals about possible CAM therapies. Many physicians feel that their knowledge is limited regarding these therapies, and that they desire some information. Therefore, we conducted a literature review of CAM therapies for OM, taking into account that many of these treatments, their validity and efficacy and have not been scientifically demonstrated. We performed a search in MEDLINE (accessed via PubMed) using the following terms: “CAM” in conjunction with “OM” and “children. Retrieved publications regarding treatment of OM in children which included these terms included randomized controlled trials, prospective/retrospective studies, and case studies. The following CAM options for OM treatment in children were considered: acupuncture, homeopathy, herbal medicine/phytotherapy, osteopathy, chiropractic, xylitol, ear candling, vitamin D supplement, and systemic and topical probiotics. We reviewed each treatment and described the level of scientific evidence of the relevant publications. The therapeutic approaches commonly associated with CAM are usually conservative, and do not include drugs or surgery. Currently, CAM is not considered by physicians a potential treatment of OM, as there is limited supporting evidence. Further studies are warranted in order to evaluate the potential value of CAM therapies for OM. PMID:26871802

  6. Antidepressant Treatment Application Research Progress in the Gynecology Malignant Tumor%抗抑郁治疗在妇科恶性肿瘤中应用的研究进展

    Institute of Scientific and Technical Information of China (English)

    冉星星; 邱丽华

    2016-01-01

    Clinical found gynecological malignant tumor patients often appear different degree of psychological barriers, including depression which is one of the common negative emotions in gynecologic malignant tumor patients. Different levels of depression and other negative emotions have certain adverse impact on the immunity, chemical treatment and quality of life in patients with malignant tumor, which can further affect their therapeutic effect and prognosis. Psychological intervention, antidepressant drug and other antidepressive treatment in patients with gynecological malignant tumor has irreplaceable position in the process of comprehensive treatment. We review the research progress of antidepressant treatment applied in the gynecology malignant tumor, and mainly focuses on the influence of depression in patients with gynecological tumors and the main antidepressant treatment.%临床上妇科恶性肿瘤患者通常会出现不同程度的心理障碍,其中抑郁是妇科恶性肿瘤患者常见的负性情绪之一,不同程度的抑郁等负面情绪对恶性肿瘤患者免疫力、化学治疗、生存质量等方面造成一定的负面影响,进而影响恶性肿瘤患者的治疗效果及预后。心理干预、抗抑郁药物等抗抑郁治疗在妇科恶性肿瘤患者综合治疗过程中有着不可取代的地位。综述抗抑郁治疗在妇科恶性肿瘤中应用的研究进展,主要着重于抑郁对妇科肿瘤患者的影响以及主要的抗抑郁治疗。

  7. Candidiasis: predisposing factors, prevention, diagnosis and alternative treatment.

    Science.gov (United States)

    Martins, Natália; Ferreira, Isabel C F R; Barros, Lillian; Silva, Sónia; Henriques, Mariana

    2014-06-01

    Candidiasis is the most common opportunistic yeast infection. Candida species and other microorganisms are involved in this complicated fungal infection, but Candida albicans continues to be the most prevalent. In the past two decades, it has been observed an abnormal overgrowth in the gastrointestinal, urinary and respiratory tracts, not only in immunocompromised patients, but also related to nosocomial infections and even in healthy individuals. There is a widely variety of causal factors that contribute to yeast infection which means that candidiasis is a good example of a multifactorial syndrome. Due to rapid increase in the incidence in these infections, this is the subject of numerous studies. Recently, the focus of attention is the treatment and, above all, the prevention of those complications. The diagnosis of candidiasis could become quite complicated. Prevention is the most effective "treatment," much more than eradication of the yeast with antifungal agents. There are several aspects to consider in the daily routine that can provide a strength protection. However, a therapeutic approach is necessary when the infection is established, and therefore, other alternatives should be explored. This review provides an overview on predisposition factors, prevention and diagnosis of candidiasis, highlighting alternative approaches for candidiasis treatment.

  8. Psychiatric and Psychological Factors in Patient Decision Making Concerning Antidepressant Use

    Science.gov (United States)

    Dijkstra, Arie; Jaspers, Merlijne; van Zwieten, Marianne

    2008-01-01

    The observation that the use of antidepressants has strongly increased during the past decade implies that on a micro level doctors and patients more often decide that antidepressants are the appropriate treatment. Therefore, it is important to increase insight into patients' decision making regarding the use of antidepressants. The decision…

  9. Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports

    Science.gov (United States)

    Guski, Louise Schow; Freund, Nanna; Gøtzsche, Peter C

    2016-01-01

    Objective To study serious harms associated with selective serotonin and serotonin-norepinephrine reuptake inhibitors. Design Systematic review and meta-analysis. Main outcome measures Mortality and suicidality. Secondary outcomes were aggressive behaviour and akathisia. Data sources Clinical study reports for duloxetine, fluoxetine, paroxetine, sertraline, and venlafaxine obtained from the European and UK drug regulators, and summary trial reports for duloxetine and fluoxetine from Eli Lilly’s website. Eligibility criteria for study selection Double blind placebo controlled trials that contained any patient narratives or individual patient listings of harms. Data extraction and analysis Two researchers extracted data independently; the outcomes were meta-analysed by Peto’s exact method (fixed effect model). Results We included 70 trials (64 381 pages of clinical study reports) with 18 526 patients. These trials had limitations in the study design and discrepancies in reporting, which may have led to serious under-reporting of harms. For example, some outcomes appeared only in individual patient listings in appendices, which we had for only 32 trials, and we did not have case report forms for any of the trials. Differences in mortality (all deaths were in adults, odds ratio 1.28, 95% confidence interval 0.40 to 4.06), suicidality (1.21, 0.84 to 1.74), and akathisia (2.04, 0.93 to 4.48) were not significant, whereas patients taking antidepressants displayed more aggressive behaviour (1.93, 1.26 to 2.95). For adults, the odds ratios were 0.81 (0.51 to 1.28) for suicidality, 1.09 (0.55 to 2.14) for aggression, and 2.00 (0.79 to 5.04) for akathisia. The corresponding values for children and adolescents were 2.39 (1.31 to 4.33), 2.79 (1.62 to 4.81), and 2.15 (0.48 to 9.65). In the summary trial reports on Eli Lilly’s website, almost all deaths were noted, but all suicidal ideation events were missing, and the information on the remaining outcomes was

  10. Prescribing patterns of antidepressants in Europe: results from the Factors Influencing Depression Endpoints Research (FINDER) study

    OpenAIRE

    Bauer, Michael; Monz, Brigitta U.; Montejo, Angel L; Quail, Deborah; Dantchev, Nicolas; Demyttenaere, Koen; Garcia-Cebrian, Ana; Grassi, Luigi; Perahia, David G. S.; Reed, Catherine; Tylee, Andre

    2008-01-01

    Antidepressant prescribing patterns and factors influencing the choice of antidepressant for the treatment of depression were examined in the Factors Influencing Depression Endpoints Research (FINDER) study, a prospective, observational study in 12 European countries of 3468 adults about to start antidepressant medication for their first episode of depression or a new episode of recurrent depression. Selective serotonin reuptake inhibitors (SSRIs) were the most commonly prescribed antidepress...

  11. Pharmacogenetics of antidepressants

    Directory of Open Access Journals (Sweden)

    Concetta eCrisafulli

    2011-02-01

    Full Text Available Up to 60% of depressed patients do not respond completely to antidepressants (AD and up to 30% do not respond at all. Genetic factors contribute for about 50% of the AD response. During the recent years the possible influence of a set of candidate genes as genetic predictors of AD response efficacy was investigated by us and others. They include the cytochrome P450 (CYP superfamily, the P-glycoprotein (ABCB1, the tryptophan hydroxylase (TPH, the catechol-O-methyltransferase (COMT, the monoamine oxidase A (MAOA, the serotonin transporter (5-HTTLPR, the norepinephrine transporter (NET, the dopamine transporter (DAT, variants in the 5HT1A, 2A , 3A, 3B and 6 receptors, adrenoreceptor beta-1 (ADRB1 and alpha-2 (ADRA2A, the dopamine receptors (D2, the G-protein beta3-subunit (GNB3, the corticotropin releasing hormone (CRH receptors (CRHR1 and CRHR2, the glucocorticoid receptors (GR, the c-AMP response-element binding (CREB and the brain-derived neurotrophic factor (BDNF. Marginal associations were reported for angiotensin I converting enzyme (ACE, circadian locomoter output cycles kaput protein (CLOCK, glutamatergic system, nitric oxide synthase (NOS and interleukin 1-beta (IL-1beta gene. In conclusion, gene variants seem to influence human behavior, liability to disorders and treatment response. Nonetheless, gene x enviroment interactions have been hypothesized to modulate several of these effects.

  12. The influence of patients' attributions of the immediate effects of treatment of depression on long-term effectiveness of behavioural activation and antidepressant medication.

    Science.gov (United States)

    Moradveisi, Latif; Huibers, Marcus J H; Arntz, Arnoud

    2015-06-01

    Patients' attributions of effects of treatment are important, as these can affect long-term outcome. Most studies so far focused on the influence of attributions to medication for anxiety and depression disorders. We investigated the effects of patients' attributions made after acute treatment on the long-term outcome of antidepressant medication (ADM) and psychological treatment (behavioural activation, BA). Data are based on a randomized trial testing the effectiveness of BA vs. ADM for major depression (MDD) in Iran. Patients with MDD (N = 100) were randomized to BA (N = 50) or ADM (N = 50). Patients' attributions were assessed at post-test (after completion of the treatments). Scores on an attribution questionnaire were factor analysed, and factor scores were retained as predictors of depressive symptoms at 1-year follow-up. Regression analysis was used to test whether attributions predicted depressive symptoms at 1-yr follow-up, controlling for symptom level, condition, and their interaction at post-test. Belief in coping efficacy was the only attribution factor significantly predicting 1-year HRSD scores, controlling for condition, post-test HRSD and their interaction. It also mediated the condition differences at follow-up. Credit to self was the single attribution factor that predicted BDI follow-up scores, controlling for condition, posttest BDI, and their interaction. It partially mediated the condition differences on the BDI at follow-up. Attribution to increased coping capacities and giving credit to self appear essential. In the long-term (at 1 year follow-up), the difference in outcome between BA and ADM (with BA being superior to ADM) is at least partially mediated by attributions.

  13. Treating Depression: Should You Consider an Antidepressant?

    Science.gov (United States)

    Treating Depression: Should You Consider An Antidepressant? What are antidepressants? Antidepressants are drugs used to treat the symptoms of depression. Do I need an antidepressant? You probably do not ...

  14. "The Effects of Cognitive Behavioral Therapy as an Anti-Depressive Treatment is Falling: A Meta-Analysis": Correction to Johnsen and Friborg (2015).

    Science.gov (United States)

    2016-03-01

    Reports an error in "The effects of cognitive behavioral therapy as an anti-depressive treatment is falling: A meta-analysis" by Tom J. Johnsen and Oddgeir Friborg (Psychological Bulletin, 2015[Jul], Vol 141[4], 747-768). There are several numerical errors in the flowchart summarizing the selection and exclusion of studies as contained in Figure 1. The correct number of titles not further investigated should be 27,381; abstracts rejected should be 1,181; Excluded, different treatment form should be (94). The errors do not affect the results or conclusions of the study as the final number of meta-analysable studies are the same as originally reported. (The following abstract of the original article appeared in record 2015-20361-001.) A meta-analysis examining temporal changes (time trends) in the effects of cognitive behavioral therapy (CBT) as a treatment for unipolar depression was conducted. A comprehensive search of psychotherapy trials yielded 70 eligible studies from 1977 to 2014. Effect sizes (ES) were quantified as Hedge's g based on the Beck Depression Inventory (BDI) and the Hamilton Rating Scale for Depression (HRSD). Rates of remission were also registered. The publication year of each study was examined as a linear metaregression predictor of ES, and as part of a 2-way interaction with other moderators (Year × Moderator). The average ES of the BDI was 1.58 (95% CI [1.43, 1.74]), and 1.69 for the HRSD (95% CI [1.48, 1.89]). Subgroup analyses revealed that women profited more from therapy than did men (p rates of remission (p < .01). Subgroup analyses confirmed that the declining trend was present in both within-group (pre/post) designs (p < .01) and controlled trial designs (p = .02). Thus, modern CBT clinical trials seemingly provided less relief from depressive symptoms as compared with the seminal trials. Potential causes and possible implications for future studies are discussed. PMID:26890388

  15. A preliminary analysis of association between plasma microRNA expression alteration and symptomatology improvement in Major Depressive Disorder (MDD patients before and after antidepressant treatment

    Directory of Open Access Journals (Sweden)

    Zhang Qiao-li

    2014-12-01

    Full Text Available Background and Objectives: Currently, there is a serious need to find practical biomarker(s for Major Depressive Disorder (MDD therapeutic target(s. This study aimed to investigate the association between microRNA (miRNA, miR expression level in Peripheral Blood Mononuclear Cells (PBMCs and symptomatology improvement in MDD patients before and after six-week antidepressant treatment. Methods: By using an Affymetrix array that covers 723 human miRNAs, 26 miRNAs were identified with significantly altered expression in PBMCs in MDD patients, of which 10 miRNAs were selected for quantitative real-time Reverse Transcription Polymerase Chain Reaction (RT-PCR study. Twenty out of all the 81 MDD patients were selected for miRNA expression levels testing and symptomatology assessments before and after six-week treatment. Results: Compared with the control group, the expression levels of miR-26b, miR-4743, miR-4498, miR-4485 and miR-1972 of the MDD group were significantly higher (P < 0.05; the changes of expression levels of miR-4743, miR-4498, miR-4485 and miR-1972 were positively related to retardation improvement (P < 0.05, and the change of expression level of miR-26b negatively to the improvement of day and night change (P < 0.05; regression analysis result demonstrated that the alteration of miR-4485 expression accounted for 28.8% of retardation improvement (P < 0.05. Conclusions: These five miRNAs (miR-4743, miR-4498, miR-4485, miR-1972 and miR-26b may serve as biomarker for MDD diagnosis and therapeutic targets for MDD treatment.

  16. No change in N-acetyl aspartate in first episode of moderate depression after antidepressant treatment: 1H magnetic spectroscopy study of left amygdala and left dorsolateral prefrontal cortex

    Directory of Open Access Journals (Sweden)

    Bajs Janović M

    2014-09-01

    Full Text Available Maja Bajs Janović,1,3 Petra Kalember,2 Špiro Janović,1,3 Pero Hrabač,2 Petra Folnegović Grošić,1 Vladimir Grošić,4 Marko Radoš,5 Neven Henigsberg2,61University Department of Psychiatry, Clinical Hospital Center Zagreb, Zagreb, 2Polyclinic Neuron, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Zagreb, 3University North, Varaždin, 4Psychiatric Hospital Sveti Ivan, Zagreb, 5University Department of Radiology, Clinical Hospital Center Zagreb, Zagreb, 6Psychiatric Clinic Vrapče, Zagreb, CroatiaBackground: The role of brain metabolites as biological correlates of the intensity, symptoms, and course of major depression has not been determined. It has also been inconclusive whether the change in brain metabolites, measured with proton magnetic spectroscopy, could be correlated with the treatment outcome. Methods: Proton magnetic spectroscopy was performed in 29 participants with a first episode of moderate depression occurring in the left dorsolateral prefrontal cortex and left amygdala at baseline and after 8 weeks of antidepressant treatment with escitalopram. The Montgomery-Asberg Depression Rating Scale, the Hamilton Rating Scale for Depression, and the Beck Depression Inventory were used to assess the intensity of depression at baseline and at the endpoint of the study. At endpoint, the participants were identified as responders (n=17 or nonresponders (n=12 to the antidepressant therapy. Results: There was no significant change in the N-acetyl aspartate/creatine ratio (NAA/Cr after treatment with antidepressant medication. The baseline and endpoint NAA/Cr ratios were not significantly different between the responder and nonresponder groups. The correlation between NAA/Cr and changes in the scores of clinical scales were not significant in either group. Conclusion: This study could not confirm any significant changes in NAA after antidepressant treatment in the first episode of moderate depression, or in

  17. Hippocampal Neurogenesis, Depressive Disorders, and Antidepressant Therapy

    Directory of Open Access Journals (Sweden)

    Eleni Paizanis

    2007-01-01

    Full Text Available There is a growing body of evidence that neural stem cells reside in the adult central nervous system where neurogenesis occurs throughout lifespan. Neurogenesis concerns mainly two areas in the brain: the subgranular zone of the dentate gyrus in the hippocampus and the subventricular zone, where it is controlled by several trophic factors and neuroactive molecules. Neurogenesis is involved in processes such as learning and memory and accumulating evidence implicates hippocampal neurogenesis in the physiopathology of depression. We herein review experimental and clinical data demonstrating that stress and antidepressant treatments affect neurogenesis in opposite direction in rodents. In particular, the stimulation of hippocampal neurogenesis by all types of antidepressant drugs supports the view that neuroplastic phenomena are involved in the physiopathology of depression and underlie—at least partly—antidepressant therapy.

  18. Potential involvement of serotonergic signaling in ketamine's antidepressant actions

    DEFF Research Database (Denmark)

    du Jardin, Kristian Gaarn; Müller, Heidi Kaastrup; Elfving, Betina;

    2016-01-01

    A single i.v. infusion of ketamine, classified as an N-methyl-D-aspartate (NMDA) receptor antagonist, may alleviate depressive symptoms within hours of administration in treatment resistant depressed patients, and the antidepressant effect may last for several weeks. These unique therapeutic...... properties have prompted researchers to explore the mechanisms mediating the antidepressant effects of ketamine, but despite many efforts, no consensus on its antidepressant mechanism of action has been reached. Recent preclinical reports have associated the neurotransmitter serotonin (5-hydroxytryptamine; 5......-HT) with the antidepressant-like action of ketamine. Here, we review the current evidence for a serotonergic role in ketamine's antidepressant effects. The pharmacological profile of ketamine may include equipotent activity on several non-NMDA targets, and the current hypotheses for the mechanisms...

  19. Tratamento de idosos com depressão utilizando tricíclicos, IMAO, ISRS e outros antidepressivos Depression treatment of elderly patients using tricyclics, MAOI, SSRI, and other antidepressants

    Directory of Open Access Journals (Sweden)

    Mônica Z Scalco

    2002-04-01

    Full Text Available Antidepressivos são eficazes no tratamento da depressão em idosos. O sucesso do tratamento depende do tipo e da gravidade da depressão; das comorbidades com outras doenças psiquiátricas ou clínicas; da escolha adequada de antidepressivos, de sua eficácia e perfil de efeitos adversos; da orientação do paciente e de sua aderência ao tratamento. O manejo dos efeitos adversos em pacientes idosos, que usam muito mais medicações e apresentam mais doenças, é o ponto forte na escolha de antidepressivos. Em geral, os inibidores seletivos da recaptação de serotonina têm sido preferidos por apresentar menos riscos de complicações por efeitos adversos. Porém, diferentes antidepressivos podem ser preferíveis para diferentes pacientes. É indispensável que o médico conheça o paciente que irá tratar e o perfil de efeitos adversos e de possíveis interações medicamentosas dos antidepressivos para poder escolher o mais adequado para cada paciente. Neste artigo, são abordados os diferentes grupos de antidepressivos no tratamento agudo da depressão em idosos e o tratamento em populações especiais de idosos (idosos debilitados e idosos com demência.Antidepressants are effective in treating depression in the elderly. Treatment response depends on the type and severity of depression, comorbidities, efficacy and tolerability of antidepressants, patient education and treatment compliance. The aging process leads to physiological changes that, in association with concomitant diseases and use of several medications, render the elderly person more vulnerable to the adverse effects of antidepressants and an increased risk of drug interactions. It is very important that psychiatrists treating elderly patients be aware of possible adverse effects and drug interactions of different antidepressants. This paper reviews data on the efficacy and safety of antidepressant agents currently available for the treatment of the elderly, and includes

  20. Inflammatory bowel diseases: an update of current treatment alternatives.

    Directory of Open Access Journals (Sweden)

    Lucrecia Suárez

    2009-11-01

    Full Text Available Inflammatory bowel diseases (IBD are characterized for having an unpredictable clinical course with periods of inactivity alternating with relapses, a very variable response to treatment and the constant threat of diverse complications. Management of IBD in children may be of particular complexity, added to the fact that published clinical trials are limited, and scientific evidence seems contradictory, explain in part why to current date there is no international consensus regarding treatment in this age group. A suitable therapy should aim at inducing and maintaining remission for as long as possible, encourage adequate growth and preventing potential complications from appearing. In more recent years, development of new therapeutic agents has allowed a more integrative approach which takes in consideration other aspects of the disease such as nutritional status, psychological welfare and general quality of life. One must also keep in mind that none of these therapeutic resources is exempt of side effects on short and long term basis, consequently, it is imperative to be thoughtful of individual features in order to make accurate clinical decisions and offer a tailored management plan which should be able to modify the disease evolution.

  1. Current Pharmaceutical Treatments and Alternative Therapies of Parkinson's Disease.

    Science.gov (United States)

    Dong, Jie; Cui, Yanhua; Li, Song; Le, Weidong

    2016-01-01

    Over the decades, pharmaceutical treatments, particularly dopaminergic (DAergic) drugs have been considered as the main therapy against motor symptoms of Parkinson's disease (PD). It is proposed that DAergic drugs in combination with other medications, such as monoamine oxidase type B inhibitors, catechol-O-methyl transferase inhibitors, anticholinergics and other newly developed non-DAergic drugs can make a better control of motor symptoms or alleviate levodopa-induced motor complications. Moreover, non-motor symptoms of PD, such as cognitive, neuropsychiatric, sleep, autonomic and sensory disturbances caused by intrinsic PD pathology or drug-induced side effects, are gaining increasing attention and urgently need to be taken care of due to their impact on quality of life. Currently, neuroprotective therapies have been investigated extensively in pre-clinical studies, and some of them have been subjected to clinical trials. Furthermore, non-pharmaceutical treatments, including deep brain stimulation (DBS), gene therapy, cell replacement therapy and some complementary managements, such as Tai chi, Yoga, traditional herbs and molecular targeted therapies have also been considered as effective alternative therapies to classical pharmaceutics. This review will provide us updated information regarding the current drugs and non-drugs therapies for PD. PMID:26585523

  2. Study Questions Use of Antidepressants for Children, Teens

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_159262.html Study Questions Use of Antidepressants for Children, Teens They ... interpersonal therapy -- as the first-line treatment," said study author Dr. Andrea Cipriani. He is an associate ...

  3. Application of antidepressant drugs in the treatment of pregnancy and breastfeeding women%抗抑郁药在妊娠期及哺乳期妇女中的应用

    Institute of Scientific and Technical Information of China (English)

    施慎逊

    2013-01-01

    尽管抗抑郁药已广泛应用于抑郁发作的治疗,但抗抑郁药在妊娠期或哺乳期妇女中的应用,如针对该人群使用抗抑郁药应注意些什么和哪些药物使用相对安全等问题一直是临床关注的焦点.本文综合文献及笔者的临床经验综述上述相关问题.%Antidepressant drugs have been widely used in the treatment of depressive disorders. However, the application of antidepressant drugs used in the pregnancy and breastfeeding women has been a clinical concern. Based on literature and author's clinical experience, this review describes what attention should be paid when antidepressant drugs are used in the pregnancy and breastfeeding women and which drugs are relatively safer.

  4. The depressogenic-like effect of acute and chronic treatment with dexamethasone and its influence on the activity of antidepressant drugs in the forced swim test in adult mice.

    Science.gov (United States)

    Wróbel, Andrzej; Serefko, Anna; Wlaź, Piotr; Poleszak, Ewa

    2014-10-01

    There is a close relationship between chronic stress, glucocorticoids and depression. Psychiatric and cognitive symptoms resembling major depression have been observed in patients experiencing elevated glucocorticoid levels, and a high percentage of people suffering from depression have undergone a stressful event/events prior to the onset of this mental disorder. In our study, we investigated whether acute and chronic treatment of dexamethasone induces depression-like behavior in mice and if dexamethasone therapy influences the activity of antidepressant drugs with diverse modes of action. The antidepressant-like effect was assessed by the forced swim test in adult mice. The depressogenic-like activity of dexamethasone turned out to be dose-dependent: only the highest tested dose of the glucocorticoid (i.e., 64μg/kg) given as a single injection increased immobility time, whereas 16μg/kg/day of dexamethasone (but not 4μg/kg/day) administered repeatedly induced a significant alteration in animal behavior. These depressogenic doses of dexamethasone (i.e., 64μg/kg and 16μg/kg/day for an acute and repeated administration, respectively) diminished the antidepressant potential of the therapeutic doses of imipramine (10mg/kg), amitriptyline (10mg/kg), tianeptine (25mg/kg), mianserin (10mg/kg), citalopram (15mg/kg) and moclobemide (25mg/kg). Two main findings of our study should be particularly underlined: (1) both single and repeated administration of dexamethasone evoked a depression-like behavior of mice, (2) both single and repeated administration of dexamethasone were able to modify the activity of the antidepressant agents from various pharmacological groups, which may lead to a considerable reduction in the efficacy of pharmacotherapy prescribed for patients with mood disorders.

  5. The effects of gestational stress and Selective Serotonin reuptake inhibitor antidepressant treatment on structural plasticity in the postpartum brain--A translational model for postpartum depression.

    Science.gov (United States)

    Haim, Achikam; Albin-Brooks, Christopher; Sherer, Morgan; Mills, Emily; Leuner, Benedetta

    2016-01-01

    This article is part of a Special Issue "Parental Care". Postpartum depression (PPD) is a common complication following childbirth experienced by one in every five new mothers. Although the neural basis of PPD remains unknown, previous research in rats has shown that gestational stress, a risk factor for PPD, induces depressive-like behavior during the postpartum period. Moreover, the effect of gestational stress on postpartum mood is accompanied by structural modifications within the nucleus accumbens (NAc) and the medial prefrontal cortex (mPFC)-limbic regions that have been linked to PPD. Mothers diagnosed with PPD are often prescribed selective serotonin reuptake inhibitor (SSRI) antidepressant medications and yet little is known about their effects in models of PPD. Thus, here we investigated whether postpartum administration of Citalopram, an SSRI commonly used to treat PPD, would ameliorate the behavioral and morphological consequences of gestational stress. In addition, we examined the effects of gestational stress and postpartum administration of Citalopram on structural plasticity within the basolateral amygdala (BLA) which together with the mPFC and NAc forms a circuit that is sensitive to stress and is involved in mood regulation. Our results show that postpartum rats treated with Citalopram do not exhibit gestational stress-induced depressive-like behavior in the forced swim test. In addition, Citalopram was effective in reversing gestational stress-induced structural alterations in the postpartum NAc shell and mPFC. We also found that gestational stress increased spine density within the postpartum BLA, an effect which was not reversed by Citalopram treatment. Overall, these data highlight the usefulness of gestational stress as a valid and informative translational model for PPD. Furthermore, they suggest that structural alterations in the mPFC-NAc pathway may underlie stress-induced depressive-like behavior during the postpartum period and provide

  6. Natural treatments for seasonal and non-seasonal depression: a review of literature and comparison of antidepressant responses

    OpenAIRE

    A. Putilov

    2013-01-01

    The symptoms of depression might be alleviated by such non-pharmacological interventions as sleep deprivation, bright light exposure, and physical exercise. Some strategies of non-drug treatment for seasonal and non-seasonal depression seem to be very effective, but the involvement of specific biological mechanisms in the observed beneficial response still remains to be clarified. A present literature review was combined with a brief summary of the results of a set of author’s investigations ...

  7. Adherence to antidepressants

    Directory of Open Access Journals (Sweden)

    Abimbola Farinde

    2013-01-01

    Full Text Available While major depression is considered a frequent mental illness there are ongoing reports of high non-adherence to antidepressant medications which places suffers at high risk for relapse, recurrence, or greater impairment,. The World Health Organization (WHO defines adherence as the extent to which a person′s behavior (e.g. taking medications can align with the agreed recommendations of a health care provider. Unfortunately while patient may recognize the importance of adherence to antidepressant medications the majority of patients do not adhere to their prescribed antidepressants. Some of the factors that may contribute to or lead to non-adherence include knowingly or unknowingly missing doses, taking extra doses, delaying administration times, or taking drug holidays. Pharmacists have the unique ability to deter non-adherence through the performance of continuous assessment and monitoring of adherence in this population given these accessibility. Additionally, pharmacists are able to develop therapeutic alliances with patients that can help to increase the likelihood of achieving positive patient outcomes. Antidepressant non-adherence can be viewed as a significant public health concern so it is important for patients to be educated about the importance of adherence, and health care professionals should be aware of factors or patient characteristics that can serve as barriers to non-adherence.

  8. Antidepressant medications and osteoporosis

    DEFF Research Database (Denmark)

    Rizzoli, R; Cooper, C; Reginster, J-Y;

    2012-01-01

    Use of antidepressant medications that act on the serotonin system has been linked to detrimental impacts on bone mineral density (BMD), and to osteoporosis. This article reviews current evidence for such effects, and identifies themes for future research. Serotonin receptors are found in all major...

  9. Irritable bowel syndrome in a psychiatristxs practice (the problem of nosological independence and a possibility of its treatment with antidepressants (in case of paroxetine efficacy

    Directory of Open Access Journals (Sweden)

    Dmitry Sergeyevich Danilov

    2013-01-01

    Full Text Available The paper discusses whether the irritable bowel syndrome is an independent nosological entity. It presents data on the association of this functional disease with mental disorders with emphasis on comorbidity with depression, as well as on the efficiency of psychopharmacotherapy options. Particular attention is given to the possibility of using antidepressants. An observation of the efficacy of paroxetine is outlined.

  10. Impeller bioreactors: a low-cost alternative in biological sewage treatment. Fluegelrad-Bioreaktor - kostenguenstige Alternative fuer die biologische Abwasserreinigung

    Energy Technology Data Exchange (ETDEWEB)

    Wilk, B.U.

    1992-10-01

    In order to fulfil the present and future requirements of waste water purification, especially in the five new Federal states, cost-efficient alternatives are required which extend overstressed sewage treatment plants based on existing capacities. Especially smaller sewage treatment plants can be extended cost-efficiently by means of the impeller bioreactor. (orig.)

  11. Antidepressant Induced Mania : Is it a risk factor for Antidepressant Abuse?

    OpenAIRE

    Ramesh, S; Khandelwal, Sudhir K

    2003-01-01

    Induction of mania is a common occurrence with antidepressant use. A case of antidepressant induced hypomania leading to antidepressant abuse is presented. The clinical implications of antidepressant abuse in bipolar disorder are discussed.

  12. Exposure to antidepressants during pregnancy--prevalences and outcomes

    DEFF Research Database (Denmark)

    Jimenez-Solem, Espen

    2014-01-01

    is challenging. The best available method is through epidemiological studies. During the past decade use of antidepressants during pregnancy has been associated with negative birth outcomes, such as congenital malformations. In spite of a considerable number of studies on the subject, the data are still...... malformations and perinatal mortality. We performed our analysis with focus on women pausing treatment before pregnancy to account for special characteristics associated with women redeeming a prescription for an antidepressant. Furthermore, we reported prevalences of antidepressant use, in Denmark, in relation...... saw a halving in prevalence of antidepressant exposure and a steep increase after delivery. Our analyses showed an association between being in treatment with an SSRI and congenital malformations. However, this increased risk was also found for women pausing treatment before pregnancy. We conclude...

  13. [Bariatric and plastic surgery in obese adolescents: an alternative treatment].

    Science.gov (United States)

    Dubern, Béatrice; Tounian, Patrice

    2014-06-01

    The increased frequency of extreme forms of obesity in adolescents and the disappointing results of conventional treatments are now leading pediatricians to consider bariatric or cosmetic surgery as the only real long-term effective therapeutic alternative. The two main techniques currently used for bariatric surgery in adolescents are gastric bypass and adjustable gastric banding. Whatever the technique, weight loss is significant with improvement of comorbidities and quality of life. In addition, the complications are identical to those in adults and equally frequent. However, because of the particularities of this age, caution is still required. Adolescence is indeed characterized by specific nutritional needs, but also changes in body image in which surgery could have a negative effect. Currently, all obese teenagers making a request for bariatric surgery should have a comprehensive assessment with global care for at least 6 months. The indication is then discussed on a case-by-case basis by multidisciplinary teams and experts. To date, the type of surgery (gastric banding, gastric sleeve, or bypass) is still widely discussed. Based on experience with adults, we believe that gastric sleeve and bypass should be preferred. In addition, obesity in adolescents almost always involves psychosocial consequences, while somatic complications are rare. Thus, the care of adipo- or gynecomastia, abdominal fat excess, and concealed penis is essential and therefore justifies cosmetic surgery.

  14. Alternating magnetic field optimization for IONP hyperthermia cancer treatment

    Science.gov (United States)

    Kastner, Elliot J.; Reeves, Russell; Bennett, William; Misra, Aditi; Petryk, Jim D.; Petryk, Alicia A.; Hoopes, P. Jack

    2015-03-01

    Iron oxide nanoparticles (IONP) have therapeutic potential to deliver a thermal dose to tumors when activated in an alternating magnetic field (AMF). Through various targeting methods such as antibody labeling or injection site choice, delivery of IONPs to tumors yields enhanced treatment accuracy and efficacy. Despite this advantage, delivery an AMF, which is sufficient to result in clinically relevant IONP heating, can result in nonspecific tissue heating via the generation of eddy currents and tissue permeated by local electric fields (joule heating). The production of eddy current heating is a function of tissue size, geometry and composition as well as coil design and operation. The purpose of this research is to increase the level of energy deposited into the IONPs versus the non-target tissue (power ratio/PR)1 in order to improve target heating and reduce nonspecific tissue damage. We propose to improve the PR using two primary concepts: (1) reduce power deposition into non-target tissue by manipulating the fields and eddy current flow and (2) enhance heat removal from non-target tissue. We have shown that controlling tissue placement within the AMF field, accounting for tissue geometry, utilizing external cooling devices, and modifying the field properties can decrease non-target heating by more than 50%, at clinically relevant AMF levels, thereby allowing for an increase in thermal dose to the tumor and increasing the therapeutic ratio.

  15. The effects of cognitive behavioral therapy as an anti-depressive treatment is falling: A meta-analysis.

    Science.gov (United States)

    Johnsen, Tom J; Friborg, Oddgeir

    2015-07-01

    A meta-analysis examining temporal changes (time trends) in the effects of cognitive behavioral therapy (CBT) as a treatment for unipolar depression was conducted. A comprehensive search of psychotherapy trials yielded 70 eligible studies from 1977 to 2014. Effect sizes (ES) were quantified as Hedge's g based on the Beck Depression Inventory (BDI) and the Hamilton Rating Scale for Depression (HRSD). Rates of remission were also registered. The publication year of each study was examined as a linear metaregression predictor of ES, and as part of a 2-way interaction with other moderators (Year × Moderator). The average ES of the BDI was 1.58 (95% CI [1.43, 1.74]), and 1.69 for the HRSD (95% CI [1.48, 1.89]). Subgroup analyses revealed that women profited more from therapy than did men (p depressive symptoms as compared with the seminal trials. Potential causes and possible implications for future studies are discussed. (PsycINFO Database Record

  16. Antidepressant activity of fingolimod in mice

    OpenAIRE

    di Nuzzo, Luigi; Orlando, Rosamaria; Tognoli, Cristina; Di Pietro, Paola; Bertini, Giuseppe; Miele, Jessica; Bucci, Domenico; Motolese, Marta; Scaccianoce, Sergio; Caruso, Alessandra; Mauro, Gianluca; De Lucia, Carmine; Battaglia, Giuseppe; Bruno, Valeria; Fabene, Paolo Francesco

    2015-01-01

    Recent findings indicate that fingolimod, the first oral drug approved for the treatment of multiple sclerosis (MS), acts as a direct inhibitor of histone deacetylases (HDACs) and enhances the production of brain-derived neurotrophic factor (BDNF) in the CNS. Both mechanisms are relevant to the pathophysiology and treatment of major depression. We examined the antidepressant activity of fingolimod in mice subjected to chronic unpredictable stress (CUS), a model of reactive depression endowed ...

  17. Alternative methods for the treatment of post-menopausal troubles [Alternative Methoden zur Behandlung postmenopausaler Beschwerden

    Directory of Open Access Journals (Sweden)

    Wasem, Jürgen

    2012-05-01

    Full Text Available [english] Menopause is described as the transition from the reproductive phase of a women to the non reproductive. Changes in hormone levels might lead to complaints and health consequences especially during peri- and postmenopause. Hormone therapy has a potential damaging health risk profile and is recommended for temporal limited therapy for acute vasomotor symptoms only.The present HTA-report aims to assess the effectiveness and the cost-effectiveness of alternative treatment methods for women with postmenopausal symptoms in Germany regarding patient relevant endpoints (reduction of symptoms and frequency of adverse events and improvement of quality of life.A systematic literature search was carried out in 33 relevant databases in September 2010. Citations were selected according to pre-defined criteria and were extracted and evaluated.In the systematic research 22 studies are identified for the effectiveness evaluation, 22 primary studies and one review.High doses of isolated genistein reduce the frequency/intensity of hot flashes while low doses of genistein show no significant effect. Intake of isoflavone extract such as genistein, daidzein, glycitein in various combinations does not have an effect on improvement of cognitive function or vaginal dryness. The effect of black cohosh and hop extract for menopausal complaints cannot be determined since results are heterogenous. The combination of isoflavone, black cohosh, monk’s pepper, valerian and vitamin E has a positive effect on menopause symptoms. Ginkgo biloba shows no significant effect on menopause symptoms and cognitive improvement beside mental flexibility. Acupuncture has a significant influence on hot flashes especially in severe cases.No final statement can be drawn regarding the effectiveness of alter­ne treatment methods due to qualitative shortcomings of included studies and a general limited availability of studies in this field. Furthermore, the generalization of the

  18. Prognosis in heart failure and the value of {beta}-blockers are altered by the use of antidepressants and depend on the type of antidepressants used

    DEFF Research Database (Denmark)

    Fosbøl, Emil Loldrup; Gislason, Gunnar H; Poulsen, Henrik Enghusen;

    2009-01-01

    BACKGROUND: Depression worsens the prognosis in patients with cardiac disease, and treatment with antidepressants may improve survival. Guidelines recommend use of selective serotonin reuptake inhibitors (SSRIs), but knowledge of the prognostic effect of different classes of antidepressants...... death associated with antidepressants, HF medication, and coadministration of these 2 drug classes was estimated by Cox proportional hazard analyses. Propensity adjusted models were performed as sensitivity analysis. During the study period, there were 53 988 deaths, of which 83.0% were due...

  19. Comparison of Explicit Forgiveness Interventions with an Alternative Treatment: A Randomized Clinical Trial

    Science.gov (United States)

    Wade, Nathaniel G.; Worthington, Everett L.; Haake, Shawn

    2009-01-01

    Forgiveness interventions can help people forgive past offenses. However, few studies have compared forgiveness interventions with genuine alternative treatments. The authors compared forgiveness interventions with a therapeutic alternative treatment. Participants reduced unforgiveness and increased forgiveness regardless of treatment condition.…

  20. 40 CFR 268.46 - Alternative treatment standards based on HTMR.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Alternative treatment standards based on HTMR. 268.46 Section 268.46 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Treatment Standards § 268.46 Alternative treatment standards based on HTMR. For the...

  1. Aquatic blues: modeling depression and antidepressant action in zebrafish.

    Science.gov (United States)

    Nguyen, Michael; Stewart, Adam Michael; Kalueff, Allan V

    2014-12-01

    Depression is a serious psychiatric condition affecting millions of patients worldwide. Unipolar depression is characterized by low mood, anhedonia, social withdrawal and other severely debilitating psychiatric symptoms. Bipolar disorder manifests in alternating depressed mood and 'hyperactive' manic/hypomanic states. Animal experimental models are an invaluable tool for research into the pathogenesis of bipolar/unipolar depression, and for the development of potential treatments. Due to their high throughput value, genetic tractability, low cost and quick reproductive cycle, zebrafish (Danio rerio) have emerged as a promising new model species for studying brain disorders. Here, we discuss the developing utility of zebrafish for studying depression disorders, and outline future areas of research in this field. We argue that zebrafish represent a useful model organism for studying depression and its behavioral, genetic and physiological mechanisms, as well as for anti-depressant drug discovery.

  2. Acute effect of different antidepressants on glycemia in diabetic and non-diabetic rats

    OpenAIRE

    Gomez, R.; Huber, J.; G. Tombini; H.M.T. Barros

    2001-01-01

    Diabetic patients have a 20% higher risk of depression than the general population. Treatment with antidepressant drugs can directly interfere with blood glucose levels or may interact with hypoglycemic agents. The treatment of depression in diabetic patients must take into account variations of glycemic levels at different times and a comparison of the available antidepressant agents is important. In the present study we evaluated the interference of antidepressants with blood glucose levels...

  3. Enhanced Antidepressant-Like Effects of Electroacupuncture Combined with Citalopram in a Rat Model of Depression

    OpenAIRE

    Yang, Jian; Pei, Yu; Pan, Yan-Li; Jia, Jun; Shi, Chen; Yu, Yan; Deng, Jia-Hui; Li, Bo; Gong, Xiao-Li; Wang,Xuan; Xiao-min WANG; Ma, Xin

    2013-01-01

    Currently, antidepressants are the dominative treatment for depression, but they have limitations in efficacy and may even produce troublesome side effects. Electroacupuncture (EA) has been reported to have therapeutic benefits in the treatment of depressive disorders. The present study was conducted to determine whether EA could enhance the antidepressant efficacy of a low dose of citalopram (an SSRI antidepressant) in the chronic unpredictable stress-induced depression model rats. Here, we ...

  4. [Therapy of dementia with antipsychotics and antidepressives].

    Science.gov (United States)

    Frölich, L; Hausner, L

    2015-04-01

    In dementia depressive symptoms, anxiety, hallucinations and delusions often occur and are accompanied by unspecific behavioral changes. A targeted pharmacotherapy is complicated by the underlying cognitive impairment and physical comorbidities. The current review focusses on recent evidence on the use of antidepressives and antipsychotics for psychotic disturbances, agitation and depression in dementia and analyzes currently published randomized controlled clinical trials and meta-analyses. The evidence on the use of antipsychotics for different indications favors risperidone, with lower evidence levels for quetiapine and aripiprazole, whereas haloperidol should be avoided. Increased mortality and the risk of cerebrovascular events due to antipsychotics are of major concern. With respect to antidepressives, the benefit of antidepressive pharmacotherapy in dementia is critically discussed because of limited efficacy and increased side effects; however, selective serotonin reuptake inhibitors (SSRI), such as citalopram and sertraline have demonstrated efficacy on neuropsychiatric behavioral symptoms in general. These conclusions on the risk-benefit ratio of antidepressives and antipsychotics in dementia are in accordance with the recommendations of the German Society of Neurology and German Association for Psychiatry, Psychotherapy and Psychosomatics (DGN/DGPPN) S3 guidelines on the treatment of dementia. PMID:25787724

  5. Potential antidepressant constituents of Nigella sativa seeds

    Directory of Open Access Journals (Sweden)

    Ehab S Elkhayat

    2016-01-01

    Full Text Available Background: Nigella sativa Linn. is well known seed in the Middle East, Asia, and the Far East as a natural remedy for many ailments and as a flavoring agent proclaimed medicinal usage dating back to the ancient Egyptians, Greeks, and Romans. An authentic saying of the Prophet Muhammad (Peace Be Upon Him about black seed is also quoted in Al-Bukhari. Objective: This study was carried out to evaluate the antidepressant effect and isolate the potential antidepressant constituents of the polar extract of N. sativa seeds. Materials and Methods: The antidepressant effect was evaluated through the immobility duration in tail suspension and forced swim tests (FSTs. Albino mice were orally treated with N. sativa polar extract and its RP-18 column chromatography fractions (50 and 100 mg/kg,. Results: The polar extract and two of its sub-fractions were significantly able to decrease the immobility time of mice when subjected to both tail suspension and FSTs, the effects are comparable to standard drug (Sertraline, 5 mg/kg. However, these treatments did not affect the number of crossings and rearing in the open field test. Phytochemical investigation of the two active fractions led to the isolation of quercetin-3-O-α-L-rhamnopyranoside 1, quercetin-7-O-β-D-gluco- pyranoside 2, tauroside E 3, and sapindoside B as the potential antidepressant constituents.

