Methylphenidate May Treat Apathy Independent of Depression

2005 ◽  
Vol 39 (11) ◽  
pp. 1947-1949 ◽  
Author(s):  
Prasad R Padala ◽  
Frederick Petty ◽  
Subhash C Bhatia
Keyword(s):  
Major Depression ◽  
Treatment Regimen ◽  
Rating Scales ◽  
Rating Scale ◽  
Case Summary ◽  
Long Time ◽  
History Of ◽  
High Degree ◽  
Hamilton Rating Scale

OBJECTIVE To report a case of apathy treated with methylphenidate in which improvement in apathy was independent of improvement of depression. CASE SUMMARY A 47-year-old woman with a 20-year history of recurrent major depression was diagnosed as having significant apathy with lack of initiative and motivation. Over the course of a 4-week treatment regimen with methylphenidate, her apathy, as measured by the Apathy Evaluation Scale, improved, with her score decreasing from 57 to 31. During this period, her depression, as assessed by the 21-item Hamilton Rating Scale for Depression, remained unchanged. DISCUSSION Our report of improvement of apathy with methylphenidate is consistent with other reports in the literature, although previous studies have not specifically used the rating scales to assess apathy. Even though this patient had experienced apathy for a long time, it had not been detected due to lack of direct questioning. In this case, as noted, the improvement of apathy was independent of improvement in depression. CONCLUSIONS A high degree of suspicion and specific inquiry is required for identification of apathy. Once detected, methylphenidate may be beneficial in its treatment, a strategy that may work independently of augmentation of antidepressants.

Depression in Inpatients: Bipolar vs Unipolar

2003 ◽  
Vol 92 (3) ◽  
pp. 1031-1039 ◽  
Author(s):  
Stella Dorz ◽  
Giuseppe Borgherini ◽  
Donatella Conforti ◽  
Caterina Scarso ◽  
Guido Magni
Keyword(s):  
Social Support ◽  
Major Depression ◽  
Social Adjustment ◽  
Rating Scales ◽  
Rating Scale ◽  
Social Impairment ◽  
Symptom Checklist ◽  
Bipolar Patients ◽  
Hamilton Rating Scale ◽  
Social Adjustment Scale

162 depressed inpatients were divided into three diagnostic groups to compare patterns of sociodemographic characteristics, psychopathology, and psychosocial: 35 had a single episode of major depression, 96 had recurrent major depression, and 31 had a bipolar disorder. Psychopathology and psychosocial functioning were measured by clinician-rated scales, Montgomery-Asberg Depression Rating Scale, Hamilton Rating Scale for Depression, Clinical Global Impression, and self-rating scales, Symptom Checklist-90, Social Support Questionnaire, Social Adjustment Scale. The three groups were comparable on sociodemographic variables, with the exception of education. Univariate analyses showed a similar social impairment as measured by Social Support Questionnaire, Social Adjustment Scale, and no significant differences were recorded for the psychopathology when the total test scores (Montgomery-Asberg Depression Rating Scale, Hamilton Rating Scale for Depression, Clinical Global Index, Symptom Checklist-90) were evaluated. Some differences emerged for single items in the Montgomery-Asberg Depression Rating Scale and Symptom Checklist-90. These findings suggest a substantial similarity among the three groups. Results are discussed in terms of the clinical similarities between unipolar and bipolar patients during a depressive episode as well as the limitations of cross-sectional study implies.

scholarly journals Neuropsychological deficits in past suicide attempters with varying levels of depression severity

2014 ◽  
Vol 44 (14) ◽  
pp. 2965-2974 ◽  
Author(s):  
J. G. Keilp ◽  
S. R. Beers ◽  
A. K. Burke ◽  
N. M. Melhem ◽  
M. A. Oquendo ◽  
...  
Keyword(s):  
Working Memory ◽  
Major Depression ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Past History ◽  
Clinical State ◽  
Suicide Attempters ◽  
History Of ◽  
Attention Memory ◽  
Interference Processing

