scholarly journals Molecular mechanisms associated with antidepressant treatment on Major Depression

2021 ◽  
Author(s):  
Lívia Ramos-da-Silva ◽  
Pamela T. Carlson ◽  
Licia C. Silva-Costa ◽  
Daniel Martins-de-Souza ◽  
Valéria de Almeida
Keyword(s):  
Major Depression ◽  
Molecular Mechanisms ◽  
Antidepressant Treatment

scholarly journals Molecular pathways to depression

2013 ◽  
Vol 35 (3) ◽  
pp. 10-14
Author(s):  
Christoph Anacker
Keyword(s):  
Major Depression ◽  
Molecular Mechanisms ◽  
Antidepressant Treatment ◽  
Biological Pathways ◽  
Mental Illnesses ◽  
Molecular Pathways ◽  
First Line ◽  
Antidepressant Treatments ◽  
Multiple Origins ◽  
Basic Concepts

Major depression is one of the most debilitating mental illnesses of our time, and, after more than 60 years of research, we have only just begun to understand some of the basic concepts of this illness with multiple origins and manifestations. Approximately one-third of all depressed patients do not respond to any first line of antidepressant therapy, demonstrating dramatically how little we still understand about the neurobiological and molecular mechanisms underlying depression and antidepressant treatment response. Our discoveries to date are likely to be just the tip of the iceberg, and much research is thus needed to identify biological pathways to depression in order to develop more effective antidepressant treatments in the future.

scholarly journals 332 - Electroconvulsive therapy in older adults with major depression was not associated with cognitive decline during a 15-year follow-up

2020 ◽  
Vol 32 (S1) ◽  
pp. 91-91
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Major Depression ◽  
Cognitive Decline ◽  
Electroconvulsive Therapy ◽  
Antidepressant Treatment ◽  
Community Sample ◽  
Control Group

AUTHORS:Kerstin Johansson, Karolina Thömkvist, Ingmar Skoog and Sacuiu SF* (*presenter)OBJECTIVE:To determine the effects of electroconvulsive therapy (ECT) in major depression in relation to the development of dementia during long-term follow-up.METHOD:In an observational clinical prospective study of consecutive patients 70 years and older diagnosed with major depression at baseline 2000-2004 (n=1090), who were free of dementia and received antidepressant treatment, with or without ECT, we sought to determine if cognitive decline (mild cognitive impairment and dementia) during 15 -year follow-up was associated with receiving ECT at baseline. The control group was selected among the participants in the Gothenburg H70 Birth Cohort Studies matched by age group and sex 1:1.RESULTS:Among patients with affective syndromes 7% received ECT. During follow-up, 157 patients were diagnosed with dementia, equal proportions among those who received ECT (14.5%) and those who did not receive ECT (14.5%). The relation between ECT and cognitive decline remained non-significant irrespective antidepressive medication or presence of mild cognitive impairment at baseline.CONCLUSION:Preliminary results indicate that ECT was not associated with the development of cognitive decline in the long-term in a hospital-based cohort of 70+ year-olds. The results remain to verify against controls from a representative community sample.

scholarly journals Quality of life, diagnosis, and treatment of patients with major depression: a prospective cohort study in primary care

2011 ◽  
Vol 33 (3) ◽  
pp. 245-251 ◽  
Author(s):  
Ana Flávia Barros da Silva Lima ◽  
Marcelo Pio de Almeida Fleck
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Cohort Study ◽  
Major Depression ◽  
Antidepressant Treatment ◽  
Epidemiologic Studies ◽  
World Health ◽  
World Health Organization Quality

OBJECTIVE: To describe the demographic and clinical characteristics, adequacy of antidepressant treatment, and changes in quality of life of patients with major depression receiving follow-up care from primary care centers. METHOD: A cohort study was performed in which major depression patients were followed-up over a nine-month period. Several evaluation instruments were used, including the World Health Organization Quality of Life and the Quality of Life-Depression, Centers for Epidemiologic Studies-Depression questionnaires. RESULTS: The sample comprised 179 individuals, mostly female (73%), with a mean age of 38 years and mean education of 9 years. At the end of the follow-up period, 42% of the individuals still presented with major depression, 25% had complete symptom remission, and only 9% were properly treated with antidepressants. In relation to quality of life, there were significant differences especially between baseline and after nine months in almost all measures. CONCLUSION: This study demonstrated that depressive symptoms are poorly recognized and that treatment is often inadequate for patients followed-up in primary care units in the south of Brazil. Most of the patients continued to have symptoms of depression over the nine-month period which were associated with impaired quality of life.