  6. Breastfeeding and Antidepressants

    OpenAIRE

    Field, Tiffany

    2008-01-01

    Although a large literature supports the benefits of breastfeeding, this review suggests that breastfeeding is less common among postpartum depressed women, even though their infants benefit from the breastfeeding. Depressed mothers, in part, do not breastfeed because of their concern about potentially negative effects of antidepressants on their infants. Although sertraline (Zoloft) and paroxetine (Paxol) concentrations are not detectable in infants’ sera, fluoxetine (Prozac) and citalopram ...

  7. Antidepressants and local anesthetics: drug interactions of interest to dentistry

    Directory of Open Access Journals (Sweden)

    Lea Rosa Chioca

    2010-10-01

    Full Text Available Introduction: Since there is a vast variety of pharmacological treatments for mental conditions, it has been increasingly more common that patients seeking dentistry treatment are continually using psychoactive drugs as antidepressants. The number of people taking antidepressants is increasing; consequently, dentists should update their knowledge on the interaction between this drug class and those used in dental daily practice, such as local anesthetics and vasoconstrictors. Objective: To conduct a literature review on this subject. Literature review and conclusion: Literature data suggest that sympathomimetic vasoconstrictors (epinephrine, norepinephrine, and phenylephrine associated with local anesthetics may potentiate the side effects of antidepressants, particularly tricyclics and MAO inhibitors, on the cardiovascular system. There are few clinical trials and preclinical studies on this subject, and most of them were carried out between the 60s and 80s. Current studies are needed, since many new antidepressant drugs with different mechanisms of action are currently marketed and being used.

  8. Tratamento da disforia pré-menstrual com antidepressivos: revisão dos ensaios clínicos controlados Treatment of premenstrual dysphoria with antidepressants: review of controlled clinical trials

    Directory of Open Access Journals (Sweden)

    Elie Cheniaux

    2006-01-01

    Full Text Available INTRODUÇÃO: A disforia pré-menstrual (DPM, que acomete entre 3% e 8% das mulheres em idade fértil, representa uma forma mais grave de síndrome pré-menstrual, na qual predominam as alterações do humor e do comportamento. Acredita-se que haja algum tipo de ligação entre a DPM e os transtornos do humor. OBJETIVO: Estudar a eficácia dos antidepressivos na DPM. MÉTODOS: Foi realizada uma revisão dos ensaios clínicos controlados com antidepressivos no tratamento da DPM, utilizando-se as seguintes bases de dados: Medline, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS, psycINFO e Biblioteca Cochrane. RESULTADOS: A clomipramina, a fluoxetina, a sertralina, a paroxetina e a venlafaxina se mostraram superiores ao placebo em diversos estudos. DISCUSSÃO: As mulheres que sofrem de DPM possivelmente apresentam uma disfunção serotoninérgica. CONCLUSÃO: Alguns antidepressivos, especialmente os inibidores seletivos da recaptação da serotonina (ISRS, parecem ser eficazes no tratamento da DPM.INTODUCTION: Premenstrual dysphoria (PMD, which affects between 3% and 8% of women during reproductive years, represents a more severe type of premenstrual syndrome. Mood and behavior changes are predominant in PMD. It is believed that there is some kind of link between PMS and mood disorders. OBJECTIVE: Studying the efficacy of antidepressants in PMD. METHODS: We elaborated a review of controlled clinical trials with antidepressants in the treatment of PMD, using the following databases: Medline, LILACS, psycINFO and Cochrane Library. RESULTS: Clomipramine, fluoxetine, sertraline, paroxetine and venlafaxine were superior to placebo in various studies. DISCUSSION: Women with PMD possibly present a serotonergic dysfunction. CONCLUSION: Some antidepressants, specialy SSRIs, seem to be effective in the treatment of PMD.

  9. Antidepressant exposure during early pregnancy and congenital malformations

    DEFF Research Database (Denmark)

    Pedersen, Lars Henning

    reassuring, however, an association with heart malformations has been suggested for e.g. paroxetine. A potential biological explanation will be reviewed. The potential teratogenic potential of antidepressants needs to be balanced against the obvious problems associated with under-treated maternal depression......Pharmacological treatment of pregnant women with depression is hampered by concerns for the developing fetus. The presentation will summarize existing knowledge on the potential association between antidepressants and congenital malformations, elaborate on the scientific background, and discuss the...

  10. Antidepressant-like activity of liposomal formulation containing nimodipine treatment in the tail suspension test, forced swim test and MAOB activity in mice.

    Science.gov (United States)

    Moreno, Lina Clara Gayoso E Almendra Ibiapina; Rolim, Hercília Maria Lins; Freitas, Rivelilson Mendes; Santos-Magalhães, Nereide Stela

    2016-09-01

    Previous studies have shown that intracellular calcium ion dysfunction may be an etiological factor in affective illness. Nimodipine (NMD) is a Ca(2+) channel blocker that has been extensively investigated for therapy of central nervous system (CNS) disorders. In this work, we have evaluated the antidepressant-like activity of nimodipine encapsulated into liposomes (NMD-Lipo) in mice through tail suspension and forced swim assays, as well as MAOB activity. During the tail suspension test, the administration of NMD-Lipo at 0.1, 1 and 10mg/kg was able to promote a reduction in the immobility time of animals greater than the positive control (imipramine). In the forced swim test, the immobility time of mice treated with NMD-Lipo was reduced. This reduction was significantly greater than that found in the animals treated with imipramine and paroxetine. This may suggest that NMD-Lipo provides more antidepressant-like activity than in positive controls. The groups that received a combination of liposomal NMD and antidepressant drugs showed lower immobility time than the groups, which were treated only with imipramine or paroxetine. The mice treated with the combination of NMD-Lipo and reserpine presented an increase in the time of immobility compared with animals treated only with NMD-Lipo. There was a significant decrease in MAOB activity in animals treated with NMD-Lipo compared with untreated animals. The results of the tail suspension test, forced swim test and MAOB activity suggested that the antidepressant activity of NMD-Lipo may be related to an increase in the cerebral monoamine concentrations.

  11. Antidepressant-like activity of liposomal formulation containing nimodipine treatment in the tail suspension test, forced swim test and MAOB activity in mice.

    Science.gov (United States)

    Moreno, Lina Clara Gayoso E Almendra Ibiapina; Rolim, Hercília Maria Lins; Freitas, Rivelilson Mendes; Santos-Magalhães, Nereide Stela

    2016-09-01

    Previous studies have shown that intracellular calcium ion dysfunction may be an etiological factor in affective illness. Nimodipine (NMD) is a Ca(2+) channel blocker that has been extensively investigated for therapy of central nervous system (CNS) disorders. In this work, we have evaluated the antidepressant-like activity of nimodipine encapsulated into liposomes (NMD-Lipo) in mice through tail suspension and forced swim assays, as well as MAOB activity. During the tail suspension test, the administration of NMD-Lipo at 0.1, 1 and 10mg/kg was able to promote a reduction in the immobility time of animals greater than the positive control (imipramine). In the forced swim test, the immobility time of mice treated with NMD-Lipo was reduced. This reduction was significantly greater than that found in the animals treated with imipramine and paroxetine. This may suggest that NMD-Lipo provides more antidepressant-like activity than in positive controls. The groups that received a combination of liposomal NMD and antidepressant drugs showed lower immobility time than the groups, which were treated only with imipramine or paroxetine. The mice treated with the combination of NMD-Lipo and reserpine presented an increase in the time of immobility compared with animals treated only with NMD-Lipo. There was a significant decrease in MAOB activity in animals treated with NMD-Lipo compared with untreated animals. The results of the tail suspension test, forced swim test and MAOB activity suggested that the antidepressant activity of NMD-Lipo may be related to an increase in the cerebral monoamine concentrations. PMID:27270234

  12. Social functioning: should it become an endpoint in trials of antidepressants?

    Science.gov (United States)

    Bech, Per

    2005-01-01

    items. An additional item measures overall life satisfaction. As most of the items in the brief Q-LES-Q include social functioning, the scale can be considered as an alternative to SF-36 or the Sheehan Disability Scale when the focus is on satisfaction with treatment. However, there are insufficient numbers of trials of antidepressants using these questionnaires to allow comparisons. The examples of trials of antidepressants with the SF-36 subscales discussed in this review have mostly involved SSRIs. These trials have demonstrated that although antidepressants improve social functioning compared with placebo over a 6-week treatment period, the endpoint scores are still significantly below the national norms at this point. Only after 12 weeks of therapy are the endpoint scores of the social functioning scales within the limits of the national norms. In relapse prevention trials or in maintenance trials to prevent recurrence of depression, comparisons of social functioning scores with national norms can be important supplementary indicators of the need for treatment. In conclusion, social functioning as part of the health-related concept of the patient-reported quality-of-life measure should constitute an endpoint in trials of antidepressants to help clarify the goals of treatment in patients with major depression. In medium- and long-term trials, SF-36 subscales should be used as a supplement to symptom-orientated scales. In trials of shorter (6-8 weeks) duration, use of other scales such as the SAS-SR, the Q-LES-Q or the Sheehan Disability Scale should be considered. These scales should be considered as supplementary to each other rather than alternatives; it may be necessary to use more than one of these scales in a trial. PMID:15813645

  13. Antidepressant-Like Effects of Sanggenon G, Isolated from the Root Bark of Morus alba, in Rats: Involvement of the Serotonergic System.

    Science.gov (United States)

    Lim, Dong Wook; Jung, Jae-Woo; Park, Ji-Hae; Baek, Nam-In; Kim, Yun Tai; Kim, In-Ho; Han, Daeseok

    2015-01-01

    The root bark of Morus alba is commonly used as an alternative medicine due to its numerous health benefits in humans. However, the antidepressant effects of various active components from M. alba have not been fully elucidated. In this study, we aimed to determine whether sanggenon G, an active compound isolated from the root bark of M. alba, exhibited antidepressant-like activity in rats subjected to forced swim test (FST)-induced depression. Acute treatment of rats with sanggenon G (30 mg/kg, intraperitoneally (i.p.)) significantly reduced immobility time and increased swimming time without any significant change in climbing. Rats treated with sanggenon G also exhibited a decrease in the limbic hypothalamic-pituitary-adrenal (HPA) axis response to the FST, as indicated by attenuation of the corticosterone response and decreased c-Fos immunoreactivity in the hypothalamic paraventricular nucleus (PVN). In addition, the antidepressant-like effects of sanggenon G were significantly inhibited by WAY100635 (1 mg/kg, i.p.; a selective 5-hydroxytryptamine1A (5-HT1A) receptor antagonist), but not SCH23390 (0.05 mg/kg, i.p.; a dopamine D1 receptor antagonist). Our findings suggested that the antidepressant-like effects of sanggenon G were mediated by an interaction with the serotonergic system. Further studies are needed to evaluate the potential of sanggenon G as an alternative therapeutic approach for the treatment of depression.

  14. Integration of alternative feedstreams for biomass treatment and utilization

    Science.gov (United States)

    Hennessey, Susan Marie; Friend, Julie; Dunson, Jr., James B.; Tucker, III, Melvin P.; Elander, Richard T.; Hames, Bonnie

    2011-03-22

    The present invention provides a method for treating biomass composed of integrated feedstocks to produce fermentable sugars. One aspect of the methods described herein includes a pretreatment step wherein biomass is integrated with an alternative feedstream and the resulting integrated feedstock, at relatively high concentrations, is treated with a low concentration of ammonia relative to the dry weight of biomass. In another aspect, a high solids concentration of pretreated biomass is integrated with an alternative feedstream for saccharifiaction.

  15. Treatment of Anxiety Disorders and Comorbid Alcohol Abuse with Buspirone in a Patient with Antidepressant-Induced Platelet Dysfunction: A Case Report

    Directory of Open Access Journals (Sweden)

    Mir Mazhar

    2013-01-01

    Full Text Available The risk of abnormal bleeding with serotonin reuptake inhibitors has been known, but there is insufficient evidence base to guide pharmacological treatment of anxiety in patients with underlying haematological conditions. The following case report is about a 50-year-old female with generalized anxiety disorder, social phobia, obsessive compulsive disorder, and alcohol abuse where pharmacological treatment of anxiety symptoms has been difficult as it would lead to bruising due to the patient’s underlying qualitative platelet dysfunction. Treatment with venlafaxine, citalopram, escitalopram, and clomipramine resulted in improvement and anxiety symptoms, as well as reduction in alcohol use, but pharmacological treatment has to be discontinued because of bruising and hematomas. In view of an active substance use disorder, benzodiazepines were avoided as a treatment option. The patient’s anxiety symptoms and comorbid alcohol abuse responded well to pharmacological treatment with buspirone which gradually titrated up to a dose of 30 mg BID. Patient was followed for around a six-month period while she was on buspirone before being discharged to family doctor’s care. Buspirone is unlikely to have a significant effect on platelet serotonin transponder and could be an effective alternative for pharmacological treatment of anxiety in patients with a bleeding diathesis.

  16. Endovascular repair:alternative treatment of ruptured abdominal aortic aneurysm

    Institute of Scientific and Technical Information of China (English)

    GUO Wei; ZHANG Hong-peng; LIU Xiao-ping; YIN Tai; JIA Xin; LIANG Fa-qi; ZHANG Guo-hua

    2009-01-01

    Background As an alternative to open aneurysm repair,endovascular aortic repair(EVAR)has been applied to ruptured abdominal aortic aneurysm(rAAA).The aim of this study was to evaluate the immediate and long-term outcomes of EVAR for rAAA.Methods From July 1997 to September 2007,20 men and six women with rAAA(median age,68 years)were treated with EVAR.Most patients with suspected rAAA underwent emergency computed tomographic angiography(CTA).The procedure was performed under general or local anesthesia.Endovascular clamping was attempted in hemodynamically unstable patients.Bifurcated endografts and aorto-uni-iliac(AUI)endografts with crossover bypass were used.Patients had CT scan prior to discharge,3,6,12 months after discharge,and annually thereafter.Results Time between diagnosis and EVAR ranged from 1 hour to 5 days.EVAR was performed under general anesthesia in 21 patients,and under local anesthesia in five patients.Endovascular aortic clamping was performed in four patients.There was no conversion to open surgery during EVAR.Stent-graft insertion was successful in all patients.One patient died during EVAR from acute myocardial infarction.Ten patients had systolic blood pressure<80 mm Hg.Eleven patients received a blood transfusion.Mean aneurysm size was(47c12)mm.Mean ICU stay was(8±3)days,mean hospital stay(18±6)days,and mean procedure time(120±32)minutes.The 30-day mortality was 23%(6/26patients),and major morbidity 35%(9/26 patients).Early endoleak occurred in 8/26 patients(31%).The mean follow-up was(18±7)months.No patient demonstrated migration of the stent-graft.Conclusions EVAR is a safe and effective option for treatment of acute rAAA,independent of the patient's general condition.Immediate and mid-term outcomes are favorable,but long-term outcome is unknown.Multi-center studies are necessary to establish the role of EVAR for rAAA.

  17. Antidepressant-Resistant Depression and Antidepressant-Associated Suicidal Behaviour: The Role of Underlying Bipolarity

    OpenAIRE

    Zoltan Rihmer; Xenia Gonda

    2011-01-01

    The complex relationship between the use of antidepressants and suicidal behaviour is one of the hottest topics of our contemporary psychiatry. Based on the literature, this paper summarizes the author's view on antidepressant-resistant depression and antidepressant-associated suicidal behaviour. Antidepressant-resistance, antidepressant-induced worsening of depression, antidepressant-associated (hypo)manic switches, mixed depressive episode, and antidepressant-associated suicidality among d...

  18. Antidepressant use during pregnancy and asthma in the offspring

    DEFF Research Database (Denmark)

    Liu, Xiaoqin; Olsen, Jørn; Pedersen, Lars Henning;

    2015-01-01

    BACKGROUND AND OBJECTIVES: It has been suggested that maternal depression during pregnancy is abstract associated with asthma in the offspring, but the role of medical treatment of depression is not known. Our goal was to examine whether prenatal antidepressant use increases the risk of asthma......, we estimated the hazard ratio (HR) for asthma in the offspring after antidepressant use during pregnancy. RESULTS: Of the 733 685 children identified, 84 683 had a diagnosis of asthma. A total of 21 371 children were exposed to prenatal maternal depression (ie, a diagnosis of depressive disorder...... or use of antidepressants 1 year before or during pregnancy). Prenatal maternal depression was associated with childhood asthma (HR: 1.25 [95% confidence interval (CI): 1.20–1.30]). Overall, 8895 children were exposed to antidepressants in utero. Compared with children born to mothers with prenatal...

  19. Long-term antidepressant use: patient perspectives of benefits and adverse effects

    Science.gov (United States)

    Cartwright, Claire; Gibson, Kerry; Read, John; Cowan, Ondria; Dehar, Tamsin

    2016-01-01

    Long-term antidepressant treatment has increased and there is evidence of adverse effects; however, little is known about patients’ experiences and views of this form of treatment. This study used mixed methods to examine patients’ views and experiences of long-term antidepressant treatment, including benefits and concerns. Data from 180 patients, who were long-term users of antidepressants (3–15 years), were extracted from an anonymous online survey of patients’ experiences of antidepressants in New Zealand. Participants had completed rating scales about the effectiveness of antidepressants, levels of depression before and during antidepressant use, quality of life, and perceived adverse effects. Two open-ended questions allowed participants to comment on personal experiences. The majority (89.4%) reported that antidepressants had improved their depression although 30% reported moderate-to-severe depression on antidepressants. Common adverse effects included withdrawal effects (73.5%), sexual problems (71.8%), and weight gain (65.3%). Adverse emotional effects, such as feeling emotionally numb (64.5%) and addicted (43%), were also common. While the majority of patients were pleased with the benefits of antidepressant treatment, many were concerned about these adverse effects. Some expressed a need for more information about long-term risks and increased information and support to discontinue. PMID:27528803

  20. Treatment Acceptability of Alternative Marital Therapies: A Comparative Analysis.

    Science.gov (United States)

    Bornstein, Philip H.; And Others

    1983-01-01

    Examined the acceptability of four therapeutic models (i.e., behavioral, psychoanalytic, systems, and eclectic) used in treatment of marital discord. Subjects (N=88) evaluated four treatment sequences as they applied to a marital case history. Results showed that, among varying treatments, behavioral and systems approaches were rated more…

  1. Antidepressant-Like Effects of Lindera obtusiloba Extracts on the Immobility Behavior of Rats in the Forced Swim Test.

    Science.gov (United States)

    Lim, Dong Wook; Lee, Mi-Sook; Her, Song; Cho, Suengmok; Lee, Chang-Ho; Kim, In-Ho; Han, Daeseok

    2016-02-27

    Lindera obtusiloba extracts are commonly used as an alternative medicine due to its numerous health benefits in Korea. However, the antidepressant-like effects of L. obtusiloba extracts have not been fully elucidated. In this study, we aimed to determine whether L. obtusiloba extracts exhibited antidepressant-like activity in rats subjected to forced swim test (FST)-induced depression. Acute treatment of rats with L. obtusiloba extracts (200 mg/kg, p.o.) significantly reduced immobility time and increased swimming time without any significant change in climbing. Rats treated with L. obtusiloba extracts also exhibited a decrease in the limbic hypothalamic-pituitary-adrenal (HPA) axis response to the FST, as indicated by attenuation of the corticosterone response and decreased c-Fos immunoreactivity in the hippocampus CA3 region. In addition, L. obtusiloba extracts, at concentrations that were not affected by cell viability, significantly decreased luciferase activity in response to cortisol in a concentration-dependent manner by the glucocorticoid binding assay in HeLa cells. Our findings suggested that the antidepressant-like effects of L. obtusiloba extracts were likely mediated via the glucocorticoid receptor (GR). Further studies are needed to evaluate the potential of L. obtusiloba extracts as an alternative therapeutic approach for the treatment of depression.

  2. Antidepressant-Like Effects of Lindera obtusiloba Extracts on the Immobility Behavior of Rats in the Forced Swim Test

    Directory of Open Access Journals (Sweden)

    Dong Wook Lim

    2016-02-01

    Full Text Available Lindera obtusiloba extracts are commonly used as an alternative medicine due to its numerous health benefits in Korea. However, the antidepressant-like effects of L. obtusiloba extracts have not been fully elucidated. In this study, we aimed to determine whether L. obtusiloba extracts exhibited antidepressant-like activity in rats subjected to forced swim test (FST-induced depression. Acute treatment of rats with L. obtusiloba extracts (200 mg/kg, p.o. significantly reduced immobility time and increased swimming time without any significant change in climbing. Rats treated with L. obtusiloba extracts also exhibited a decrease in the limbic hypothalamic-pituitary-adrenal (HPA axis response to the FST, as indicated by attenuation of the corticosterone response and decreased c-Fos immunoreactivity in the hippocampus CA3 region. In addition, L. obtusiloba extracts, at concentrations that were not affected by cell viability, significantly decreased luciferase activity in response to cortisol in a concentration-dependent manner by the glucocorticoid binding assay in HeLa cells. Our findings suggested that the antidepressant-like effects of L. obtusiloba extracts were likely mediated via the glucocorticoid receptor (GR. Further studies are needed to evaluate the potential of L. obtusiloba extracts as an alternative therapeutic approach for the treatment of depression.

  3. Multidimensional Treatment Foster Care: An Alternative to Residential Treatment for High Risk Children and Adolescents

    Directory of Open Access Journals (Sweden)

    Philip A. Fisher

    2012-07-01

    Full Text Available This paper describes the Multidimensional Treatment Foster Care program (MTFC, an evidence based approach for providing psychotherapeutic treatment for very troubled children and adolescents that is an alternative to residential care. Versions of the MTFC program have been developed and validated for young children with a history of maltreatment as well as for older children and adolescents who are involved with the youth justice system. In the paper we describe the development of the MTFC program and its foundations in the social learning model that originated at the Oregon Social Learning Center in the 1960's and 70's. We present information about program elements. We then review the research that has been conducted on MTFC.

  4. Antidepressant Use and Risk of Out-of-Hospital Cardiac Arrest

    DEFF Research Database (Denmark)

    Weeke, P; Jensen, Aksel Karl Georg; Folke, F;

    2012-01-01

    Treatment with some types of antidepressants has been associated with sudden cardiac death. It is unknown whether the increased risk is due to a class effect or related to specific antidepressants within drug classes. All patients in Denmark with an out-of-hospital cardiac arrest (OHCA) were.......17-12.2). An association between cardiac arrest and antidepressant use could be documented in both the SSRI and TCA classes of drugs....

  5. Effects of calcium channel blocker, nifedipine, on antidepressant activity of fluvoxamine, venlafaxine and tianeptine in mice

    OpenAIRE

    SHARMA, Ashok K.; Anjan Khadka; Navdeep Dahiya

    2015-01-01

    Background: Cardiovascular diseases are commonly associated with depression. Calcium channel blockers (CCBs) form commonly used group of drugs for the treatment of a number of cardiovascular diseases. Nifedipine, a CCB, has been shown to possess antidepressant activity and potentiate antidepressant activity of imipramine and sertraline, however, literature on its interaction with newer antidepressant drugs such as fluvoxamine, venlafaxine and tianeptine is limited. Hence, the present study wa...

  6. Neurogenesis and The Effect of Antidepressants

    Directory of Open Access Journals (Sweden)

    Philippe Taupin

    2006-01-01

    Full Text Available The recent evidence that neurogenesis occurs throughout adulthood and neural stem cells (NSCs reside in the adult central nervous system (CNS suggests that the CNS has the potential for self-repair. Beside this potential, the function of newly generated neuronal cells in the adult brain remains the focus of intense research. The hippocampus of patients with depression show signs of atrophy and neuronal loss. This suggests that adult neurogenesis may contribute to the biology of depression. The observations that antidepressants, like fluoxetine, increase neurogenesis in the dentate gyrus (DG and neurogenesis is required for the behavioral effect of antidepressants, lead to a new theory for depression and the design of new strategies and drugs for the treatment of depression. However, the role of adult neurogenesis in the etiology of depression remains the source of controversies and debates.

  7. Antidepressant-Induced Female Sexual Dysfunction.

    Science.gov (United States)

    Lorenz, Tierney; Rullo, Jordan; Faubion, Stephanie

    2016-09-01

    Because 1 in 6 women in the United States takes antidepressants and a substantial proportion of patients report some disturbance of sexual function while taking these medications, it is a near certainty that the practicing clinician will need to know how to assess and manage antidepressant-related female sexual dysfunction. Adverse sexual effects can be complex because there are several potentially overlapping etiologies, including sexual dysfunction associated with the underlying mood disorder. As such, careful assessment of sexual function at the premedication visit followed by monitoring at subsequent visits is critical. Treatment of adverse sexual effects can be pharmacological (dose reduction, drug discontinuation or switching, augmentation, or using medications with lower adverse effect profiles), behavioral (exercising before sexual activity, scheduling sexual activity, vibratory stimulation, psychotherapy), complementary and integrative (acupuncture, nutraceuticals), or some combination of these modalities. PMID:27594188

  8. Alternative Treatment Applications in Children with Respiratory Tract Infections in the West of Turkey

    OpenAIRE

    Naci Topaloğlu; Şule Yıldırım; Mustafa Tekin; Ayşegül Uludağ; Kenan Özgen

    2013-01-01

    Introduction: It is known that the trend toward alternative treatments is increasing each day regardless of the differences between communities. We aimed to detect alternative treatments in our region and to determine the thoughts of families about these treatments. Materials and Methods: A total of 214 patients presenting to General Pediatrics Outpatient Clinics of Çanakkale Onsekiz Mart University Teaching and Research Hospital between October 2012 and February 2012 with fever, coughs, s...

  9. Cost-effectiveness of collaborative care including PST and an antidepressant treatment algorithm for the treatment of major depressive disorder in primary care; A randomised clinical trial

    NARCIS (Netherlands)

    M.A. IJff (Marjoliek); K.M.L. Huijbregts (Klaas); H.W. van Marwijk (Harm); A.T.F. Beekman (Aartjan); L. van Hakkaart-van Roijen (Leona); M.P.M.H. Rutten-van Mölken (Maureen); J. Unützer (Jürgen); C.M. van der Feltz-Cornelis (Christina)

    2007-01-01

    textabstractBackground. Depressive disorder is currently one of the most burdensome disorders worldwide. Evidence-based treatments for depressive disorder are already available, but these are used insufficiently, and with less positive results than possible. Earlier research in the USA has shown goo

  10. [Hypnosis as an alternative treatment for pain in palliative medicine].

    Science.gov (United States)

    Peintinger, Christa; Hartmann, Wolfgang

    2008-01-01

    Pain--which can have a variety of causes--constitutes a severe problem for patients in need of palliative care, because this pain usually dramatically impairs their quality of life. Thus, the more advanced a terminal illness has become, the more hospital staff should focus on holistic treatment, encompassing body, mind and soul of the patient. Apart from conventional medication-based pain therapy, there is also a variety of non-medicinal treatments for pain. One of these methods is hypnosis, an imaginative treatment that activates available resources; it is not only an effective way of alleviating pain, but it also can ease psychological problems at the same time. PMID:19165446

  11. Antidepressants and inflammatory bowel disease: a systematic review

    Directory of Open Access Journals (Sweden)

    Andrews Jane M

    2006-09-01

    Full Text Available Abstract Background A number of studies have suggested a link between the patient's psyche and the course of inflammatory bowel disease (IBD. Although pharmacotherapy with antidepressants has not been widely explored, some investigators have proposed that treating psychological co-morbidities with antidepressants may help to control disease activity. To date a systematic analysis of the available studies assessing the efficacy of antidepressants for the control of somatic symptoms in IBD patients has not been performed. Methods We searched electronic databases, without any language restriction. All relevant papers issued after 1990 were examined. Results 12 relevant publications were identified. All of them referred to non-randomised studies. Antidepressants reported in these publications included paroxetine, bupropion, amitriptyline, phenelzine, and mirtazapine. In 10 articles, paroxetine, bupropion, and phenelzine were suggested to be effective for treating both psychological and somatic symptoms in patients suffering from IBD. Amitriptyline was found ineffective for treating somatic symptoms of IBD. Mirtazapine was not recommended for IBD patients. Conclusion Although most of reviewed papers suggest a beneficial effect of treatment with antidepressants in patients with IBD, due to the lack of reliable data, it is impossible to judge the efficacy of antidepressants in IBD. Properly designed trials are justified and needed based upon the available uncontrolled data.

  12. Antidepressants versus placebo in major depression: an overview.

    Science.gov (United States)

    Khan, Arif; Brown, Walter A

    2015-10-01

    Although the early antidepressant trials which included severely ill and hospitalized patients showed substantial drug-placebo differences, these robust differences have not held up in the trials of the past couple of decades, whether sponsored by pharmaceutical companies or non-profit agencies. This narrowing of the drug-placebo difference has been attributed to a number of changes in the conduct of clinical trials. First, the advent of DSM-III and the broadening of the definition of major depression have led to the inclusion of mildly to moderately ill patients into antidepressant trials. These patients may experience a smaller magnitude of antidepressant-placebo differences. Second, drug development regulators, such as the U.S. Food and Drug Administration and the European Medicines Agency, have had a significant, albeit underappreciated, role in determining how modern antidepressant clinical trials are designed and conducted. Their concerns about possible false positive results have led to trial designs that are poor, difficult to conduct, and complicated to analyze. Attempts at better design and patient selection for antidepressant trials have not yielded the expected results. As of now, antidepressant clinical trials have an effect size of 0.30, which, although similar to the effects of treatments for many other chronic illnesses, such as hypertension, asthma and diabetes, is less than impressive. PMID:26407778

  13. A medical alternative to the treatment of compensatory sweating.

    Science.gov (United States)

    Cladellas, Esther; Callejas, Marco A; Grimalt, Ramon

    2008-01-01

    Compensatory sweating after sympathectomy does not have a satisfactory, free-of-secondary-effects treatment. Glycopyrrolate has been successfully used to treat other types of hyperhidrosis. Compensatory sweating after sympathectomy could respond to the topical application of glycopyrrolate. Ten patients were selected with compensatory sweating after sympathectomy. One milliliter of a 2% water solution of topical glycopyrrolate was applied once a day over the affected area and massaged for 30 seconds. Treatment was maintained for 6 weeks. The results were rated using a scale from 1 to 10 of satisfaction at the end of the study. Eight of the 10 treated patients dramatically improved with the topical application of glycopyrrolate. Two patients quit the treatment due to secondary effects (accommodative failure and dry mouth). The results of the study demonstrated that local application of glycopyrrolate might be the treatment of choice for compensatory hyperhidrosis. PMID:18844718

  14. Is biological treatment a viable alternative for micropollutant removal in drinking water treatment processes?

    Science.gov (United States)

    Benner, Jessica; Helbling, Damian E; Kohler, Hans-Peter E; Wittebol, Janneke; Kaiser, Elena; Prasse, Carsten; Ternes, Thomas A; Albers, Christian N; Aamand, Jens; Horemans, Benjamin; Springael, Dirk; Walravens, Eddy; Boon, Nico

    2013-10-15

    In western societies, clean and safe drinking water is often taken for granted, but there are threats to drinking water resources that should not be underestimated. Contamination of drinking water sources by anthropogenic chemicals is one threat that is particularly widespread in industrialized nations. Recently, a significant amount of attention has been given to the occurrence of micropollutants in the urban water cycle. Micropollutants are bioactive and/or persistent chemicals originating from diverse sources that are frequently detected in water resources in the pg/L to μg/L range. The aim of this review is to critically evaluate the viability of biological treatment processes as a means to remove micropollutants from drinking water resources. We first place the micropollutant problem in context by providing a comprehensive summary of the reported occurrence of micropollutants in raw water used directly for drinking water production and in finished drinking water. We then present a critical discussion on conventional and advanced drinking water treatment processes and their contribution to micropollutant removal. Finally, we propose biological treatment and bioaugmentation as a potential targeted, cost-effective, and sustainable alternative to existing processes while critically examining the technical limitations and scientific challenges that need to be addressed prior to implementation. This review will serve as a valuable source of data and literature for water utilities, water researchers, policy makers, and environmental consultants. Meanwhile this review will open the door to meaningful discussion on the feasibility and application of biological treatment and bioaugmentation in drinking water treatment processes to protect the public from exposure to micropollutants. PMID:24053940

  15. Drugs, genes and the blues: pharmacogenetics of the antidepressant response from mouse to man.

    Science.gov (United States)

    O'Leary, Olivia F; O'Brien, Fionn E; O'Connor, Richard M; Cryan, John F

    2014-08-01

    While antidepressant drugs are beneficial to many patients, current treatments for depression remain sub-optimal. Up to half of patients with a major depressive episode fail to achieve remission with a first line antidepressant treatment. Identification of the molecular mechanisms that dictate whether a patient will successfully respond to a particular antidepressant treatment while tolerating its side-effects is not only a major challenge in biological psychiatry research but is also one that shows great promise. This review summarises data from both clinical and preclinical studies that point to a role of specific genes in the response and resistance to antidepressant therapeutics. Moreover, we discuss how such findings have increased our understanding of the mechanism of action of antidepressant drugs. Finally, we comment on how this information may potentially influence the future development of personalised medicine approaches for the treatment of depression.

  16. Thermotherapy. An alternative for the treatment of American cutaneous leishmaniasis.

    Directory of Open Access Journals (Sweden)

    López Liliana

    2012-05-01

    Full Text Available Abstract Background Pentavalent antimonials (Sb5 and miltefosine are the first-line drugs for treating cutaneous leishmaniasis in Colombia; however, toxicity and treatment duration negatively impact compliance and cost, justifying an active search for better therapeutic options. We compared the efficacy and safety of thermotherapy and meglumine antimoniate for the treatment of cutaneous leishmaniasis in Colombia. Method An open randomized Phase III clinical trial was performed in five military health centres. located in northwestern, central and southern Colombia. Volunteers with parasitological positive diagnosis (Giemsa-stained smears of cutaneous leishmaniasis were included. A single thermotherapy session involving the application of 50°C at the center and active edge of each lesion. Meglumine antimoniate was administered intramuscularly at a dose of 20 mg Sb5/kg weight/day for 20 days. Results Both groups were comparable. The efficacy of thermotherapy was 64% (86/134 patients by protocol and 58% (86/149 by intention-to-treat. For the meglumine antimoniate group, efficacy by protocol was 85% (103/121 patients and 72% (103/143 by intention-to-treat, The efficacy between the treatments was statistically significant (p 0.01 and Leishmania species responsible for infection. The side effects of meglumine antimoniate included myalgia, arthralgia, headache and fever. Regarding thermotherapy, the only side effect was pain at the lesion area four days after the initiation of treatment. Conclusion Although the efficacy rate of meglumine antimoniate was greater than that of thermotherapy for the treatment of cutaneous leishmaniasis, the side effects were also greater. Those factors, added to the increased costs, the treatment adherence problems and the progressive lack of therapeutic response, make us consider thermotherapy as a first line treatment for cutaneous leishmaniasis. Registered ClinicalTrials.gov NCT00471705

  17. Depressão vascular no idoso: resposta ao tratamento antidepressivo associado a inibidor das colinesterases Vascular depression in elderly: response to treatment with antidepressant associated to cholinesterase inhibitor

    Directory of Open Access Journals (Sweden)

    Ricardo Barcelos

    2007-01-01

    Full Text Available CONTEXTO: Entre os transtornos neuropsiquiátricos ocasionados por eventos cerebrovasculares, a depressão vascular é pouco diagnosticada por médicos não especialistas, causando aumento da morbimortalidade de pacientes idosos. CASO CLÍNICO: Trata-se de um paciente com 67 anos que apresentou resposta parcial a tratamento com inibidores da recaptura de serotonina e efeitos adversos autonômicos graves com outros antidepressivos. A adição de rivastigmina ao citalopram promoveu sucesso terapêutico, com redução de 23 para 7 pontos, na escala de Hamilton para depressão. DISCUSSÃO: O resultado obtido traz novas perspectivas para o tratamento da depressão vascular, sendo necessários ensaios clínicos controlados que evidenciem o benefício da adição dos inibidores das colinesterases aos antidepressivos no tratamento destes pacientes.CONTEXT: Among neuropsychiatric disorders caused by cerebrovascular factors, vascular depression is diagnosed in a small degree by general practitioners, causing morbid-mortality increase in elderly. CASE REPORT: That is a case of a 67 year-old-man with partial response after treatment with a Selective Serotonin Receptors Inhibitor, and severe autonomic adverse effects with other antidepressants. The addition of rivastigmine to citalopram resulted in a therapeutic success, with a reduction of 23 to 7 points on the Hamilton Depressive Scale (HAM-D. DISCUSSION: The result obtained brings new perspectives to the treatment of vascular depression, providing that randomized controlled trials with larger sample sizes confirm the positive effect of the addition of a cholinesterase inhibitor to antidepressants in the treatment of these patients.

  18. Use of Complementary and Alternative Medicine (CAM) Treatments by Parents of Children with Autism Spectrum Disorders

    Science.gov (United States)

    Christon, Lillian M.; Mackintosh, Virginia H.; Myers, Barbara J.

    2010-01-01

    Parents of children with autism spectrum disorders (ASDs) may elect to use complementary and alternative medicine (CAM) treatments with their children in place of, or in addition to, conventional treatments. CAM treatments are controversial and understudied and, for most, the efficacy has not been established. The current study (n = 248) examined…

  19. A Simple Alternative Treatment for Syndactyly of the Toe.

    Science.gov (United States)

    Nash, William J; Walker, Roland; Patel, Rajiv S; Singh, Sam

    2016-01-01

    Toe syndactyly is a common congenital malformation affecting approximately 1 in 2000 people and can cause significant emotional and psychological distress for the patient. We report a case of a 41-year-old female who was concerned about the aesthetic appearance of her bilateral second and third toe with incomplete, simple syndactyly and had requested surgical correction. A number of operative techniques have been described in the orthopedic and plastic surgery data, with no one technique proving superior. We used medical tattooing to create the appearance of a complete interdigital cleft. This low-risk, and low-cost procedure resulted in a satisfactory outcome for the patient. To the best of our knowledge, this is the first reported case using this technique, which we propose as a simple alternative to surgical correction of toe syndactyly. PMID:26261069

  20. Antidepressant induced excessive yawning and indifference

    Directory of Open Access Journals (Sweden)

    Bruno Palazzo Nazar

    2015-03-01

    Full Text Available Introduction Antidepressant induced excessive yawning has been described as a possible side effect of pharmacotherapy. A syndrome of indifference has also been described as another possible side effect. The frequency of those phenomena and their physiopathology are unknown. They are both considered benign and reversible after antidepressant discontinuation but severe cases with complications as temporomandibular lesions, have been described. Methods We report two unprecedented cases in which excessive yawning and indifference occurred simultaneously as side effects of antidepressant therapy, discussing possible physiopathological mechanisms for this co-occurrence. Case 1: A male patient presented excessive yawning (approximately 80/day and apathy after venlafaxine XR treatment. Symptoms reduced after a switch to escitalopram, with a reduction to 50 yawns/day. Case 2: A female patient presented excessive yawning (approximately 25/day and inability to react to environmental stressors with desvenlafaxine. Conclusion Induction of indifference and excessive yawning may be modulated by serotonergic and noradrenergic mechanisms. One proposal to unify these side effects would be enhancement of serotonin in midbrain, especially paraventricular and raphe nucleus.

  1. Antidepressants and Suicide Risk: A Comprehensive Overview

    Directory of Open Access Journals (Sweden)

    Roberto Tatarelli

    2010-08-01

    Full Text Available The annual worldwide suicide rate currently averages approximately 13 per 100,000 individuals per year (0.013% per year, with higher average rates for men than for women in all but a few countries, very low rates in children, and relatively high rates in elderly men. Suicide rates vary markedly between countries, reflecting in part differences in case-identification and reporting procedures. Rates of attempted suicide in the general population average 20–30 times higher than rates of completed suicide, but are probably under-reported. Research on the relationship between pharmacotherapy and suicidal behavior was rare until a decade ago. Most ecological studies and large clinical studies have found that a general reduction in suicide rates is significantly correlated with higher rates of prescribing modern antidepressants. However, ecological, cohort and case-control studies and data from brief, randomized, controlled trials in patients with acute affective disorders have found increases, particularly in young patients and particularly for the risk of suicide attempts, as well as increases in suicidal ideation in young patients. whether antidepressants are associated with specific aspects of suicidality (e.g., higher rates of completed suicide, attempted suicide and suicidal ideation in younger patients with major affective disorders remains a highly controversial question. In light of this gap this paper analyzes research on the relationship between suicidality and antidepressant treatment.

  2. Impact of Antidepressant Drugs on Sexual Function and Satisfaction.

    Science.gov (United States)

    Baldwin, David S; Manson, Chris; Nowak, Magda

    2015-11-01

    Pleasurable sexual activity is important in many human relationships and can provide a sense of physical, emotional and social well-being. Depressive symptoms and depressive illness are associated with impairments in sexual function and sexual dissatisfaction in untreated and treated patients. Most currently available antidepressant drugs are associated with development or worsening of sexual dysfunction in a substantial proportion of patients. Sexual difficulties during antidepressant treatment often resolve as depression lifts, but can persist over long periods, reducing self-esteem and affecting mood and relationships adversely. Sexual difficulties during antidepressant treatment typically have many possible causes but the incidence and nature of dysfunction varies between drugs. Many interventions can be considered when managing sexual dysfunction associated with antidepressants but no approach is 'ideal'. Because treatment-emergent sexual difficulties are less frequent with certain drugs, presumably related to differences in pharmacological properties, and since current interventions are suboptimal, a lower incidence of sexual dysfunction is a relevant tolerability target when developing novel antidepressants. PMID:26519341

  3. Evaluation of alternative treatments for spent fuel rod consolidation wastes and other miscellaneous commercial transuranic wastes

    International Nuclear Information System (INIS)

    Eight alternative treatments (and four subalternatives) are considered for both existing commercial transuranic wastes and future wastes from spent fuel consolidation. Waste treatment is assumed to occur at a hypothetical central treatment facility (a Monitored Retrieval Storage facility was used as a reference). Disposal in a geologic repository is also assumed. The cost, process characteristics, and waste form characteristics are evaluated for each waste treatment alternative. The evaluation indicates that selection of a high-volume-reduction alternative can save almost $1 billion in life-cycle costs for the management of transuranic and high-activity wastes from 70,000 MTU of spent fuel compared to the reference MRS process. The supercompaction, arc pyrolysis and melting, and maximum volume reduction alternatives are recommended for further consideration; the latter two are recommended for further testing and demonstration

  4. Evaluation of alternative treatments for spent fuel rod consolidation wastes and other miscellaneous commercial transuranic wastes

    Energy Technology Data Exchange (ETDEWEB)

    Ross, W.A.; Schneider, K.J.; Oma, K.H.; Smith, R.I.; Bunnell, L.R.