BackgroundOur previous work identified deficits in interference processing and learning/memory in past suicide attempters who were currently depressed and medication-free. In this study, we extend this work to an independent sample studied at various stages of illness and treatment (mild symptoms, on average) to determine if these deficits in past suicide attempters are evident during a less severe clinical state.MethodA total of 80 individuals with a past history of major depression and suicide attempt were compared with 81 individuals with a history of major depression and no lifetime suicide attempts on a battery of neurocognitive measures assessing attention, memory, abstract/contingent learning, working memory, language fluency and impulse control.ResultsPast attempters performed more poorly in attention, memory and working memory domains, but also in an estimate of pre-morbid intelligence. After correction for this estimate, tests that had previously distinguished past attempters – a computerized Stroop task and the Buschke Selective Reminding Test – remained significantly worse in attempters. In a secondary analysis, similar differences were found among those with the lowest levels of depression (Hamilton Depression Rating Scale score <10), suggesting that these deficits may be trait markers independent of current symptomatology.ConclusionsDeficits in interference processing and learning/memory constitute an enduring defect in information processing that may contribute to poor adaptation, other higher-order cognitive impairments and risk for suicidal behavior.

scholarly journals Physical exercise for late-life major depression

2015 ◽  
Vol 207 (3) ◽  
pp. 235-242 ◽  
Author(s):  
M. Belvederi Murri ◽  
M. Amore ◽  
M. Menchetti ◽  
G. Toni ◽  
F. Neviani ◽  
...  
Keyword(s):  
Primary Care ◽  
Major Depression ◽  
Physical Exercise ◽  
Primary Outcome ◽  
Rating Scale ◽  
Late Life ◽  
Lower Intensity ◽  
Progressive Exercise ◽  
Primary Care Patients ◽  
Hamilton Rating Scale

BackgroundInterventions including physical exercise may help improve the outcomes of late-life major depression, but few studies are available.AimsTo investigate whether augmenting sertraline therapy with physical exercise leads to better outcomes of late-life major depression.MethodPrimary care patients (>65 years) with major depression were randomised to 24 weeks of higher-intensity, progressive aerobic exercise plus sertraline (S+PAE), lower-intensity, non-progressive exercise plus sertraline (S+NPE) and sertraline alone. The primary outcome was remission (a score of $10 on the Hamilton Rating Scale for Depression).ResultsA total of 121 patients were included. At study end, 45% of participants in the sertraline group, 73% of those in the S+NPE group and 81% of those in the S+PAE group achieved remission (P = 0.001). A shorter time to remission was observed in the S+PAE group than in the sertraline-only group.ConclusionsPhysical exercise may be a safe and effective augmentation to antidepressant therapy in late-life major depression.

scholarly journals Cerebral gliosarcoma with perivascular involvement in a cat

2019 ◽  
Vol 5 (2) ◽  
pp. 205511691987978
Author(s):  
Patricia Álvarez ◽  
Annette Wessmann ◽  
Mireia Pascual ◽  
Oriol Comas ◽  
Dolors Pi ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Septum Pellucidum ◽  
Soft Mass ◽  
Case Summary ◽  
Fluid Attenuated Inversion Recovery ◽  
History Of ◽  
High Degree ◽  
The Brain ◽  
Clinical Mri ◽  
Gross Examination

Case summary A 5-year-old neutered male domestic shorthair cat presented with an 18-month history of facial tics, and progressive general ataxia, weakness, lethargy and anorexia of 2 weeks’ duration. MRI of the brain showed a well-defined heterogeneous hyperintense mass on T1-weighted and T2-weighted images, with central hypointensity in the rostral commissure and septum pellucidum, and perilesional hyperintensity in fluid-attenuated inversion recovery, suggestive of perilesional oedema. Gross examination in a transverse section of the brain at the level of the septum pellucidum revealed a 0.2 cm brown soft mass. Histopathological examination identified a biphasic neoplastic proliferation of mesenchymal and neuroepithelial cell populations. Fusiform cells were predominately distributed in bundles showing a high degree of anisocytosis and marked immune-positive reaction to vimentin immunochemistry, confirming a sarcomatous origin. Additionally, high numbers of astrocytic cells were identified by an intense immunopositive reaction to glial fibrillary acidic protein and negative reaction to oligodendrocyte transcription factor 2 immunochemistry. Vascular invasion of the neoplasia into the wall of a medium branch of the rostral cerebral artery was present (secondary Scherer structures). Based on these characteristics, the tumour was defined as a gliosarcoma. Gliosarcoma is a recognised astrocytoma grade IV anaplastic glial cell tumour with sarcomatous differentiation. Relevance and novel information To our knowledge, this is the first report describing a cerebral gliosarcoma in a cat including clinical, MRI, macroscopic and histopathological features and immunolabelling characteristics.