Comparative Efficacy and Safety of Sertraline Versus Nortriptyline in Major Depression in Patients 70 and Older

1999 ◽  
Vol 11 (1) ◽  
pp. 85-99 ◽  
Author(s):  
Sanford I. Finkel ◽  
Ellen M. Richter ◽  
Cathryn M. Clary
Keyword(s):  
Major Depression ◽  
Rating Scale ◽  
Antidepressant Treatment ◽  
Change Score ◽  
Attrition Rate ◽  
Double Blind ◽  
Almost All ◽  
Positive Effect ◽  
Population Segment

Background. Few randomized, double-blind studies that examine antidepressant treatment in patients 70 years and older are available. To provide additional data on the safety and efficacy of antidepressants in this rapidly growing population segment, a subgroup analysis of a larger sertraline vs. nortriptyline elderly depression treatment study was performed. Methods. Outpatients (N = 76) who met DSM-III-R criteria for major depression with a minimum Hamilton Depression Rating Scale (HAM-D) severity score of 18 were randomized to 12 weeks of flexible dose treatment with sertraline (50–150 mg) or nortriptyline (25–100 mg). Results. Both treatments significantly improved depression as measured by the HAM-D and Clinical Global Impression scales. At Weeks 10, 12, and endpoint, sertraline demonstrated a significantly greater reduction in depression severity compared to nortriptyline as measured by improvement on the 24-item HAM-D (mean adjusted change score of 14.8 vs. 7.6, respectively, at Week 12; p = .001). Sixty-five percent of sertraline-treated patients were responders by Week 12 (50% or greater reduction from baseline in 24-item HAM-D score) compared to 26% of nortriptyline-treated patients (p < .05). Sertraline treatment had a significantly more positive effect, when compared to nortriptyline, across almost all associated measures of cognitive function, energy, anxiety, and quality of life and was better tolerated than nortriptyline, with a lower attrition rate/side effect burden. Conclusion. The efficacy advantage of sertraline appeared to be even greater in this subgroup of older patients drawn from a larger treatment study of depression that included elderly individuals over the age of 60.

The Efficacy and Tolerability of Combined Antidepressant Treatment in Different Depressive Subgroups

1993 ◽  
Vol 162 (3) ◽  
pp. 363-368 ◽  
Author(s):  
Sinead O'brien ◽  
Patrick McKeon ◽  
Myra O'regan
Keyword(s):  
Treatment Group ◽  
Side Effects ◽  
Major Depression ◽  
Orthostatic Hypotension ◽  
Antidepressant Treatment ◽  
Combined Treatment ◽  
Endogenous Depression ◽  
Double Blind Study ◽  
Double Blind ◽  
Global Improvement

Eighty patients admitted to hospital with major depression were randomly allocated to six weeks of treatment with tranylcypromine, amitriptyline, or tranylcypromine and amitriptyline in combination, in a double-blind study. Scores on the HRSD improved significantly in all three groups, but there were no differences between the three groups. Patients on tranylcypromine and amitriptyline combined improved more according to their self-ratings after six weeks, and response was earlier as measured by a clinical global improvement scale. Those with endogenous depression improved more than those with neurotic depression, irrespective of treatment group. Combined treatment was less well tolerated than single treatments and gave rise to more side-effects, although there was no serious toxicity. Orthostatic hypotension was observed more frequently in patients on combined treatment. This group also experienced a significant increase in weight and prolongation of the P-R interval on ECG.

scholarly journals A double blind, placebo-controlled pilot study of galantamine augmentation of antidepressant treatment in older adults with major depression

2008 ◽  
Vol 23 (6) ◽  
pp. 625-631 ◽  
Author(s):  
Paul E. Holtzheimer ◽  
Thomas W. Meeks ◽  
Mary E. Kelley ◽  
Mustafa Mufti ◽  
Raymond Young ◽  
...  
Keyword(s):  
Older Adults ◽  
Pilot Study ◽  
Major Depression ◽  
Antidepressant Treatment ◽  
Double Blind ◽  
Double Blind Placebo

Progress against Major Depression in Canada

2002 ◽  
Vol 47 (8) ◽  
pp. 775-780 ◽  
Author(s):  
Scott B Patten
Keyword(s):  
Public Health ◽  
Health Status ◽  
Major Depression ◽  
Population Health ◽  
Professional Education ◽  
Large Scale ◽  
Antidepressant Treatment ◽  
Point Prevalence ◽  
Treatment Utilization ◽  
Distress Scale

Background: Generally, public health strategies for major depression have focused on case-finding, public and professional education, and disease-management strategies. In principle, increased rates of treatment utilization and improved treatment outcomes should lead to improved mental health at the population level. Progress of this sort, however, has been difficult to confirm. Methods: The National Population Health Survey (NPHS) is a large-scale longitudinal study of a representative sample drawn from the Canadian population. To date, Statistics Canada has released data from 3 NPHS cycles: 1994–1995, 1996–1997, and 1998–1999. Treatment utilization and major depression measures were employed in the NPHS survey, providing a unique source of longitudinal Canadian data. In this study, major depression point prevalence (defined using a predictive instrument for annual major depressive episode [MDE] prevalence and responses from a distress scale) and associated treatment utilization were evaluated over time. Results: Between 1994–1995 and 1995–1996, the proportion of persons with depression receiving antidepressant treatment increased dramatically, from 18.2% (12.3% to 22.1%) in 1994–1995 to 32.6% (23.0% to 42.2%) in 1998–1999. Point prevalence of major depression was 2.4%, 1.8%, and 1.9% in the 3 NPHS iterations. Conclusions: Data from the NPHS suggest public health progress against major depression in Canada. More people with major depression in Canada are receiving treatment, and these changes may have been associated with improved population health status. However, both random variation and extraneous societal factors could account for the observed trends in prevalence. It is impossible to relate changes in utilization directly to population health status using the NPHS data.

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