    1986-05-01

    Eight alternative treatments (and four subalternatives) are considered for both existing commercial transuranic wastes and future wastes from spent fuel consolidation. Waste treatment is assumed to occur at a hypothetical central treatment facility (a Monitored Retrieval Storage facility was used as a reference). Disposal in a geologic repository is also assumed. The cost, process characteristics, and waste form characteristics are evaluated for each waste treatment alternative. The evaluation indicates that selection of a high-volume-reduction alternative can save almost $1 billion in life-cycle costs for the management of transuranic and high-activity wastes from 70,000 MTU of spent fuel compared to the reference MRS process. The supercompaction, arc pyrolysis and melting, and maximum volume reduction alternatives are recommended for further consideration; the latter two are recommended for further testing and demonstration.

  5. 阿立哌唑合并抗抑郁药治疗抑郁症的临床疗效及安全性研究%Study on the clinical effect and safety of aripiprazole combined with antidepressants in the treatment of depression

    Institute of Scientific and Technical Information of China (English)

    姜美俊

    2014-01-01

    目的:探讨阿立哌唑合并抗抑郁药(三环类抗抑郁剂阿米替林)治疗抑郁症的临床疗效及安全性。方法选择120例抑郁症患者随机分为研究组和对照组。对照组给予常规抗抑郁药物治疗,研究组在常规抗抑郁治疗基础上给予阿立哌唑。采用汉密尔顿抑郁量表和副反应量表对两组患者治疗前和治疗后进行评定。结果研究组治疗后的第1、2、4、6周汉密尔顿抑郁量表评分分别与对照组同期比较,差异有统计学意义(P0.05)。结论阿立哌唑能够提高抗抑郁药(三环类抗抑郁剂阿米替林)治疗抑郁症的临床治疗效果,可作为临床抗抑郁治疗的一种增效手段。%Objective To study clinical effect and safety of aripiprazole combined with antidepressants(tricyclic antidepressants amitriptyline) in the treatment of depression. Methods From January 2010 to December 2013, 120 patients with depression patients were selected and randomly divided into study group and control group , control group was given regular treatment of antidepressant drugs, study group was given aripiprazole combined with antidepressants(tricyclic antidepressants amitriptyline). The Hamilton Depression Scale (HAMD) and Treatment Emergent Symptom Scale (TESS) were used in the two group s of patients before and after treatment. Results Hamilton Depression Scale scores in the study group after treatment of the first week, second week, fourth week and sixth week of study group was compared with those in control group , the difference was statistically significant(P0.05). Conclusion Aripiprazole can improve the clinical efficacy of antidepressants (tricyclic antidepressants amitriptyline) in the treatment of depression, which can be one of the augmentations in the treatment of depression.

  6. Mechanisms for alternative treatments in Parkinson's disease: acupuncture, tai chi, and other treatments.

    Science.gov (United States)

    Ghaffari, Bijan D; Kluger, Benzi

    2014-06-01

    At least 40% of patients with Parkinson's disease (PD) use one or more forms of alternative therapy (AT) to complement standard treatments. This article reviews the commonest forms of AT for PD, including acupuncture, tai chi, yoga, mindfulness, massage, herbal medicine, and cannabis. We discuss the current evidence for the clinical efficacy of each AT and discuss potential mechanisms, including those suggested by animal and human studies. With a few notable exceptions, none of the treatments examined were investigated rigorously enough to draw definitive conclusions about efficacy or mechanism. Tai chi, acupuncture, Mucuna pruriens, cannabinoids, and music therapy have all been proposed to work through specific mechanisms, although current evidence is insufficient to support or refute these claims, with the possible exception of Mucuna pruriens (which contains levodopa). It is likely that most ATs predominantly treat PD patients through general mechanisms, including placebo effects, stress reduction, and improved mood and sleep, and AT may provide patients with a greater locus of control regarding their illness. PMID:24760476

  7. Odanacatib: an emerging novel treatment alternative for postmenopausal osteoporosis.

    Science.gov (United States)

    Schultz, Thomas C; Valenzano, Jonathan P; Verzella, Jessica L; Umland, Elena M

    2015-11-01

    Odanacatib represents a novel treatment option in the approach of postmenopausal women. Postmenopausal women with osteoporosis experience a disturbance in bone remodeling wherein bone resorption exceeds bone formation. Cathepsin K is a lysosomal cysteine protease found primarily in osteoclasts that plays a major role in the breakdown of bone via its collagenase properties. Targeting a new area of pathophysiology, odanacatib inhibits cathepsin K to reduce bone resorption while preserving bone formation. Phase II and III trials have shown efficacy in increasing bone mineral density in the target treatment group. Overall, safety studies have found odanacatib to be well-tolerated and comparable to placebo; however, some imbalances in adverse events have been observed in the Phase III trials. Current and future studies will analyze the long-term ability of odanacatib in preventing bone fracture. PMID:26344800

  8. Odanacatib: an emerging novel treatment alternative for postmenopausal osteoporosis.

    Science.gov (United States)

    Schultz, Thomas C; Valenzano, Jonathan P; Verzella, Jessica L; Umland, Elena M

    2015-11-01

    Odanacatib represents a novel treatment option in the approach of postmenopausal women. Postmenopausal women with osteoporosis experience a disturbance in bone remodeling wherein bone resorption exceeds bone formation. Cathepsin K is a lysosomal cysteine protease found primarily in osteoclasts that plays a major role in the breakdown of bone via its collagenase properties. Targeting a new area of pathophysiology, odanacatib inhibits cathepsin K to reduce bone resorption while preserving bone formation. Phase II and III trials have shown efficacy in increasing bone mineral density in the target treatment group. Overall, safety studies have found odanacatib to be well-tolerated and comparable to placebo; however, some imbalances in adverse events have been observed in the Phase III trials. Current and future studies will analyze the long-term ability of odanacatib in preventing bone fracture.

  9. Psychiatric and psychological factors in patient decision making concerning antidepressant use

    NARCIS (Netherlands)

    Dijkstra, Arie; Jaspers, Merlijne; van Zwieten, Marianne

    2008-01-01

    The observation that the use of antidepressants has strongly increased during the past decade implies that on a micro level doctors and patients more often decide that antidepressants are the appropriate treatment. Therefore, it is important to increase insight into patients' decision making regardi

  10. Implementing guidelines for depression on antidepressant prescribing in general practice : a quasi-experimental evaluation

    NARCIS (Netherlands)

    Franx, Gerdien; Huyser, Jochanan; Koetsenruijter, Jan; van der Feltz-Cornelis, Christina M.; Verhaak, Peter F. M.; Grol, Richard P. T. M.; Wensing, Michel

    2014-01-01

    Background: Internationally, guidelines for depression recommend a stepped care approach, implying that antidepressant medication should not be offered as a first step treatment to patients with sub-threshold or mild depression. In the Netherlands, antidepressant prescribing rates in general practic

  11. An alternative treatment of occlusal wear: Cast metal occlusal surface

    OpenAIRE

    Sandeep Kumar; Aman Arora; Reena Yadav

    2012-01-01

    Acrylic resin denture teeth often exhibit rapid occlusal wear, which may lead to decrease in the chewing efficiency, loss of vertical dimension of occlusion, denture instability, temporomandibular joint disturbances, etc. There are various treatment options available like, use of highly cross linked acrylic teeth, amalgam or metal inserts on occlusal surface, use of composite, gold or metal occlusal surface, etc. Several articles have described methods to construct gold and metal occlusal sur...

  12. New (alternative) temozolomide regimens for the treatment of glioma

    OpenAIRE

    Wick, W.; Platten, M; Weller, M.

    2009-01-01

    One barrier to successful treatment of malignant glioma is resistance to alkylating agents such as temozolomide. The cytotoxic activity of temozolomide and other alkylating agents is believed to be manifested largely by the formation of O-methylguanine DNA adducts. Consequently, the primary mechanism of resistance to temozolomide is a function of the activity of the DNA repair enzyme O-methylguanine DNA methyltransferase (MGMT). Fortuitously, MGMT is inactivated after each reaction (ie, suici...

  13. Treatment of Diabetic Gastroparesis by Complementary and Alternative Medicines

    OpenAIRE

    Hao Liu; Bo Yu; Meng Zhang; Kun Liu; Fu-Chun Wang; Xin-Yan Gao

    2015-01-01

    Gastroparesis is a common gastrointestinal complication in diabetes, induced by hyperglycemia and characterized by delayed gastric emptying and upper abdominal symptoms, such asnausea, vomiting, early satiety, bloating and epigastric pain. Diabetic gastroparesis (DGP) affects life quality and glycemic control, and is a challenge to treat in both Western and Eastern medicine. Routine treatment in Western medicine includes gastric emptying promoted by prokinetic agents, gastric pacemaking, or s...

  14. SCIENTIFIC BASED OF ACUPUNCTURE AS ALTERNATIVE TREATMENT OF DIABETES MELLITUS

    OpenAIRE

    Koosnadi Saputra; Suhariningsih Suhariningsih; RTS Adikara; Sagiran Sagiran; Felix Tirtakusumanah

    2012-01-01

    Background: Acupuncture its traditional form is based upon the stimulation of well defined points on the body by insertion of metal needles, such needling is considered necessary influenced biological mechanism by intrinsic and extrinsic activation after acupuncture points stimulation. Many clinical report therapeutic effect acupuncture treatment of Diabetes Mellitus especially Non Insulin dependent, the effectiveness of mild or middle type of disease is better that severe one and accompanyin...

  15. Alternative for Anti-TNF Antibodies for Arthritis Treatment

    OpenAIRE

    Paquet, Joseph; Henrionnet, Christel; Pinzano, Astrid; Vincourt, Jean-Baptiste; Gillet, Pierre; Netter, Patrick; Chary-Valckenaere, Isabelle; Loeuille, Damien; Pourel, Jacques; Grossin, Laurent

    2011-01-01

    Tumor necrosis factor-α (TNF-α), a proinflammatory cytokine, plays a key role in the pathogenesis of many inflammatory diseases, including arthritis. Neutralization of this cytokine by anti-TNF-α antibodies has shown its efficacy in rheumatoid arthritis (RA) and is now widely used. Nevertheless, some patients currently treated with anti-TNF-α remain refractory or become nonresponder to these treatments. In this context, there is a need for new or complementary therapeutic strategies. In this ...

  16. Thermal epiphysiodesis Made with RFA. An Alternative Treatment for Leg Length Discrepancy

    DEFF Research Database (Denmark)

    Shiguetomi Medina, Juan Manuel

    or discomfort were presented during the follow-up period. Discussion and Conclusion Epiphysiodesis using radio frequency ablation is an innovative technique that may represent an alternative way of treatment that potentially involves less scarring, less exposure to X-rays, and reduces the risk of injuring...... radio frequency ablation inhibited growth without damaging the surrounding structures. This may represent an alternative treatment for leg length discrepancy....

  17. [Alternative treatment in psychiatric and psychotherapy facilities in Germany].

    Science.gov (United States)

    Andritzky, W

    1996-01-01

    Questionnaires were sent to 545 clinics with at least partial psychotherapeutic or psychiatric activities to find out the spectrum of therapeutic techniques and methods used, as well as the spectrum of therapists' qualifications. From the 314 responding clinics, 127 different methods were named with an average of 4.0 each. The proportion of physicians and psychologists to patients becomes worse the bigger the clinics are: e.g., in the class of less than 50 beds, one psychologist cares for 7 patients; in the class 51-300 beds, the relation is one to 48. The six most frequently used methods are: music therapy (36.9%), imagery (25.2%), dance therapy (23.2%), autogenous training (22.6%), body therapies (21.7%), and psychodrama (18.2%). Apart from physicians and psychologists, 38 other professional groups were named. Comparing the answers concerning the methods with the performing professional group, an apparent trend towards a professional diversification was found, e.g. only 62% of music therapy is performed by music therapists, the rest by other professional groups. Finally, analysis of special remarks on the questionnaires resulted in four groups: discussions concerning the term alternative methods, recommendations to use unconventional methods after the clinical phase, conceptual changes of a clinic, and broader theoretical backgrounds integrating various methods, e.g. the psychoanalytic concept. PMID:8851128

  18. Obtaining membranes for alternative treatment hydrogels of cutaneous leishmaniasis

    International Nuclear Information System (INIS)

    Polymeric Hydrogels formed by crosslinked polymeric chains were obtained by ionizing radiation process according to Rosiak technique. In the last 40 years the use of hydrogels has been investigated for various applications as curatives. In this work hydrogel membranes were synthesized with poly (N-2-pyrrolidone) (PVP), poly (vinyl alcohol) (PVA), chitosan and laponita clay for use as a vehicle for controlled glucantime release on the surface of skin tissues injured by leishmaniasis. Leishmaniasis is a disease caused by a protozoan parasite of the genus Leishmania transmitted by the bite of phlebotomies sandfly. The traditional treatment of patients infected by these parasites is done with pentavalent antimony in injectable form. However, these antimonates are highly toxic and cause side effects in these patients. In addition, patients with heart and kidney disease can not use this treatment. In treatment with drug delivery hydrogel membrane applied on the surface of leishmaniasis injured tissues the drug is released directly to the wound in a controlled manner, reducing the side effects. Membranes prepared in this study were characterized by X-ray diffraction (XRD), thermogravimetric analysis (TG), swelling, gel fraction, infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and atomic force microscopy (AFM). The characterizations of cytotoxicity and drug release were made 'in vitro' and 'in vivo' with functional test according to ethical protocol of the Division of Infectious and Parasitic Diseases at the Hospital of Clinics, Sao Paulo University-School of Medicine, University. The 'in vivo' test of these membranes proved to be effective in controlled release of drugs directly into leishmaniasis damaged tissues. Results of 'in vivo' tests using PVP/PVAl / clay 1,5% and glucantime membrane showed remarkable contribution to wound reduction and cure in clinical therapy. (author)

  19. Depression during pregnancy: views on antidepressant use and information sources of general practitioners and pharmacists

    Directory of Open Access Journals (Sweden)

    Schobben Fred

    2009-07-01

    Full Text Available Abstract Background The use of antidepressants during pregnancy has increased in recent years. In the Netherlands, almost 2% of all pregnant women are exposed to antidepressants. Although guidelines have been developed on considerations that should be taken into account, prescribing antidepressants during pregnancy is still a subject of debate. Physicians and pharmacists may have opposing views on using medication during pregnancy and may give contradictory advice on whether or not to take medication for depression and anxiety disorders during pregnancy. In this study, we investigated information sources used by general practitioners (GPs and pharmacists and their common practices. Methods A questionnaire on the use of information sources and the general approach when managing depression during pregnancy was sent out to 1400 health care professionals to assess information sources on drug safety during pregnancy and also the factors that influence decision-making. The questionnaires consisted predominantly of closed multiple-choice questions. Results A total of 130 GPs (19% and 144 pharmacists (21% responded. The most popular source of information on the safety of drug use during pregnancy is the Dutch National Health Insurance System Formulary, while a minority of respondents contacts the Dutch national Teratology Information Service (TIS. The majority of GPs contact the pharmacy with questions concerning drug use during pregnancy. There is no clear line with regard to treatment or consensus between GPs on the best therapeutic strategy, nor do practitioners agree upon the drug of first choice. GPs have different views on stopping or continuing antidepressants during pregnancy or applying alternative treatment options. The debate appears to be ongoing as to whether or not specialised care for mother and child is indicated in cases of gestational antidepressant use. Conclusion Primary health care workers are not univocal concerning therapy for

  20. [Calcitonin as an alternative treatment for root resorption].

    Science.gov (United States)

    Pierce, A; Berg, J O; Lindskog, S

    1989-01-01

    Inflammatory root resorption is a common finding following trauma and will cause eventual destruction of the tooth root if left untreated. This study examined the effects of intrapulpal application of calcitonin, a hormone known to inhibit osteoclastic bone resorption, on experimental inflammatory root resorption induced in monkeys. Results were histologically evaluated using a morphometric technique and revealed that calcitonin was an effective medicament for the treatment of inflammatory root resorption. It was concluded that this hormone could be a useful therapeutic adjunct in difficult cases of external root resorption. PMID:2576918

  1. [Calcitonin as an alternative treatment for root resorption].

    Science.gov (United States)

    Pierce, A; Berg, J O; Lindskog, S

    1989-01-01

    Inflammatory root resorption is a common finding following trauma and will cause eventual destruction of the tooth root if left untreated. This study examined the effects of intrapulpal application of calcitonin, a hormone known to inhibit osteoclastic bone resorption, on experimental inflammatory root resorption induced in monkeys. Results were histologically evaluated using a morphometric technique and revealed that calcitonin was an effective medicament for the treatment of inflammatory root resorption. It was concluded that this hormone could be a useful therapeutic adjunct in difficult cases of external root resorption.

  2. Rapid Antidepressant Changes with Sleep Deprivation in Major Depressive Disorder are Associated with Changes in Vascular Endothelial Growth Factor (VEGF): a Pilot Study

    OpenAIRE

    Ibrahim, Lobna; Duncan, Wallace; Luckenbaugh, David A.; Yuan, Peixiong; Machado-Vieira, Rodrigo; Carlos A Zarate

    2011-01-01

    While conventional antidepressants benefit many patients with major depressive disorder (MDD), as much as eight to 12 weeks can elapse before significant improvements in depressive symptoms are seen. Treatments that act more rapidly in MDD are urgently needed. Sleep deprivation (SD) has been shown to produce a rapid antidepressant response within one day in 50–60% of patients with MDD; thus, identifying its antidepressant mechanism may contribute to the development of antidepressants that act...

  3. Peripheral administration of lactate produces antidepressant-like effects

    KAUST Repository

    Carrard, A

    2016-10-18

    In addition to its role as metabolic substrate that can sustain neuronal function and viability, emerging evidence supports a role for l-lactate as an intercellular signaling molecule involved in synaptic plasticity. Clinical and basic research studies have shown that major depression and chronic stress are associated with alterations in structural and functional plasticity. These findings led us to investigate the role of l-lactate as a potential novel antidepressant. Here we show that peripheral administration of l-lactate produces antidepressant-like effects in different animal models of depression that respond to acute and chronic antidepressant treatment. The antidepressant-like effects of l-lactate are associated with increases in hippocampal lactate levels and with changes in the expression of target genes involved in serotonin receptor trafficking, astrocyte functions, neurogenesis, nitric oxide synthesis and cAMP signaling. Further elucidation of the mechanisms underlying the antidepressant effects of l-lactate may help to identify novel therapeutic targets for the treatment of depression.

  4. An alternative treatment of occlusal wear: cast metal occlusal surface.

    Science.gov (United States)

    Kumar, Sandeep; Arora, Aman; Yadav, Reena

    2012-01-01

    Acrylic resin denture teeth often exhibit rapid occlusal wear, which may lead to decrease in the chewing efficiency, loss of vertical dimension of occlusion, denture instability, temporomandibular joint disturbances, etc. There are various treatment options available like, use of highly cross linked acrylic teeth, amalgam or metal inserts on occlusal surface, use of composite, gold or metal occlusal surface, etc. Several articles have described methods to construct gold and metal occlusal surfaces, however, these methods are time-consuming, expensive and requires many cumbersome steps. These methods also requires the patient to be without the prosthesis for the time during which the laboratory procedures are performed. This article presents a quick, simple and relatively inexpensive procedure for construction of metal occlusal surfaces on complete dentures. PMID:22945724

  5. An alternative treatment of occlusal wear: Cast metal occlusal surface

    Directory of Open Access Journals (Sweden)

    Sandeep Kumar

    2012-01-01

    Full Text Available Acrylic resin denture teeth often exhibit rapid occlusal wear, which may lead to decrease in the chewing efficiency, loss of vertical dimension of occlusion, denture instability, temporomandibular joint disturbances, etc. There are various treatment options available like, use of highly cross linked acrylic teeth, amalgam or metal inserts on occlusal surface, use of composite, gold or metal occlusal surface, etc. Several articles have described methods to construct gold and metal occlusal surfaces, however, these methods are time-consuming, expensive and requires many cumbersome steps. These methods also requires the patient to be without the prosthesis for the time during which the laboratory procedures are performed. This article presents a quick, simple and relatively inexpensive procedure for construction of metal occlusal surfaces on complete dentures.

  6. Alternative therapies in the treatment of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Federico Lombardi, MD, FESC; Sebastiano Belletti, MD; Alberto Lomuscio, MD.

    2013-04-01

    Full Text Available Atrial fibrillation (AF is the most common clinical arrhythmia and represents a major social and economic problem. The number of subjects with AF is constantly increasing as a result of aging and improved survival in several cardiac and non-cardiac diseases. Patients with AF are often symptomatic, have a reduced physical capacity and are at high risk for thromboembolic events. Moreover, AF is associated with increased mortality and independently of the management based either on rhythm or rate control strategy, whereas the safety and efficacy of most anti-arrhythmic drugs are questionable. Increasing attention has therefore been addressed to evaluate the possible therapeutic and/or preventive effects of forms of treatment coming from ancient medical traditions of Far East, like acupuncture and yoga. In traditional Chinese medicine, acupuncture has been found effective in managing patients with paroxysmal supraventricular tachycardia. Recently, also in the Western literature, reports have been published supporting the clinical efficacy of acupuncture to treat arterial hypertension and to reduce chest pain. Other studies have evaluated the effects of acupuncture and other methods of Eastern Medicine, i.e., Qigong, Tai Chi Chuan and Yoga, in the treatment of cardiac illnesses associated with supraventricular arrhythmias. Two reports on the effects of acupuncture in preventing or reducing the rate of AF recurrences in patients with persistent or paroxysmal AF have been recently reported . Another ancient traditional eastern form of therapy and prevention, i.e., yoga, has been recently shown to reduce episodes of atrial fibrillation and improve the symptoms of anxiety and depression often associated with this arrhythmia. Growing evidence indicates that acupuncture and yoga are safe, without any pro-arrhythmic effect and with limited cost. All these factors should be considered when evalu­ating the efficacy of therapeutic intervention for an epi

  7. Environmental Effects of Sewage Sludge Carbonization and Other Treatment Alternatives

    Directory of Open Access Journals (Sweden)

    Yu-Fong Huang

    2013-02-01

    Full Text Available Carbonization is a newly developed process that converts sewage sludge to biocoal, a type of solid biomass that can partially substitute for coal during power generation. This study presents an assessment of the environmental effects of various sewage sludge treatment processes, including carbonization, direct landfills, co-incineration with municipal solid waste, and mono-incineration in Taiwan. This assessment was conducted using the life cycle assessment software SimaPro 7.2 and the IMPACT2002+ model. Results show that carbonization is the best approach for sewage sludge treatment, followed in descending order by co-incineration with municipal solid waste, direct landfills, and mono-incineration. The carbonization process has noticeable positive effects in the environmental impact categories of terrestrial ecotoxicity, aquatic ecotoxicity, land occupation, ionizing radiation, aquatic eutrophication, non-renewable energy, and mineral extraction. For the emission quantity of greenhouse gases, landfilling has the greatest impact (296.9 kg CO2 eq./t sludge, followed by mono-incineration (232.2 kg CO2 eq./t sludge and carbonization (146.1 kg CO2 eq./t sludge. Co-incineration with municipal solid waste has the benefit of reducing green house gas emission (–15.4 kg CO2 eq./t sludge. In the aspect of energy recovery, sewerage sludge that has been pretreated by thickening, digestion, and dewatering still retains a high moisture content, and thus requires a significant amount of energy use when used as a substitute solid fuel. Therefore, the carbonization of sewage sludge would be a more sustainable option if the energy delivery and integration processes are made more efficient.

  8. Antidepressants for bipolar disorder A meta-analysis of randomized, double-blind, controlled trials

    Institute of Scientific and Technical Information of China (English)

    Yingli Zhang; Huan Yang; Shichang Yang; Wei Liang; Ping Dai; Changhong Wang; Yalin Zhang

    2013-01-01

    OBJECTIVE: To examine the efficacy and safety of short-term and long-term use of antidepres-sants in the treatment of bipolar disorder. DATA SOURCES:A literature search of randomized, double-blind, control ed trials published until December 2012 was performed using the PubMed, ISI Web of Science, Medline and Cochrane Central Register of Control ed Trials databases. The keywords“bipolar disorder, bipolar I disorder, bipolar II disorder, bipolar mania, bipolar depression, cyclothymia, mixed mania and depression, rapid cycling and bipolar disorder”, AND “antidepressant agent, antidepressive agents second-generation, antidepressive agents tricyclic, monoamine oxidase inhibitor, noradrenaline uptake in-hibitor, serotonin uptake inhibitor, and tricyclic antidepressant agent” were used. The studies that were listed in the reference list of the published papers but were not retrieved in the above-mentioned databases were supplemented. STUDY SELECTION: Studies selected were double-blind randomized control ed trials assessing the efficacy and safety of antidepressants in patients with bipolar disorder. Al participants were aged 18 years or older, and were diagnosed as having primary bipolar disorder. Antidepressants or antidepressants combined with mood stabilizers were used in experimental interventions. Placebos, mood stabilizers, antipsychotics and other antide pressants were used in the control interventions. Studies that were quasi-randomized studies, or used antidepressants in combination with antipsy-chotics in the experimental group were excluded. Al analyses were conducted using Review Man-ager 5.1 provided by the Cochrane Col aboration. MAIN OUTCOME MEASURES:The primary outcome was the response and switching to mania. The secondary outcomes included remission, discontinuation rate, and suicidality. RESULTS: Among 5 001 treatment studies published, 14 double-blind randomized control ed trials involving 1 244 patients were included in the meta

  9. Targeting Gonadotropins: An Alternative Option for Alzheimer Disease Treatment

    Directory of Open Access Journals (Sweden)

    Gemma Casadesus

    2006-01-01

    Full Text Available Recent evidence indicates that, alongside oxidative stress, dysregulation of the cell cycle in neurons susceptible to degeneration in Alzheimer disease may play a crucial role in the initiation of the disease. As such, the role of reproductive hormones, which are closely associated with the cell cycle both during development and after birth, may be of key import. While estrogen has been the primary focus, the protective effects of hormone replacement therapy on cognition and dementia only during a “crucial period” led us to expand the study of hormonal influences to other members of the hypothalamic pituitary axis. Specifically, in this review, we focus on luteinizing hormone, which is not only increased in the sera of patients with Alzheimer disease but, like estrogen, is modulated by hormone replacement therapy and also influences cognitive behavior and pathogenic processing in animal models of the disease. Targeting gonadotropins may be a useful treatment strategy for disease targeting multiple pleiotropic downstream consequences.

  10. The unfulfilled promise of the antidepressant medications.

    Science.gov (United States)

    Davey, Christopher G; Chanen, Andrew M

    2016-05-16

    Australia has one of the highest rates of antidepressant use in the world; it has more than doubled since 2000, despite evidence showing that the effectiveness of these medications is lower than previously thought. An increasing placebo response rate is a key reason for falling effectiveness, with the gap between response to medications and placebo narrowing. Psychotherapies are effective treatments, but recent evidence from high-quality studies suggests that their effectiveness is also modest. Combined treatment with medication and psychotherapy provides greater effectiveness than either alone. The number of patients receiving psychotherapy had been declining, although this trend is probably reversing with the Medicare Better Access to Mental Health Care initiative. Antidepressant medications still have an important role in the treatment of moderate to severe depression; they should be provided as part of an overall treatment plan that includes psychotherapy and lifestyle strategies to improve diet and increase exercise. When medications are prescribed, they should be used in a way that maximises their chance of effectiveness. PMID:27169968

  11. An alternative parameterization of Bayesian logistic hierarchical models for mixed treatment comparisons

    NARCIS (Netherlands)

    Pechlivanoglou, Petros; Abegaz, Fentaw; Postma, Maarten J; Wit, Ernst

    2015-01-01

    Mixed treatment comparison (MTC) models rely on estimates of relative effectiveness from randomized clinical trials so as to respect randomization across treatment arms. This approach could potentially be simplified by an alternative parameterization of the way effectiveness is modeled. We introduce

  12. Alternative/Complementary Approaches to Treatment of Children with Autism Spectrum Disorders.

    Science.gov (United States)

    Levy, Susan E.; Hyman, Susan L.

    2002-01-01

    This article reviews common complementary or alternative medicine (CAM) treatments used to address symptoms of autistic spectrum disorders, including vitamin supplements, medications, antibiotics, antifungals, diet strategies, chelation/mercury detoxification, and nonbiologic treatments. Strategies that professionals may use in assessing the…

  13. Complementary and alternative medicine modalities for the treatment of irritable bowel syndrome: facts or myths?

    Science.gov (United States)

    Wu, Justin C Y

    2010-11-01

    Due to unsatisfactory results from conventional treatment of irritable bowel syndrome (IBS), complementary and alternative medicine (CAM) modalities are increasingly popular treatment alternatives. Unfortunately, most CAM clinical trials have been of poor quality, and the efficacies of these therapies have not been adequately elucidated, even through systematic reviews or meta-analyses. There is also a general lack of understanding of their mechanisms of action. Currently, insufficient evidence exists to support the use of traditional Chinese medicine, acupuncture, meditation, and reflexology for treatment of IBS. However, there is some evidence supporting the use of peppermint oil and gut-directed hypnotherapy for IBS treatment. Due to mounting evidence of the microbiologic and immunologic basis of IBS, probiotics and exclusion diets are also becoming promising treatment modalities. This paper will review the current literature on various CAM practices for IBS treatment and appraise their advantages and disadvantages in clinical practice.

  14. Treatment with tianeptine induces antidepressive-like effects and alters the neurotrophin levels, mitochondrial respiratory chain and cycle Krebs enzymes in the brain of maternally deprived adult rats.

    Science.gov (United States)

    Della, Franciela P; Abelaira, Helena M; Réus, Gislaine Z; Santos, Maria Augusta B dos; Tomaz, Débora B; Antunes, Altamir R; Scaini, Giselli; Morais, Meline O S; Streck, Emilio L; Quevedo, João

    2013-03-01

    Maternally deprived rats were treated with tianeptine (15 mg/kg) once a day for 14 days during their adult phase. Their behavior was then assessed using the forced swimming and open field tests. The BDNF, NGF and energy metabolism were assessed in the rat brain. Deprived rats increased the immobility time, but tianeptine reversed this effect and increased the swimming time; the BDNF levels were decreased in the amygdala of the deprived rats treated with saline and the BDNF levels were decreased in the nucleus accumbens within all groups; the NGF was found to have decreased in the hippocampus, amygdala and nucleus accumbens of the deprived rats; citrate synthase was increased in the hippocampus of non-deprived rats treated with tianeptine and the creatine kinase was decreased in the hippocampus and amygdala of the deprived rats; the mitochondrial complex I and II-III were inhibited, and tianeptine increased the mitochondrial complex II and IV in the hippocampus of the non-deprived rats; the succinate dehydrogenase was increased in the hippocampus of non-deprived rats treated with tianeptine. So, tianeptine showed antidepressant effects conducted on maternally deprived rats, and this can be attributed to its action on the neurochemical pathways related to depression.

  15. The Blackfeet Indian culture camp: Auditioning an alternative indigenous treatment for substance use disorders.

    Science.gov (United States)

    Gone, Joseph P; Calf Looking, Patrick E

    2015-05-01

    American Indian and Alaska Native (AIAN) communities experience alarming health disparities, including high rates of substance use disorders (SUDs). Psychological services for AIANs, including SUDs treatment, are primarily funded by the federal Indian Health Service and typically administered by tribal governments. Tribal administration of SUDs treatment programs has routinely involved either inclusion of traditional cultural practices into program activities or adaptation of conventional treatment approaches to distinctive community sensibilities. In this article, we investigate a third possibility: the collaborative, community-based development of an alternative indigenous intervention that was implemented as a form of SUDs treatment in its own right and on its own terms. Specifically, in July of 2012, we undertook a trial implementation of a seasonal cultural immersion camp based on traditional Pikuni Blackfeet Indian cultural practices for 4 male clients from the reservation's federally funded SUDs treatment program. Given a variety of logistical and methodological constraints, the pilot offering of the culture camp primarily served as a demonstration of "proof of concept" for this alternative indigenous intervention. In presenting and reflecting on this effort, we consider many challenges associated with alternative indigenous treatment models, especially those associated with formal outcome evaluation. Indeed, we suggest that the motivation for developing local indigenous alternatives for AIAN SUDs treatment may work at cross-purposes to the rigorous assessment of therapeutic efficacy for such interventions. Nevertheless, we conclude that these efforts afford ample opportunities for expanding the existing knowledge base concerning the delivery of community-based psychological services for AIANs. PMID:25961644

  16. Adherence to antidepressant medications: an evaluation of community pharmacists' counseling practices

    Directory of Open Access Journals (Sweden)

    Chong WW

    2013-08-01

    Full Text Available Wei Wen Chong,1,2 Parisa Aslani,1 Timothy F Chen1 1Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia; 2Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia Background: Recent studies have shown that pharmacists have a role in addressing antidepressant nonadherence. However, few studies have explored community pharmacists' actual counseling practices in response to antidepressant adherence-related issues at various phases of treatment. The purpose of this study was to evaluate counseling practices of community pharmacists in response to antidepressant adherence-related issues. Methods: A simulated patient method was used to evaluate pharmacist counseling practices in Sydney, Australia. Twenty community pharmacists received three simulated patient visits concerning antidepressant adherence-related scenarios at different phases of treatment: 1 patient receiving a first-time antidepressant prescription and hesitant to begin treatment; 2 patient perceiving lack of treatment efficacy for antidepressant after starting treatment for 2 weeks; and 3 patient wanting to discontinue antidepressant treatment after 3 months due to perceived symptom improvement. The interactions were recorded and analyzed to evaluate the content of consultations in terms of information gathering, information provision including key educational messages, and treatment recommendations. Results: There was variability among community pharmacists in terms of the extent and content of information gathered and provided. In scenario 1, while some key educational messages such as possible side effects and expected benefits from antidepressants were mentioned frequently, others such as the recommended length of treatment and adherence-related messages were rarely addressed. In all scenarios, about two thirds of pharmacists explored patients' concerns about antidepressant treatment. In scenarios 2 and 3, only half of all pharmacists

  17. Antidepressant-Resistant Depression and Antidepressant-Associated Suicidal Behaviour: The Role of Underlying Bipolarity

    Directory of Open Access Journals (Sweden)

    Zoltan Rihmer

    2011-01-01

    Full Text Available The complex relationship between the use of antidepressants and suicidal behaviour is one of the hottest topics of our contemporary psychiatry. Based on the literature, this paper summarizes the author's view on antidepressant-resistant depression and antidepressant-associated suicidal behaviour. Antidepressant-resistance, antidepressant-induced worsening of depression, antidepressant-associated (hypomanic switches, mixed depressive episode, and antidepressant-associated suicidality among depressed patients are relatively most frequent in bipolar/bipolar spectrum depression and in children and adolescents. As early age at onset of major depressive episode and mixed depression are powerful clinical markers of bipolarity and the manic component of bipolar disorder (and possible its biological background shows a declining tendency with age antidepressant-resistance/worsening, antidepressant-induced (hypomanic switches and “suicide-inducing” potential of antidepressants seem to be related to the underlying bipolarity.

  18. Antidepressants Accumulate in Lipid Rafts Independent of Monoamine Transporters to Modulate Redistribution of the G Protein, Gαs.

    Science.gov (United States)

    Erb, Samuel J; Schappi, Jeffrey M; Rasenick, Mark M

    2016-09-16

    Depression is a significant public health problem for which currently available medications, if effective, require weeks to months of treatment before patients respond. Previous studies have shown that the G protein responsible for increasing cAMP (Gαs) is increasingly localized to lipid rafts in depressed subjects and that chronic antidepressant treatment translocates Gαs from lipid rafts. Translocation of Gαs, which shows delayed onset after chronic antidepressant treatment of rats or of C6 glioma cells, tracks with the delayed onset of therapeutic action of antidepressants. Because antidepressants appear to specifically modify Gαs localized to lipid rafts, we sought to determine whether structurally diverse antidepressants accumulate in lipid rafts. Sustained treatment of C6 glioma cells, which lack 5-hydroxytryptamine transporters, showed marked concentration of several antidepressants in raft fractions, as revealed by increased absorbance and by mass fingerprint. Closely related molecules without antidepressant activity did not concentrate in raft fractions. Thus, at least two classes of antidepressants accumulate in lipid rafts and effect translocation of Gαs to the non-raft membrane fraction, where it activates the cAMP-signaling cascade. Analysis of the structural determinants of raft localization may both help to explain the hysteresis of antidepressant action and lead to design and development of novel substrates for depression therapeutics.

  19. Alternating Pulse Current in Electrocoagulation for Wastewater Treatment to Prevent the Passivation or Al Electrode

    Institute of Scientific and Technical Information of China (English)

    MAO Xuhui; HONG Song; ZHU Hua; LIN Hui; WEI Lin; GAN Fuxing

    2008-01-01

    A novel current feed style, alternating pulse current, was proposed in electrocoagulation aiming at preventing the passivation of electrode materials. The open circuit potential (OCP) measurements after anodic and cathodic potentiodynamic polarization showed that cathodic polarization could activate Al electrode. The surface of Al electrode after alternating pulse current electrocoagulation was investigated by scanning electron microscope (SEM) and X-ray photoelectron spectroscopy (XPS), and the results indicate that passivation of Al is not observed. Furthermore, the simulated wastewater treatment tests show that alternating pulse current electrocoagulation has a visible energy saving effect and is worthy of generalization.

  20. Behavioral and biochemical effects of ketamine and dextromethorphan relative to its antidepressant-like effects in Swiss Webster mice.

    Science.gov (United States)

    Nguyen, Linda; Lucke-Wold, Brandon P; Logsdon, Aric F; Scandinaro, Anna L; Huber, Jason D; Matsumoto, Rae R

    2016-09-28

    Ketamine has been shown to produce rapid and robust antidepressant effects in depressed individuals; however, its abuse potential and adverse psychotomimetic effects limit its widespread use. Dextromethorphan (DM) may serve as a safer alternative on the basis of pharmacodynamic similarities to ketamine. In this proof-of-concept study, behavioral and biochemical analyses were carried out to evaluate the potential involvement of brain-derived neurotrophic factor (BDNF) in the antidepressant-like effects of DM in mice, with comparisons to ketamine and imipramine. Male Swiss, Webster mice were injected with DM, ketamine, or imipramine and their behaviors were evaluated in the forced-swim test and the open-field test. Western blots were used to measure BDNF and its precursor, pro-BDNF, protein expression in the hippocampus and the frontal cortex of these mice. Our results show that both DM and imipramine reduced immobility time in the forced-swim test without affecting locomotor activity, whereas ketamine reduced immobility time and increased locomotor activity. Ketamine also rapidly (within 40 min) increased pro-BDNF expression in an α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor-dependent manner in the hippocampus, whereas DM and imipramine did not alter pro-BDNF or BDNF levels in either the hippocampus or the frontal cortex within this timeframe. These data show that DM shares some features with both ketamine and imipramine. Additional studies examining DM may aid in the development of more rapid, safe, and efficacious antidepressant treatments. PMID:27580401

  1. Interaction of antidepressants with the serotonin and norepinephrine transporters

    DEFF Research Database (Denmark)

    Sørensen, Lena; Andersen, Jacob; Thomsen, Mette;

    2012-01-01

    as treatment of depression and anxiety disorders or as psychostimulant drugs of abuse. Despite their clinical importance, the molecular mechanisms by which various types of antidepressant drugs bind and inhibit SERT and NET are still elusive for the majority of the inhibitors, including the molecular basis...

  2. Intentional replantation: case report of an alternative treatment for endodontic therapy failure

    Directory of Open Access Journals (Sweden)

    Flares BARATTO FILHO

    2004-11-01

    Full Text Available The aim of this study was to present an alternative treatment after the occurrence of endodontic therapy failure. The authors report a clinical case of a second maxillary permanent molar, which was indicated for intentional replantation as an alternative treatment. Extraction was performed followed by apicoectomy of the three roots and radicular decontamination with citric acid (pH=1 for 1min; the roots were then retro-obturated with amalgam and the tooth replanted in the alveolus. The extra-buccal period lasted 15 min. Clinico-radiographical follow-up examinations were done at 2, 3 and 5 years and no symptoms or radicular resorption were found. There was bone neo-formation at the palatal root that had presented a periapical lesion. Intentional replantation can be indicated correctly as an alternative treatment for cases in which conservativeendodontic therapy or surgical technique cannot be performed.

  3. Antidepressants for older people: what can we learn from the current evidence base?

    Science.gov (United States)

    Katona, Cornelius; Bindman, Dorothea C; Katona, Cara P

    2014-10-01

    This paper updates our previous review of the evidence base for managing depression in old age while focusing more specifically on the use of antidepressants. Overall, recent systematic reviews and meta-analyses indicate that antidepressants are effective in the acute treatment of depression in old age but that the superiority of active drug over placebo is quite modest. The depression of Alzheimer's disease is probably not treated effectively with antidepressants. The most consistent evidence is for the effectiveness of continued antidepressant treatment in those depressed patients who respond well to acute treatment. There remains a clear need for more research to identify effective treatments for resistant depression though therapeutic nihilism should be avoided if first-line treatment fails. PMID:24975955

  4. [Unpredictable chronic mild stress effects on antidepressants activities in forced swim test].

    Science.gov (United States)

    Kudryashov, N V; Kalinina, T S; Voronina, T A

    2015-02-01

    The experiments has been designed to study unpredictable chronic mild stress effect on anti-depressive activities of amitriptyline (10 mg/kg) and fluoxetine (20 mg/kg) in forced swim test in male outbred mice. It is shown that acute treatment with fluoxetine does not produce any antidepressant effects in mice following stress of 14 days while the sub-chronic injections of fluoxetine result in more deep depressive-like behavior. In 28 daily stressed mice, antidepressant effect of fluoxetine is observed independently of the injection rates. Amitriptyline demonstrates the antidepressant activity regardless of the duration of stress or administration scheduling, but at the same time the severity of anti-immobilization effect of amitriptyline in stressed mice is weaker in compare to non-stressed trails. Thus, the injection rates and duration of unpredictable mild chronic stress are the parameters that determine the efficiency of antidepressants in the mouse forced swimming test.