Use of Three Depression Scales for Evaluation of Pretreatment Severity and of Improvement after Treatment

2000 ◽  
Vol 87 (2) ◽  
pp. 389-394 ◽  
Author(s):  
Carmen Senra Rivera ◽  
Carolina RancañO Pérez ◽  
Elizabeth Sánchez Cao ◽  
Salomé Barba Sixto
Keyword(s):  
Major Depression ◽  
Tricyclic Antidepressants ◽  
Rating Scale ◽  
Severity Rating ◽  
Four Levels ◽  
Pretreatment Severity ◽  
Castilian Spanish ◽  
Depression Scales ◽  
Hamilton Rating Scale ◽  
Improvement Rating

We investigated the Castilian Spanish versions of three scales (the Hamilton Rating Scale for Depression, the Carroll Rating Scale for Depression, and the Montgomery-Asberg Depression Rating Scale) as to their suitability for classifying major depression patients in four levels of severity prior to treatment with tricyclic antidepressants, and also as to their suitability for classifying these patients in four improvement levels when administered posttreatment. Although the scales behaved quite similarly, each was most efficient at the task for which it had been designed, i.e., severity rating for the Hamilton and Carroll scales, improvement rating for the Montgomery-Asberg scale.

Assessment and treatment of dysthymia. The development of the Cornell dysthymia rating scale

1997 ◽  
Vol 12 (4) ◽  
pp. 190-193 ◽  
Author(s):  
J Cohen
Keyword(s):  
Major Depression ◽  
Rating Scale ◽  
Pharmacologic Treatment ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Insidious Onset ◽  
Assessment And Treatment ◽  
Depressive Personality ◽  
Hamilton Rating Scale

SummaryThe understanding and classification of persistently depressed mood has undergone many changes since the term ‘dysthymia’ was first used nearly 150 years ago. Originally it was applied to both melancholia and mania; later it was applied to depressive personality. The Diagnostic and Statistical Manual (DSM)-III in 1980 and in subsequent updates classified dysthymia as a mood disorder, characterized by a frequently insidious onset and a course that is chronic and unremitting. The assessment of clinical response in the pharmacologic treatment of dysthymia has been more difficult than that for major depression. The Hamilton Rating Scale for Depression, among others, is oriented towards episodic rather than chronic states of depression. A new rating scale, the Cornell Dysthymia Rating Scale, has been developed to better assess milder symptomatology in chronically depressed patients. Early studies suggest its utility, but further validation of the scale is needed in patients with dysthymia and without major depression.

Pramipexole: Augmentation in the Treatment of Depressive Symptoms

CNS Spectrums ◽  
2006 ◽  
Vol 11 (3) ◽  
pp. 172-175 ◽  
Author(s):  
Sanjay Gupta ◽  
Jennifer L. Vincent ◽  
Bradford Frank
Keyword(s):  
Depressive Symptoms ◽  
Treatment Regimen ◽  
Rating Scale ◽  
Bipolar Depression ◽  
Case Series ◽  
Unipolar Depression ◽  
Off Label Use ◽  
Retrospective Case ◽  
Off Label ◽  
Hamilton Rating Scale

ABSTRACTWe describe a retrospective case series of three patients, two with bipolar depression and one with unipolar depression. Pramipexole is a Food and Drug Administration-approved antiparkinsonian agent, which, when used to augment antidepressants, would be considered an off-label use and should be discussed with the patient. These patients had robust responses to pramipexole augmentation of their treatment regimen. All three patients had been taking an atypical antipsychotic. The depressive symptoms were evaluated using the Hamilton Rating Scale for Depression.