  5. Cysteamine-related agents could be potential antidepressants through increasing central BDNF levels.

    Science.gov (United States)

    Tsai, Shih-Jen

    2006-01-01

    Major depressive disorder (MDD) is a common mental disease, but with an unknown etiology. Antidepressants are the main biological treatment for MDD. However, current antidepressive agents have a slow onset of effect and a substantial proportion of MDD patients do not clinically improve, despite maximal medication. Thus, the exploration for new antidepressants with novel strategies may help to develop faster and more effective antidepressant agents. Studies in the recent decades have demonstrated that antidepressants increase central brain-derived neurotrophic factor (BDNF) levels and activating the BDNF-signaling pathway may play an important role in their therapeutic mechanism. Cysteamine is a natural product of cells and constitutes the terminal region of the CoA molecule. Recent work has found that cysteamine and a related agent, cystamine, have neuroprotective effects in Huntington's disease (HD) mice, through enhancing central BDNF levels. Furthermore, cystamine or cysteamine injection could increase serum BDNF levels in wild-type mice as well as HD mice. Since activation of the BDNF-dependent pathway plays an important role in the mechanism of antidepressant therapeutic action, cystamine or its derivatives could have potential antidepressant therapeutic effects. Among these agents, pantethine may be one of the most promising agents. It is a naturally occurring compound which can be administered orally with negligible side effects, and is metabolized to cysteamine. Further evaluation of the therapeutic and toxic effects of these cysteamine-related antidepressant agents in MDD animal models is needed before any clinical application. PMID:16797865

  6. Spadin, a Sortilin-derived peptide: a new concept in the antidepressant drug design

    Directory of Open Access Journals (Sweden)

    Heurteaux Catherine

    2011-07-01

    Full Text Available Depression is the most common of psychiatric illnesses. The design of effective treatments for this disorder is a challenging process. Recently, the two-pore domain potassium channel TREK-1 has been identified as a new target in depression, and its antagonists might become effective antidepressants. Deletion of TREK-1 gene results in a depression-resistant phenotype that mimics antidepressant treatments. Here, we validate the fast antidepressant effects of spadin, a secreted peptide derived from the propeptide generated by the maturation of the sortilin receptor and acting through TREK-1 inhibition.

  7. Waste management system alternatives for treatment of wastes from spent fuel reprocessing

    International Nuclear Information System (INIS)

    This study was performed to help identify a preferred TRU waste treatment alternative for reprocessing wastes with respect to waste form performance in a geologic repository, near-term waste management system risks, and minimum waste management system costs. The results were intended for use in developing TRU waste acceptance requirements that may be needed to meet regulatory requirements for disposal of TRU wastes in a geologic repository. The waste management system components included in this analysis are waste treatment and packaging, transportation, and disposal. The major features of the TRU waste treatment alternatives examined here include: (1) packaging (as-produced) without treatment (PWOT); (2) compaction of hulls and other compactable wastes; (3) incineration of combustibles with cementation of the ash plus compaction of hulls and filters; (4) melting of hulls and failed equipment plus incineration of combustibles with vitrification of the ash along with the HLW; (5a) decontamination of hulls and failed equipment to produce LLW plus incineration and incorporation of ash and other inert wastes into HLW glass; and (5b) variation of this fifth treatment alternative in which the incineration ash is incorporated into a separate TRU waste glass. The six alternative processing system concepts provide progressively increasing levels of TRU waste consolidation and TRU waste form integrity. Vitrification of HLW and intermediate-level liquid wastes (ILLW) was assumed in all cases

  8. Waste management system alternatives for treatment of wastes from spent fuel reprocessing

    Energy Technology Data Exchange (ETDEWEB)

    McKee, R.W.; Swanson, J.L.; Daling, P.M.; Clark, L.L.; Craig, R.A.; Nesbitt, J.F.; McCarthy, D.; Franklin, A.L.; Hazelton, R.F.; Lundgren, R.A.

    1986-09-01

    This study was performed to help identify a preferred TRU waste treatment alternative for reprocessing wastes with respect to waste form performance in a geologic repository, near-term waste management system risks, and minimum waste management system costs. The results were intended for use in developing TRU waste acceptance requirements that may be needed to meet regulatory requirements for disposal of TRU wastes in a geologic repository. The waste management system components included in this analysis are waste treatment and packaging, transportation, and disposal. The major features of the TRU waste treatment alternatives examined here include: (1) packaging (as-produced) without treatment (PWOT); (2) compaction of hulls and other compactable wastes; (3) incineration of combustibles with cementation of the ash plus compaction of hulls and filters; (4) melting of hulls and failed equipment plus incineration of combustibles with vitrification of the ash along with the HLW; (5a) decontamination of hulls and failed equipment to produce LLW plus incineration and incorporation of ash and other inert wastes into HLW glass; and (5b) variation of this fifth treatment alternative in which the incineration ash is incorporated into a separate TRU waste glass. The six alternative processing system concepts provide progressively increasing levels of TRU waste consolidation and TRU waste form integrity. Vitrification of HLW and intermediate-level liquid wastes (ILLW) was assumed in all cases.

  9. Perinatal Antidepressant Use: Understanding Women’s Preferences and Concerns

    OpenAIRE

    Battle, Cynthia L.; Salisbury, Amy L.; SCHOFIELD, CASEY A.; ORTIZ-HERNANDEZ, SAMIA

    2013-01-01

    Perinatal depression is prevalent and linked with a host of adverse consequences for women and newborns. Rates of engagement in depression treatment are, however, strikingly low among pregnant and postpartum women, with the majority of affected women receiving no mental health treatment. Research indicates that perinatal women are extremely reluctant to take antidepressant medications, yet the nature of women’s concerns and treatment decisionmaking patterns have not been well documented. Deve...

  10. Antidepressant Effects of Ginsenosides from Panax notoginseng

    Institute of Scientific and Technical Information of China (English)

    YAO Yang; SANG Wei; YANG Xiu-shi; ZHAI Mei-jing; WANG Li-li; QIN Pei-you; WU Li; ZHOU Xian-rong; WANG Li-jun; ZHU Zhi-hua; REN Gui-xing

    2012-01-01

    Ginsenosides Rg1,Rb1,R1,Rd,and Re are major constituents of Panax notoginseng,a famous traditional Chinese medicinal herb,which has both stimulative and inhibitory effects on the central nervous system (CNS).The monoamine hypothesis proposes that depression is a result of the depletion of 5-hydroxytryptamine (5-HT),norepinephrine (NE) and dopamine (DA) in addition to the activation of monoamine oxidase in the CNS.The purpose of this study was to determine whether P.notoginseng Saponin (PNS) has an antidepressant activity.We investigated the antidepressant-like activities of Rg1,Rb1,R1,Rd,and Re in mice,using two animal models of depression.In addition,we analyzed the neurochemicals by the chronic unpredictable mild stress test.Our results showed that Rb 1,Rd,and Re treatment at 10 mg kg-1 significantly reduced the duration of immobility in both the tail suspension and forced swimming tests.Rb1,Rd,and Re increases in 5HT and NE levels at 10 mg kg-1 in both the frontal cortex and hippocampus.Dopamine levels increased in the hippocampus and the striatum.Moreover,5-hydroxyindoleacetic acid (5-HIAA) levels were found increased in the hippocampus.These findings suggest that the antidepressant effects of Rb1,Rd,and Re may be related to the increase in 5-HT and NE in the CNS,and through the alterations in the synthesis or metabolism of dopamine.

  11. [Driving fitness in therapy with antidepressive drugs].

    Science.gov (United States)

    Soyka, M; Dittert, S; Gartenmeier, A; Schäfer, M

    1998-04-01

    The driving ability of patients under therapy with antidepressives is seen less restrictive than some years ago. The inhibition of psychomotor performance is of special interest. Some empirical studies point at antidepressives increasing the risk for accidents at least in elderly patients. Different groups of antidepressants apparently show different effects. Tricyclic antidepressants were shown to worsen cognitive and psychomotor performance in some patients while serotonin reuptake inhibitors and some other new antidepressants may cause less behavioral toxicity. Methodological problems in assessing driving ability and some recent findings are discussed. PMID:9587241

  12. The International Society for Bipolar Disorders (ISBD) Task Force Report on Antidepressant Use in Bipolar Disorders

    NARCIS (Netherlands)

    Pacchiarotti, Isabella; Bond, David J.; Baldessarini, Ross J.; Nolen, Willem A.; Grunze, Heinz; Licht, Rasmus W.; Post, Robert M.; Berk, Michael; Goodwin, Guy M.; Sachs, Gary S.; Tondo, Leonardo; Findling, Robert L.; Youngstrom, Eric A.; Tohen, Mauricio; Undurraga, Juan; Gonzalez-Pinto, Ana; Goldberg, Joseph F.; Yildiz, Aysegul; Altshuler, Lori L.; Calabrese, Joseph R.; Mitchell, Philip B.; Thase, Michael E.; Koukopoulos, Athanasios; Colom, Francesc; Frye, Mark A.; Malhi, Gin S.; Fountoulakis, Konstantinos N.; Vazquez, Gustavo; Perlis, Roy H.; Ketter, Terence A.; Cassidy, Frederick; Akiskal, Hagop; Azorin, Jean-Michel; Valenti, Marc; Mazzei, Diego Hidalgo; Lafer, Beny; Kato, Tadafumi; Mazzarini, Lorenzo; Martinez-Aran, Anabel; Parker, Gordon; Souery, Daniel; Ozerdem, Aysegul; McElroy, Susan L.; Girardi, Paolo; Bauer, Michael; Yatham, Lakshmi N.; Zarate, Carlos A.; Nierenberg, Andrew A.; Birmaher, Boris; Kanba, Shigenobu; El-Mallakh, Rif S.; Serretti, Alessandro; Rihmer, Zoltan; Young, Allan H.; Kotzalidis, Georgios D.; MacQueen, Glenda M.; Bowden, Charles L.; Ghaemi, S. Nassir; Lopez-Jaramillo, Carlos; Rybakowski, Janusz; Ha, Kyooseob; Perugi, Giulio; Kasper, Siegfried; Amsterdam, Jay D.; Hirschfeld, Robert M.; Kapczinski, Flavio; Vieta, Eduard

    2013-01-01

    Objective: The risk-benefit profile of antidepressant medications in bipolar disorder is controversial. When conclusive evidence is lacking, expert consensus can guide treatment decisions. The International Society for Bipolar Disorders (ISBD) convened a task force to seek consensus recommendations

  13. Benzo[a]pyrene treatment leads to changes in nuclear protein expression and alternative splicing

    Energy Technology Data Exchange (ETDEWEB)

    Yan Chunlan; Wu Wei [Department of Toxicology, Zhejiang University School of Public Health, 388 Yu-Hang-Tang Road, Hangzhou, Zhejiang 310058 (China); Li Haiyan [Department of Toxicology, Zhejiang University School of Public Health, 388 Yu-Hang-Tang Road, Hangzhou, Zhejiang 310058 (China); Huzhou Maternity and Child Care Hospital, Huzhou, Zhejiang 313000 (China); Zhang Guanglin [Department of Toxicology, Zhejiang University School of Public Health, 388 Yu-Hang-Tang Road, Hangzhou, Zhejiang 310058 (China); Duerksen-Hughes, Penelope J. [Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92354 (United States); Zhu Xinqiang, E-mail: zhuxq@zju.edu.cn [Department of Toxicology, Zhejiang University School of Public Health, 388 Yu-Hang-Tang Road, Hangzhou, Zhejiang 310058 (China); Yang Jun, E-mail: gastate@zju.edu.cn [Department of Toxicology, Zhejiang University School of Public Health, 388 Yu-Hang-Tang Road, Hangzhou, Zhejiang 310058 (China); Zhejiang-California International Nanosystems Institute, Hangzhou, Zhejiang 310029 (China)

    2010-04-01

    Benzo[a]pyrene (BaP) is a potent pro-carcinogen generated from the combustion of fossil fuel and cigarette smoke. Previously, using a proteomic approach, we have shown that BaP can induce changes in the expression of many cellular proteins, including transcription regulators. In the present study, using a similar approach, we examined the nuclear protein response to BaP in HeLa cells and found that BaP treatment caused expression changes in many nuclear proteins. Twenty-four of these proteins were successfully identified, several of which are involved in the alternative splicing of mRNA, DNA replication, recombination, and repair. The changed expression levels were further confirmed by immunoblot analysis using specific antibodies for two proteins, Lamin A and mitotic checkpoint protein Bub3. The nuclear localization of these two proteins was also confirmed by confocal microscopy. To determine whether alternative splicing was activated following BaP treatment, we examined Fas and CD44, two genes previously shown to be targets of alternative splicing in respond to DNA damage. While no significant activation of alternative splicing was observed for Fas, CD44 splicing variants were found after BaP treatment. Together, these data show that DNA damage induces dramatic changes in nuclear protein expression, and that alternative splicing might be involved in the cellular response to DNA damage.

  14. The role of complementary and alternative medicine in the treatment of eating disorders: A systematic review.

    Science.gov (United States)

    Fogarty, Sarah; Smith, Caroline A; Hay, Phillipa

    2016-04-01

    This systematic review critically appraises the role of complementary and alternative medicine in the treatment of those with an eating disorder. Sixteen studies were included in the review. The results of this review show that the role of complementary and alternative medicine in the treatment of those with an eating disorder is unclear and further studies should be conducted. A potential role was found for massage and bright light therapy for depression in those with Bulimia Nervosa and a potential role for acupuncture and relaxation therapy, in the treatment of State Anxiety, for those with an eating disorder. The role of these complementary therapies in treating eating disorders should only be provided as an adjunctive treatment only. PMID:26970732

  15. The role of complementary and alternative medicine in the treatment of eating disorders: A systematic review.

    Science.gov (United States)

    Fogarty, Sarah; Smith, Caroline A; Hay, Phillipa

    2016-04-01

    This systematic review critically appraises the role of complementary and alternative medicine in the treatment of those with an eating disorder. Sixteen studies were included in the review. The results of this review show that the role of complementary and alternative medicine in the treatment of those with an eating disorder is unclear and further studies should be conducted. A potential role was found for massage and bright light therapy for depression in those with Bulimia Nervosa and a potential role for acupuncture and relaxation therapy, in the treatment of State Anxiety, for those with an eating disorder. The role of these complementary therapies in treating eating disorders should only be provided as an adjunctive treatment only.

  16. Two implant overdenture–the first alternative treatment for patients with complete edentulous mandible

    OpenAIRE

    Melescanu Imre, M; Marin, M.; Preoteasa, E; Tancu, AM; Preoteasa, CT

    2011-01-01

    Given the increasing life expectancy in the coming years, dental practitioners, as other specialists from different medical fields, will encounter an increasing number of complete edentulous patients. These patients, with a longer active life and higher standards of life quality, will have different expectations for their complete dentures, higher than the standard treatment that uses conventional complete dentures. Two–implant overdenture is considered the first alternative treatment in comp...

  17. EMSAM (deprenyl patch): how a promising antidepressant was underutilized.

    Science.gov (United States)

    Asnis, Gregory M; Henderson, Margaret A

    2014-01-01

    The EMSAM patch is a unique monoamine oxidase inhibitor (MAOI) being the only antidepressant utilizing a transdermal delivery system. This was welcomed by clinicians who hoped that EMSAM would be better tolerated than oral MAOIs and non-MAOI antidepressants, as well as being effective for treatment in a wide spectrum of depressed patients including atypical depression, bipolar depression, and refractory depression. Unfortunately, the clinical use of EMSAM has been underutilized and its potential usefulness overlooked. This article suggests that fear of possible side effects, particularly the "cheese reaction" and serotonin syndrome, are some of the main contributors to underutilization by clinicians. These risks have been significantly exaggerated with the 6 mg/day dose not even requiring a special diet. Other contributing factors leading to underutilization are reviewed such as: the lack of studies addressing many important clinical questions; inadequate data analyses; not evaluating the effect of EMSAM on comorbid psychiatric conditions, particularly anxiety disorders; lack of antidepressant comparators versus EMSAM; no dose-response relationship examined; various depressive subtypes and conditions are unexplored, eg, bipolar depression and refractory depression; poor insurance coverage for an expensive medication; as well as minimal marketing efforts and postmarketing studies. On the other hand, many potential advantages of EMSAM are not highlighted enough in the literature and by pharmaceutical companies which might have increased clinical interest and utilization of the antidepressant. For example, the advantages of EMSAM include: avoidance of swallowing issues, as can be seen with oral antidepressants; minimal side effects, probably due to a favorable pharmacokinetic profile; minimal evidence of suicidal behavior, probably relating to the transdermal route of administration; low rates of inducing hypomanic/manic episodes; as well as significant efficacy in

  18. Control of seed-borne pathogens on legumes by microbial and other alternative seed treatments

    NARCIS (Netherlands)

    Tinivella, F.; Hirata, L.M.; Celan, M.A.; Wright, S.A.I.; Amein, T.; Schmitt, A.; Wolf, van der J.M.; Koch, E.; Groot, S.P.C.

    2009-01-01

    Greenhouse trials were carried out in order to test the efficacy of different seed treatments as alternatives to chemicals against Colletotrichum lindemuthianum cause of anthracnose on bean and Ascochyta spp. cause of Ascochyta blights on pea, respectively. Resistance inducers, commercially formulat

  19. Old and New Controversies in the Alternative Treatment of Attention-Deficit Hyperactivity Disorder

    Science.gov (United States)

    Rojas, Neal L.; Chan, Eugenia

    2005-01-01

    Use of complementary and alternative medicine (CAM) for treatment of attention-deficit hyperactivity disorder (ADHD) has become widespread in both referral and primary care populations. We review the purported mechanism of action and available evidence for selected CAM therapies for ADHD. Enduring controversies, such as elimination of artificial…

  20. Perinatal antidepressant use: understanding women's preferences and concerns.

    Science.gov (United States)

    Battle, Cynthia L; Salisbury, Amy L; Schofield, Casey A; Ortiz-Hernandez, Samia

    2013-11-01

    Perinatal depression is prevalent and linked with a host of adverse consequences for women and newborns. Rates of engagement in depression treatment are, however, strikingly low among pregnant and postpartum women, with the majority of affected women receiving no mental health treatment. Research indicates that perinatal women are extremely reluctant to take antidepressant medications, yet the nature of women's concerns and treatment decision- making patterns have not been well documented. Developing a clearer understanding of women's treatment preferences and behaviors may help identify solutions to the under-treatment of perinatal depression. In this mixed methods study, we conducted in-depth interviews with 61 pregnant women, approximately half of whom were experiencing clinical levels of depression. In addition to assessing psychiatric diagnoses, symptoms, and functional impairment, we conducted qualitative interviews addressing women's preferences for depression treatment, concerns, and decision-making patterns. Consistent with prior reports, women were significantly more likely to voice a preference for non-pharmacologic depression treatments, as opposed to antidepressant medications. Many depressed women reported a great degree of uncertainty regarding how to treat their depression, and those with more severe depression symptoms were more likely to endorse decisional conflict. Analysis of qualitative comments yielded detailed information about the nature of women's concerns and preferences related to use of antidepressant medications and other aspects of treatment engagement. We discuss findings in the context of improving patient-centered care for perinatal depression.

  1. The Association of Antidepressant Medication and Body Weight Gain.

    Directory of Open Access Journals (Sweden)

    Sara Ranjbar

    2013-04-01

    Full Text Available Objective: To review the literature and discover which antidepressants are responsible for weight gain and then to discuss the areas with lack of adequate knowledge. Method: An electronic search was conducted through Medline, Pubmed, Cochrane library, and ScienceDirect. Forty nine empirical researches were identified and reviewed. Results: Amitriptyline, clomipramine, and mirtazapine have been associated with more weight gain induction in clinical studies, but not in animal-based studies. All TCAs have been reported to cause weight gain except protriptyline. MAOIs have been associated with weight gain. In SSRI group, citalopram and ecitalopram induce weight, yet mixed results exist for paroxetine and fluoxetine. Researches unanimously reported weight loss effect for bupropion. Some studies suggest contributing factors in the relationship of antidepressants with body weight changes including age, gender, base-line weights and treatment duration. Various results of different treatment durations have been reported in some cases but there are not continuous time-dependent studies for the influences of antidepressants on body weight changes. Conclusion: More studies are required to discover underlying mechanisms and the time-dependent effects of antidepressants on body weight changes.

  2. Gene expression profile analysis of genes in rat hippocampus from antidepressant treated rats using DNA microarray

    Directory of Open Access Journals (Sweden)

    Shin Minkyu

    2010-11-01

    Full Text Available Abstract Background The molecular and biological mechanisms by which many antidepressants function are based on the monoamine depletion hypothesis. However, the entire cascade of mechanisms responsible for the therapeutic effect of antidepressants has not yet been elucidated. Results We used a genome-wide microarray system containing 30,000 clones to evaluate total RNA that had been isolated from the brains of treated rats to identify the genes involved in the therapeutic mechanisms of various antidepressants, a tricyclic antidepressant (imipramine. a selective serotonin reuptake inhibitor (fluoxetine, a monoamine oxidase inhibitor (phenelzine and psychoactive herbal extracts of Nelumbinis Semen (NS. To confirm the differential expression of the identified genes, we analyzed the amount of mRNA that was isolated from the hippocampus of rats that had been treated with antidepressants by real-time RT-PCR using primers specific for selected genes of interest. These data demonstrate that antidepressants interfere with the expression of a large array of genes involved in signaling, survival and protein metabolism, suggesting that the therapeutic effect of these antidepressants is very complex. Surprisingly, unlike other antidepressants, we found that the standardized herbal medicine, Nelumbinis Semen, is free of factors that can induce neurodegenerative diseases such as caspase 8, α-synuclein, and amyloid precursor protein. In addition, the production of the inflammatory cytokine, IFNγ, was significantly decreased in rat hippocampus in response to treatment with antidepressants, while the inhibitory cytokine, TGFβ, was significantly enhanced. Conclusions These results suggest that antidepressants function by regulating neurotransmission as well as suppressing immunoreactivity in the central nervous system.

  3. Potential involvement of serotonergic signaling in ketamine's antidepressant actions: A critical review.

    Science.gov (United States)

    du Jardin, Kristian Gaarn; Müller, Heidi Kaastrup; Elfving, Betina; Dale, Elena; Wegener, Gregers; Sanchez, Connie

    2016-11-01

    A single i.v. infusion of ketamine, classified as an N-methyl-d-aspartate (NMDA) receptor antagonist, may alleviate depressive symptoms within hours of administration in treatment resistant depressed patients, and the antidepressant effect may last for several weeks. These unique therapeutic properties have prompted researchers to explore the mechanisms mediating the antidepressant effects of ketamine, but despite many efforts, no consensus on its antidepressant mechanism of action has been reached. Recent preclinical reports have associated the neurotransmitter serotonin (5-hydroxytryptamine; 5-HT) with the antidepressant-like action of ketamine. Here, we review the current evidence for a serotonergic role in ketamine's antidepressant effects. The pharmacological profile of ketamine may include equipotent activity on several non-NMDA targets, and the current hypotheses for the mechanisms responsible for ketamine's antidepressant activity do not appear to preclude the possibility that non-glutamate neurotransmitters are involved in the antidepressant effects. At multiple levels, the serotonergic and glutamatergic systems interact, and such crosstalk could support the notion that changes in serotonergic neurotransmission may impact ketamine's antidepressant potential. In line with these prospects, ketamine may increase 5-HT levels in the prefrontal cortex of rats, plausibly via hippocampal NMDA receptor inhibition and activation of α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptors. In addition, a number of preclinical studies suggest that the antidepressant-like effects of ketamine may depend on endogenous activation of 5-HT receptors. Recent imaging and behavioral data predominantly support a role for 5-HT1A or 5-HT1B receptors, but the full range of 5-HT receptors has currently not been systematically investigated in this context. Furthermore, the nature of any 5-HT dependent mechanism in ketamine's antidepressant effect is currently not

  4. Comparative LCA of decentralized wastewater treatment alternatives for non-potable urban reuse.

    Science.gov (United States)

    Opher, Tamar; Friedler, Eran

    2016-11-01

    Municipal wastewater (WW) effluent represents a reliable and significant source for reclaimed water, very much needed nowadays. Water reclamation and reuse has become an attractive option for conserving and extending available water sources. The decentralized approach to domestic WW treatment benefits from the advantages of source separation, which makes available simple small-scale systems and on-site reuse, which can be constructed on a short time schedule and occasionally upgraded with new technological developments. In this study we perform a Life Cycle Assessment to compare between the environmental impacts of four alternatives for a hypothetical city's water-wastewater service system. The baseline alternative is the most common, centralized approach for WW treatment, in which WW is conveyed to and treated in a large wastewater treatment plant (WWTP) and is then discharged to a stream. The three alternatives represent different scales of distribution of the WW treatment phase, along with urban irrigation and domestic non-potable water reuse (toilet flushing). The first alternative includes centralized treatment at a WWTP, with part of the reclaimed WW (RWW) supplied back to the urban consumers. The second and third alternatives implement de-centralized greywater (GW) treatment with local reuse, one at cluster level (320 households) and one at building level (40 households). Life cycle impact assessment results show a consistent disadvantage of the prevailing centralized approach under local conditions in Israel, where seawater desalination is the marginal source of water supply. The alternative of source separation and GW reuse at cluster level seems to be the most preferable one, though its environmental performance is only slightly better than GW reuse at building level. Centralized WW treatment with urban reuse of WWTP effluents is not advantageous over decentralized treatment of GW because the supply of RWW back to consumers is very costly in materials and

  5. Antidepressant therapy with milnacipran and venlafaxine

    Directory of Open Access Journals (Sweden)

    Lucilla Mansuy

    2010-08-01

    Full Text Available Lucilla MansuyPierre Fabre Médicament, Toulouse, FranceAbstract: Specific serotonin norepinephrine reuptake inhibitors (SNRIs have been described as “better tolerated tricyclic antidepressants” or as “boosted” selective serotonin reuptake inhibitors (SSRIs. Venlafaxine has become a therapeutic reference treatment for major depression. Although less widely studied, indirect comparisons with another SNRI, milnacipran, suggest an equivalent efficacy. This paper discusses these indirect comparisons and the recently published first double-blind, head-to-head comparison. Venlafaxine has potency at serotonin transporters which is about 30-fold greater than that at norepinephrine transporters while milnacipran has a similar potency at each transporter. Thus, at low doses, venlafaxine acts essentially as a SSRI, with significant noradrenergic activity only occurring at higher doses. To overcome the problem of the differing profile of venlafaxine at increasing doses, the first head-to-head study compared the therapeutic effects and tolerability of the two antidepressants when flexibly titrated to the high dose of 200 mg/day. The study showed that the two SNRIs have similar efficacy and safety profiles. Both drugs produced about 42% remissions at the end of the 20-week study. The most frequent adverse events in both groups were nausea, dizziness, headache, and sweating. Certain specific differences in tolerability are discussed.Keywords: milnacipran, venlafaxine, antidepressant efficacy, tolerability, dose-titration

  6. Neuritin produces antidepressant actions and blocks the neuronal and behavioral deficits caused by chronic stress.

    Science.gov (United States)

    Son, Hyeon; Banasr, Mounira; Choi, Miyeon; Chae, Seung Yeon; Licznerski, Pawel; Lee, Boyoung; Voleti, Bhavya; Li, Nanxin; Lepack, Ashley; Fournier, Neil M; Lee, Ka Rim; Lee, In Young; Kim, Juhyun; Kim, Joung-Hun; Kim, Yong Ho; Jung, Sung Jun; Duman, Ronald S

    2012-07-10

    Decreased neuronal dendrite branching and plasticity of the hippocampus, a limbic structure implicated in mood disorders, is thought to contribute to the symptoms of depression. However, the mechanisms underlying this effect, as well as the actions of antidepressant treatment, remain poorly characterized. Here, we show that hippocampal expression of neuritin, an activity-dependent gene that regulates neuronal plasticity, is decreased by chronic unpredictable stress (CUS) and that antidepressant treatment reverses this effect. We also show that viral-mediated expression of neuritin in the hippocampus produces antidepressant actions and prevents the atrophy of dendrites and spines, as well as depressive and anxiety behaviors caused by CUS. Conversely, neuritin knockdown produces depressive-like behaviors, similar to CUS exposure. The ability of neuritin to increase neuroplasticity is confirmed in models of learning and memory. Our results reveal a unique action of neuritin in models of stress and depression, and demonstrate a role for neuroplasticity in antidepressant treatment response and related behaviors. PMID:22733766

  7. REM sleep homeostasis in the absence of REM sleep: Effects of antidepressants.

    Science.gov (United States)

    McCarthy, Andrew; Wafford, Keith; Shanks, Elaine; Ligocki, Marcin; Edgar, Dale M; Dijk, Derk-Jan

    2016-09-01

    Most antidepressants suppress rapid eye movement (REM) sleep, which is thought to be important to brain function, yet the resulting REM sleep restriction is well tolerated. This study investigated the impact of antidepressants with different mechanisms of action, such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCA), on the regulation of REM sleep in rats. REM sleep was first demonstrated to be homeostatically regulated using 5, 8 and 10 h of REM-sleep specific restriction through EEG-triggered arousals, with an average of 91 ± 10% of lost REM sleep recovered following a 26-29 -hour recovery period. Acute treatment with the antidepressants paroxetine, citalopram and imipramine inhibited REM sleep by 84 ± 8, 84 ± 8 and 69 ± 9% respectively relative to vehicle control. The pharmacologically-induced REM sleep deficits by paroxetine and citalopram were not fully recovered, whereas, after imipramine the REM sleep deficit was fully compensated. Given the marked difference between REM sleep recovery following the administration of paroxetine, citalopram, imipramine and REM sleep restriction, the homeostatic response was further examined by pairing REM sleep specific restriction with the three antidepressants. Surprisingly, the physiologically-induced REM sleep deficits incurred prior to suppression of REM sleep by all antidepressants was consistently recovered. The data indicate that REM sleep homeostasis remains operative following subsequent treatment with antidepressants and is unaffected by additional pharmacological inhibition of REM sleep. PMID:27150557

  8. REM sleep homeostasis in the absence of REM sleep: Effects of antidepressants.

    Science.gov (United States)

    McCarthy, Andrew; Wafford, Keith; Shanks, Elaine; Ligocki, Marcin; Edgar, Dale M; Dijk, Derk-Jan

    2016-09-01

    Most antidepressants suppress rapid eye movement (REM) sleep, which is thought to be important to brain function, yet the resulting REM sleep restriction is well tolerated. This study investigated the impact of antidepressants with different mechanisms of action, such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCA), on the regulation of REM sleep in rats. REM sleep was first demonstrated to be homeostatically regulated using 5, 8 and 10 h of REM-sleep specific restriction through EEG-triggered arousals, with an average of 91 ± 10% of lost REM sleep recovered following a 26-29 -hour recovery period. Acute treatment with the antidepressants paroxetine, citalopram and imipramine inhibited REM sleep by 84 ± 8, 84 ± 8 and 69 ± 9% respectively relative to vehicle control. The pharmacologically-induced REM sleep deficits by paroxetine and citalopram were not fully recovered, whereas, after imipramine the REM sleep deficit was fully compensated. Given the marked difference between REM sleep recovery following the administration of paroxetine, citalopram, imipramine and REM sleep restriction, the homeostatic response was further examined by pairing REM sleep specific restriction with the three antidepressants. Surprisingly, the physiologically-induced REM sleep deficits incurred prior to suppression of REM sleep by all antidepressants was consistently recovered. The data indicate that REM sleep homeostasis remains operative following subsequent treatment with antidepressants and is unaffected by additional pharmacological inhibition of REM sleep.

  9. Modulation of muscarinic system with serotonin-norepinephrine reuptake inhibitor antidepressant attenuates depression in mice

    Directory of Open Access Journals (Sweden)

    Paramdeep Singh

    2015-01-01

    Full Text Available Objective: Several studies suggest that muscarinic receptor antagonist scopolamine is a rapidly acting antidepressant for the treatment-resistant depression. Therefore, this study was carried out to investigate the possibility of synergistic potential of scopolamine with antidepressants for the treatment of depression without memory impairment in mice. Materials and Methods: Antidepressants such as citalopram, duloxetine, fluvoxamine, and venlafaxine at their median effective dose that is 12.5, 42.8, 17.5, 15.7 mg/kg p.o., respectively, were evaluated in combination with scopolamine 0.2 mg/kg intraperitoneally for the synergistic potential for ameliorating depression in Swiss albino mice. A battery of tests including forced swim test (FST and tail suspension test (TST were performed in all the groups comprising vehicle control, scopolamine, antidepressants per se, and the combinations of antidepressants with scopolamine. This was followed by the locomotor activity and memory tests. Results: Behavioral studies indicated that only antidepressant venlafaxine with scopolamine resulted in 95.5% and 93.6% reduction in immobility time compared to the vehicle control in FST and TST, respectively. This is significant (P < 0.0001 synergistic hyper-additive antidepressive-like effect compared to scopolamine per se and venlafaxine per se treatment effects in antidepressant paradigms. All the data were evaluated using the one-way analysis of variance followed by individual comparisons using Tukey′s post-hoc test. Control open field studies demonstrated no significant increase in general locomotion after co-administration of the compounds. Step down avoidance paradigm confirmed that scopolamine at the selected dose has no cognition deficit in any mice. Conclusions: The dose of scopolamine selected for synergistic potential has no detrimental effect on memory. The present results suggest the concoction of scopolamine with venlafaxine for enhanced synergistic

  10. Combination of intravitreal bevacizumab and peripheral photocoagulation: an alternative treatment in eales disease.

    Science.gov (United States)

    Cp, Juarez; Al, Gramajo; Jd, Luna

    2013-01-01

    To report the efficacy of combination therapy (bevacizumab and photocoagulation) in a case of Eales Disease this study has been performed. Bevacizumab (Avastin, 1.25 mg/0.05 ml) was injected intravitreously for the treatment of iris and retinal neovascularization in a 56-year old Hispanic female with photocoagulation treatment to control the recurrence of vitreous haemorrhage. Our results revealed that stabilization of the disease and improvement in visual acuity were achieved without any signs of recurrence. Intravitreal bevacizumab in combination with photocoagulation treatment of ischemic retinal areas may be a good alternative for patients with recurrent vitreous haemorrhage due to Eales disease.

  11. Antidepressants are selective serotonin neuronal reuptake inhibitors: 40-year history

    Directory of Open Access Journals (Sweden)

    D. S. Danilov

    2015-01-01

    Full Text Available The paper presents historical prerequisites for designing antidepressants from a group of selective serotonin neuronal reuptake inhibitors (SSRIs: to determine a lower serotonin concentration in the different tissues of depressed patients; to establish a higher serotonin concentration in the treatment of depressed patients with tricyclic antidepressants, and to formulate the serotonergic theory of depression. It also provides a consecutive account of the history of clinical introduction of individual SSRI representatives, such as fluoxetine, zimelidine, fluvoxamine, indalpine, citalopram, sertraline, paroxetine, and escitalopram. There are data from the history of studying the mechanism of SSRI action: from the theory of the importance of an increase in the concentration of serotonin in the synaptic cleft to the current understanding of complex successive intracellular rearrangements at the level of the postsynaptic neuron. The history of studying the efficacy of SSRIs in treating depression is considered in detail. Emphasis is laid on the reasons for a paradoxical difference in the evaluations of the efficiency of therapy with SSRIs versus other groups of antidepressants at different developmental stages of psychopharmacology. The role of marketing technologies in disseminating the data on the efficacy of this or that group of antidepressants is described. The practical significance of differences in individual SSRI representatives (the potency of serotonin uptake inhibition; the degree of selectivity and activity against the serotonergic system; the likelihood of an unfavorable pharmacokinetic interaction with other drugs; the half-life of elimination; the quickness of achieving a therapeutic dose is analyzed. Whether it is possible and reasonable to differentially choose different SSRI representatives in the treatment of depressions at the present stage is discussed. The authors state their belief that researches should be continued to

  12. PTSD and comorbid AUD: a review of pharmacological and alternative treatment options

    Directory of Open Access Journals (Sweden)

    Ralevski E

    2014-03-01

    Full Text Available Elizabeth Ralevski, Lening A Olivera-Figueroa, Ismene Petrakis Yale University School of Medicine, Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT, USA Background: Although posttraumatic stress disorder (PTSD and alcohol use disorders (AUD frequently co-occur there are no specific treatments for individuals diagnosed with these comorbid conditions. The main objectives of this paper are to review the literature on pharmacological options for PTSD and comorbid AUD, and to summarize promising behavioral and alternative interventions for those with these dual diagnoses. Methods: We conducted a comprehensive search on PsycINFO and MEDLINE/PubMed databases using Medical Subject Headings terms in various combinations to identify articles that used pharmacotherapy for individuals with dual diagnoses of PTSD and AUD. Similar strategies were used to identify articles on behavioral and alternative treatments for AUD and PTSD. We identified and reviewed six studies that tested pharmacological treatments for patients with PTSD and comorbid AUD. Results: The literature on treatment with US Food and Drug Administration approved medications for patients with dual diagnosis of PTSD and AUD is very limited and inconclusive. Promising evidence indicates that topiramate and prazosin may be effective in reducing PTSD and AUD symptoms in individuals with comorbidity. Seeking safety has had mixed efficacy in clinical trials. The efficacy of other behavioral and alternative treatments (mindfulness-based, yoga, and acupuncture is more difficult to evaluate since the evidence comes from small, single studies without comparison groups. Conclusion: There is a clear need for more systematic and rigorous study of pharmacological, behavioral, and alternative treatments for patients with dual diagnoses of PTSD and AUD. Keywords: dual diagnosis, PTSD, AUD, pharmacotherapy

  13. Neoechinulin A induced memory improvements and antidepressant-like effects in mice.

    Science.gov (United States)

    Sasaki-Hamada, Sachie; Hoshi, Maho; Niwa, Yuki; Ueda, Yudai; Kokaji, Aya; Kamisuki, Shinji; Kuramochi, Kouji; Sugawara, Fumio; Oka, Jun-Ichiro

    2016-11-01

    Neoechinulin A is an isoprenyl indole alkaloid that exhibits scavenging, neurotrophic factor-like, and anti-apoptotic activities. However, the effectiveness of neoechinulin A in animal models of disease has not yet been explored. In the present study, we investigated the effects of neoechinulin A on memory impairment in lipopolysaccharide (LPS)-treated mice and its antidepressant-like effects in mice. In the Y-maze test, the intracerebroventicular (i.c.v.) administration of LPS (10μg/mouse) significantly decreased spontaneous alternation behavior, which was prevented by the prior administration of neoechinulin A (300ng/mouse, i.c.v.). None of the treatments altered the locomotor activity of mice. Moreover, the administration of neoechinulin A decreased the immobility time in the forced-swim test or tail suspension test, which was prevented by the prior administration of WAY100635 (an antagonist of 5-HT1A receptors) and parachlorophenylalanine (an inhibitor of tryptophan hydroxylase). These results suggest that neoechinulin A improves memory functions in LPS-treated mice, and also exerts antidepressant-like effects through changes in the 5-HT system. PMID:27495355

  14. Assessment of the Risk of Suicide-Related Events Induced by Concomitant Use of Antidepressants in Cases of Smoking Cessation Treatment with Varenicline and Assessment of Latent Risk by the Use of Varenicline

    Science.gov (United States)

    Akimoto, Hayato; Oshima, Shinji; Negishi, Akio; Ohara, Kousuke; Ohshima, Shigeru; Inoue, Naoko; Kobayashi, Daisuke

    2016-01-01

    Smoking Cessation Treatment (SCT) is a policy that has to be promoted for health economics, and expectations for the success of treatments with varenicline (VAR) are large. However, the Food and Drug Administration (FDA) have issued a warning on VAR-induced depression and suicide. In the present study, utilizing the FDA Adverse Event Reporting System (FAERS), we searched for antidepressants (ADs) used during SCT that cause fewer suicide-related events (SRE) (Study 1). We also investigated whether VAR concomitantly administered with ADs increases the risk of SRE (Study 2). In addition, we investigated whether the use of VAR alone is a latent risk factor of SRE. The backgrounds of cases with and without SRE were matched using the Propensity Score. In Study 1, the highest integrated Reporting Odds Ratio (iROR) was noted in concomitantly administered mirtazapine (iROR 6.98; 95% Confidence Interval (CI) 1.57–30.99), while the lowest ratio was noted in concomitantly administered amitriptyline (iROR 0.59; iROR95%CI 0.23–1.50). Study 2 clarified that SCT increases the risk of SRE in AD-treated cases (iROR 8.02; iROR95%CI 5.47–11.76; not significance). Of ADs concomitantly used during SCT with VAR, amitriptyline and mirtazapine showed the lowest and highest risks, respectively (Study 1). It was clarified that concomitant use of VAR in the treatment of depression with ADs increased the risk of SRE (Study 2). The results of Studies 1 and 2 suggested that the use of VAR alone is a latent risk factor inducing suicide. PMID:27657721

  15. Tricyclic antidepressant overdose treated with adjunctive lipid rescue and plasmapheresis

    OpenAIRE

    Odigwe, Chibuzo Clement; Tariq, Madiha; Kotecha, Tulsi; Mustafa, Usman; Senussi, Nizar; Ikwu, Isaac; Bhattarcharya, Anirban; Ngene, John Ifeanyi; Ojiako, Kizito; Iroegbu, Nkemakolam

    2016-01-01

    Tricyclic antidepressant poisoning remains a major cause of morbidity and mortality, particularly in the setting of suicidal attempts. The current standard of care for treatment is the administration of sodium bicarbonate infusion. Adjunctive lipid emulsion therapy and plasmapheresis have received attention recently. We report an 18-year-old patient who was successfully managed with lipid emulsion and plasmapheresis as adjuncts to sodium bicarbonate treatment and review some of the recent lit...

  16. Tricyclic antidepressant overdose treated with adjunctive lipid rescue and plasmapheresis.

    Science.gov (United States)

    Odigwe, Chibuzo Clement; Tariq, Madiha; Kotecha, Tulsi; Mustafa, Usman; Senussi, Nizar; Ikwu, Isaac; Bhattarcharya, Anirban; Ngene, John Ifeanyi; Ojiako, Kizito; Iroegbu, Nkemakolam

    2016-07-01

    Tricyclic antidepressant poisoning remains a major cause of morbidity and mortality, particularly in the setting of suicidal attempts. The current standard of care for treatment is the administration of sodium bicarbonate infusion. Adjunctive lipid emulsion therapy and plasmapheresis have received attention recently. We report an 18-year-old patient who was successfully managed with lipid emulsion and plasmapheresis as adjuncts to sodium bicarbonate treatment and review some of the recent literature. PMID:27365872

  17. Antidepressant Use Amongst College Students: Findings of a Phenomenological Study

    OpenAIRE

    Reshmi L. Singh, Ph.D; College of Pharmacy, University of Minnesota; Marcia M. Worley, Ph.D.; Cynthia Peden-McAlpine, Ph.D.

    2012-01-01

    Background: Depression among college students is an escalating problem and could have serious consequences such as suicide. There has been an increase in use of antidepressants on college campuses in United States. However, an in depth understanding of this phenomenon from the college student’s perspective is lacking in the literature. Objective: This study examined college students’ experiences and treatment decision making during their depression treatment. Methods: A longitudinal, phenomen...

  18. The Cerebral Glucose Metabolic Response to Combined Total Sleep Deprivation and Antidepressant Treatment in Geriatric Depression: A Randomized, Placebo Controlled Study

    OpenAIRE

    Smith, Gwenn S.; Reynolds, Charles F; Houck, Patricia R.; Dew, Mary Amanda; Ginsberg, Joshua; Ma, Yilong; Mulsant, Benoit H.; Bruce G Pollock

    2008-01-01

    A randomized, placebo controlled study was performed to evaluate whether the onset of the glucose metabolic effects of a selective serotonin reuptake inhibitor (paroxetine) would be accelerated by total sleep deprivation (TSD). Patients were randomly assigned to one of three groups: TSD and paroxetine treatment, TSD and two weeks of placebo followed by paroxetine treatment, or two weeks of paroxetine treatment. Sixteen elderly depressed patients who met DSM-IV criteria for major depressive di...

  19. Influence of baseline severity on antidepressant efficacy for anxiety disorders : meta-analysis and meta-regression

    NARCIS (Netherlands)

    de Vries, Ymkje Anna; de Jonge, Peter; van den Heuvel, Edwin; Turner, Erick H; Roest, Annelieke M

    2016-01-01

    BACKGROUND: Antidepressants are established first-line treatments for anxiety disorders, but it is not clear whether they are equally effective across the severity range. AIMS: To examine the influence of baseline severity of anxiety on antidepressant efficacy for generalised anxiety disorder (GAD),

  20. Psychotherapy in Antidepressant Patients

    OpenAIRE

    Regina H. Powers; Kniesner, Thomas J.; Thomas J. Croghan

    2002-01-01

    December 2002 (Revised from October 2002). Depression is a condition with various modes of treatment, including pharmacotherapy, psychotherapy, and some combination of each. The role of psychotherapy in the treatment of depression relative to the role of pharmacotherapy is not well understood, and guidelines for psychotherapy in the primary care setting differ from guidelines for specialty care. There is little evidence about the circumstances in actual practice that affect the use of psychot...

  1. Alternatives for managing wastes from reactors and post-fission operations in the LWR fuel cycle. Volume 2. Alternatives for waste treatment

    Energy Technology Data Exchange (ETDEWEB)

    1976-05-01

    Volume II of the five-volume report is devoted to the description of alternatives for waste treatment. The discussion is presented under the following section titles: fuel reprocessing modifications; high-level liquid waste solidification; treatment and immobilization of chop-leach fuel bundle residues; treatment of noncombustible solid wastes; treatment of combustible wastes; treatment of non-high-level liquid wastes; recovery of transuranics from non-high-level wastes; immobilization of miscellaneous non-high-level wastes; volatile radioisotope recovery and off-gas treatment; immobilization of volatile radioisotopes; retired facilities (decontamination and decommissioning); and, modification and use of selected fuel reprocessing wastes. (JGB)

  2. Alternatives for managing wastes from reactors and post-fission operations in the LWR fuel cycle. Volume 2. Alternatives for waste treatment

    International Nuclear Information System (INIS)

    Volume II of the five-volume report is devoted to the description of alternatives for waste treatment. The discussion is presented under the following section titles: fuel reprocessing modifications; high-level liquid waste solidification; treatment and immobilization of chop-leach fuel bundle residues; treatment of noncombustible solid wastes; treatment of combustible wastes; treatment of non-high-level liquid wastes; recovery of transuranics from non-high-level wastes; immobilization of miscellaneous non-high-level wastes; volatile radioisotope recovery and off-gas treatment; immobilization of volatile radioisotopes; retired facilities (decontamination and decommissioning); and, modification and use of selected fuel reprocessing wastes

  3. Hyperhidrosis and Its Treatment: A Safe and Effective Alternative in the Treatment of Palmoplantar Hyperhidrosis, Iontophoresis

    Directory of Open Access Journals (Sweden)

    Deren Özcan

    2011-03-01

    Full Text Available Primary hyperhidrosis is characterized by excessive sweating of unknown cause which most commonly involves the palms, soles, and axillae in a bilateral and symmetrical fashion. Since it leads to physical discomfort and psychosocial difficulties in the affected individuals, it should be treated effectively. However, treatment can be challenging as its pathophysiology is poorly understood. There are several treatment options, including topical or systemic medications and surgical or non-surgical invasive techniques. Iontophoresis is the introduction of ionized substances into the surface tissues by means of an electric current. It is a non-invasive, safe, well tolerated, and effective treatment method for primary hyperhidrosis without long-term adverse effects and compensatory hyperhidrosis. Iontophoresis is suggested as a first-line therapy in severe palmoplantar hyperhidrosis and second-line therapy in milder cases that are unresponsive to topical treatments. In axillary hyperhidrosis it is less effective and not practical to use. Being time consuming and requiring maintenance therapy are its most important disadvantages. In this article, hyperhidrosis and the principal treatment options, the indications of iontophoresis for the treatment of primary hyperhidrosis, its mechanism of action, treatment protocol and procedure, adverse effects, and contraindications are reviewed.

  4. Disrupting the rhythm of depression: design and protocol of a randomized controlled trial on preventing relapse using brief cognitive therapy with or without antidepressants

    Directory of Open Access Journals (Sweden)

    Huibers Marcus JH

    2011-01-01

    Full Text Available Abstract Background Maintenance treatment with antidepressants is the leading strategy to prevent relapse and recurrence in patients with recurrent major depressive disorder (MDD who have responded to acute treatment with antidepressants (AD. However, in clinical practice most patients (up to 70-80% are not willing to take this medication after remission or take too low dosages. Moreover, as patients need to take medication for several years, it may not be the most cost-effective strategy. The best established effective and available alternative is brief cognitive therapy (CT. However, it is unclear whether brief CT while tapering antidepressants (AD is an effective alternative for long term use of AD in recurrent depression. In addition, it is unclear whether the combination of AD to brief CT is beneficial. Methods/design Therefore, we will compare the effectiveness and cost-effectiveness of brief CT while tapering AD to maintenance AD and the combination of CT with maintenance AD. In addition, we examine whether the prophylactic effect of CT was due to CT tackling illness related risk factors for recurrence such as residual symptoms or to its efficacy to modify presumed vulnerability factors of recurrence (e.g. rigid explicit and/or implicit dysfunctional attitudes. This is a multicenter RCT comparing the above treatment scenarios. Remitted patients on AD with at least two previous depressive episodes in the past five years (n = 276 will be recruited. The primary outcome is time related proportion of depression relapse/recurrence during minimal 15 months using DSM-IV-R criteria as assessed by the Structural Clinical Interview for Depression. Secondary outcome: economic evaluation (using a societal perspective and number, duration and severity of relapses/recurrences. Discussion This will be the first trial to investigate whether CT is effective in preventing relapse to depression in recurrent depression while tapering antidepressant treatment

  5. Alternative Treatment Applications in Children with Respiratory Tract Infections in the West of Turkey

    Directory of Open Access Journals (Sweden)

    Naci Topaloğlu

    2013-04-01

    Full Text Available Introduction: It is known that the trend toward alternative treatments is increasing each day regardless of the differences between communities. We aimed to detect alternative treatments in our region and to determine the thoughts of families about these treatments. Materials and Methods: A total of 214 patients presenting to General Pediatrics Outpatient Clinics of Çanakkale Onsekiz Mart University Teaching and Research Hospital between October 2012 and February 2012 with fever, coughs, sore throat, wheezing and diagnosed as upper or lower respiratory tract infection and their parents are included in the study. Results: A total of 93.7% of parents were using non-drug applications with varying frequencies. Alternative practices are being used prior to drug treatment (62.7%, with drugs (28.7%, when there is no response to drugs (6.7% or never (1.9%. Most common used applications to reduce cough was to give pure honey (30.6% and the most common application to lower the fever was to use warm shower (48.1%. Most common source of information for these applications was relatives and family members. It was shown that the most requested resources to get information were doctors, nurses and other health care professionals with 84.5%. There was statistically significant correlation between educational status and frequency of usage of non-drug applications. However, requested source of information did not change according to the educational status. Conclusions: As a result we thought that doctors and nurses dealing with child health and disease should obtain information about alternative treatments and help the parents about logical managements. (Journal of Current Pediatrics 2013; 11: 23-6

  6. Photochemical treatment as an alternative to improve the quality of wastewater after advanced primary treatment.

    Directory of Open Access Journals (Sweden)

    Hernández Fernando

    2014-12-01

    Full Text Available The present research contains the photochemical treatment (PCT of residual wastewater effluent derived from an advanced primary treatment process (APT. The application employed an ultraviolet light system, hydrogen peroxide and ozone as a free hydroxyl’s radicals generator; strong oxidants for the organic contaminants mineralization which affects the water quality. The aliquots of the APT and PCT were analyzed by determination of the parameters as the color, turbidity, electric conductivity, COD, UV-Vis spectrometry, anion and cation techniques, enabling the determination of the photo-oxidative wastewater treatment efficiency. The microbiological assays denote the one hundred percent photo-oxidative effectiveness for the removal of undesirable microorganisms. After the treatment, the water is suitable for its reuse, commercialization or spill into a body receptor without any risk for the environment or the health.

  7. Decision making software for effective selection of treatment train alternative for wastewater using analytical hierarchy process.

    Science.gov (United States)

    Prasad, A D; Tembhurkar, A R

    2013-10-01

    Proper selection of treatment process and synthesis of treatment train is complex engineering activity requires crucial decision making during planning and designing of any Wastewater Treatment Plant (WWTP). Earlier studies on process selection mainly considered cost as the most important selection criteria and number of studies focused on cost optimization models using dynamic programming, geometric programming and nonlinear programming. However, it has been noticed that traditional cost analysis alone cannot be applied to evaluate Treatment Train (TT) alternatives, as number of important non-tangible factors cannot be easily expressed in monetary units. Recently researches focus on use of multi-criteria technique for selection of treatment process. AHP provides a powerful tool for multi-hierarchy and multi-variable system overcoming limitation of traditional techniques. The AHP model designed to facilitate proper decision making and reduce the margin of errors during optimization due to number of parameters in the hierarchy levels has been used in this study. About 14 important factors and 13 sub factors were identified for the selection of treatment alternatives for wastewater and sludge stream although cost is one of the most important selection criteria. The present paper provides details of developing a soft-tool called "ProSelArt" using an AHP model aiding for proper decision making. PMID:25906585

  8. Do continued antidepressants protect against dementia in patients with severe depressive disorder?

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Forman, Julie Lyng; Andersen, Per Kragh

    2011-01-01

    Studies on humans show that depressive disorder is associated with an increased risk of developing cognitive dysfunction, and animal studies suggest that antidepressants may have neuroprotective abilities. On the basis of these observations, it was hypothesized that treatment with antidepressants...... may decrease the risk of developing dementia in patients with depression. We investigated whether continued treatment with antidepressants is associated with a decreased rate of dementia in a population of patients discharged from psychiatric healthcare service with a diagnosis of depression. We used...... one prescription of older antidepressants [relative risk (RR)=0.83 (95% confidence interval (CI)=0.70-0.98)]. This finding was replicated with Alzheimer's disease as the outcome [RR=0.66 (95% CI=0.47-0.94)] but not with dementia of other kinds as the outcome [RR=0.88 (95% CI=0.73-1.06)]. In contrast...

  9. Treatment of Anxiety Disorders and Comorbid Alcohol Abuse with Buspirone in a Patient with Antidepressant-Induced Platelet Dysfunction: A Case Report

    OpenAIRE

    Mir Mazhar; Tariq Hassan; Tariq Munshi

    2013-01-01

    The risk of abnormal bleeding with serotonin reuptake inhibitors has been known, but there is insufficient evidence base to guide pharmacological treatment of anxiety in patients with underlying haematological conditions. The following case report is about a 50-year-old female with generalized anxiety disorder, social phobia, obsessive compulsive disorder, and alcohol abuse where pharmacological treatment of anxiety symptoms has been difficult as it would lead to bruising due to the patient’s...

  10. Cryosurgery as an effective alternative for treatment of oral lesions in children.

    Science.gov (United States)

    Rezende, Karla Mayra; Moraes, Paulo de Camargo; Oliveira, Luciana Butini; Thomaz, Luiz Alexandre; Junqueira, José Luiz Cintra; Bönecker, Marcelo

    2014-01-01

    Children can exhibit a wide variety of oral pathologies, such as oral lesions, bone lesions, tumors, cysts and cutaneous lesions. Different techniques have been described for the treatment of these lesions, but all of them are invasive. This paper presents a series of cases that demonstrate the clinical efficacy of cryosurgery as an alternative to invasive surgical treatments of the most common oral lesions in children. This technique has been well tolerated by patients due to the absence of anesthesia, rapid healing and minimal bleeding. Cryotherapy has many applications in oral medicine and is an extremely useful alternative in patients to whom surgery is contraindicated due to age or medical history. It is a simple procedure to perform, minimally invasive, low-cost and very effective in pediatric dentistry clinic. PMID:25250502

  11. Assessing substrates underlying the behavioral effects of antidepressants using the modified rat forced swimming test.

    Science.gov (United States)

    Cryan, John F; Valentino, Rita J; Lucki, Irwin

    2005-01-01

    Selective serotonin reuptake inhibitors (SSRIs) are the most widely prescribed antidepressant class today and exert their antidepressant-like effects by increasing synaptic concentrations of serotonin (5-HT). The rat forced swim test (FST) is the most widely used animal test predictive of antidepressant action. Procedural modifications recently introduced by our laboratory have enabled SSRI-induced behavioral responses to be measured in the modified FST. The use of this model to understand the pharmacological and physiological mechanisms underlying the role of 5-HT in the behavioral effects of antidepressant drugs is reviewed. Although all antidepressants reduced behavioral immobility, those antidepressants that increase serotonergic neurotransmission predominantly increase swimming behavior whereas those that increase catacholaminergic neurotransmission increase climbing behavior. The 5-HT(1A), 5-HT(1B/1D) and 5-HT(2C) receptors are the 5-HT receptors most important to the therapeutic effects of SSRIs, based on extensive evaluation of agonists and antagonists of individual 5-HT receptor subtypes. Studies involving chronic administration have shown that the effects of antidepressants are augmented following chronic treatment. Other studies have demonstrated strain differences in the response to serotonergic compounds. Finally, a physiological model of performance in the rat FST has been proposed involving the regulation of 5-HT transmission by corticotropin releasing factor (CRF).

  12. Adsorption plant as alternative in gas treatment at underground stores; Adsorptionsanlagen als Alternative bei der Gasaufbereitung an Untertagespeichern

    Energy Technology Data Exchange (ETDEWEB)

    Schulz, T. [Engelhard Process Chemicals GmbH, Hannover (Germany)

    1997-09-01

    The demand for natural gas depends largely on the climatic conditions during the year. During the cold period, the extra demand is met from natural gas stores. Depending on the current gas demand, a gas treatment plant at an underground store must be able to work in a wide range of operating conditions. The gas throughput and the working pressure must be mentioned in the first place here. Other requirements which are derived from the task, concern the starting behaviour and operation on stand-by. Usually, each underground store is provided with a natural gas drying plant at the outlet, as the gas absorbs water vapour in salt caverns and in former natural gas/petroleum stores. In certain cases, apart from purely removing water vapour, it may be necessary to remove high hydrocarbons. Examples of this are the use of former natural gas fields or petroleum fields, whose cover gas contains a high proportion of high hydrocarbons. Mixing with injected gas can lead to the specified gas quality no longer being complied with at the outlet and in addition to gas drying, the hydrocarbon dewpoint must be reset. After introduction of the process, there is an explanation from case studies of why adsorptive gas treatment plants can represent an alternative to the conventional process. The process also offers the required flexibility to convert to pure gas drying if the cover gas is reduced by increasing dilution, without any conversion being necessary. (orig.) [Deutsch] Die Erdgasnachfrage haengt in grossem Masse von den klimatischen Bedingungen waehrend des Jahres ab. Waehrend der kalten Jahreszeit wird der Mehrbedarf aus Erdgasspeichern gedeckt. Abhaengig von der aktuellen Gasnachfrage muss eine Gasaufbereitungsanlage an einem Untertagespeicher in einem breiten Bereich von Betriebsbedingungen zuverlaessig arbeiten koennen. Hier sind in erster Linie der Gasdurchsatz und der Betriebsdruck zu nennen. Weitere Anforderungen, die sich aus der Aufgabenstellung ableiten, betreffen das

  13. Antidepressant Use Amongst College Students: Findings of a Phenomenological Study

    Directory of Open Access Journals (Sweden)

    Reshmi L. Singh, Ph.D

    2012-01-01

    Full Text Available Background: Depression among college students is an escalating problem and could have serious consequences such as suicide. There has been an increase in use of antidepressants on college campuses in United States. However, an in depth understanding of this phenomenon from the college student’s perspective is lacking in the literature. Objective: This study examined college students’ experiences and treatment decision making during their depression treatment. Methods: A longitudinal, phenomenological research methodology was completed. The participants were nine students who were taking antidepressants for diagnosis of depression. Recruitment was done via brochures placed at University bulletin boards, and a mental health clinic. Three audio taped, unstructured interviews were conducted with each participant over four months. The central question asked was: What has the experience of treating depression been for you? Analysis of text was done using Van Manen’s lifeworld existentials of lived body, lived time, lived relation and lived space as the organizing framework. Results: Thirteen themes were identified within the four lifeworlds. The results showed that lived relation with providers was important for college students’ decision to both initiate and continue antidepressant use. Students’ role was defined in conjunction with provider’s role by them as wanting to be a ‘player’ in their treatment decisions and needing to be ‘acknowledged’ as such by their providers. Conclusions: Overall, the underlying essential theme of ‘autonomy’ was portrayed by the students’ experiential accounts of their depression treatment and treatment decision making.

  14. Peroxidase of Brazilian Cerrado grass as an alternative for agro industrial waste treatment

    OpenAIRE

    Raquel Pinheiro Reis Souza Ramalho; Paulo Sérgio Scalize; Samantha Salomão Caramori

    2016-01-01

    Decontamination of wastewater continues to be a challenge for society and the scientific community. Despite the availability of various materials for study, enzymes stand out due to their specificity for decomposition and biodegradability for disposal. New sources of enzymes may represent efficient and low-cost alternatives compared to routinely used techniques. In this survey, the peroxidase profile from Echinolaena inflexa fruits was studied for possible applications in the treatment of...

  15. “Living proof” and the pseudo-science of alternative cancer treatments

    OpenAIRE

    Vickers, Andrew J.; Cassileth, Barrie R

    2008-01-01

    Michael Gearin-Tosh was an English Professor at Oxford University who was diagnosed with multiple myeloma in 1994. He rejected conventional chemotherapeutic approaches and turned to a variety of alternative cancer treatments, particularly those involving nutritional supplements and dietary change. In 2002, Dr Gearin-Tosh published a book, “Living Proof”, recounting his experiences. The book gained significant public and media attention. One chapter was written by Carmen Wheatley, an advocate ...

  16. An alternative mebendazole formulation for cystic echinococcosis: the treatment efficacy, pharmacokinetics and safety in mice

    OpenAIRE

    Liu, Cong-Shan; Zhang, Hao-Bing; Lei, Wen; Zhang, Chao-Wei; Jiang, Bin; Zheng, Qi; Yin, Jian-Hai; Han, Xiu-Min

    2014-01-01

    Background Cystic echinococcosis is a serious zoonotic infection worldwide caused by metacestodes of Echinococcus gruanulosus. Mebendazole and albendazole are the only two drugs used in the treatment of this disease with cure rates only about 30% due to the poor oral absorption. Thus an alternative treatment for this disease is needed. Methods A mebendazole oily suspension (MBZ-OS) was prepared and orally administrated to mice infected with echinococcus cysts for 8 months at 12.5 mg/kg and 25...

  17. Alternatives to vancomycin for the treatment of methicillin-resistant Staphylococcus aureus infections.

    Science.gov (United States)

    Micek, Scott T

    2007-09-15

    Vancomycin remains the reference standard for the treatment of systemic infection caused by methicillin-resistant Staphylococcus aureus (MRSA). However, as a result of limited tissue distribution, as well as the emergence of isolates with reduced susceptibility and in vitro resistance to vancomycin, the need for alternative therapies that target MRSA has become apparent. New treatment options for invasive MRSA infections include linezolid, daptomycin, tigecycline, and quinupristin/dalfopristin. Additionally, a number of new anti-MRSA compounds are in development, including novel glycopeptides (dalbavancin, telavancin, and oritavancin), ceftobiprole, and iclaprim. The present article will review clinical issues surrounding the newly marketed and investigational agents with activity against MRSA. PMID:17712745

  18. Interstitial laser coagulation of benign prostatic hyperplasia: a minimally invasive treatment alternative

    Science.gov (United States)

    Ordonez, Robert F.; Mittemeyer, Bernhard T.; Aronoff, David R.; de Riese, Werner T. W.

    2003-06-01

    The use of minimally invasive treatments for benign prostatic hyperplasia (BPH) have been introduced into the medical community. Over the last decade several minimally invasive treatment techniques have been approved for use. In particular, interstitial laser coagulation (ILC) has shown pomise as an alternative to the current gold standard, transurethral resection of prostate (TURP). Studies show ILC to have equal efficacy as TURP while causing less side effects. Future technical advances as well as increased physician experience with ILC could lead to the replacement of TURP as the gold standard in trestment of BPH.

  19. Augmentation Strategies for Patients with Major Depressive Disorder with an Inadequate Response to Antidepressant Monotherapy

    Directory of Open Access Journals (Sweden)

    Moica Th

    2014-04-01

    Full Text Available Introduction: Major depressive disorder is a chronic and debilitating disease characterized by a wide range of emotional and physical symptoms that coexist during a depressive episode and may reoccur at some point during the progression of the disease for the majority of patients. The purpose of the study was to investigate psychiatrists’ experience regarding the response to antidepressive treatment and their options regarding augmentation strategies in depression with incomplete response to antidepressant monotherapy.

  20. Antidepressant potential of nitrogen-containing heterocyclic moieties: An updated review

    OpenAIRE

    Nadeem Siddiqui; Andalip; Sandhya Bawa; Ruhi Ali; Obaid Afzal; M Jawaid Akhtar; Bishmillah Azad; Rajiv Kumar

    2011-01-01

    Depression is currently the fourth leading cause of disease or disability worldwide. Antidepressant is approved for the treatment of major depression (including paediatric depression), obsessive-compulsive disorder (in both adult and paediatric populations), bulimia nervosa, panic disorder and premenstrual dysphoric disorder. Antidepressant is a psychiatric medication used to alleviate mood disorders, such as major depression and dysthymia and anxiety disorders such as social anxiety disorder...

  1. IL1B基因多态性与儿童期创伤交互作用对抗抑郁剂疗效的影响%Influence of interleukin-1 beta gene polymorphism and childhood maltreatment on antidepressant treatment

    Institute of Scientific and Technical Information of China (English)

    陈颖; 张志珺; 徐治; 浦梦佳; 耿磊钰

    2015-01-01

    目的 探讨白介素1-β(interleukin-1 beta,IL1 B)基因启动子区rs16944位点基因多态性与儿童期创伤的交互作用对抗抑郁剂疗效的影响.方法 对204例抑郁症患者进行8周心理精神量表评估随访.应用Snapshot检测IL1B基因位点rs16944单核苷酸多态性.应用Unphased 3.0.13软件包分析rs16944多态性与抗抑郁疗效关联性,Logistic回归分析基因-环境交互作用对抗抑郁药物疗效的影响.结果 8周治愈组与未治愈组间性别、年龄、教育程度、家族史、发病次数、HAMD-17项基线及用药情况差异均无统计学意义.药物基因关联分析表明IL1B基因rs16944位点AA基因型携带者疗效较差(x2=3.931,P=0.047).两患者组间儿童期创伤经历问卷总分差异无统计学意义.基因和环境交互分析发现rs16944位点AA基因型与儿童期创伤相互作用及较差的抗抑郁剂疗效相关(P=0.043).结论 IL1B基因rs16944位点多态性与儿童期创伤相互作用可能影响抑郁患者临床疗效.%Objective To explore the influence of interleukin-1 beta (IL1B) gene polymorphism and childhood maltreatment on antidepressant treatment.Methods Two hundred and four patients with major depressive disorder (MDD) have received treatment with single antidepressant drugs and were followed up for 8 weeks.Hamilton depression scale-17 (HAMD-17) was used to evaluate the severity of depressive symptoms and therapeutic effect.Childhood maltreatment was assessed using Childhood Trauma Questionnaire, a 28-item Short Form (CTQ-SF).Single nucleotide polymorphism (SNP) of the IL1B gene was determined using a SNaPshot method.Correlation of rs16944 gene polymorphism with response to treatment was analyzed using Unphased 3.0.13 software.The main and interactive effects of SNP and childhood maltreatment on the antidepressant treatment were analyzed using Logistic regression analysis.Results No significant difference of gender, age, year of education, family history

  2. Maintenance Treatment of Antidepressant Combined with Cognitive Behav-ior Therapy in Depression%帕罗西汀合并认知行为治疗对抑郁症维持治疗的研究

    Institute of Scientific and Technical Information of China (English)

    杨永春; 汪正华; 周海丽

    2014-01-01

    Objective To explore the combined with cognitive behavior therapy of depression.Methods A total of 66 patients with depression into two groups. Observation group(n=33).Control group(n=33). The two groups were treated with Paroxetion. On the ba-sis, The Observation group combined with Cognitive Behavior Therapy. HAMD scores were compared between the two groups be-fore treatment and 4.8 and 12 weeks after treatment. The Automatic Thoughts Questionnaire (ATQ) scores were compared between the two groups before treatment and 3.6 and 9 months after treatment. Results The Observation group reduced obviously in HAMD scores at 4. 8 and12 weeks. (P<0.05) The Observation group reduced obviously in ATQ scores at 3. 6 and 9 months. (P<0.05) Conclusion Antidepressant combined with cognitive behavior can improve the curative effect and enhance in maintenance treatment.%目的:探讨合并认知行为治疗对抑郁症维持治疗的影响。方法将66例患者分成两组:观察组(33例)对照组(33例)。2组均采用帕罗西汀治疗。在此基础上,观察组合并认知行为治疗。观察两组治疗前,治疗后4、8、12周HAMD评分和治疗前治疗后3、6、9个月自动思维问卷(ATQ)情况。结果观察组治疗后4、8、12周HAMD评分均显著低于对照组。(P<0.05)观察组治疗后3、6、9个月ATO评分明显低于对照组(P<0.05)。结论抗抑郁剂合并认知行为治疗可以显著提高临床疗效,对维持治疗亦有明显影响。

  3. Treatment-Specific Changes in Decentering Following Mindfulness-Based Cognitive Therapy versus Antidepressant Medication or Placebo for Prevention of Depressive Relapse

    Science.gov (United States)

    Bieling, Peter J.; Hawley, Lance L.; Bloch, Richard T.; Corcoran, Kathleen M.; Levitan, Robert D.; Young, L. Trevor; MacQueen, Glenda M.; Segal, Zindel V.

    2012-01-01

    Objective: To examine whether metacognitive psychological skills, acquired in mindfulness-based cognitive therapy (MBCT), are also present in patients receiving medication treatments for prevention of depressive relapse and whether these skills mediate MBCT's effectiveness. Method: This study, embedded within a randomized efficacy trial of MBCT,…

  4. Correlates of antiretroviral and antidepressant adherence among depressed HIV-infected patients.

    Science.gov (United States)

    Bottonari, Kathryn A; Tripathi, Shanti P; Fortney, John C; Curran, Geoff; Rimland, David; Rodriguez-Barradas, Maria; Gifford, Allen L; Pyne, Jeffrey M

    2012-05-01

    Although crucial for efficacy of pharmacotherapy, adherence to prescribed medication regimens for both antiretrovirals and antidepressants is often suboptimal. As many depressed HIV-infected individuals are prescribed both antiretrovirals and antidepressants, it is important to know whether correlates of nonadherence are similar or different across type of regimen. The HIV Translating Initiatives for Depression into Effective Solutions (HI-TIDES) study was a single-blinded, longitudinal, randomized controlled effectiveness trial comparing collaborative care to usual depression care at three Veterans Affairs HIV clinics. The current investigation utilized self-report baseline interview and chart-abstracted data. Participants were 225 depressed HIV-infected patients who were prescribed an antidepressant (n=146), an antiretroviral (n=192), or both (n=113). Treatment adherence over the last 4 days was dichotomized as "less than 90% adherence" or "90% or greater adherence." After identifying potential correlates of nonadherence, we used a seemingly unrelated regression (SUR) bivariate probit model, in which the probability of adherence to HIV medications and the probability of adherence to antidepressant medications are modeled jointly. Results indicated that 75.5% (n=146) of those prescribed antiretrovirals reported 90%-plus adherence to their antiretroviral prescription and 76.7% (n=112) of those prescribed antidepressants reported 90%-plus adherence to their antidepressant prescription, while 67% of those prescribed both (n=113) reported more than 90% adherence to both regimens. SUR results indicated that education, age, and HIV symptom severity were significant correlates of antiretroviral medication adherence while gender and generalized anxiety disorder diagnosis were significant correlates of adherence to antidepressant medications. In addition, antiretroviral adherence did not predict antidepressant adherence (β=1.62, p=0.17), however, antidepressant adherence

  5. "My dirty little habit": Patient constructions of antidepressant use and the 'crisis' of legitimacy.

    Science.gov (United States)

    Ridge, Damien; Kokanovic, Renata; Broom, Alex; Kirkpatrick, Susan; Anderson, Claire; Tanner, Claire

    2015-12-01

    Discontents surrounding depression are many, and include concerns about a creeping appropriation of everyday kinds of misery; divergent opinions on the diagnostic category(ies); and debates about causes and appropriate treatments. The somewhat mixed fortunes of antidepressants - including concerns about their efficacy, overuse and impacts on personhood - have contributed to a moral ambivalence around antidepressant use for people with mental health issues. Given this, we set out to critically examine how antidepressant users engage in the moral underpinnings of their use, especially how they ascribe legitimacy (or otherwise) to this usage. Using a modified constant comparative approach, we analyzed 107 narrative interviews (32 in UKa, 36 in UKb, 39 in Australia) collected in three research studies of experiences of depression in the UK (2003-4 UKa, and 2012 UKb) and in Australia (2010-11). We contend that with the precariousness of the legitimacy of the pharmaceutical treatment of depression, participants embark on their own legitimization work, often alone and while distressed. We posit that here, individuals with depression may be particularly susceptible to moral uncertainty about their illness and pharmaceutical interventions, including concerns about shameful antidepressant use and deviance (e.g. conceiving medication as pseudo-illicit). We conclude that while people's experiences of antidepressants (including successful treatments) involve challenges to illegitimacy narratives, it is difficult for participants to escape the influence of underlying moral concerns, and the legitimacy quandary powerfully shapes antidepressant use. PMID:26498732

  6. Depressão resistente a tratamento: uma revisão das estratégias farmacológicas de potencialização de antidepressivos Treatment-resistant depression: review of pharmacologic antidepressant strategies

    Directory of Open Access Journals (Sweden)

    Milena Antunes Santos

    2006-01-01

    Full Text Available OBJETIVO: Fazer uma revisão sobre oito estratégias farmacológicas de potencialização de antidepressivos na DRT. MÉTODOS: Fez-se um levantamento bibliográfico de 1990 até janeiro de 2006, nas bases eletrônicas de busca Medline, LILACS e da Biblioteca Cochrane, utilizando-se os termos de busca treatment, resistant, refractory e depression e os descritores depression, drug resistance e augmentation, incluindo apenas ensaios controlados duplo-cegos. Foi consultada a referência dos artigos para obtenção de ensaios realizados em data anterior a 1990 e artigos originais de valor histórico. RESULTADOS: Foram encontrados 17 estudos duplo-cegos com o lítio, seis com o hormônio tireoidiano, dois com a buspirona, seis com o pindolol, um com a carbamazepina, dois com a lamotrigina e quatro com a olanzapina. Foram favoráveis à potencialização 41,2% dos ensaios com lítio; 60% daqueles com hormônio tireoidiano e antidepressivos tricíclicos e nenhum com hormônio tireoidiano e inibidores seletivos da recaptação da serotonina (ISRS; 50% dos com pindolol; 100% dos ensaios com carbamazepina e 40% daqueles com olanzapina. Nenhum dos estudos com a buspirona foi favorável. No único estudo com lamotrigina não houve eficácia de tratamento na avaliação pelo critério principal, mas superioridade ao placebo em critérios secundários. CONCLUSÃO: Na DRT há evidência de eficácia apenas em relação ao lítio na potencialização de várias classes de antidepressivos e ao hormônio tireoidiano na potencialização de tricíclicos. A olanzapina foi razoavelmente estudada e sua eficácia não foi estabelecida. Os poucos estudos realizados com a buspirona e o pindolol não comprovaram sua eficácia. A carbamazepina foi muito pouco estudada, e a lamotrigina ainda não foi adequadamente avaliada.OBJECTIVE: The aim of this study is to review eight pharmacologic antidepressant augmentation strategies in TRD. METHODS: Database search on Medline

  7. [Antidepressives and traffic safety].

    Science.gov (United States)

    Herberg, K W

    1994-09-01

    The influence of paroxetine (1x20 mg/day) on safety-relevant performance was compared with the effects of doxepin (2x50 mg/day) and placebo. The medication covered a 3-week period. On day 20 of treatment, ethanol was additionally administered (0.05% BAC). The study group comprised 60 healthy male and female volunteers in the age range 37-60 years, who were assigned to the three structurally identical medication groups under randomized, double-blind conditions. The functional capacity of primary interest was investigated in seven tests to record visual orientation, forced concentration, simple reaction time, choice reaction time, reaction under stress, vigilance, and motor co-ordination. Test sessions took place before the treatment and five times during the medication phase. Paroxetine proved comparable to placebo in all cases, while in comparison with the two reference substances doxepin revealed loss of vigilance and motor coordination, as well as of concentration and the simple (acoustic) reaction time. PMID:7959523

  8. Liver Function Test Abnormalities in Depressed Patients Treated with Antidepressants: A Real-World Systematic Observational Study in Psychiatric Settings

    Science.gov (United States)

    Verstuyft, Céline; Corruble, Emmanuelle; Perlemuter, Gabriel; Colle, Romain

    2016-01-01

    Background Concerning the risk of antidepressant induced liver injury, it is not clear whether psychiatrists perform a liver function test (LFT) and whether an increase in aminotransferase levels should contraindicate antidepressant treatment. Aim To evaluate LFT availability, the prevalence of LFT abnormalities and the probable cause of an altered LFT in patients with a major depressive episode (MDE) requiring an antidepressant drug. Methods We studied LFT evaluation in a real world psychiatric setting, in a sample of 321 consecutive patients with a current major depressive episode (MDE) requiring an antidepressant drug treatment, but without current alcohol or drug dependence or unstable medical disease. Results An LFT is performed in 36.1% (116/321) of depressed patients. One fifth of antidepressant-treated patients who had an LFT evaluation had abnormal results. The most frequent causes of LFT abnormalities were: NAFLD (nonalcoholic fatty liver disease) (7/321; 2.1%), acute alcohol consumption (4/321; 1.2%), antidepressant-induced liver injury (3/321; 0.9%), hepatitis C virus infection (2/321; 0.6%) and heart failure (1/321; 0.3%). The cause of LFT abnormalities was unknown in 32% of patients (8/25) due to the absence of etiological investigations. Conclusion These results demonstrate that an LFT is infrequently performed by psychiatrists in depressed patients requiring an antidepressant drug. Baseline LFT assessment and observations during the first six months of antidepressant treatment may be useful for detection of patients with pre-existing liver disease such as NAFLD, and early identification of cases of antidepressant-induced liver injury. An increase in aminotransferase levels may be related to an underlying liver disease, but does not contraindicate antidepressant treatment. PMID:27171561

  9. Safety analysis of new type antidepressants in treatment of depression in patients with coronary heart disease%新型抗抑郁药物治疗冠心病并发抑郁症的安全性分析

    Institute of Scientific and Technical Information of China (English)

    焦全德; 魏旭明; 王朝清; 任明芬

    2015-01-01

    Objective To evaluate the safety of new-generation of antidepressants and amitriptyline in the treatment of depression in patients with coronary heart disease (CHD). Methods A total of 194 patients with first-episode depression with CHD were divided into amitriptyline group(n=40), venlafaxine group(n=40), mirtazapine group(n=48)and escitalo⁃pram group(n=66). The blood routine test, liver function, blood lipids and blood glucose (GLU) were monitored after treat⁃ment for six weeks, and which were compared before and after treatment. Results The levels of white blood cells (WBC) and neutrophil count (NE) were significantly lower in amitriptyline group after 6-week treatment (P<0.05), but the levels of acid alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (T-CHO) and GLU were significant⁃ly increased after treatment than those before treatment (P<0.05). The levels of WBC, NE and GLU were significantly de⁃creased in venlafaxine group after 6-week treatment (P<0.05). The levels of ALT, AST, low density lipoprotein (LDL) were significantly increased in mirtazapine group after six-week treatment (P<0.05). In escitalopram group, the level of three ac⁃yl glycerin (TG) was significantly increased after six-week treatment than before treatment ( P<0.05). There was a signifi⁃cant difference in AST change after treatment between venlafaxine group and mirtazapine group (P<0.05). There was a sig⁃nificant decrease in WBC in amitriptyline group than that of mirtazapine group after six-week treatment ( P<0.05). There was a significant decrease in NE in amitriptyline group than that of mirtazapine group and escitalopram group ( P<0.05). The increase level of AST was significant higher in amitriptyline group than that of venlafaxine group (P < 0.05). Conclusion Three different kinds of new-generation of antidepressants have fewer influence in routine blood test, liver function, blood lipids and blood glucose than those of amitriptyline

  10. Atomized sludges via spray-drying at low temperatures: an alternative to conventional wastewater treatment plants.

    Science.gov (United States)

    Cusidó, Joan A; Cremades, Lázaro V

    2012-08-30

    Removal of sludges from Wastewater Treatment Plants (WWTP) represents a serious worldwide environmental problem for which alternatives other than their simple incineration are investigated. In this work the treatment of raw sludge from urban WWTP by means of a minimization process through spray-drying is analyzed as well as some proposals for revaluating the resulting dry product. Analysis is supported by some experimental results obtained with a laboratory spray dryer. The experimental procedure at laboratory scale is extrapolated to an industrial plant scale. An economic analysis of the proposal in relation to other possible sludge treatments is presented, taking into account in this case the comparison between the costs of the processes of sludge thickening, stabilization and dehydratation and the costs of spray-drying (especially power consumption), minimization of the final waste and reuse options. Finally, an environmental balance of the process is presented. In contrast with the classical treatment line, this alternative allows transforming sludges, i.e., a waste, into a valuable product with several applications. PMID:22525834

  11. The Sedating Antidepressant Trazodone Impairs Sleep-Dependent Cortical Plasticity

    OpenAIRE

    Aton, Sara J.; Seibt, Julie; Dumoulin, Michelle C.; Coleman, Tammi; Shiraishi, Mia; Frank, Marcos G.

    2009-01-01

    Background Recent findings indicate that certain classes of hypnotics that target GABAA receptors impair sleep-dependent brain plasticity. However, the effects of hypnotics acting at monoamine receptors (e.g., the antidepressant trazodone) on this process are unknown. We therefore assessed the effects of commonly-prescribed medications for the treatment of insomnia (trazodone and the non-benzodiazepine GABAA receptor agonists zaleplon and eszopiclone) in a canonical model of sleep-dependent, ...

  12. Mechanism of Residual Stress Reduction in Low Alloy Steel by a Low Frequency Alternating Magnetic Treatment

    Institute of Scientific and Technical Information of China (English)

    Yanli Song; Lin Hua

    2012-01-01

    Residual stress reduction in low alloy steel by a low frequency alternating magnetic treatment and its mechanism were investigated. Experimental results revealed that average stress reductions of 20%-24% were obtained in the welded samples. Moreover, compared with the zones with lower initial stress levels, more remarkable stress reductions were obtained in the stress concentration zones. The microstructures and magnetic domains were observed by scanning electron microscopy (SEM) and atomic force microscopy (AFM). Based on the analysis of the microstructure and magnetic domain changes, the mechanism of stress reduction by the magnetic treatment has been concluded: (1) the magneto-plastic deformations mainly due to the more uniform redistribution of dislocations are the fundamental cause of stress relaxation; and (2) surface topography is also proved to affect the magnetic treatment results to some degree by influencing magnetic domains.

  13. Meditation over medication for irritable bowel syndrome? On exercise and alternative treatments for irritable bowel syndrome.

    Science.gov (United States)

    Asare, Fredrick; Störsrud, Stine; Simrén, Magnus

    2012-08-01

    Complimentary alternative treatment regimens are widely used in irritable bowel syndrome (IBS), but the evidence supporting their use varies. For psychological treatment options, such as cognitive behavioral therapy, mindfulness, gut-directed hypnotherapy, and psychodynamic therapy, the evidence supporting their use in IBS patients is strong, but the availability limits their use in clinical practice. Dietary interventions are commonly included in the management of IBS patients, but these are primarily based on studies assessing physiological function in relation to dietary components, and to a lesser degree upon research examining the role of dietary components in the therapeutic management of IBS. Several probiotic products improve a range of symptoms in IBS patients. Physical activity is of benefit for health in general and recent data implicates its usefulness also for IBS patients. Acupuncture does not seem to have an effect beyond placebo in IBS. A beneficial effect of some herbal treatments has been reported. PMID:22661301

  14. Signaling pathways regulating Homer1a expression: implications for antidepressant therapy.

    Science.gov (United States)

    Serchov, Tsvetan; Heumann, Rolf; van Calker, Dietrich; Biber, Knut

    2016-03-01

    Homer1a is upregulated by several different antidepressant measures, including non-pharmacological treatments, like sleep deprivation (SD) and electroconvulsive therapy (ECT) and antidepressant drugs, such as imipramine, fluoxetine and ketamine. Homer1a induction might thus be a crucial joint mechanism for antidepressant therapy in general. However, the upstream signaling pathways that regulate or induce Homer1a expression are still not well understood. The main focus of the present review is to offer an overview of the current knowledge about the potential role of Homer1a in depression and the signaling pathways responsible for Homer1a regulation. It is suggested here that a detailed characterization of the signaling mechanisms leading to Homer1a expression might provide novel therapeutic targets for antidepressant drug development. PMID:26641965

  15. Studies on antidepressant action of a new oxazolidinone derivative AS-8.

    Science.gov (United States)

    Kostowski, W; Płaźnik, A; Bidziński, A; Rosnowska, E; Jessa, M; Nazar, M

    1994-01-01

    On the basis of previous laboratory studies AS-8 was suggested to possess antidepressant-like activity. Forced swim test, learned helplessness and conflict Vogel's test were performed after three prior administrations of AS-8 (24, 5 and 1 h before the test). The data have shown that AS-8 produces moderate antidepressant effect but did not induce anxiolytic-like action. Biochemical data revealed increased brain 5-HT and 5-HIAA levels following AS-8 administration. The combined treatment of rats with AS-8 (100 mg/kg) and amitriptyline (5 mg/kg) or desipramine (1.25 mg/kg) significantly stimulated active behavior in the forced swim test above the level obtained with each of the drug given separately. The present data suggest the potential antidepressant efficacy of AS-8 in conjunction with small doses of tricyclic antidepressants.

  16. Alternative Strategies for the Treatment of Classical Congenital Adrenal Hyperplasia: Pitfalls and Promises

    Directory of Open Access Journals (Sweden)

    Ali S. Calikoglu

    2010-01-01

    Full Text Available Despite decades of different treatment algorithms, the management of congenital adrenal hyperplasia (CAH remains clinically challenging. This is due to the inherent difficulty of suppressing adrenal androgen production using near physiological dosing of glucocorticoids (GC. As a result, alternating cycles of androgen versus GC excess can occur and may lead to short stature, obesity, virilization, and alterations in puberty. Novel therapeutic alternatives, including new and more physiological means of GC delivery, inhibitors at the level of CRH or ACTH secretion and/or action, as well as “rescue strategies”, such as GnRH analogs, anti-androgens, aromatase inhibitors, and estrogen receptor blockers, are available; many of these agents, however, still require active investigation in CAH. Bilateral adrenalectomy is effective but it is also still an experimental approach. Gene therapy and stem cells, to provide functional adrenal cortical tissue, are at preclinical stage but provide exciting avenues for a potential cure for CAH.

  17. Alternative Strategies for the Treatment of Classical Congenital Adrenal Hyperplasia: Pitfalls and Promises

    Directory of Open Access Journals (Sweden)

    Calikoglu AliS

    2010-06-01

    Full Text Available Despite decades of different treatment algorithms, the management of congenital adrenal hyperplasia (CAH remains clinically challenging. This is due to the inherent difficulty of suppressing adrenal androgen production using near physiological dosing of glucocorticoids (GC. As a result, alternating cycles of androgen versus GC excess can occur and may lead to short stature, obesity, virilization, and alterations in puberty. Novel therapeutic alternatives, including new and more physiological means of GC delivery, inhibitors at the level of CRH or ACTH secretion and/or action, as well as "rescue strategies", such as GnRH analogs, anti-androgens, aromatase inhibitors, and estrogen receptor blockers, are available; many of these agents, however, still require active investigation in CAH. Bilateral adrenalectomy is effective but it is also still an experimental approach. Gene therapy and stem cells, to provide functional adrenal cortical tissue, are at preclinical stage but provide exciting avenues for a potential cure for CAH.

  18. Complementary and Alternative Medicine Treatment Options for Otitis Media: A Systematic Review.

    Science.gov (United States)

    Marom, Tal; Marchisio, Paola; Tamir, Sharon Ovnat; Torretta, Sara; Gavriel, Haim; Esposito, Susanna

    2016-02-01

    Otitis media (OM) has numerous presentations in children. Together with conventional medical therapies aimed to prevent and/or treat OM, a rising number of complementary and alternative medicine (CAM) treatment options can be offered. Since OM is common in children, parents may ask healthcare professionals about possible CAM therapies. Many physicians feel that their knowledge is limited regarding these therapies, and that they desire some information. Therefore, we conducted a literature review of CAM therapies for OM, taking into account that many of these treatments, their validity and efficacy and have not been scientifically demonstrated.We performed a search in MEDLINE (accessed via PubMed) using the following terms: "CAM" in conjunction with "OM" and "children. Retrieved publications regarding treatment of OM in children which included these terms included randomized controlled trials, prospective/retrospective studies, and case studies.The following CAM options for OM treatment in children were considered: acupuncture, homeopathy, herbal medicine/phytotherapy, osteopathy, chiropractic, xylitol, ear candling, vitamin D supplement, and systemic and topical probiotics. We reviewed each treatment and described the level of scientific evidence of the relevant publications.The therapeutic approaches commonly associated with CAM are usually conservative, and do not include drugs or surgery. Currently, CAM is not considered by physicians a potential treatment of OM, as there is limited supporting evidence. Further studies are warranted in order to evaluate the potential value of CAM therapies for OM. PMID:26871802

  19. Retrospective multicenter evaluation of the "fly-catching syndrome" in 24 dogs: EEG, BAER, MRI, CSF findings and response to antiepileptic and antidepressant treatment.

    Science.gov (United States)

    Wrzosek, Marcin; Płonek, Marta; Nicpoń, Józef; Cizinauskas, Sigitas; Pakozdy, Akos

    2015-12-01

    The fly-catching syndrome (FCS) is a rare canine condition of sudden, occasional, or constant episodes of biting the air. It may be accompanied by jumping, licking, and swallowing. The etiology of FCS is unknown and controversial. Various explanations for its occurrence have included epileptoid disorders such as visual cortex epileptiform disturbances and simple and complex partial seizures as well as compulsive disorders, hallucinatory behavior, and stereotypy. A retrospective multicenter analysis of 24 dogs with clinical symptoms of FCS is presented. Clinical signs at the time of presentation, the mean age at onset of the disease, the response to treatment, and the clinical outcome were recorded and analyzed in all patients. All dogs underwent clinical, neurological, and otoscopic examinations. Complete blood cell counts (CBCs) and serum chemistry panels were obtained from each dog. Diagnostic testing included MRI and EEG examinations in 21 cases, BAER in 19 cases, and CSF analysis in 20 cases. The EEG revealed spike activity in 8 (38%) of the 21 cases, 7 of which had activity in the occipital lobes. The brainstem auditory evoked response (BAER) revealed three cases of bilateral deafness. The MRI revealed six cases of Chiari malformation (CM), one case of syringohydromyelia (SM), and one case of a falx cerebri meningioma. The dogs were divided into groups according to their treatment protocol. Group A included dogs treated with phenobarbital (PB), and group B consisted of dogs treated with fluoxetine (FLX). Thirty-six percent of the dogs in group A responded to PB, while 100% of the dogs in group B responded to FLX. The results suggest that FCS is more responsive to FLX than PB. However, the etiology of this behavior remains unclear in most cases.

  20. Hippocampal protein expression is differentially affected by chronic paroxetine treatment in adolescent and adult rats: A possible mechanism of paradoxical antidepressant responses in young persons

    Directory of Open Access Journals (Sweden)

    Emily Aspasia Karanges

    2013-07-01

    Full Text Available Selective serotonin reuptake inhibitors (SSRIs are commonly recognised as the pharmacological treatment of choice for patients with depressive disorders, yet their use in adolescent populations has come under scrutiny following reports of minimal efficacy and an increased risk of suicidal ideation and behavior in this age group. The biological mechanisms underlying these effects are largely unknown. Accordingly, the current study examined changes in hippocampal protein expression following chronic administration of paroxetine in drinking water (target dose = 10 mg/kg for 22 days to adult and adolescent rats. Results indicated age-specific changes in protein expression, with paroxetine significantly altering expression of 8 proteins in adolescents only and 10 proteins solely in adults. A further 12 proteins were significantly altered in both adolescents and adults. In adults, protein changes were generally suggestive of a neurotrophic and neuroprotective effect of paroxetine, with significant downregulation of apoptotic proteins Galectin 7 and Cathepsin B, and upregulation of the neurotrophic factor Neurogenin 1 and the antioxidant proteins Aldose reductase and Carbonyl reductase 3. Phosphodiesterase 10A, a signalling protein associated with major depressive disorder, was also downregulated (−6.5 fold in adult rats. Adolescent rats failed to show the neurotrophic and neuroprotective effects observed in adults, instead displaying upregulation of the proapoptotic protein BH3-interacting domain death agonist (4.3 fold. Adolescent protein expression profiles also suggested impaired phosphoinositide signalling (Protein kinase C: −3.1 fold and altered neurotransmitter transport and release (Syntaxin 7: 5.7 fold; Dynamin 1: −6.9 fold. The results of the present study provide clues as to possible mechanisms underlying the atypical response of human adolescents to paroxetine treatment.

  1. Alternative agents to vancomycin for the treatment of methicillin-resistant Staphylococcus aureus infections.

    Science.gov (United States)

    Culos, Kathryn A; Cannon, Joan P; Grim, Shellee A

    2013-01-01

    Resistant gram-positive infections, specifically methicillin-resistant Staphylococcus aureus (MRSA), carry an increased risk for morbidity and mortality. Historically, MRSA has been a cause of nosocomial infections, although recent reports have noted an increased prevalence in community-acquired MRSA infections. Vancomycin is the preferred agent to treat MRSA. However, cases of S. aureus with reduced susceptibility to vancomycin have been reported, prompting the need for alternative treatment options. In this review, we discuss the currently available agents with MRSA activity and those in development. Linezolid and quinupristin/dalfopristin have been demonstrated as effective although potential toxicities must be taken into consideration before their use. Daptomycin, tigecycline, telavancin, and ceftaroline are well tolerated but lack the clinical data to support a superior place in treatment over vancomycin. Several new agents in various stages of development have also demonstrated MRSA activity. Currently, vancomycin remains the gold-standard treatment option for MRSA infections. In situations that limit its use, consideration of patient-specific parameters, cost, and relevant clinical data demonstrating drug safety and efficacy should be employed for the selection of the appropriate alternative agent. PMID:21642833

  2. Irradiation as an alternative treatment to methyl bromide for insect control

    International Nuclear Information System (INIS)

    Methyl Bromide (MB) is widely used as a fumigant for the control of pests of stored grain, legumes, oil seeds, dry fruits and nuts, pest of timber, soil insects, soil nematodes, soil pathogens of plants, and as a quarantine treatment against pest of fresh horticultural products, and pests and diseases in propagation material. The global phase-out of MBB in advanced countries by 2005 and in developing countries by 2015 under the Montreal Protocol, because of its ozone depleting property, has prompted increasing interest in the use of irradiation as an alternative to MB for insect control in food and agricultural commodities in recent years. Irradiation at fairly low doses, of the order of 1 kGy or less is an effective alternative to chemical treatment of foods. The advantages of radiation processing include short treatment time in comparison to several days of exposure required in chemical fumigation, no undesirable chemical residues in the food, no resistance developed by the insects and no significant changes in the organoleptic, physicochemical and functional properties or the nutritive value of the treated products. Turkey is the leading country in the world, in production and exports of dried fig, apricot,raisin and hazelnut. One of the main problem in the export trade is infestation by stored product insects. In Turkey, the new legal regulations on food irradiation were published in Official Newspaper on November 6, 1999. (3 tables and 10 refs. included)

  3. Binding of the Multimodal Antidepressant Drug Vortioxetine to the Human Serotonin Transporter

    DEFF Research Database (Denmark)

    Andersen, Jacob; Ladefoged, Lucy Kate; Wang, Danyang;

    2015-01-01

    Selective inhibitors of the human serotonin transporter (hSERT) have been first-line treatment against depression for several decades. Recently, vortioxetine was approved as a new therapeutic option for the treatment of depression. Vortioxetine represents a new class of antidepressant drugs with ......-based drug discovery of novel multimodal drugs with fine-tuned selectivity across different transporter and receptor proteins in the human brain.......Selective inhibitors of the human serotonin transporter (hSERT) have been first-line treatment against depression for several decades. Recently, vortioxetine was approved as a new therapeutic option for the treatment of depression. Vortioxetine represents a new class of antidepressant drugs...

  4. Development of an Alternative Treatment Scheme for Sr/TRU Removal: Permanganate Treatment of AN-107 Waste

    International Nuclear Information System (INIS)

    A number of Hanford tanks received waste containing organic complexants, which increase the volubility of Sr-90 and transuranic (TRU) elements. Wastes from these tanks require additional pretreatment to remove Sr-90 and TRU for immobilization as low activity waste (Waste Envelope C). The baseline pretreatment process for Sr/TRU removal was isotopic exchange and precipitation with added strontium and iron. However, studies at both Battelle and Savannah River Technology Center (SRTC) have shown that the Sr/Fe precipitates were very difficult to filter. This was a result of the formation of poor filtering iron solids. An alternate treatment technology was needed for Sr/TRU removal. Battelle had demonstrated that permanganate treatment was effective for decontaminating waste samples from Hanford Tank SY-101 and proposed that permanganate be examined as an alternative Sr/TRU removal scheme for complexant-containing tank wastes such as AW107. Battelle conducted preliminary small-scale experiments to determine the effectiveness of permanganate treatment with AN-107 waste samples that had been archived at Battelle from earlier studies. Three series of experiments were performed to evaluate conditions that provided adequate Sr/TRU decontamination using permanganate treatment. The final series included experiments with actual AN-107 diluted feed that had been obtained specifically for BNFL process testing. Conditions that provided adequate Sr/TRU decontamination were identified. A free hydroxide concentration of 0.5M provided adequate decontamination with added Sr of 0.05M and permanganate of 0.03M for archived AN-107. The best results were obtained when reagents were added in the sequence Sr followed by permanganate with the waste at ambient temperature. The reaction conditions for Sr/TRU removal will be further evaluated with a 1-L batch of archived AN-107, which will provide a large enough volume of waste to conduct crossflow filtration studies (Hallen et al. 2000a)

  5. Development of an Alternative Treatment Scheme for Sr/TRU Removal: Permanganate Treatment of AN-107 Waste

    Energy Technology Data Exchange (ETDEWEB)

    RT Hallen; SA Bryan; FV Hoopes

    2000-08-04

    A number of Hanford tanks received waste containing organic complexants, which increase the volubility of Sr-90 and transuranic (TRU) elements. Wastes from these tanks require additional pretreatment to remove Sr-90 and TRU for immobilization as low activity waste (Waste Envelope C). The baseline pretreatment process for Sr/TRU removal was isotopic exchange and precipitation with added strontium and iron. However, studies at both Battelle and Savannah River Technology Center (SRTC) have shown that the Sr/Fe precipitates were very difficult to filter. This was a result of the formation of poor filtering iron solids. An alternate treatment technology was needed for Sr/TRU removal. Battelle had demonstrated that permanganate treatment was effective for decontaminating waste samples from Hanford Tank SY-101 and proposed that permanganate be examined as an alternative Sr/TRU removal scheme for complexant-containing tank wastes such as AW107. Battelle conducted preliminary small-scale experiments to determine the effectiveness of permanganate treatment with AN-107 waste samples that had been archived at Battelle from earlier studies. Three series of experiments were performed to evaluate conditions that provided adequate Sr/TRU decontamination using permanganate treatment. The final series included experiments with actual AN-107 diluted feed that had been obtained specifically for BNFL process testing. Conditions that provided adequate Sr/TRU decontamination were identified. A free hydroxide concentration of 0.5M provided adequate decontamination with added Sr of 0.05M and permanganate of 0.03M for archived AN-107. The best results were obtained when reagents were added in the sequence Sr followed by permanganate with the waste at ambient temperature. The reaction conditions for Sr/TRU removal will be further evaluated with a 1-L batch of archived AN-107, which will provide a large enough volume of waste to conduct crossflow filtration studies (Hallen et al. 2000a).

  6. Dysfunctional beliefs and attitudes on sleep and sleep disturbances pre- and post-antidepressant treatments in patients with major depression%抑郁症患者抗抑郁治疗前后不良睡眠信念和态度与睡眠问题的比较

    Institute of Scientific and Technical Information of China (English)

    李卫晖; 黄啸; 张丽

    2011-01-01

    目的:探讨抑郁症患者短期药物治疗前后不良睡眠信念和态度与睡眠问题的关系.方法:66名抑郁症住院患者纳入调查,分别在4周治疗前后进行不良睡眠信念和态度(dysfunctional beliefs and attitudes on sleep,DBAS),睡眠质量指数问卷(PSQI),汉密顿抑郁量表(HDRS),汉密顿焦虑量表(HAMA)的评估.结果:4周治疗后,抑郁和焦虑症状得到明显缓解,但仍存在睡眠问题,并且睡眠质量更多地与不良睡眠信念和态度相关.结论:对抑郁症患者有必要进行针对性强的认知行为治疗.%Objective To explore the relationship between dysfunctional beliefs and attitudes on sleep and sleep disturbances before and after a short-term pharmacotherapy in patients with major depression.Methods Sixty-six ( 29 male, 37 female, 34.0 ± 9.5 years old) patients with major depression were recruited before the treatment.Dysfunctional Beliefs and Attitudes about Sleep (DBAS)questionnaire, Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Rating Scale (HDRS),and Hamilton Anxiety Scale (HAMA) were assessed before and after a 4-week antidepressant treatment.Results After the 4-week antidepressant treatment, depressive and anxiety symptoms were alleviated significantly, whereas sleep disturbance still persisted.And sleep quality was closely related with problematic sleep beliefs after the treatment.Conclusion Some evidences are provided for cognitive behavioral therapy during antidepressant therapy, and the therapy should be matched with problematic beliefs and attitudes.

  7. Sensitivity during the forced swim test is a key factor in evaluating the antidepressant effects of abscisic acid in mice.

    Science.gov (United States)

    Qi, Cong-Cong; Shu, Yu-Mian; Chen, Fang-Han; Ding, Yu-Qiang; Zhou, Jiang-Ning

    2016-03-01

    Abscisic acid (ABA), a crucial phytohormone, is distributed in the brains of mammals and has been shown to have antidepressant effects in the chronic unpredictable mild stress test. The forced swim test (FST) is another animal model that can be used to assess antidepressant-like behavior in rodents. Here, we report that the antidepressant effects of ABA are associated with sensitivities to the FST in mice. Based on mean immobility in the 5-min forced swim pre-test, ICR mice were divided into short immobility mice (SIM) and long immobility mice (LIM) substrains. FST was carried out 8 days after drug administration. Learned helplessness, as shown by increased immobility, was only observed in SIM substrain and could be prevented by an 8-day ABA treatment. Our results show that ABA has antidepressant effects in SIM substrain and suggest that mice with learned helplessness might be more suitable for screening potential antidepressant drugs.

  8. Designing an aerobic exercise training in water as an alternative treatment for depression: A new method

    Directory of Open Access Journals (Sweden)

    Morteza Mohammadiyoun

    2007-01-01

    Full Text Available Introduction: A highly disruptive emotional disorder is major depression, characterized by abnormal regulation of feelings of sadness and happiness. Traditional treatment for depression was pharmacological treatment. One alternative that has been shown to be effective in alleviating depression is physical activity. Previous observation and interventional studies have suggested that regular aerobic exercise reduced symptoms of depression. Moreover physical activity and exercise in water may have some beneficial effects on mood. However the purpose of this investigation was to design an aerobic exercise pattern in water and evaluate the effects of this pattern on depression.Methods and Materials: Two hundred and forty-nine male undergraduates allocated for this study. The Beck Depression Inventory was used to measure the presence and degree of depression. Fifty –two males (body mass, 67.8  9.3 kg; height, 1.73  0.04 m; age, 22.26  2.4 who obtained a depressive score more than 18 participated in an aerobic exercise program. The aerobic exercise program included unstructured water- polo sessions, 60 minute duration, three times per week for seven weeks. The participants trained at 60-70 % of maximum heart rate. The Beck Depression Inventory was administered before aerobic exercise training, at the first, twelfth, and twenty- first sessions. Results: Analysis of variance with repeated measures (ANOVA showed that levels of depression score were significantly higher pre-treatment than in middle-treatment (P<0.05. A significant change was observed between the pre-treatment and post-treatment (P<0.05, the level of depression score was lower in post-treatment. Comparison of Beck score in the depressed samples at the first day (25.19, twelfth (15.08, and the twenty-first (11.64 of session, after performance of the practice, was significant (P<0.05. The results in control group at pre and post training exercise unchanged significantly. Conclusion

  9. Parents' Views and Experiences about Complementary and Alternative Medicine Treatments for Their Children with Autistic Spectrum Disorder

    Science.gov (United States)

    Senel, Hatice Gunayer

    2010-01-01

    Use of complementary and alternative medicine (CAM) treatments have been increasing for children with autistic spectrum disorder (ASD). In this study, 38 Turkish parents of children with ASD were surveyed related with their use of CAM treatments, experiences, and views for each treatment. They mentioned "Vitamins and minerals", "Special Diet",…

  10. First Episode Mania Probably Associated with Discontinuation of Paroxetine Treatment

    OpenAIRE

    Birmay Cam

    2015-01-01

    Antidepressant-induced mania have been reported with all major antidepressant classes in a subgroup of about 20-40% of bipolar patients. Mania/hypomania due to antidepressant withdrawal is rarely reported in the literature as case report. Mania/hypomania due to antidepressant withdrawal is reported to be associated with tricyclic antidepressants as well as selective serotonin reuptake inhibitors. This article offered mania occurring after discontinuation of treatment with paroxetine male pati...

  11. [Combined tricyclic antidepressants and ritalin in elderly depressives].

    Science.gov (United States)

    Naor, S; Talmon, Y; Guy, N

    1992-10-01

    Psychostimulants, including ritalin (methylphenidate), were used as antidepressives in the '50s but were then replaced by tricyclics and MAO inhibitors. Treatment of depression with psychostimulants is still controversial. Several anecdotal reports in the past decade approved the use of tricyclic antidepressants (TCA) together with methylphenidate in apathetic and withdrawal states in medically ill and in elderly patients. Ritalin elevates mood by releasing catecholamines and blocking their re-uptake, and also increases serum TCA levels. 5 men and 5 women between the ages of 65 and 79 were diagnosed as suffering from major depressive disorders, either single or recurrent, based on the Revised Diagnostic and Statistical Manual for Mental Disorders (DSM-III-R). They had been treated with TCA for up to several months with no response. Following addition of methylphenidate, 5-15 mg/d for 2 weeks, 4 men and 3 women improved rapidly, 2 of them within 24 hours. PMID:1459498

  12. Updated review of complementary and alternative medicine treatments for systemic lupus erythematosus.

    Science.gov (United States)

    Greco, Carol M; Nakajima, Claire; Manzi, Susan

    2013-11-01

    It is estimated that over 50 % of patients with systemic lupus erythematosus (SLE) have utilized complementary and alternative medicine (CAM) treatments to reduce symptoms and manage their health. However, there are relatively few randomized controlled trials of CAM for SLE. This review describes recent studies of vitamins and supplements, acupuncture, and mind-body interventions in SLE patients. The recent trials of CAM treatments for SLE indicate that supplements such as vitamin D, omega 3 fatty acids, N-acetyl cysteine and turmeric show some promise for reducing SLE disease activity. In addition, mind-body methods such as cognitive-behavioral therapy and other counseling interventions may improve mood and quality of life in SLE.

  13. Errors of Omission and Commission during Alternative Reinforcement of Compliance: The Effects of Varying Levels of Treatment Integrity

    Science.gov (United States)

    Leon, Yanerys; Wilder, David A.; Majdalany, Lina; Myers, Kristin; Saini, Valdeep

    2014-01-01

    We conducted two experiments to evaluate the effects of errors of omission and commission during alternative reinforcement of compliance in young children. In Experiment 1, we evaluated errors of omission by examining two levels of integrity during alternative reinforcement (20 and 60%) for child compliance following no treatment (baseline) versus…

  14. Antidepressant-like activity of anthocyanidins from Hibiscus rosa-sinensis flowers in tail suspension test and forced swim test

    Directory of Open Access Journals (Sweden)

    Pallavi B Shewale

    2012-01-01

    Conclusion: It can be concluded that MHR and AHR possess potential antidepressant activity (through dopaminergic, noradrenergic and serotonergic mechanisms and has therapeutic potential in the treatment of CNS disorders and provides evidence at least at preclinical levels.

  15. The Effect of Sympathetic Antagonists on the Antidepressant Action of Alprazolam

    Directory of Open Access Journals (Sweden)

    Gorash ZM

    2008-01-01

    Full Text Available Alprazolam is an anti-anxiety drug shown to be effective in the treatment of depression. In this study, the effect of sympathetic receptor antagonists on alprazolam–induced antidepressant action was studied using a mouse model of forced swimming behavioral despair. The interaction of three sympathetic receptor antagonists with benzodiazepines, which may impact the clinical use of alprazolam, was also studied. Behavioral despair was examined in six groups of albino mice. Drugs were administered intraperitoneally. The control group received only a single dose of 1% Tween 80. The second group received a single dose of alprazolam, and the third group received an antagonist followed by alprazolam. The fourth group was treated with imipramine, and the fifth group received an antagonist followed by imipramine. The sixth group was treated with a single dose of an antagonist alone (atenolol, a β1-selective adrenoceptor antagonist; propranolol, a non selective β-adrenoceptor antagonist; and prazocin, an α1-adrenoceptor antagonist. Results confirmed the antidepressant action of alprazolam and imipramine. Prazocin treatment alone produced depression, but it significantly potentiated the antidepressant actions of imipramine and alprazolam. Atenolol alone produced an antidepressant effect and potentiated the antidepressant action of alprazolam. Propranolol treatment alone produced depression, and antagonized the effects of alprazolam and imipramine, even producing depression in combined treatments. In conclusion, our results reveal that alprazolam may produce antidepressant effects through the release of noradrenaline, which stimulates β2 receptors to produce an antidepressant action. Imipramine may act by activating β2 receptors by blocking or down-regulating β1 receptors.

  16. Fear erasure in mice requires synergy between antidepressant drugs and extinction training.

    Science.gov (United States)

    Karpova, Nina N; Pickenhagen, Anouchka; Lindholm, Jesse; Tiraboschi, Ettore; Kulesskaya, Natalia; Agústsdóttir, Arna; Antila, Hanna; Popova, Dina; Akamine, Yumiko; Bahi, Amine; Sullivan, Regina; Hen, René; Drew, Liam J; Castrén, Eero

    2011-12-23

    Antidepressant drugs and psychotherapy combined are more effective in treating mood disorders than either treatment alone, but the neurobiological basis of this interaction is unknown. To investigate how antidepressants influence the response of mood-related systems to behavioral experience, we used a fear-conditioning and extinction paradigm in mice. Combining extinction training with chronic fluoxetine, but neither treatment alone, induced an enduring loss of conditioned fear memory in adult animals. Fluoxetine treatment increased synaptic plasticity, converted the fear memory circuitry to a more immature state, and acted through local brain-derived neurotrophic factor. Fluoxetine-induced plasticity may allow fear erasure by extinction-guided remodeling of the memory circuitry. Thus, the pharmacological effects of antidepressants need to be combined with psychological rehabilitation to reorganize networks rendered more plastic by the drug treatment.

  17. 21 CFR 862.3910 - Tricyclic antidepressant drugs test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Tricyclic antidepressant drugs test system. 862... Test Systems § 862.3910 Tricyclic antidepressant drugs test system. (a) Identification. A tricyclic antidepressant drugs test system is a device intended to measure any of the tricyclic antidepressant drugs...

  18. Peroxidase of Brazilian Cerrado grass as an alternative for agro industrial waste treatment

    Directory of Open Access Journals (Sweden)

    Raquel Pinheiro Reis Souza Ramalho

    2016-03-01

    Full Text Available Decontamination of wastewater continues to be a challenge for society and the scientific community. Despite the availability of various materials for study, enzymes stand out due to their specificity for decomposition and biodegradability for disposal. New sources of enzymes may represent efficient and low-cost alternatives compared to routinely used techniques. In this survey, the peroxidase profile from Echinolaena inflexa fruits was studied for possible applications in the treatment of wastewater. The protein content was found to be 5.33 mg g-1. The optimum reaction conditions were: 50°C, pH 7.5 at 0.1 mol L-1 of phosphate buffer for 15 min. The enzyme was inactivated after 5 min at 94°C and was inhibited when incubated with ascorbic acid at 10 mmol L-1. In tests using phenols and agro industrial waste, the peroxidase was able to oxidase 87.5% of catechol, 67.8% of pyrogallol, 39.1% of resorcinol and still presented 29.1% of the degradation capacity of raw wastewater phenolic compounds. The results showed that the Echinolaena inflexa peroxidase, a new source of enzymes, is a potential alternative to wastewater treatment.

  19. 维持抗抑郁药治疗抑郁症复发或复发的预防有效性和成本效益比较%Comparison of effectiveness and cost effectiveness of maintenance of antidepressants in the treatment or prevention of depression recurrence

    Institute of Scientific and Technical Information of China (English)

    赵勇刚

    2016-01-01

    目的:观察正念认知疗法与维持减少或中断抗抑郁治疗对于抑郁症复发或复发的预防有效性和成本效益。方法:收治先前发生抑郁症事件≥3次及维持性抗抑郁治疗剂量患者400例,随机平分为 MBCT-TS 组或维持抗抑郁组,观察两组抑郁症复发时间或复发次数,24个月内对患者随访5次。结果:两组复发时间或复发次数差异无统计学意义(P>0.05),严重不良反应数亦然。结论:对于预防抑郁症复发,MBCT-TS并不优于维持抗抑郁治疗,两种治疗对于抑郁症复发或反复、残留症状和生活质量均产生积极的影响。%Objective:To observe the effectiveness and cost effectiveness of mindfulness based cognitive therapy,and maintain the reduction or interruption of antidepressant treatment for depression relapse or recurrence prevention.Methods:400 patients with depression occurred≥3 times and received maintenance dose of antidepression therapy were selected.They were randomly divided into the MBCT-TS group and the maintenance of antidepressant treatment group.The time of relapse and recurrence of depression were observed.Patients were followed up for 5 times during 24 months.Results:There was no significant difference between groups in the time of recurrence or the frequency of recurrence(P>0.05),and the number of serious adverse reactions was also the same.Conclusion:For preventing the recurrence of depression,MBCT-TS is not superior to maintenance of antidepressant treatment,and these two types of treatment have a positive impact on the recurrence or relapse of depression,residual symptoms and quality of life.

  20. Is the use of antidepressants associated with patient-reported outcomes following total hip replacement surgery?

    Science.gov (United States)

    Greene, Meridith E; Rolfson, Ola; Gordon, Max; Annerbrink, Kristina; Malchau, Henrik; Garellick, Göran

    2016-10-01

    Background and purpose - Patients with anxiety and/or depression tend to report less pain reduction and less satisfaction with surgical treatment. We hypothesized that the use of antidepressants would be correlated to patient-reported outcomes (PROs) 1 year after total hip replacement (THR), where increased dosage or discontinuation would be associated with worse outcomes. Patients and methods - THR cases with pre- and postoperative patient-reported outcome measures (PROMs) were selected from the Swedish Hip Arthroplasty Register (n = 9,092; women: n = 5,106). The PROMs were EQ-5D, visual analog scale (VAS) for pain, Charnley class, and VAS for satisfaction after surgery. These cases were merged with a national database of prescription purchases to determine the prevalence of antidepressant purchases. Regression analyses were performed where PROs were dependent variables and sex, age, Charnley class, preoperative pain, preoperative health-related quality of life (HRQoL), patient-reported anxiety/depression, and antidepressant use were independent variables. Results - Antidepressants were used by 10% of the cases (n = 943). Patients using antidepressants had poorer HRQoL and higher levels of pain before and after surgery and they experienced less satisfaction. Preoperative antidepressant use was independently associated with PROs 1 year after THR regardless of patient-reported anxiety/depression. Interpretation - Antidepressant usage before surgery was associated with reduced PROs after THR. Cases at risk of poorer outcomes may be identified through review of the patient's medical record. Clinicians are encouraged to screen for antidepressant use preoperatively, because their use may be associated with PROs after THR. PMID:27482877

  1. Negotiating the neurochemical self: anti-depressant consumption in women's recovery from depression.

    Science.gov (United States)

    Fullagar, Simone

    2009-07-01

    Anti-depressant treatment can be viewed as an exercise of biopower that is articulated through policies and practices aimed at the reduction of depression, population healthcare costs and effects on labour force productivity. Drawing upon a feminist governmentality perspective, this article examines the discourses that shaped women's experiences of anti-depressant medication in an Australian qualitative study on recovery from depression. The majority of women had been prescribed anti-depressants to treat a chemical imbalance in the brain, manage symptoms and restore normal functioning. One-third of participants identified anti-depressants as helpful in their recovery, while two-thirds were either highly ambivalent about, or critical of, medication as a solution to depression. Thirty-one women who identified the ;positive' benefits of anti-depressants actively constituted themselves as biomedical consumers seeking to redress a chemical imbalance. The problem of depression, the emergence of molecular science and the push for pharmacological solutions are contributing to the discursive formation of new subject positions - such as the neurochemically deficient self. Three themes were identified in relation to medication use, namely restoring normality, signifying recovery success and control/uncertainty. Anti-depressant medication offered women a normalized pathway to successful recovery that stood in stark contrast to the biologically deficient and morally failing self. These women's stories importantly reveal the gender relations and paradoxes arising from biopolitical technologies that shape selfhood for women in advanced liberal societies.

  2. Evaluation of Antidepressant activity of Simvastatin, Lovastatin and Atorvastatin in Male Swiss Mice - An Experimental Study

    Directory of Open Access Journals (Sweden)

    Gudadappanavar Anupama M

    2013-06-01

    Full Text Available Context: Depression is the commonest mood disorder, could also be secondary to a number of physical disorders. Pharmacological treatment of such co-morbidities is difficult. If statins show antidepressant activity that could appear to be better lipid-lowering agents as they provide additional benefits in cardiovascular disorders with co-morbidity like depression. Aims: To investigate the effect of simvastatin, lovastatin and atorvastatin for their antidepressant activity using forced swim test and tail suspension test on behavioral models of depression in male swiss mice. Design: Experimental Study Methods and Material: The in vivo antidepressant activity of simvastatin and lovastatin was studied using forced swim test and tail suspension test. The mice received the drug as per their weight and subjected for experimentation. Group mean immobility time was calculated in treated and control groups for comparison. Statistical analysis used: One-way analysis of variance (ANOVA followed by Bonferroni’s multiple comparison test. (P / 0.05 Results: Simvastatin and Lovastatin used in the present study showed significant antidepressant activity in both behavioral models of depression (p<0.05 while atorvastatin failed to show significant antidepressant action. Conclusion: The study suggests that the antidepressant activity of simvastatin and lovastatin, if could be extrapolated to clinical situations, appear to be better lipid-lowering agents as they provide additional benefits in cardiovascular disorders with co-morbidity like depression.

  3. EMSAM (deprenyl patch: how a promising antidepressant was underutilized

    Directory of Open Access Journals (Sweden)

    Asnis GM

    2014-10-01

    Full Text Available Gregory M Asnis,1,2 Margaret A Henderson2 1Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York, NY, USA; 2Anxiety and Depression Clinic, Montefiore Medical Center, New York, NY, USA Abstract: The EMSAM patch is a unique monoamine oxidase inhibitor (MAOI being the only antidepressant utilizing a transdermal delivery system. This was welcomed by clinicians who hoped that EMSAM would be better tolerated than oral MAOIs and non-MAOI antidepressants, as well as being effective for treatment in a wide spectrum of depressed patients including atypical depression, bipolar depression, and refractory depression. Unfortunately, the clinical use of EMSAM has been underutilized and its potential usefulness overlooked. This article suggests that fear of possible side effects, particularly the “cheese reaction” and serotonin syndrome, are some of the main contributors to underutilization by clinicians. These risks have been significantly exaggerated with the 6 mg/day dose not even requiring a special diet. Other contributing factors leading to underutilization are reviewed such as: the lack of studies addressing many important clinical questions; inadequate data analyses; not evaluating the effect of EMSAM on comorbid psychiatric conditions, particularly anxiety disorders; lack of antidepressant comparators versus EMSAM; no dose–response relationship examined; various depressive subtypes and conditions are unexplored, eg, bipolar depression and refractory depression; poor insurance coverage for an expensive medication; as well as minimal marketing efforts and postmarketing studies. On the other hand, many potential advantages of EMSAM are not highlighted enough in the literature and by pharmaceutical companies which might have increased clinical interest and utilization of the antidepressant. For example, the advantages of EMSAM include: avoidance of swallowing issues, as can be seen with oral antidepressants

  4. [Eslicarbazepine acetate: a novel therapeutic alternative in the treatment of focal seizures].

    Science.gov (United States)

    Mauri-Llerda, José A

    2012-05-01

    Epilepsy is one of the most common neurological diseases. In recent years an important number of drugs have been added to the therapeutic options we have available to us. With the aim of offering an optimal clinical effectiveness, the mechanisms of action or chemical structures of the antiepileptic drugs recently introduced onto the market have been modified with respect to the first, so-called classical or conventional, antiepileptics. Eslicarbazepine acetate belongs to this group of recently incorporated pharmaceuticals and is a novel single daily dose voltage-gated sodium channel blocker, which acts selectively in groups of rapid-activation neurons. It has been approved for indication in associated therapy in adults with partial onset seizures, with or without secondary generalisation. It is widely metabolised to eslicarbazepine and, to a lesser extent, to R-licarbazepine and oxcarbazepine. In 800 mg and 1200 mg doses it has been shown to bring about a significant reduction in a high percentage of patients with refractory epilepsy in simultaneous treatment with up to three antiepileptic drugs, and this effectiveness is maintained in open follow-up studies lasting up to a year. It is generally speaking well-tolerated; most of the adverse side-effects range in intensity from mild to moderate, and the percentage of patients who withdraw from treatment for this reason is low. Eslicarbazepine acetate is an alternative treatment in associated therapy in patients with partial epilepsy who do not respond adequately to treatment in monotherapy. PMID:22532219

  5. An alternative treatment option for a bony defect from large odontoma using recycled demineralization at chairside.

    Science.gov (United States)

    Lee, JuHyon; Lee, Eun-Young; Park, Eun-Jin; Kim, Eun-Suk

    2015-04-01

    Odontoma is the most common odontogenic benign tumor, and the treatment of choice is generally surgical removal. After excision, bone grafts may be necessary depending on the need for further treatment, or the size and location of the odontoma. Although the osteogenic capacity of a demineralized tooth was verified as early as 1967 by Urist and many other investigators, the cumbersome procedure, including a long demineralization time, may be less than comfortable for clinicians. A modified ultrasonic technology, with periodic negative pressure and temperature control, facilitated rapid and aseptic preparation of demineralized teeth for bone grafts. This approach reduces the demineralization time dramatically (≤80 minutes), so that the graft material can be prepared chairside on the same day as the extraction. The purpose of this article is to describe two cases of large compound odonotomas used as graft material prepared chairside for enucleation-induced bony defects. These two clinical cases showed favorable wound healing without complications, and good bony support for future dental implants or orthodontic treatment. Finally, this report will suggest the possibility of recycling the benign pathologic hard tissue as an alternative treatment option for conventional bone grafts in clinics.

  6. Comparison of the antidepressant effects of venlafaxine and dosulepin in a naturalistic setting

    DEFF Research Database (Denmark)

    Bukh, Jens Drachmann; Jørgensen, Martin Balslev; Dam, Henrik;

    2009-01-01

    The relative efficacy of the various classes of antidepressants has not been established. Observational studies in naturalistic settings are important in evaluating treatment outcomes with antidepressants, since controlled clinical trials include only a minority of patients present in clinical...... practice. This study sought to evaluate in a naturalistic setting the treatment outcomes of dosulepin and venlafaxine for patients with depressive episodes. At the university hospital in Copenhagen, Denmark, between 1998 and early 2001, the first-line treatment for psychiatric inpatients with depression...... because of an underpowered design) after replacing dosulepin with venlafaxine as first-line drug for depression in a naturalistic inpatient setting....

  7. Effects of antidepressant treatment on visual reaction time of patients with depressive disorder%抗抑郁治疗对抑郁症患者视觉反应时间的影响

    Institute of Scientific and Technical Information of China (English)

    范征莉; 陈敏

    2011-01-01

    Objective To explore the effects of antidepressant treatment on visual reaction time of patients with depressive disorder. Methods 32 patients met the Chinese classification and diagnostic criteria of mental disorders-3(CCMD-3) for depressive disorder were selected as depression group and treated with paroxetine. Hamilton depression scale 17(HAMD-17) was used to evaluate their depressive symptoms, EP102-1 multi-functional reaction time analyzer and computer reaction time measurement software system were employed to detect their visual reaction time before treatment and 8 weeks after treatment. Another 32 staffs and students with similar age,gender and education to patients in depression group were chosen as control group. Results After treatment in depression group, HAMD-17 scores of patients were significantly lower, and detection indexes of visual simple reaction time and complex reaction time were shorter than those before treatment(P<0.01). But the mean and the shortest reaction time of patients in depression group were still shorter than those in control group(P<0.05), and the longest reaction time and error reaction rates of them showed no statistically significant difference when compared with those in control group(P>0.05). Conclusion The detection indexes of reaction time can reflect condition of patients with depressive disorder to some extent.%目的 探讨抗抑郁治疗对抑郁症患者视觉反应时间的影响.方法 选择32例符合中国精神障碍分类与诊断标准第3版(CCMD-3)抑郁症诊断标准的患者作为抑郁组采用帕罗西汀治疗,治疗前和治疗8周末采用汉密尔顿抑郁量表-17 (HAMD-17)评定其抑郁症状,EP102-1型多功能反应时间测定仪与计算机反应时间测定软件系统检测视觉反应时间.选择年龄、性别、文化程度相似的单位职工和学生32名作为对照组.结果 抑郁组患者治疗后,HAMD-17评分较治疗前明显降低,视觉简单反应时间及复杂反应

  8. Researching complementary and alternative treatments – the gatekeepers are not at home

    Directory of Open Access Journals (Sweden)

    Koithan Mary

    2007-02-01

    Full Text Available Abstract Background To explore the strengths and weaknesses of conventional biomedical research strategies and methods as applied to complementary and alternative medicine (CAM, and to suggest a new research framework for assessing these treatment modalities. Discussion There appears to be a gap between published studies showing little or no efficacy of CAM, and reports of substantial clinical benefit from patients and CAM practitioners. This "gap" might be partially due to the current focus on placebo-controlled randomized trials, which are appropriately designed to answer questions about the efficacy and safety of pharmaceutical agents. In an attempt to fit this assessment strategy, complex CAM treatment approaches have been dissected into standardized and often simplified treatment methods, and outcomes have been limited. Unlike conventional medicine, CAM has no regulatory or financial gatekeeper controlling their therapeutic "agents" before they are marketed. Treatments may thus be in widespread use before researchers know of their existence. In addition, the treatments are often provided as an integrated 'whole system' of care, without careful consideration of the safety issue. We propose a five-phase strategy for assessing CAM built on the acknowledgement of the inherent, unique aspects of CAM treatments and their regulatory status in most Western countries. These phases comprise: 1. Context, paradigms, philosophical understanding and utilization 2. Safety status 3. Comparative effectiveness. 4. Component efficacy 5. Biological mechanisms. Summary Using the proposed strategy will generate evidence relevant to clinical practice, while acknowledging the absence of regulatory and financial gatekeepers for CAM. It will also emphasize the important but subtle differences between CAM and conventional medical practice.

  9. Low- vs high- frequency Repetitive Transcranial Magnetic Stimulation as an add-on treatment for refractory depression

    Directory of Open Access Journals (Sweden)

    julien eeche

    2012-03-01

    Full Text Available Objectives: Repetitive transcranial magnetic stimulation (rTMS seems to be effective as an antidepressant treatment, however, some confusion remain about the best parameters to apply and the efficacy of its association with pharmacological antidepressant treatments.Method: In a single blind randomized study14 patients with unipolar resistant depression to one antidepressant treatment were enrolled to received, in combination with venlafaxine (150 mg, either 20 sessions of 10Hz rTMS (2 000 pulses per session applied over le left dorsolateral prefrontal cortex (DLPFC or 20 sessions of 1 Hz rTMS (120 stimulations per sessions applied over the right DLPFC. Results: A similar antidepressant effect was observed in both groups with a comparable antidepressant delay of action (2 weeks and a comparable number of patients in remission after 4 weeks of daily rTMS sessions (66 vs 50 %.Conclusion: Low- and high- frequency rTMS seem to be effective as an add-on treatment to venlafaxine in pharmacological refractory major depression. Due to its short duration and its safety, low frequency rTMS may be a useful alternative treatment for patients with refractory depression.

  10. The quetiapine active metabolite N-desalkylquetiapine and the neurotensin NTS₁ receptor agonist PD149163 exhibit antidepressant-like effects on operant responding in male rats.

    Science.gov (United States)

    Hillhouse, Todd M; Shankland, Zachary; Matazel, Katelin S; Keiser, Ashley A; Prus, Adam J

    2014-12-01

    Major depressive disorder is the most common mood disorder in the United States and European Union; however, the limitations of clinically available antidepressant drugs have led researchers to pursue novel pharmacological treatments. Clinical studies have reported that monotherapy with the atypical antipsychotic drug quetiapine produces a rapid reduction in depressive symptoms that is apparent after 1 week of treatment, and it is possible that the active metabolite N-desalkylquetiapine, which structurally resembles an antidepressant drug, produces antidepressant effects. Neuropharmacological evaluations of the neurotensin NTS1 receptor agonist PD149163 suggest antidepressant efficacy, but the effects of a NTS₁ receptor agonist in an antidepressant animal model have yet to be reported. The present study examined the antidepressant-like effects of N-desalkylquetiapine, PD14916, quetiapine, the tricyclic antidepressant drug imipramine, the atypical antipsychotic drug risperidone, and the typical antipsychotic drug raclopride on responding in male Sprague-Dawley rats trained on a differential-reinforcement-of-low-rate 72-s operant schedule, a procedure used for screening antidepressant drugs. Quetiapine, PD149163, risperidone, and imipramine exhibited antidepressant-like effects by increasing the number of reinforcers earned, decreasing the number of responses emitted, and shifting the interresponse time (IRT) distributions to the right. N-Desalkylquetiapine produced a partial antidepressant-like effect by decreasing the number of responses emitted and producing a rightward shift in the IRT distributions, but it did not significantly alter the number of reinforcers earned. Raclopride decreased reinforcers and responses. These data suggest that N-desalkylquetiapine likely contributes to quetiapine's antidepressant efficacy and identify NTS₁ receptor activation as a potential novel pharmacologic strategy for antidepressant drugs.

  11. [Complementary and alternative medicine for insomnia].

    Science.gov (United States)

    Yamashita, Hidehisa; Machino, Akihiko; Shishida, Kazuhiro; Yoshino, Atsuo; Yamawaki, Shigeto

    2015-06-01

    Frequency of insomnia is increasing with age. Benzodiazepine receptor agonist has been prescribed for insomnia in the elderly, but there are some patients who complain the effect is not sufficient. Adherence for sleeping pills is very low in elderly Japanese, because there has been strong stigma against sleeping pills. Complementary and alternative medicine for insomnia is widely used in elderly Japanese. Sedative antidepressants, novel antipsychotics, anti-histamine drugs, and supplements are used for insomnia as complementary and alternative medicine. But evidence of these drugs for insomnia is insufficient. In this paper, we outline the previous reports such as the advantages and disadvantages of these drugs for the treatment of insomnia in the elderly. PMID:26065137

  12. Brain 5-HT deficiency increases stress vulnerability and impairs antidepressant responses following psychosocial stress.

    Science.gov (United States)

    Sachs, Benjamin D; Ni, Jason R; Caron, Marc G

    2015-02-24

    Brain serotonin (5-HT) deficiency and exposure to psychosocial stress have both been implicated in the etiology of depression and anxiety disorders, but whether 5-HT deficiency influences susceptibility to depression- and anxiety-like phenotypes induced by psychosocial stress has not been formally established. Most clinically effective antidepressants increase the extracellular levels of 5-HT, and thus it has been hypothesized that antidepressant responses result from the reversal of endogenous 5-HT deficiency, but this hypothesis remains highly controversial. Here we evaluated the impact of brain 5-HT deficiency on stress susceptibility and antidepressant-like responses using tryptophan hydroxylase 2 knockin (Tph2KI) mice, which display 60-80% reductions in brain 5-HT. Our results demonstrate that 5-HT deficiency leads to increased susceptibility to social defeat stress (SDS), a model of psychosocial stress, and prevents the fluoxetine (FLX)-induced reversal of SDS-induced social avoidance, suggesting that 5-HT deficiency may impair antidepressant responses. In light of recent clinical and preclinical studies highlighting the potential of inhibiting the lateral habenula (LHb) to achieve antidepressant and antidepressant-like responses, we also examined whether LHb inhibition could achieve antidepressant-like responses in FLX-insensitive Tph2KI mice subjected to SDS. Our data reveal that using designer receptors exclusively activated by designer drugs (DREADDs) to inhibit LHb activity leads to reduced SDS-induced social avoidance behavior in both WT and Tph2KI mice. This observation provides additional preclinical evidence that inhibiting the LHb might represent a promising alternative therapeutic approach under conditions in which selective 5-HT reuptake inhibitors are ineffective.

  13. Suicidality and aggression during antidepressant treatment

    DEFF Research Database (Denmark)

    Sharma, Tarang; Guski, Louise Schow; Freund, Nanna;

    2016-01-01

    reports for duloxetine, fluoxetine, paroxetine, sertraline, and venlafaxine obtained from the European and UK drug regulators, and summary trial reports for duloxetine and fluoxetine from Eli Lilly's website.Eligibility criteria for study selection Double blind placebo controlled trials that contained any....... These trials had limitations in the study design and discrepancies in reporting, which may have led to serious under-reporting of harms. For example, some outcomes appeared only in individual patient listings in appendices, which we had for only 32 trials, and we did not have case report forms for any......Objective To study serious harms associated with selective serotonin and serotonin-norepinephrine reuptake inhibitors.Design Systematic review and meta-analysis.Main outcome measures Mortality and suicidality. Secondary outcomes were aggressive behaviour and akathisia.Data sources Clinical study...

  14. Suicidality and aggression during antidepressant treatment

    DEFF Research Database (Denmark)

    Sharma, Tarang; Guski, Louise Schow; Freund, Nanna;

    2016-01-01

    OBJECTIVE: To study serious harms associated with selective serotonin and serotonin-norepinephrine reuptake inhibitors.Design Systematic review and meta-analysis. MAIN OUTCOME MEASURES: Mortality and suicidality. Secondary outcomes were aggressive behaviour and akathisia. DATA SOURCES: Clinical s...

  15. Potential Antidepressant Role of Neurotransmitter CART: Implications for Mental Disorders

    Directory of Open Access Journals (Sweden)

    Peizhong Mao

    2011-01-01

    Full Text Available Depression is one of the most prevalent and debilitating public health concerns. Although no single cause of depression has been identified, it appears that interaction among genetic, epigenetic, biochemical, environmental, and psychosocial factors may explain its etiology. Further, only a fraction of depressed patients show full remission while using current antidepressants. Therefore, identifying common pathways of the disorder and using that knowledge to develop more effective pharmacological treatments are two primary targets of research in this field. Brain-enriched neurotransmitter CART (cocaine- and amphetamine-regulated transcript has multiple functions related to emotions. It is a potential neurotrophic factor and is involved in the regulation of hypothalamic-pituitary-adrenal axis and stress response as well as in energy homeostasis. CART is also highly expressed in limbic system, which is considered to have an important role in regulating mood. Notably, adolescents carrying a missense mutation in the CART gene exhibit increased depression and anxiety. Hence, CART peptide may be a novel promising antidepressant agent. In this paper, we summarize recent progress in depression and CART. In particular, we emphasize a new antidepressant function for CART.

  16. Effects of antidepressants on P2X7 receptors.

    Science.gov (United States)

    Wang, Wei; Xiang, Zheng-Hua; Jiang, Chun-Lei; Liu, Wei-Zhi; Shang, Zhi-Lei

    2016-08-30

    Antidepressants including paroxetine, fluoxetine and desipramine are commonly used for treating depression. P2×7 receptors are member of the P2X family. Recent studies indicate that these receptors may constitute a novel potential target for the treatment of depression. In the present study, we examined the action of these antidepressants on cloned rat P2×7 receptors that were stably expressed in human embryonic kidney (HEK) 293 cells by using the whole-cell patch-clamp technique, and found that paroxetine at a dose of 10µM could significantly reduce the inward currents evoked by the P2×7 receptors agonist BzATP by pre-incubation for 6-12 but not by acute application (10µM) or pre-incubation for 2-6h at a dose of 1µM, 3µM or 10µM paroxetine. Neither fluoxetine nor desipramine had significant effects on currents evoked by BzATP either applied acutely or by pre-incubation at various concentrations. These results suggest that the sensitivity of rat P2×7 receptors to antidepressants is different, which may represent an unknown mechanism by which these drugs exert their therapeutic effects and side effects. PMID:27318632

  17. HIPPOTHERAPY SIMULATOR AS ALTERNATIVE METHOD FOR HIPPOTHERAPY TREATMENT IN HEMIPLEGIC CHILDREN

    Directory of Open Access Journals (Sweden)

    Mohamed Ali Elshafey

    2014-04-01

    Full Text Available Background: Hippotherapy considered as worldwide techniques used in rehabilitation of children with neurological disorders as it improved gait pattern, balance, postural control, strengthen, range of motion and gross and fine motor skills development but it encounter some technical problems. Purpose: The purpose of the current study was to compare between hippotherapy and hippotherapy simulators effect on back geometry and balance in hemiplegic children. Materials and Methods: Thirty ambulant hemiplegic children, their age ranges from four to six years old participated in this study. They were randomly divided into two matched groups (control and study. The control group treated with hippotherapy for half hour in addition to the selected physical therapy program, while the study group treated with hippotherapy simulators for half hour in addition to the selected physical therapy program also. All children received the treatment three times weekly for three successive months. Spinal geometry were evaluated by Formatric instrumentation systems and balance were evaluated by pediatric balance scale before and after treatment Results: There was significant improvement in all the measured variables for both groups after comparing of their pre and post-treatment mean values with non-significant difference between both groups post treatment. Conclusion: Hippotherapy simulators is an alternative method for hippotherapy could be used for modulation of back geometry and for improving balance in hemiplegic children. Brief summary and potential implication: Hippotherapy simulator was used in treatment of back geometry and balance in hemiplegic children, all the measurements were compared with hippotherapy. The results were nearly the same in both groups.

  18. [Endoscopic ultrasound-guided ethanol ablation: an alternative option for the treatment of pancreatic insulinoma].

    Science.gov (United States)

    Bor, Renáta; Farkas, Klaudia; Bálint, Anita; Molnár, Tamás; Nagy, Ferenc; Valkusz, Zsuzsanna; Sepp, Krisztián; Tiszlavicz, László; Hamar, Sándor; Szepes, Zoltán

    2014-10-12

    Endoscopic ultrasound is the most accurate imaging modality for the diagnosis of pancreatic cancer, and endoscopic ultrasound-guided fine needle injection has already been used for palliative interventions. Surgical resection is currently the standard treatment for pancreatic insulinoma. Medical treatment may be necessary for symptomatic patients with unresectable disease. Case reports have been published about the success of endoscopic ultrasound-guided alcoholic ablation, but it has not been reported previously in Hungarian literature. The authors present the history of an 83-year-old woman who was evaluated because of repeated hypoglycemic coma occurring during the night. Endosonographic image and laboratory findings (elevated serum insulin and chromogranin A) revealed pancreatic insulinoma. Because of severe comorbidities and high risk of surgical resection, the decision was made to ablate the insulinoma by endoscopic ultrasound-guided alcohol injection. A total of 3 mL 95% ethanol was injected into the tumor. Despite the discontinuation of the diazoxide therapy the hypoglycemic episodes disappeared. This case history confirms that endoscopic ultrasound-guided alcoholic ablation is a novel, minimal invasive alternative treatment for patients with pancreatic neuroendocrine tumors in whom surgery is not feasible. PMID:25282110

  19. Novel Virtual Environment for Alternative Treatment of Children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Juliana M. de Oliveira

    2016-01-01

    Full Text Available Cerebral palsy is a severe condition usually caused by decreased brain oxygenation during pregnancy, at birth or soon after birth. Conventional treatments for cerebral palsy are often tiresome and expensive, leading patients to quit treatment. In this paper, we describe a virtual environment for patients to engage in a playful therapeutic game for neuropsychomotor rehabilitation, based on the experience of the occupational therapy program of the Nucleus for Integrated Medical Assistance (NAMI at the University of Fortaleza, Brazil. Integration between patient and virtual environment occurs through the hand motion sensor “Leap Motion,” plus the electroencephalographic sensor “MindWave,” responsible for measuring attention levels during task execution. To evaluate the virtual environment, eight clinical experts on cerebral palsy were subjected to a questionnaire regarding the potential of the experimental virtual environment to promote cognitive and motor rehabilitation, as well as the potential of the treatment to enhance risks and/or negatively influence the patient’s development. Based on the very positive appraisal of the experts, we propose that the experimental virtual environment is a promising alternative tool for the rehabilitation of children with cerebral palsy.

  20. Novel Virtual Environment for Alternative Treatment of Children with Cerebral Palsy

    Science.gov (United States)

    de Oliveira, Juliana M.; Fernandes, Rafael Carneiro G.; Pinto, Cristtiano S.; Pinheiro, Plácido R.; Ribeiro, Sidarta

    2016-01-01

    Cerebral palsy is a severe condition usually caused by decreased brain oxygenation during pregnancy, at birth or soon after birth. Conventional treatments for cerebral palsy are often tiresome and expensive, leading patients to quit treatment. In this paper, we describe a virtual environment for patients to engage in a playful therapeutic game for neuropsychomotor rehabilitation, based on the experience of the occupational therapy program of the Nucleus for Integrated Medical Assistance (NAMI) at the University of Fortaleza, Brazil. Integration between patient and virtual environment occurs through the hand motion sensor “Leap Motion,” plus the electroencephalographic sensor “MindWave,” responsible for measuring attention levels during task execution. To evaluate the virtual environment, eight clinical experts on cerebral palsy were subjected to a questionnaire regarding the potential of the experimental virtual environment to promote cognitive and motor rehabilitation, as well as the potential of the treatment to enhance risks and/or negatively influence the patient's development. Based on the very positive appraisal of the experts, we propose that the experimental virtual environment is a promising alternative tool for the rehabilitation of children with cerebral palsy. PMID:27403154

  1. Could cryosurgery be an alternative treatment for basal cell carcinoma of the vulva?

    Directory of Open Access Journals (Sweden)

    Verónica Garza-Rodríguez

    2014-01-01

    Full Text Available Basal cell carcinomas (BCC on the genital area account for less than 1% of all BCCs. Surgical management is indicated. Recurrence rate of vulvar BCC has been reported to be 10-20%. Mohs micrographic surgery (MMS is a superior surgical option. Other treatments include radiation and topical immuntherapy. Cryosurgery for vulvar BCC has not been reported. We present the case of a 88-year-old Hispanic woman with a vulvar ulcer that was confirmed as BCC by histopathology and treated with liquid nitrogen cryosurgery. Control biopsy was performed on day 90 was negative for BCC. No clinical evidence of recurrence was detected after one year. Although, the vulva is considered to be a high-risk site with respect to BCC and MMS is the gold standard for treatment, the delicate nature of the area may preclude complete removal by a surgical technique without compromising vital anatomical function. Liquid nitrogen cryosurgery uses the effects of extreme cold to effect deep destruction of the tumor and surrounding tissues. This is the first report of a vulvar BCC successfully treated with liquid nitrogen cryosurgery. We suggest this technique could be of benefit as an alternative treatment in cases where excisional procedures cannot be performed.

  2. EVALUATION OF ALTERNATE STAINLESS STEEL SURFACE TREATMENTS FOR MASS SPECTROSCOPY AND OTHER TRITIUM SYSTEMS

    Energy Technology Data Exchange (ETDEWEB)

    Clark, E.; Mauldin, C.; Neikirk, K.

    2012-02-29

    There are specific components in the SRS Tritium Facilities that are required to introduce as few chemical impurities (such as protium and methane) as possible into the process gas. Two such components are the inlet systems for the mass spectroscopy facilities and hydrogen isotope mix standard containers. Two vendors now passivate stainless steel components for these systems, and both are relatively small businesses whose future viability can be questioned, which creates the need for new sources. Stainless steel containers were designed to evaluate alternate surface treatment vendors for tritium storage and handling for these high purity tritium systems. Five vendors applied their own 'best' surface treatments to two containers each - one was a current vendor, another was a chemical vapor deposited silicon coating, and the other three were electropolishing and chemical cleaning vendors. Pure tritium gas was introduced into all ten containers and the composition was monitored over time. The only observed impurities in the gas were some HT, less CT{sub 4}, and very small amounts of T{sub 2}O in all cases. The currently used vendor treated containers contained the least impurities. The chemical vapor deposited silicon treatment resulted in the highest impurity levels. Sampling one set of containers after about one month of tritium exposure revealed the impurity level to be nearly the same as that after more than a year of exposure - this result suggests that cleaning new stainless steel components by tritium gas contact for about a month may be a worthy operation.

  3. Potential antidepressant-like properties of the TC G-1008, a GPR39 (zinc receptor) agonist.

    Science.gov (United States)

    Młyniec, Katarzyna; Starowicz, Gabriela; Gaweł, Magdalena; Frąckiewicz, Ewelina; Nowak, Gabriel

    2016-09-01

    Some forms of depression appear to be more related to the glutamatergic system. G-coupled protein receptor 39 (GPR39) is the metabotropic zinc receptor, which may be involved in the pathophysiology of depression and in the antidepressant response. Its deficiency abolishes the antidepressant response, which means that GPR39 is required to obtain a therapeutic effect in depression. This raises the possibility that agonists of the zinc receptor may have a role in antidepressant treatment. To explore this possibility we investigated animal behaviour in the forced swim test, the tail suspension test (to assess antidepressant-like properties), the light/dark test and the elevated plus maze test (to assess anxiolytic-like properties), following acute administration of a GPR39 agonist (TC G-1008). We found an antidepressant response (as measured by the forced swim test but not by the tail suspension test) in mice following the GPR39 agonist treatment. Additionally, we observed the opposite results in the light/dark box (decreased overall distance; increased time spent in the lit compartment; decreased time spent in the dark compartment; increased freezing time) and elevated plus maze (no significant changes), which may be a consequence of the sedative effect of TC G-1008. We also found hippocampal GPR39 and brain-derived neurotrophic factor (BDNF) up-regulation following administration of the GPR39 agonist, which may be undiscovered so far as a possible novel agent in the treatment of mood disorders. PMID:27235821

  4. The role of the Internet in cancer patients' engagement with complementary and alternative treatments.

    Science.gov (United States)

    Broom, Alex; Tovey, Philip

    2008-04-01

    This article draws on a study of 80 National Health Service cancer patients and their experiences of using the Internet within disease and treatment processes. It focuses on the role the Internet plays in the context of potential or actual engagement with complementary and alternative medicine (CAM). The results depart from previous conceptualizations of the Internet as a major source of CAM knowledge, and second, as a major pathway to patient CAM usage. Moreover, the results highlight significant anxiety as patients attempt to process vast amounts of complex biomedical diagnostic and prognostic information online. For patients attempting to embrace alternative therapeutic models of cancer care, exposure to prognostic data may pose considerable risks to individual well-being and engagement with healing practices. On the basis of these results we problematize social theorizations of the Internet as contributing to such things as: the democratization of knowledge; the deprofessionalization of medicine; and patient empowerment. We emphasize, instead, the potential role of the Internet in reinforcing biomedicine's paradigmatic dominance in cancer care. PMID:18400826

  5. Biotechnology as an alternative for carbon disulfide treatment in air pollution control

    Energy Technology Data Exchange (ETDEWEB)

    Rojo, N.; Gallastegi, G.; Barona, A.; Gurtubay, L.; Elias, A. [Univ. of the Basque Country, Bilbao (Spain). Dept. of Chemical and Environmental Engineering; Gabriel Ibarra-Berastegi [Univ. of the Basque Country, Bilbao (Spain). Dept. of Nuclear Engineering and Fluid Mechanics

    2010-07-01

    The industry demand for CS{sub 2} has changed considerably over the last 2 decades and is expected to increase. This paper discussed the technical and financial feasibility of eliminating carbon disulphide (CS{sub 2}) from exhaust gases use biotechnology. The global emissions of this hazardous air pollutant are estimated to exceed 250,000 tonnes per year. However, the emission range depends on the source. The conventional technologies for treating CS{sub 2} emissions include thermal oxidation, thermo-catalytic processes or incineration. However, these technologies have drawbacks, such as high energy consumption and the generation of secondary by-products that require additional treatment. Recently, biotechnology was touted as an affordable, effective, and ecologically sound alternative to treat waste gases containing CS{sub 2}. Biological technologies based on microorganisms to biodegrade air pollutants overcome many of the disadvantages of conventional techniques and are particularly useful for the removal of relatively low concentrations of pollutants. The main properties, sources, and uses of CS{sub 2} were summarized in this paper along with alternative biotreatments for CS{sub 2}. Several applications of the technical and economical feasibility of biofilters and biotrickling filters were presented. Further research is required before their widespread industrial application. 72 refs., 3 tabs.

  6. Treatment of sewage sludge in a thermophilic membrane reactor (TMR) with alternate aeration cycles.

    Science.gov (United States)

    Collivignarelli, Maria Cristina; Castagnola, Federico; Sordi, Marco; Bertanza, Giorgio

    2015-10-01

    The management of sewage sludge is becoming a more and more important issue, both at national and international level, in particular due to the uncertain recovery/disposal future options. Therefore, it is clear that the development of new technologies that can mitigate the problem at the source by reducing sludge production is necessary, such as the European Directive 2008/98/EC prescribes. This work shows the results obtained with a thermophilic membrane reactor, for processing a biological sludge derived from a wastewater treatment plant (WWTP) that treats urban and industrial wastewater. Sewage sludge was treated in a thermophilic membrane reactor (TMR), at pilot-scale (1 m(3) volume), with alternate aeration cycles. The experimentation was divided into two phases: a "startup phase" during which, starting with a psychrophilic/mesophilic biomass, thermophilic conditions were progressively reached, while feeding a highly biodegradable substrate; the obtained thermophilic biomass was then used, in the "regime phase", to digest biological sludge which was fed to the plant. Good removal yields were observed: 64% and 57% for volatile solids (VS) and total COD (CODtot), respectively, with an average hydraulic retention time (HRT) equal to 20 d, an organic loading rate (OLR) of about 1.4-1.8 kg COD m(-3) d(-1) and aeration/non aeration cycles alternated every 4 h.

  7. Antifungal treatments in artificial incubation of crayfish eggs (Pacifastacus leniusculus, Astacidae: Searching for alternatives to formaldehyde

    Directory of Open Access Journals (Sweden)

    J.M. Carral

    2009-01-01

    Full Text Available Considering the concerns about the safety of the use of formaldehyde as antifungal agent, the effects of three alternative chemicals (potassium sorbate, copper hydroxide and magnesium chloride were tested in the artificial incubation of signal crayfish (Pacifastacus leniusculus eggs. Eight treatments were performed during 15 min every other day: formaldehyde at 3000 ppm (control, potassium sorbate at 5000 and 10000 ppm, copper hydroxide at 40, 60, 80 and 200 ppm, and magnesium chloride at 10000 ppm. Eggs were incubated in a flow through system at a density of 20 eggs·cm−2. After 61 days of incubation, the highest efficiencies were obtained with 200 ppm of copper hydroxide (77.6% of survivors to stage 2 with no significant differences from the control (74.3%. Lower concentrations of copper hydroxide resulted in high egg mortality whereas potassium sorbate and magnesium chloride were ineffective to avoid fungal growth and total egg mortality took place. From the obtained results, copper hydroxide baths at 200 ppm could be considered as a good alternative to formaldehyde.

  8. INVO Procedure: Minimally Invasive IVF as an Alternative Treatment Option for Infertile Couples

    Directory of Open Access Journals (Sweden)

    Elkin Lucena

    2012-01-01

    Full Text Available Intravaginal culture (IVC, also called INVO (intravaginal culture of oocytes, is an assisted reproduction procedure where oocyte fertilization and early embryo development are carried out within a gas permeable air-free plastic device, placed into the maternal vaginal cavity for incubation. In the present study we assessed the outcome of the INVO procedure, using the recently designed INVOcell device, in combination with a mild ovarian stimulation protocol. A total of 125 cycles were performed. On average 6.5 oocytes per cycle were retrieved, and a mean of 4.2 were placed per INVOcell device. The cleavage rate obtained after the INVO culture was 63%. The procedure yielded 40%, 31.2%, and 24% of clinical pregnancy, live birth, and single live birth rates per cycle, respectively. Our results suggest that the INVO procedure is an effective alternative treatment option in assisted reproduction that shows comparable results to those reported for existing IVF techniques.

  9. A Behavioral Perspective of Childhood Trauma and Attachment Issues: Toward Alternative Treatment Approaches for Children with a History of Abuse

    Science.gov (United States)

    Prather, Walter; Golden, Jeannie A.

    2009-01-01

    Attachment theory provides a useful conceptual framework for understanding trauma and the treatment of children who have been abused. This article examines childhood trauma and attachment issues from the perspective of behavior analysis, and provides a theoretical basis for two alternative treatment models for previously abused children and their…

  10. A synopsis of short-term responses to alternative restoration treatments in sagebrush-steppe: the SageSTEP project

    Science.gov (United States)

    The Sagebrush Steppe Treatment Evaluation Project (SageSTEP) is an integrated long-term study that evaluates ecological effects of alternative treatments designed to reduce woody fuels and to stimulate the herbaceous understory of sagebrush steppe communities of the intermountain west. This synopsis...

  11. Stereotactic body radiation therapy as an alternative treatment for small hepatocellular carcinoma.

    Directory of Open Access Journals (Sweden)

    Sang Min Yoon

    Full Text Available BACKGROUND: Even with early stage hepatocellular carcinoma (HCC, patients are often ineligible for surgical resection, transplantation, or local ablation due to advanced cirrhosis, donor shortage, or difficult location. Stereotactic body radiation therapy (SBRT has been established as a standard treatment option for patients with stage I lung cancer, who are not eligible for surgery, and may be a promising alternative treatment for patients with small HCC who are not eligible for curative treatment. MATERIALS AND METHODS: A registry database of 93 patients who were treated with SBRT for HCC between 2007 and 2009 was analyzed. A dose of 10-20 Gy per fraction was given over 3-4 consecutive days, resulting in a total dose of 30-60 Gy. The tumor response was determined using dynamic computed tomography or magnetic resonance imaging, which was performed 3 months after completion of SBRT. RESULTS: The median follow-up period was 25.6 months. Median size of tumors was 2 cm (range: 1-6 cm. Overall patients' survival rates at 1 and 3 years were 86.0% and 53.8%, respectively. Complete and partial tumor response were achieved in 15.5% and 45.7% of patients, respectively. Local recurrence-free survival rate was 92.1% at 3 years. Most local failures were found in patients with HCCs > 3 cm, and local control rate at 3 years was 76.3% in patients with HCC > 3 cm, 93.3% in patients with tumors between 2.1-3 cm, and 100% in patients with tumors ≤ 2 cm, respectively. Out-of-field intrahepatic recurrence-free survival rates at 1 and 3 years were 51.9% and 32.4%, respectively. Grade ≥ 3 hepatic toxicity was observed in 6 (6.5%. CONCLUSIONS: SBRT was effective in local control of small HCC. SBRT may be a promising alternative treatment for patients with small HCC which is unsuitable for other curative therapy.

  12. Antidepressants modulate glycine action in rat hippocampus

    OpenAIRE

    Chang, Hyun-Kyung; Kim, Khae Hawn; Kang, Ki-Woon; Kang, Yoo-Jin; Kim, Tae-Wook; Park, Hun-Kyung; Kim, Sung-Eun; Kim, Chang-Ju

    2015-01-01

    Antidepressants are drugs that relieve symptoms of depressive disorders. Fluoxetine, tianeptine, and milnacipran are different types of antidepressants, and they have widely been used for relieving of depression symptoms. In the present study, the effects of fluoxetine, tianeptine, and milnacipran on the glycine-induced ion current by nystatin-perforated patch clamp and on the amplitude of field potential in the hippocampal CA1 region by multichannel extracellular recording, MED64, system, we...

  13. Alternatives to chemotherapy and radiotherapy as adjuvant treatment for lung cancer.

    Science.gov (United States)

    Shepherd, F A

    1997-06-01

    Because adjuvant chemotherapy has resulted in only modest prolongation of survival for patients with lung cancer, investigators have turned to the evaluation of alternative treatment strategies for this patient population. Immunotherapy with Bacillus Calmette Guerin, Corynebacterium parvum, and levamisole has been evaluated in several prospective randomized trials, and no study has shown a statistically significant difference in overall survival. Interferon has been evaluated in three trials of adjuvant therapy after response to chemotherapy for small cell lung cancer. Different interferon preparations were used, but none of the trials showed a significant prolongation of survival. The retinoids have been evaluated as adjuvant treatment after complete resection of stage IN-SCLC. One trial showed a reduction in second primary tumors, and in particular, tumors to tobacco smoking in patients treated with retinyl palmitate. A second trial using 13-cis retinoic acid is ongoing in North America. In the last decade, several inhibitors of angiogenesis have been identified, and they are now beginning to be evaluated in the clinical setting. The National Cancer Institute of Canada Clinical Trials Group and the European Organization for Research and Treatment of Cancer have initiated a study of adjuvant marimastat, a metalloproteinase inhibitor, for patients who have responded to induction chemotherapy for small cell lung cancer. This is the first adjuvant antiangiogenesis factor trial to be initiated for any tumor type. Other investigational agents which are currently undergoing Phase I and Phase II testing include monoclonal antibodies which may inhibit tumour cell growth by binding to growth factors, or which may be conjugated to toxins or chemotherapeutic agents which result in tumour cell death. In the last decade, we have witnessed an explosion in our knowledge and understanding of the regulation of normal and neoplastic cell growth at the molecular level. It remains

  14. The Prefrontal Dectin-1/AMPA Receptor Signaling Pathway Mediates The Robust and Prolonged Antidepressant Effect of Proteo-β-Glucan from Maitake

    Science.gov (United States)

    Bao, Hongkun; Ran, Pengzhan; Zhu, Ming; Sun, Lijuan; Li, Bai; Hou, Yangyang; Nie, Jun; Shan, Liping; Li, Hongliang; Zheng, Shangyong; Xu, Xiufeng; Xiao, Chunjie; Du, Jing

    2016-01-01

    Proteo-β-glucan from Maitake (PGM) is a strong immune regulator, and its receptor is called Dectin-1. Cumulative evidence suggests that AMPA receptors are important for the treatment of depression. Here, we report that PGM treatment leads to a significant antidepressant effect in the tail suspension test and forced swim test after sixty minutes of treatment in mice. After five consecutive days of PGM treatment, this antidepressant effect remained. PGM treatment did not show a hyperactive effect in the open field test. PGM significantly enhanced the expression of its receptor Dectin-1, as well as p-GluA1(S845) and GluA1, but not GluA2 or GluA3 in the prefrontal cortex (PFC) after five days of treatment. The Dectin-1 inhibitor Laminarin was able to block the antidepressant effect of PGM. At the synapses of PFC, PGM treatment significantly up-regulated the p-GluA1(S845), GluA1, GluA2, and GluA3 levels. Moreover, PGM’s antidepressant effects and the increase of p-GluA1(S845)/GluA1 lasted for 3 days after stopping treatment. The AMPA-specific antagonist GYKI 52466 was able to block the antidepressant effect of PGM. This study identified PGM as a novel antidepressant with clinical potential and a new antidepressant mechanism for regulating prefrontal Dectin-1/AMPA receptor signalling. PMID:27329257

  15. Alternating treatment with didanosine and zidovudine versus either drug alone for the treatment of advanced HIV infection. The Alter Study. Nordic HIV Therapy Group

    DEFF Research Database (Denmark)

    Gerstoft, J; Melander, H; Bruun, J N;

    1997-01-01

    The efficacy and safety of an alternating regime with zidovudine and didanosine versus treatment with either drug alone were investigated in a randomized, open, controlled trial, 552 patients with advanced HIV infection, 47% of whom had received prior treatment with zidovudine, were enrolled...

  16. Comparison of alternative flue gas dry treatment technologies in waste-to-energy processes.

    Science.gov (United States)

    Dal Pozzo, Alessandro; Antonioni, Giacomo; Guglielmi, Daniele; Stramigioli, Carlo; Cozzani, Valerio

    2016-05-01

    Acid gases such as HCl and SO2 are harmful both for human health and ecosystem integrity, hence their removal is a key step of the flue gas treatment of Waste-to-Energy (WtE) plants. Methods based on the injection of dry sorbents are among the Best Available Techniques for acid gas removal. In particular, systems based on double reaction and filtration stages represent nowadays an effective technology for emission control. The aim of the present study is the simulation of a reference two-stage (2S) dry treatment system performance and its comparison to three benchmarking alternatives based on single stage sodium bicarbonate injection. A modelling procedure was applied in order to identify the optimal operating configuration of the 2S system for different reference waste compositions, and to determine the total annual cost of operation. Taking into account both operating and capital costs, the 2S system appears the most cost-effective solution for medium to high chlorine content wastes. A Monte Carlo sensitivity analysis was carried out to assess the robustness of the results. PMID:26951719

  17. Usefulness of Photodynamic Therapy as a Possible Therapeutic Alternative in the Treatment of Basal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Paola Savoia

    2015-09-01

    Full Text Available Basal cell carcinoma (BCC is the most common cancer in individuals with fair skin type (I–II and steadily increasing in incidence (70% of skin malignancy. It is locally invasive but metastasis is usually very rare, with an estimated incidence of 0.0028%–0.55%. Conventional therapy is surgery, especially for the H region of the face and infiltrative lesions; in case of inoperable tumors, radiotherapy is a valid option. Recently, topical photodynamic therapy (PDT has become an effective treatment in the management of superficial and small nodular BCC. PDT is a minimally invasive procedure that involves the administration of a photo-sensibilizing agent followed by irradiation at a pre-defined wavelength; this determines the creation of reactive oxygen species that specifically destroy target cells. The only major side effect is pain, reported by some patients during the irradiation. The high cure rate and excellent cosmetic outcome requires considering this possibility for the management of patients with both sporadic and hereditary BCC. In this article, an extensive review of the recent literature was made, in order to clarify the role of PDT as a possible alternative therapeutic option in the treatment of BCC.

  18. Improving adhesion between luting cement and zirconia-based ceramic with an alternative surface treatment.

    Science.gov (United States)

    Martins, Aurealice Rosa Maria; Gotti, Valéria Bisinoto; Shimano, Marcos Massao; Borges, Gilberto Antônio; Gonçalves, Luciano de Souza

    2015-01-01

    This study evaluated the influence of an alternative surface treatment on the microshear bond strength (μsbs) of zirconia-based ceramic. Thirty-five zirconia disks were assigned to five groups according to the following treatments: Control (CO), glass and silane were not applied to the zirconia surface; G1, air blasted with 100μm glass beads + glaze + silane; G2, a gel containing 15% (by weight) glass beads applied to the ceramic surface + glaze + silane; G3, a gel containing 25% (by weight) glass beads applied to the ceramic surface + glaze + silane; and G4, a gel containing 50% (by weight) glass beads applied to the ceramic surface + glaze + silane. The specimens were built up using RelyX ARC®, according to the manufacturer's recommendations, and inserted in an elastomeric mold with an inner diameter of 0.8 mm. The μsbs test was performed using a testing machine at a crosshead speed of 0.5 mm/min. ANOVA and Tukey's test (p ceramic and the luting cement. PMID:25859635

  19. New Alternatives for Autoimmune Disease Treatments: Physicochemical and Clinical Comparability of Biosimilar Etanercept

    Directory of Open Access Journals (Sweden)

    Mariana P. Miranda-Hernández

    2016-01-01

    Full Text Available Etanercept is a recombinant fusion protein approved for the treatment of TNF-α mediated diseases such as rheumatoid arthritis (RA, psoriasis, psoriatic arthritis, and ankylosing spondylitis. Herein, we present an evaluation of the physicochemical and biological properties of a biosimilar etanercept and its reference product followed by a clinical study in patients diagnosed with RA intended to demonstrate comparability of their immunomodulatory activity. Identity analyses showed a total correspondence of the primary and higher-order structure between the two products. In regard to intrinsic heterogeneity, both products showed to be highly heterogenous; however the biosimilar etanercept exhibited similar charge and glycan heterogeneity intervals compared to the reference product. Apoptosis inhibition assay also showed that, despite the high degree of heterogeneity exhibited by both products, no significant differences exist in their in vitro activity. Finally, the clinical assessment conducted in RA-diagnosed patients did not show significant differences in the evaluated pharmacodynamic markers of both products. Collectively, the results from the comparability exercise provide convincing evidence that the evaluated biosimilar etanercept can be considered an effective alternative for the treatment of RA.

  20. Molecular cloning and functional characterization of a mouse gene upregulated by lipopolysaccharide treatment reveals alternative splicing

    International Nuclear Information System (INIS)

    Treatment of mouse cells with lipopolysaccharide (LPS) potently initiates an inflammatory response, but the underlying mechanisms are unclear. We therefore sought to characterize cDNA sequences of a new mouse LPS-responsive gene, and to evaluate the effects of MLrg. Full-length cDNAs were obtained from LPS-treated NIH3T3 cells. We report that the MLrg gene produces two alternative splice products (GenBank Accession Nos. (DQ316984) and (DQ320011)), respectively, encoding MLrgW and MLrgS polypeptides. Both proteins contain zinc finger and leucine zipper domains and are thus potential regulators of transcription. Expression of MLrgW and MLrgS were robustly upregulated following LPS treatment, and the proteins were localized predominantly in the nuclear membrane and cytoplasm. In stable transfectants over-expressing MLrgW the proportion of cells in G1 phase was significantly reduced, while in cells over-expressing MLrgS the proportion of cells in G2 was significantly increased; both proteins are thus potential regulators of cell cycle progression. Upregulation of MLrgW and MLrgS may be an important component of the LPS inflammatory pathway and of the host response to infection with GNB.

  1. Regulation of neurotrophic factors and energy metabolism by antidepressants in astrocytes

    KAUST Repository

    Martin, Jean Luc

    2013-09-01

    There is growing evidence that astrocytes are involved in the neuropathology of major depression. In particular, decreases in glial cell density observed in the cerebral cortex of individuals with major depressive disorder are accompanied by a reduction of several astrocytic markers suggesting that astrocyte dysfunction may contribute to the pathophysiology of major depression. In rodents, glial loss in the prefrontal cortex is sufficient to induce depressive-like behaviors and antidepressant treatment prevents the stress-induced reduction of astrocyte number in the hippocampus. Collectively, these data support the existence of a link between astrocyte loss or dysfunction, depressive-like behavior and antidepressant treatment. Astrocytes are increasingly recognized to play important roles in neuronal development, neurotransmission, synaptic plasticity and maintenance of brain homeostasis. It is also well established that astrocytes provide trophic, structural, and metabolic support to neurons. In this article, we review evidence that antidepressants regulate energy metabolism and neurotrophic factor expression with particular emphasis on studies in astrocytes. These observations support a role for astrocytes as new targets for antidepressants. The contribution of changes in astrocyte glucose metabolism and neurotrophic factor expression to the therapeutic effects of antidepressants remains to be established. © 2013 Bentham Science Publishers.

  2. Modifying 5-HT1A receptor gene expression as a new target for antidepressant therapy

    Directory of Open Access Journals (Sweden)

    Paul R Albert

    2010-06-01

    Full Text Available Major depression is the most common form of mental illness, and is treated with antidepressant compounds that increase serotonin (5-HT neurotransmission. Increased 5-HT1A autoreceptor levels in the raphe nuclei act as a “brake” to inhibit the 5-HT system, leading to depression and resistance to antidepressants. Several 5-HT1A receptor agonists (buspirone, flesinoxan, ipsapirone that preferentially desensitize 5-HT1A autoreceptors have been tested for augmentation of antidepressant drugs with mixed results. One explanation could be the presence of the C(-1019G 5-HT1A promoter polymorphism that prevents gene repression of the 5-HT1A autoreceptor. Furthermore, down-regulation of 5-HT1A autoreceptor expression, not simply desensitization of receptor signaling, appears to be required to enhance and accelerate antidepressant action. The current review focuses on the transcriptional regulators of 5-HT1A autoreceptor expression, their roles in permitting response to 5-HT1A-targeted treatments and their potential as targets for new antidepressant compounds for treatment-resistant depression.

  3. KETAMINE'S MECHANISM OF ACTION: A PATH TO RAPID-ACTING ANTIDEPRESSANTS.

    Science.gov (United States)

    Abdallah, Chadi G; Adams, Thomas G; Kelmendi, Benjamin; Esterlis, Irina; Sanacora, Gerard; Krystal, John H

    2016-08-01

    Major depressive disorder (MDD) is a common and debilitating psychiatric disorder. Traditional antidepressants are of limited efficacy and take weeks to months to yield full therapeutic effects. Thus, there is a clear need for effective rapid-acting antidepressant medications. The N-methyl-d-aspartate receptor (NMDA-R) antagonist, ketamine, has received a great deal of attention over the last 20 years due to the discovery that a single subanesthetic dose leads to a rapid antidepressant effect in individuals with treatment-resistant depression. Animal and human research suggest that ketamine's antidepressant effects are mediated by a glutamate surge that leads to a cascade of events that result in synaptogenesis and reversal of the negative effects of chronic stress and depression, particularly within the prefrontal cortex (PFC). Preclinical and clinical data have provided compelling insights into the mechanisms underlying the rapid-acting antidepressant effects of ketamine. This review discusses stress-related neurobiology of depression and the safety, tolerability, and efficacy of ketamine for MDD, along with a review of ketamine's mechanism of action and prospective predictors of treatment response. Research limitations and future clinical prospects are also discussed. PMID:27062302

  4. Antidepressant Effects of AMPA and Ketamine Combination: Role of Hippocampal BDNF, Synapsin, and mTOR

    Science.gov (United States)

    Akinfiresoye, Luli; Tizabi, Yousef

    2013-01-01

    Rationale A number of preclinical and clinical studies suggest ketamine, a glutamate NMDA (N-methyl-D-aspartate) receptor antagonist, has a rapid and lasting antidepressant effect when administered either acutely or chronically. It has been postulated that this effect is due to stimulation of AMPA (alpha-amino-3-hydroxy-5-methyl–4-isoxazolepropionic acid) receptors. Objective In this study, we tested whether AMPA alone has an antidepressant effect and if the combination of AMPA and ketamine provides added benefit in Wistar-Kyoto (WKY) rats, a putative animal model of depression. Results Chronic AMPA treatment resulted in a dose dependent antidepressant effect in both the forced swim test (FST) and sucrose preference test. Moreover, chronic administration (10–11d) of combinations of AMPA and ketamine, at doses that were ineffective on their own, resulted in a significant antidepressant effect. The behavioral effects were associated with increases in hippocampal brain derived neurotrophic factor (BDNF), synapsin, and mammalian target of rapamycin (mTOR). Conclusion These findings are the first to provide evidence for an antidepressant effect of AMPA, and suggest the usefulness of AMPA-ketamine combination in treatment of depression. Furthermore, these effects appear to be associated with increases in markers of hippocampal neurogenesis and synaptogenesis, suggesting a mechanism of their action. PMID:23732839

  5. Antidepressant potential of nitrogen-containing heterocyclic moieties: An updated review

    Directory of Open Access Journals (Sweden)

    Nadeem Siddiqui

    2011-01-01

    Full Text Available Depression is currently the fourth leading cause of disease or disability worldwide. Antidepressant is approved for the treatment of major depression (including paediatric depression, obsessive-compulsive disorder (in both adult and paediatric populations, bulimia nervosa, panic disorder and premenstrual dysphoric disorder. Antidepressant is a psychiatric medication used to alleviate mood disorders, such as major depression and dysthymia and anxiety disorders such as social anxiety disorder. Many drugs produce an antidepressant effect, but restrictions on their use have caused controversy and off-label prescription a risk, despite claims of superior efficacy. Our current understanding of its pathogenesis is limited and existing treatments are inadequate, providing relief to only a subset of people suffering from depression. Reviews of literature suggest that heterocyclic moieties and their derivatives has proven success in treating depression.

  6. Is increased antidepressant exposure a contributory factor to the obesity pandemic?

    Science.gov (United States)

    Lee, S H; Paz-Filho, G; Mastronardi, C; Licinio, J; Wong, M-L

    2016-01-01

    Major depressive disorder (MDD) and obesity are both common heterogeneous disorders with complex aetiology, with a major impact on public health. Antidepressant prescribing has risen nearly 400% since 1988, according to data from the Centers for Disease Control and Prevention (CDC). In parallel, adult obesity rates have doubled since 1980, from 15 to 30 percent, while childhood obesity rates have more than tripled. Rising obesity rates have significant health consequences, contributing to increased rates of more than thirty serious diseases. Despite the concomitant rise of antidepressant use and of the obesity rates in Western societies, the association between the two, as well as the mechanisms underlying antidepressant-induced weight gain, remain under explored. In this review, we highlight the complex relationship between antidepressant use, MDD and weight gain. Clinical findings have suggested that obesity may increase the risk of developing MDD, and vice versa. Hypothalamic-pituitary-adrenal (HPA) axis activation occurs in the state of stress; concurrently, the HPA axis is also dysregulated in obesity and metabolic syndrome, making it the most well-understood shared common pathophysiological pathway with MDD. Numerous studies have investigated the effects of different classes of antidepressants on body weight. Previous clinical studies suggest that the tricyclics amitriptyline, nortriptyline and imipramine, and the serotonin norepinephrine reuptake inhibitor mirtazapine are associated with weight gain. Despite the fact that selective serotonin reuptake inhibitor (SSRI) use has been associated with weight loss during acute treatment, a number of studies have shown that SSRIs may be associated with long-term risk of weight gain; however, because of high variability and multiple confounds in clinical studies, the long-term effect of SSRI treatment and SSRI exposure on body weight remains unclear. A recently developed animal paradigm shows that the combination of

  7. 拉莫三嗪联合抗抑郁药物治疗双相抑郁的研究:国内文献Meta分析%Meta-analysis of clinical effects and switching rate of lamotrigine and antidepressants in treatment of bipolar depression

    Institute of Scientific and Technical Information of China (English)

    王志强; 文璐; 任欣; 金卫东

    2015-01-01

    Objective To assess the difference in therapy efficacy and safety between lamotrigine adding antidepressants and sin-gle antidepressant in treatment of bipolar depression. Methods studies meeting our criteria were analyzed by based-evidence medi-cine,comparing the difference in symptoms changes,efficacy rate,and switching rate. Results The decreasing of symptoms scale in combined group was more significant than that of single antidepressant( WMD= -1. 81,95%CI:-2. 64 ~ -1. 71,Z=5. 52,P<0. 01),and effective rate in combined group was more higher than that of single antidepressants(59/109 vs 35/106,OR=2. 43,95%CI:1. 38~ 4. 27,Z=3. 08,P<0. 01),And switching rate in combined group was more lower than that of single antidepressants(7/86vs. 21/85,OR=0. 2,95%CI=0. 10 -0. 66,Z=2. 86,P<0. 01). Conclusion Lamotrigine adding antidepressant may promote treating efficacy,and decrease switching.%目的:评价拉莫三嗪联合抗抑郁药物与单一使用抗抑郁药物治疗双相抑郁症的疗效与安全性。方法应用循证医学方法对符合标准的5项研究进行分析,评价拉莫三嗪联合抗抑郁药物与单一使用抗抑郁药物治疗双相抑郁的有效率、症状学变化以及转相率的差异。结果拉莫三嗪联合抗抑郁药物与单一使用抗抑郁药物相比,症状改善更为明显(WMD=-1.81,95%CI:-2.64~-1.71,Z=5.52,P<0.01),有效率较高(59/109 vs.35/106,OR=2.43,95%CI:1.38~4.27,Z=3.08,P<0.01),而且也显著降低了联合组的转相率(7/86vs.21/85,OR=0.26,95%CI=0.10-0.66,Z=2.86,P<0.01)。结论拉莫三嗪联合抗抑郁药物不仅可以增加治疗效应,而且也降低了转相风险。

  8. Improving adhesion between luting cement and zirconia-based ceramic with an alternative surface treatment

    Directory of Open Access Journals (Sweden)

    Aurealice Rosa Maria MARTINS

    2015-01-01

    Full Text Available This study evaluated the influence of an alternative surface treatment on the microshear bond strength (μsbs of zirconia-based ceramic. Thirty-five zirconia disks were assigned to five groups according to the following treatments: Control (CO, glass and silane were not applied to the zirconia surface; G1, air blasted with 100μm glass beads + glaze + silane; G2, a gel containing 15% (by weight glass beads applied to the ceramic surface + glaze + silane; G3, a gel containing 25% (by weight glass beads applied to the ceramic surface + glaze + silane; and G4, a gel containing 50% (by weight glass beads applied to the ceramic surface + glaze + silane. The specimens were built up using RelyX ARC®, according to the manufacturer’s recommendations, and inserted in an elastomeric mold with an inner diameter of 0.8 mm. The μsbs test was performed using a testing machine at a crosshead speed of 0.5 mm/min. ANOVA and Tukey’s test (p < 0.05 were applied to the bond strength values (in MPa. CO (15.6 ± 4.1 showed the lowest μsbs value. There were no statistical differences between the G1 (24.9 ± 7.4, G2 (24.9 ± 2.3, G3 (35.0 ± 10.3 and G4 (35.3 ± 6.0 experimental groups. Those groups submitted to surface treatments with higher concentrations of glass showed a lower frequency of adhesive failures. In conclusion, the glass application improved the interaction between the ceramic and the luting cement.

  9. INTRAPERITONEAL DEXTROSE ADMINISTRATION AS AN ALTERNATIVE EMERGENCY TREATMENT FOR HYPOGLYCEMIC YEARLING CALIFORNIA SEA LIONS (ZALOPHUS CALIFORNIANUS).

    Science.gov (United States)

    Fravel, Vanessa A; Van Bonn, William; Gulland, Frances; Rios, Carlos; Fahlman, Andreas; Graham, James L; Havel, Peter J

    2016-03-01

    The Marine Mammal Center (TMMC) cares for malnourished California sea lion (CSL) (Zalophus californianus) pups and yearlings every year. Hypoglycemia is a common consequence of malnutrition in young CSLs. Administering dextrose during a hypoglycemic crisis is vital to recovery. Traditional veterinary approaches to treat hypoglycemia pose therapeutic challenges in otariids, as vascular access and catheter maintenance can be difficult. The current approach to a hypoglycemic episode at TMMC is to administer dextrose intravenously (i.v.) by medically trained personnel. Intraperitoneal (i.p.) dextrose administration is an attractive alternative to i.v. administration because volunteer staff with basic training can administer treatment instead of waiting for trained staff to treat. This study compares the effects of i.v., i.p., and no dextrose administration on serum glucose and insulin in clinically healthy, euglycemic CSL yearlings. Three groups of animals, consisting of five sea lions each, were treated with 500 mg/kg dextrose using one of the following routes: i.v., i.p., or no dextrose (control). A jugular catheter was placed, and blood samples were collected at times 0, 5, 15, 30, 60, 120, 180, and 240 min after dextrose administration. I.v. dextrose administration resulted in an increase of serum glucose concentrations from a baseline level of approximately 150 mg/dl to a peak of approximately 350 mg/dl. The resulting hyperglycemia persisted for approximately 2 hr and was associated with an attenuated plasma insulin response compared with most terrestrial mammals. Intraperitoneal dextrose administration resulted in increases of serum glucose to approximately 200 mg/dl, which gradually declined to baseline by 2 hr after dextrose administration. These data suggest that the initial treatment of a hypoglycemic crisis in young malnourished CSLs can be accomplished with i.p. dextrose, thus enabling minimally trained volunteer staff to respond immediately to a crisis

  10. Successful antidepressant chronotherapeutics enhance fronto-limbic neural responses and connectivity in bipolar depression.

    Science.gov (United States)

    Vai, Benedetta; Poletti, Sara; Radaelli, Daniele; Dallaspezia, Sara; Bulgarelli, Chiara; Locatelli, Clara; Bollettini, Irene; Falini, Andrea; Colombo, Cristina; Smeraldi, Enrico; Benedetti, Francesco

    2015-08-30

    The identification of antidepressant response predictors in bipolar disorder (BD) may provide new potential enhancements in treatment selection. Repeated total sleep deprivation combined with light therapy (TSD+LT) can acutely reverse depressive symptoms and has been proposed as a model antidepressant treatment. This study aims at investigating the effect of TSD+LT on effective connectivity and neural response in cortico-limbic circuitries during implicit processing of fearful and angry faces in patients with BD. fMRI and Dynamic Causal Modeling (DCM) were combined to study the effect of chronotherapeutics on neural responses in healthy controls (HC, n = 35) and BD patients either responder (RBD, n = 26) or non responder (nRBD, n = 11) to 3 consecutive TSD+LT sessions. Twenty-four DCMs exploring connectivity between anterior cingulate cortex (ACC), dorsolateral prefrontal cortex (DLPFC), Amygdala (Amy), fusiform gyrus and visual cortex were constructed. After treatment, patients significantly increased their neural responses in DLPFC, ACC and insula. nRBD showed lower baseline and endpoint neural responses than RBD. The increased activity in ACC and in medial prefrontal cortex, associated with antidepressant treatment, was positively associated with the improvement of depressive symptomatology. Only RBD patients increased intrinsic connectivity from DLPFC to ACC and reduced the modulatory effect of the task on Amy-DLPFC connection. A successful antidepressant treatment was associated with an increased functional activity and connectivity within cortico-limbic networks, suggesting the possible role of these measures in providing possible biomarkers for treatment efficacy. PMID:26195295

  11. SLUDGE TREATMENT PROJECT PHASE 1 SLUDGE STORAGE OPTIONS ASSESSMENT OF T PLANT VERSUS ALTERNATE STORAGE FACILITY

    Energy Technology Data Exchange (ETDEWEB)

    RUTHERFORD WW; GEUTHER WJ; STRANKMAN MR; CONRAD EA; RHOADARMER DD; BLACK DM; POTTMEYER JA

    2009-04-29

    The CH2M HILL Plateau Remediation Company (CHPRC) has recommended to the U.S. Department of Energy (DOE) a two phase approach for removal and storage (Phase 1) and treatment and packaging for offsite shipment (Phase 2) of the sludge currently stored within the 105-K West Basin. This two phased strategy enables early removal of sludge from the 105-K West Basin by 2015, allowing remediation of historical unplanned releases of waste and closure of the 100-K Area. In Phase 1, the sludge currently stored in the Engineered Containers and Settler Tanks within the 105-K West Basin will be transferred into sludge transport and storage containers (STSCs). The STSCs will be transported to an interim storage facility. In Phase 2, sludge will be processed (treated) to meet shipping and disposal requirements and the sludge will be packaged for final disposal at a geologic repository. The purpose of this study is to evaluate two alternatives for interim Phase 1 storage of K Basin sludge. The cost, schedule, and risks for sludge storage at a newly-constructed Alternate Storage Facility (ASF) are compared to those at T Plant, which has been used previously for sludge storage. Based on the results of the assessment, T Plant is recommended for Phase 1 interim storage of sludge. Key elements that support this recommendation are the following: (1) T Plant has a proven process for storing sludge; (2) T Plant storage can be implemented at a lower incremental cost than the ASF; and (3) T Plant storage has a more favorable schedule profile, which provides more float, than the ASF. Underpinning the recommendation of T Plant for sludge storage is the assumption that T Plant has a durable, extended mission independent of the K Basin sludge interim storage mission. If this assumption cannot be validated and the operating costs of T Plant are borne by the Sludge Treatment Project, the conclusions and recommendations of this study would change. The following decision-making strategy, which is

  12. SLUDGE TREATMENT PROJECT PHASE 1 SLUDGE STORAGE OPTIONS. ASSESSMENT OF T PLANT VERSUS ALTERNATE STORAGE FACILITY

    International Nuclear Information System (INIS)

    The CH2M HILL Plateau Remediation Company (CHPRC) has recommended to the U.S. Department of Energy (DOE) a two phase approach for removal and storage (Phase 1) and treatment and packaging for offsite shipment (Phase 2) of the sludge currently stored within the 105-K West Basin. This two phased strategy enables early removal of sludge from the 105-K West Basin by 2015, allowing remediation of historical unplanned releases of waste and closure of the 100-K Area. In Phase 1, the sludge currently stored in the Engineered Containers and Settler Tanks within the 105-K West Basin will be transferred into sludge transport and storage containers (STSCs). The STSCs will be transported to an interim storage facility. In Phase 2, sludge will be processed (treated) to meet shipping and disposal requirements and the sludge will be packaged for final disposal at a geologic repository. The purpose of this study is to evaluate two alternatives for interim Phase 1 storage of K Basin sludge. The cost, schedule, and risks for sludge storage at a newly-constructed Alternate Storage Facility (ASF) are compared to those at T Plant, which has been used previously for sludge storage. Based on the results of the assessment, T Plant is recommended for Phase 1 interim storage of sludge. Key elements that support this recommendation are the following: (1) T Plant has a proven process for storing sludge; (2) T Plant storage can be implemented at a lower incremental cost than the ASF; and (3) T Plant storage has a more favorable schedule profile, which provides more float, than the ASF. Underpinning the recommendation of T Plant for sludge storage is the assumption that T Plant has a durable, extended mission independent of the K Basin sludge interim storage mission. If this assumption cannot be validated and the operating costs of T Plant are borne by the Sludge Treatment Project, the conclusions and recommendations of this study would change. The following decision-making strategy, which is

  13. Efficiency of enzymatic and other alternative clarification and fining treatments on turbidity and haze in cherry juice

    DEFF Research Database (Denmark)

    Meyer, Anne Boye Strunge; Köser, C.; Adler-Nissen, Jens

    2001-01-01

    function. Individual and interactive effects on turbidity and haze formation in precentrifuged and uncentrifuged cherry juice of treatments with pectinase, acid protease, bromelain, gallic acid, and gelatin-silica sol were investigated in a factorial experimental design with 32 different parameter...... combinations. Gelatin-silica sol consistently had the best effect on juice clarity. Centrifugation of cherry juice (10000g for 15 min) prior to clarification treatment significantly improved juice clarity and diminished the rate of haze formation during cold storage of juice. Both treatment of precentrifuged...... cherry juice with Novozym 89L protease and co- addition of pectinase and gallic acid improved cherry juice clarity and diminished haze levels. None of the alternative treatments produced the unwieldy colloids notorious to gelatin- silica sol treatment. The data suggest that several alternative...

  14. GREYWATER TREATMENT SYSTEM IN UNIVERSITI KEBANGSAAN MALAYSIA MOSQUE: UTILIZING FILTER WELLS AS AN ALTERNATIVE SUSTAINABLE INNOVATION

    Directory of Open Access Journals (Sweden)

    Nangkula Utaberta

    2014-09-01

    Full Text Available Water is one of the natural resources that support entire creature’s needs in earth. It was also a key element of sustainable living. The important of water is proved by fact that human body were consists of 80% water which makes daily water needs is definitely important. Same thing was happen on earth which also consists of 71 % water.  Unfortunately,  nowadays qualities  as well  as quantities  of  water is getting  poor caused many environmental decline. Those situation is feel quite irony, first is because in one side human are depending on water badly, and in another side, qualities and quantities water have been decreasing because of their own. This environmental issue, especially water was realized by Universiti Kebangsaan Malaysia (UKM by starting to be a first pioneer in Green & Sustainability Campus in Malaysia.  Although UKM is located in water-rich country, still UKM try to commit to save environment as well as manage its environment aspect. The usage of water in UKM itself is categorized in high level. UKM have around 20.000 students and most of them are dwelling in campus.  For  big  campus  like  this,  UKM  had  one  main  Mosque  which  accommodates  some  daily  worship  of Moslem as the majority one. For activities like ablution, washing and bathing, UKM Mosque had produce quite big  amount  of  grey  water.  Grey  water itself  is residual  water that  still fresh  and can  be recycled for some purposes such as landscape irrigation and cleaning service. One alternative method to treats the grey water is by the usage of filter wells. This paper is trying to analysis and proposes some design of grey water system in UKM mosque in order to save environment. With proper grey water treatment, UKM Mosque will contribute to save water and UKM’s environment. This successful water treatment is also can be an alternative model to apply in another building.

  15. Ketamine enantiomers in the rapid and sustained antidepressant effects.

    Science.gov (United States)

    Muller, John; Pentyala, Sahana; Dilger, James; Pentyala, Srinivas

    2016-06-01

    Recent evidence has suggested that the N-methyl-D-aspartate receptor antagonist ketamine shows significant therapeutic effects in major depression and bipolar disorder. This effect is especially important in treatment-resistant depression and depression with suicidal ideation. In this review we explain the mechanism of action, drug efficacy, and the side effects of ketamine; the antidepressive effects of ketamine; the individual effects of ketamine isomers, R(-) ketamine and S(+) ketamine; the effects of the combination of ketamine with electroconvulsive therapy; and the possible use of ketamine in treating depression. PMID:27354907

  16. Investigation of alternative phosphating treatments for nickel and hexavalent chromium elimination

    International Nuclear Information System (INIS)

    obtained with passivation treatment in niobium containing solution could be considered as a promising alternative to replace passivation with hexavalent chromium ions. Despite of the promising results, adjustments in the baths to obtain stability are still needed and should guide the next steps of the subject of this research. (author)

  17. Therapeutic efficacy of alternative primaquine regimens to standard treatment in preventing relapses by Plasmodium vivax

    Science.gov (United States)

    Tamayo Perez, María-Eulalia; Aguirre-Acevedo, Daniel Camilo

    2015-01-01

    Objective: To compare efficacy and safety of primaquine regimens currently used to prevent relapses by P. vivax. Methods: A systematic review was carried out to identify clinical trials evaluating efficacy and safety to prevent malaria recurrences by P. vivax of primaquine regimen 0.5 mg/kg/ day for 7 or 14 days compared to standard regimen of 0.25 mg/kg/day for 14 days. Efficacy of primaquine according to cumulative incidence of recurrences after 28 days was determined. The overall relative risk with fixed-effects meta-analysis was estimated. Results: For the regimen 0.5 mg/kg/day/7 days were identified 7 studies, which showed an incidence of recurrence between 0% and 20% with follow-up 60-210 days; only 4 studies comparing with the standard regimen 0.25 mg/kg/day/14 days and no difference in recurrences between both regimens (RR= 0.977, 95% CI= 0.670 to 1.423) were found. 3 clinical trials using regimen 0.5 mg/kg/day/14 days with an incidence of recurrences between 1.8% and 18.0% during 330-365 days were identified; only one study comparing with the standard regimen (RR= 0.846, 95% CI= 0.484 to 1.477). High risk of bias and differences in handling of included studies were found. Conclusion: Available evidence is insufficient to determine whether currently PQ regimens used as alternative rather than standard treatment have better efficacy and safety in preventing relapse of P. vivax. Clinical trials are required to guide changes in treatment regimen of malaria vivax. PMID:26848199

  18. Microbial and Natural Metabolites That Inhibit Splicing: A Powerful Alternative for Cancer Treatment

    Directory of Open Access Journals (Sweden)

    Nancy Martínez-Montiel

    2016-01-01

    Full Text Available In eukaryotes, genes are frequently interrupted with noncoding sequences named introns. Alternative splicing is a nuclear mechanism by which these introns are removed and flanking coding regions named exons are joined together to generate a message that will be translated in the cytoplasm. This mechanism is catalyzed by a complex machinery known as the spliceosome, which is conformed by more than 300 proteins and ribonucleoproteins that activate and regulate the precision of gene expression when assembled. It has been proposed that several genetic diseases are related to defects in the splicing process, including cancer. For this reason, natural products that show the ability to regulate splicing have attracted enormous attention due to its potential use for cancer treatment. Some microbial metabolites have shown the ability to inhibit gene splicing and the molecular mechanism responsible for this inhibition is being studied for future applications. Here, we summarize the main types of natural products that have been characterized as splicing inhibitors, the recent advances regarding molecular and cellular effects related to these molecules, and the applications reported so far in cancer therapeutics.

  19. An alternative treatment of hyperlipidemia with red yeast rice: a case report

    Directory of Open Access Journals (Sweden)

    Lin James S

    2010-01-01

    Full Text Available Abstract Introduction Hyperlipidemia is prevalent and is highly associated with coronary heart disease. Some patients are reluctant or opt not to take lipid-lowering prescription medications for fear of adverse drug reactions. There are currently few well-designed randomized controlled trials showing the possibility of reducing cholesterol using red yeast rice. Meanwhile, adverse effects have also been reported. Case presentation A 64-year-old Asian man was diagnosed with hyperlipidemia despite a healthy lifestyle. In addition to diet changes, the patient used red yeast rice and succeeded in lowering his level of serum lipids. Conclusion Based on this case and a review of current literature, in addition to therapeutic lifestyle change, red yeast rice may be a useful alternative treatment for primary hyperlipidemia in patients with low cardiac risk and who refuse to take any lipid-lowering prescription medication or who maybe be statin intolerant. However, primary care physicians must be aware of the potential side effects of taking red yeast rice.

  20. Grape bagasse as an alternative natural adsorbent of cadmium and lead for effluent treatment

    International Nuclear Information System (INIS)

    This work investigated the utilization of grape bagasse as an alternative natural adsorbent to remove Cd(II) and Pb(II) ions from laboratory effluent. X-ray diffractometry, Fourier transform infrared spectroscopy, scanning electron microscopy, nuclear magnetic resonance, thermogravimetric analyses, surface analysis, porosity and porous size were used for characterization of the material. Batch experiments were carried out to evaluate the adsorption capacity of the material. Parameters such as adsorption pH and contact time were optimized for the maximum accumulation onto the solid surface. The pH values found were 7 and 3 for Cd(II) and Pb(II), respectively, and contact time was 5 min for both metals. Adsorption capacity for metals were calculated from adsorption isotherms by applying the Langmueir model and found to be 0.774 and 0.428 mmol g-1 for Cd(II) and Pb(II), respectively. The competition between metals for the same adsorption sites on grape bagasse was also evaluated, showing an increasing affinity for Pb(II) over Cd(II) when only these metals are present. The potential of this material was demonstrated by efficient metal removal from laboratory effluent using a glass column. The results indicate that the referred material could be employed as adsorbent for effluent treatment, especially due to its easy acquisition and low cost as well as the fast adsorption involved

  1. Microbial and Natural Metabolites That Inhibit Splicing: A Powerful Alternative for Cancer Treatment.

    Science.gov (United States)

    Martínez-Montiel, Nancy; Rosas-Murrieta, Nora Hilda; Martínez-Montiel, Mónica; Gaspariano-Cholula, Mayra Patricia; Martínez-Contreras, Rebeca D

    2016-01-01

    In eukaryotes, genes are frequently interrupted with noncoding sequences named introns. Alternative splicing is a nuclear mechanism by which these introns are removed and flanking coding regions named exons are joined together to generate a message that will be translated in the cytoplasm. This mechanism is catalyzed by a complex machinery known as the spliceosome, which is conformed by more than 300 proteins and ribonucleoproteins that activate and regulate the precision of gene expression when assembled. It has been proposed that several genetic diseases are related to defects in the splicing process, including cancer. For this reason, natural products that show the ability to regulate splicing have attracted enormous attention due to its potential use for cancer treatment. Some microbial metabolites have shown the ability to inhibit gene splicing and the molecular mechanism responsible for this inhibition is being studied for future applications. Here, we summarize the main types of natural products that have been characterized as splicing inhibitors, the recent advances regarding molecular and cellular effects related to these molecules, and the applications reported so far in cancer therapeutics. PMID:27610372

  2. Irradiation as an alternative treatment to methyl bromide for insect control

    International Nuclear Information System (INIS)

    Turkey is the leading country in the world, in production and exports of dried fig, apricot, raisin and hazelnut. One of main problem in the export trade is infestation by stored product insects. Using MB is very effective for controlling stored product insects in Turkey. MB has also listed as an ozone depleting substance and worldwide production will be phased out in the near future, than Turkey will be faced very serious problem for export dry fruits and hazelnut. Use of irradiation to disinfest agricultural products has obvius advantages, most of which are influenced by environmental, cultural, economic, commercial and govermental factors. The first two factors, effectiveness and economy, are adressed principally. Research conducted world-wide in the past four decades have shown that radiation processing is an effective and safe method for controlling insect pests of stored products. Irradiation offers an effective alternative quarantine treatment which is more environmentally friendly and sustainable as compared to fumigants. In view of the phasing out of the currently used post harvest chemical fumigants, irradiation either alone or in conjuction with other post-harvest procedures can contribute towards the goals of achieving food security in developing and less developed countries by effectively reducing post-harvest losses

  3. Alternative temozolomide dosing regimens and novel combinations for the treatment of advanced metastatic melanoma

    Directory of Open Access Journals (Sweden)

    Wen-Jen Hwu

    2011-12-01

    Full Text Available Over the past 30 years, there has been no significant improvement in treatment outcomes for patients with advanced stage IV metastatic melanoma, and prognosis remains poor. Melanoma is known to be responsive to immunomodulatory agents, to be a highly vascular tumor, and to be fairly resistant to standard cytotoxic chemotherapy. Ongoing research is attempting to find novel combinations that may have therapeutic synergy. Alternative dosedense schedules of temozolomide appear promising and are being actively investigated, based on their potential to overcome chemoresistance to alkylating agents and the proven activity of temozolomide in the brain. Outcomes of studies investigating single-agent temozolomide suggest that it has activity similar to single-agent dacarbazine. Other studies combining temozolomide with either interferon- alfa or thalidomide suggest that the addition of these immunomodulatory agents to temozolomide improves response rates and may improve overall survival. The best results have been achieved with the extended, daily, dosedense temozolomide regimen. Further research is needed to determine the optimal temozolomide regimen and best combination approach

  4. The mesolimbic dopamine system as a target for rapid antidepressant action.

    Science.gov (United States)

    Willner, P

    1997-07-01

    Chronic treatment with antidepressant drugs produces a variety of changes in dopaminergic neurotransmission, most notably a sensitization of behavioural responses to agonists acting at dopamine D2/D3 receptors within the nucleus accumbens. Evidence from animal models of depression (the forced swim test and the chronic mild stress procedure) indicates that these effects are crucial for the therapeutic effect of antidepressants in these models. Antidepressant-like effects in animal models are also seen with drugs that act directly on the dopaminergic system. Because of its prolonged time-course, the chronic mild stress procedure can be used to examine onset latencies. Some dopamine-active drugs (e.g. the catechol-O-methyltransferase inhibitor tolcapone; D2/D3 agonists administered intermittently) are active in this procedure but have a time-course comparable to that of conventional antidepressants. Other dopamine-active drugs may have a more rapid onset; the evidence to date suggests this possibility for the D2/D3 agonist pramipexole and the preferential presynaptic antagonist amisulpride. In clinical studies, rapid-onset latencies have been claimed for the D2/D3 agonist roxindole, the preferential presynaptic antagonist sulpiride and the relatively selective dopamine-uptake inhibitor amineptine. The mechanisms that might give rise to a rapid onset of dopamine-mediated antidepressant effects are discussed. PMID:9347387

  5. [Antidepressant-resistant depression and bipolar spectrum - diagnostic and therapeutic considerations].

    Science.gov (United States)

    Rihmer, Zoltán; Gonda, Xénia; Rihmer, Annamária; Döme, Péter

    2016-01-01

    According to the results of epidemiological studies mood disorders with unipolar (major and minor depressive disorder; dysthymia) or bipolar features are among the most prevalent psychiatric disorders. These disorders with their frequent comorbidities (alcohol and/or drug use disorders, smoking, suicide, cardiovascular disorders) pose great public health challenge and cause substantial individual and familar burdens as well. Since SSRIs and other new antidepressant agents entered the market the possibilities to treat depression improved substantially but 25-35 percent of major depressives do not respond even to the second antidepressant trial but the rate of patients who are resistant after the third and fourth adequate antidepressant trial are around only 15-25 and 10 percent, respectively. Pharmacotherapy-resistant depression is a multicausal phenomenon. Along with its well-known risk-factors investigations of the past decade have revealed that unrecognised or hidden (subsyndromal or subthreshold) bipolarity is one of the most frequent causes of treatment resistance. In the case of bipolar depression (either as a part of syndromal bipolar I or II disorder or a subsyndromal manifestation) antidepressant monotherapy should be avoided and, instead of it, the administration of a mood stabilizer (primarily lithium and lamotrigine) or some atypical antipsychotics (preferably quetiapine) are recommended. If antidepressant is inevitably necessary in bipolar depression, we should use it always in combination with mood stabilizers or atypical antipsychotics. PMID:27244871

  6. Antidepressant No Help to Heart Failure Patients: Study

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_159604.html Antidepressant No Help to Heart Failure Patients: Study Depression ... 2016 TUESDAY, June 28, 2016 (HealthDay News) -- The antidepressant Lexapro may not help heart failure patients suffering ...

  7. Antidepressant Effects of Resveratrol in an Animal Model of Depression

    Science.gov (United States)

    Akinfiresoye, Laura L. Hurley, Luli; Kalejaiye, Olubukola; Tizabi, Yousef

    2014-01-01

    Resveratrol (3,4’,5-trihydroxy-trans-stilbene) is a natural non-flavonoid polyphenol antioxidant extracted from red grapes in the processing of wine. Initially it was studied for its potential as anticancer drug, and later was found to reduce cardiovascular disease. More recently resveratrol was shown to alleviate depressive-like symptoms induced by stress or other means in mice and rats. The major purpose of this study was to investigate whether resveratrol would manifest an antidepressant effect in Wistar-Kyoto (WKY) rats, a putative and non-induced animal model of depression, and whether this effect might be associated with an increase in hippocampal and frontal cortical brain-derived neurotrophic factor (BDNF), a protein implicated in chronic effects of many antidepressants. Adult male WKY rats were injected with two doses of resveratrol (10 and 40 mg/kg, i.p.) and their behavior in the open field locomotor activity (LMA), forced swim test (FST: a measure of helplessness), and sucrose preference test (SPT: a measure of anhedonia) was evaluated after a single acute injection or following 7 days of daily treatment. Both acute and chronic administration of resveratrol resulted in a dose-dependent decrease in FST. However, only chronic resveratrol resulted in dose-dependent increase in sucrose consumption. LMA was not affected by any treatment. Parallel to the observed behavioral effects the level of hippocampal, but not frontal cortical, BDNF was also dose-dependently elevated after chronic resveratrol administration. These findings indicate an antidepressant-like effect of resveratrol in an animal model of depression possibly via activation of hippocampal BDNF, and suggest therapeutic potential of resveratrol in at least a subpopulation of depressed patients. PMID:24717328

  8. Antidepressant or Antipsychotic Overdose in the Intensive Care Unit - Identification of Patients at Risk

    DEFF Research Database (Denmark)

    Borg, Linda; Julkunen, Anna; Madsen, Kristian Rørbaek;

    2016-01-01

    adverse signs at hospital admission that turned out to need intensive care treatment. The effect of the antidepressants overdose risk assessment (ADORA) system was evaluated in patients with antidepressant as well as antipsychotic overdose. Our hypothesis was that patients with low ADORA do not need...... obvious need of intensive care. Of the 157 patients included, 12 patients (8%) developed events during the ICU stay. Only 3 patients received intubation, vasoactive drugs and/or dialysis. None developed ventricular dysrhythmias. There were no fatalities. All the patients with low-risk assessment by ADORA...

  9. Extrapyramidal symptoms and antidepressant drugs: neuropharmacological aspects of a frequent interaction in the elderly.

    Science.gov (United States)

    Govoni, S; Racchi, M; Masoero, E; Zamboni, M; Ferini-Strambi, L

    2001-03-01

    Depression is the most prevalent functional psychiatric disorder in late life. The problem of motor disorders associated with antidepressant use is relevant in the elderly. Elderly people are physically more frail and more likely to be suffering from physical illness, and any drug given may exacerbate pre-existing diseases, or interact with other drug treatments being administered for physical conditions. Antidepressants have been reported to induce extrapyramidal symptoms, including parkinsonism. These observations prompted us to review the neurobiological mechanism that may be involved in this complex interplay including neurotransmitters and neuronal circuits involved in movement and emotion control and their changes related to aging and disease. The study of the correlations between motor and mood disorders and their putative biochemical bases, as presented in this review, provide a rationale either to understand or to foresee motor side effects for psychotropic drugs, in particular antidepressants. PMID:11317214

  10. Constructed wetland: an alternative for wastewater treatment; Humedales construidos: una alternativa a considerar para el tratamiento de aguas residuales

    Energy Technology Data Exchange (ETDEWEB)

    Plaza de los Reyes del Rio, C.; Vidal Saez, G.

    2007-07-01

    Research and trends dealing with sewage and industrial wastewaters treated by constructed wetlands are shown in this paper. Plant and constructed wetlands configurations are also described. Sewage domestic wastewaters from individual houses or villages have used constructed wetlands as wastewater treatment. On the other hand, constructed wetlands as finally treatment working together with conventional technologies could be a good alternative for improving the treated quality wastewater. (Author) 56 refs.

  11. Alternative concepts for treatment and disposal of Hanford site high-level waste in tanks

    Energy Technology Data Exchange (ETDEWEB)

    Claghorn, R.D.; Powell, W.J.

    1994-12-01

    Some innovative approaches have recently been proposed that may have significant schedule, cost, or environmental advantages which could improve the current HLW program strategy. Three general categories of alternative concepts are now under consideration: (1) process/product alternatives, (2) facility layout options, and (3) contracting strategies. This report compares the alternate approaches to the current program baseline to illustrate their potential significance and to identify the risks associated with each approach.

  12. Alternative concepts for treatment and disposal of Hanford site high-level waste in tanks

    International Nuclear Information System (INIS)

    Some innovative approaches have recently been proposed that may have significant schedule, cost, or environmental advantages which could improve the current HLW program strategy. Three general categories of alternative concepts are now under consideration: (1) process/product alternatives, (2) facility layout options, and (3) contracting strategies. This report compares the alternate approaches to the current program baseline to illustrate their potential significance and to identify the risks associated with each approach

  13. Analysis of 23andMe antidepressant efficacy survey data: implication of circadian rhythm and neuroplasticity in bupropion response.

    Science.gov (United States)

    Li, Q S; Tian, C; Seabrook, G R; Drevets, W C; Narayan, V A

    2016-01-01

    Genetic predisposition may contribute to the differences in drug-specific, class-specific or antidepressant-wide treatment resistance. Clinical studies with the genetic data are often limited in sample sizes. Drug response obtained from self-reports may offer an alternative approach to conduct a study with much larger sample size. Using the phenotype data collected from 23andMe 'Antidepressant Efficacy and Side Effects' survey and genotype data from 23andMe's research participants, we conducted genome-wide association study (GWAS) on subjects of European ancestry using four groups of phenotypes (a) non-treatment-resistant depression (n=7795) vs treatment-resistant depression (TRD, n=1311), (b) selective serotonin reuptake inhibitors (SSRI) responders (n=6348) vs non-responders (n=3340), (c) citalopram/escitalopram responders (n=2963) vs non-responders (n=2005), and (d) norepinephrine-dopamine reuptake inhibitor (NDRI, bupropion) responders (n=2675) vs non-responders (n=1861). Each of these subgroups was also compared with controls (n ~ 190 000). The most significant association was from bupropion responders vs non-responders analysis. Variant rs1908557 (P=2.6 × 10(-8), OR=1.35) passed the conventional genome-wide significance threshold (P=5 × 10(-8)) and was located within the intron of human spliced expressed sequence tags in chromosome 4. Gene sets associated with long-term depression, circadian rhythm and vascular endothelial growth factor (VEGF) pathway were enriched in the bupropion analysis. No single-nucleotide polymorphism passed genome-wide significance threshold in other analyses. The heritability estimates for each response group compared with controls were between 0.15 and 0.25, consistent with the known heritability for major depressive disorder. PMID:27622933

  14. Evaluation of healthcare waste treatment/disposal alternatives by using multi-criteria decision-making techniques.

    Science.gov (United States)

    Özkan, Aysun

    2013-02-01

    Healthcare waste should be managed carefully because of infected, pathological, etc. content especially in developing countries. Applied management systems must be the most appropriate solution from a technical, environmental, economic and social point of view. The main objective of this study was to analyse the current status of healthcare waste management in Turkey, and to investigate the most appropriate treatment/disposal option by using different decision-making techniques. For this purpose, five different healthcare waste treatment/disposal alternatives including incineration, microwaving, on-site sterilization, off-site sterilization and landfill were evaluated according to two multi-criteria decision-making techniques: analytic network process (ANP) and ELECTRE. In this context, benefits, costs and risks for the alternatives were taken into consideration. Furthermore, the prioritization and ranking of the alternatives were determined and compared for both methods. According to the comparisons, the off-site sterilization technique was found to be the most appropriate solution in both cases.

  15. Antidepressants modulate glycine action in rat hippocampus.

    Science.gov (United States)

    Chang, Hyun-Kyung; Kim, Khae Hawn; Kang, Ki-Woon; Kang, Yoo-Jin; Kim, Tae-Wook; Park, Hun-Kyung; Kim, Sung-Eun; Kim, Chang-Ju

    2015-12-01

    Antidepressants are drugs that relieve symptoms of depressive disorders. Fluoxetine, tianeptine, and milnacipran are different types of antidepressants, and they have widely been used for relieving of depression symptoms. In the present study, the effects of fluoxetine, tianeptine, and milnacipran on the glycine-induced ion current by nystatin-perforated patch clamp and on the amplitude of field potential in the hippocampal CA1 region by multichannel extracellular recording, MED64, system, were studied. In the present results, fluoxetine, tianeptine, and milnacipran reduced glycine-induced ion current in the hippocampal CA1 neurons in nystatin-perforated patch clamp method. These drugs enhanced the amplitude of the field potential in the hippocampal CA1 region in MED64 system. These results suggest that antidepressants may increase neuronal activity by enhancing field potential through inhibition on glycine-induced ion current. PMID:26730381

  16. Preliminary engineering assessment of treatment alternatives for groundwater from the Hanford 200 Area 200-BP-5 plumes

    International Nuclear Information System (INIS)

    This report presents the results of the Preliminary Engineering Assessment of Treatment Alternatives (PEATA), an engineering evaluation of potential treatment alternatives for groundwater extracted from the 200-BP-5 Area's 216-BY Cribs and 216-B-5 Reverse Well plumes. The primary objective of the PEATA was to identify treatment technologies that are worth further consideration (i.e., treatability testing or a more refined engineering evaluation). It will also provide a basis for evaluating the results of the treatability testing that is currently being conducted on the presumptive remedy of ion exchange with disposal of spent resin and will serve as a guide for selection of other technologies for additional testing. Because there are little data or past experience with groundwater similar to the BY-Crib and B-5 Reverse Well Plumes, treatment efficiencies cannot be predicted with certainty and rigorous treatment system designs and costs cannot be developed. This applies to all alternatives, including the presumptive remedy of ion exchange. The approach for this study was to develop conceptual designs and approximate costs for the treatment technologies that were most likely to be effective on the BY-Crib and B-5 Reverse Well groundwater

  17. An Alternate Method for Fourier Transform Infrared (FTIR) Spectroscopic Determination of Soil Nitrate Using Derivative Analysis and Sample Treatments

    NARCIS (Netherlands)

    Choe, E.; Meer, van der F.; Rossiter, D.; Salm, van der C.; Kim, K.W.

    2010-01-01

    This study aimed at examining effective sample treatments and spectral processing for an alternate method of soil nitrate determination using the attenuated total reflectance (ATR) of Fourier transform infrared (FTIR) spectroscopy. Prior to FTIR measurements, soil samples were prepared as paste to e

  18. The value of complementary and alternative medicine in the treatment of climacteric symptoms : Results of a survey among German gynecologists

    NARCIS (Netherlands)

    von Studnitz, Friederike S. G.; Eulenburg, Christine; Mueck, Alfred O.; Buhling, Kai J.

    2013-01-01

    Objectives: The present study aims to detect the attitude and experience towards complementary and alternative medicine (CAM) in the treatment of climacteric disorders among gynecologists in Germany. Study design: A self-administered questionnaire, containing 15 questions, was sent to all gynecologi

  19. A preliminary evaluation of alternatives for treatment of INEL Low-Level Waste and low-level mixed waste

    Energy Technology Data Exchange (ETDEWEB)

    Smith, T.H.; Roesener, W.S.; Jorgensen-Waters, M.J.; Edinborough, C.R.

    1992-06-01

    The Mixed and Low-Level Waste Treatment Facility (MLLWTF) project was established in 1991 by the US Department of Energy Idaho Field Office to provide treatment capabilities for Idaho National Engineering Laboratory (INEL) low-level mixed waste and low-level waste. This report identifies and evaluates the alternatives for treating that waste. Twelve treatment alternatives, ranging from ``no-action`` to constructing and operating the MLLWTF, are identified and evaluated. Evaluations include facility performance, environmental, safety, institutional, schedule, and rough order-of-magnitude cost comparisons. The performance of each alternative is evaluated against lists of ``musts`` and ``wants.`` Also included is a discussion of other key considerations for decision making. Analysis of results indicated further study is necessary to obtain the best estimate of future waste volumes and characteristics from the expanded INEL Decontamination and Decommissioning Program. It is also recommended that conceptual design begin as scheduled on the MLLWTF, maximum treatment alternative while re-evaluating the waste volume projections.

  20. Declining efficacy in controlled trials of antidepressants: effects of placebo dropout

    NARCIS (Netherlands)

    Schalkwijk, S.J.; Undurraga, J.; Tondo, L.; Baldessarini, R.J.

    2014-01-01

    Drug-placebo differences (effect-sizes) in controlled trials of antidepressants for major depressive episodes have declined for several decades, in association with selectively increasing clinical improvement associated with placebo-treatment. As these trends require adequate explanation, we tested