Suicidal Ideation in Parkinson's Disease

CNS Spectrums ◽  
2009 ◽  
Vol 14 (8) ◽  
pp. 431-436 ◽  
Author(s):  
Arthur Kummer ◽  
Francisco Cardoso ◽  
Antonio Lucio Teixeira
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Suicidal Ideation ◽  
Major Depression ◽  
Attempted Suicide ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Disease Onset ◽  
Mini Mental Status Exam ◽  
Hamilton Rating Scale

ABSTRACTObjective: To assess the frequency of suicidal ideation and suicide attempts in patients with Parkinson's disease.Methods: The Mini International Neuropsychiatric Interview (MINI), Beck Depression Inventory (BDI), and Hamilton Rating Scale for Depression (HAM-D) were administered to 90 consecutive, non-demented Parkinson's disease patients. They were also submitted to a complete neurologic examination which included brief cognitive batteries, the Mini Mental Status Exam, and Frontal Assessment Battery. We analyzed the scores of the section of the MINI related to the risk of suicide as well as the specific questions of BDI and HAM-D concerning suicidal ideation.Results: No patient had ever attempted suicide. According to MINI, suicidal ideation was present in 13 patients (14.4%) with Parkinson's disease. All instruments assessed the risk of suicide in a similar way. Suicidal ideation was associated only with lower age (P=.022), lower age of Parkinson's disease onset (P=.021), panic disorder (P=.004), social anxiety disorder (P=.007), and major depression (P<.001). Logistic regression analysis indicated that major depression was the main predictor of suicidal ideation.Conclusion: Suicide attempts seem to be uncommon in Parkinson's disease, despite the fact that the rates of suicidal ideation are possibly elevated. Depression seems to be the most important predictor of suicidal ideation in Parkinson's disease.

scholarly journals Tolerability and Efficacy of Vortioxetine Versus SSRIs in Elderly With Major Depression. Study Protocol of the VESPA Study: A Pragmatic, Multicentre, Open-Label, Parallel-Group, Superiority, Randomized Trial

2020 ◽  
Author(s):  
Giovanni Ostuzzi ◽  
Chiara Gastaldon ◽  
Angelo Barbato ◽  
Barbara D’Avanzo ◽  
Mauro Tettamanti ◽  
...  
Keyword(s):  
Major Depression ◽  
Randomized Trial ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Rating Scales ◽  
Rating Scale ◽  
The Elderly ◽  
Tolerability Profile ◽  
Open Label ◽  
Parallel Group

Abstract Introduction. Depression is a highly prevalent condition in the elderly, with a vast impact on quality of life, life expectancy, and medical outcomes. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed agents in this condition and, although generally safe, tolerability issues cannot be overlooked. Vortioxetine is an antidepressant with a novel mechanism of action. Based on available studies, it may have a promising tolerability profile in the elderly, as it does not adversely affect psychomotor or cognitive performance, and does not alter cardiovascular and endocrine parameters. The present study aims to assess the tolerability profile of vortioxetine in comparison with the SSRIs considered as a single group in elderly participants with depression. The rate of participants withdrawing from treatment due to adverse events after six months of follow-up will be the primary outcome. Methods and analysis. This is a pragmatic, multicentre, open-label, parallel-group, superiority, randomized trial funded by the Italian Medicines Agency (AIFA - Agenzia Italiana del Farmaco ). Thirteen Italian Community Psychiatric Services will consecutively enrol elderly participants suffering from an episode of major depression over a period of 12 months. Participants will be assessed at baseline and after 1, 3 and 6 months of follow-up. At each time point, the following validated rating scales will be administered: Montgomery–Åsberg Depression Rating Scale (MADRS), Antidepressant Side-Effect Checklist (ASEC), EuroQual 5 Dimensions (EQ-5D), Short Blessed Test (SBT), and Charlson Age-Comorbidity Index (CACI). Outcome assessors and the statistician will be masked to treatment allocation. A total of 358 participants (179 in each group) will be enrolled. Ethics and dissemination. This study will fully adhere to the ICH E6 Guideline for Good Clinical Practice. Participants’ data will be managed and safeguarded according to the European Data Protection Regulation 2016/679. An external Ethical Advisory Board will help guarantee high ethical standards. Trial registration number. EudraCT number: 2018-001444-66; Clinicaltrials.gov: NCT03779789, first submitted on December 12, 2018 and first posted on December 19 th trial status: protocol version 1.5; 09/06/2018. Recruitment started on February 2019 and it is ongoing. It is expected to end approximately on September 30 th 2021.

scholarly journals Tolerability and Efficacy of Vortioxetine Versus SSRIs in Elderly with Major Depression. Study Protocol of the Vespa Study: A Pragmatic, Multicentre, Open-Label, Parrallel-Group, Superiority, Randomized Trial

2019 ◽  
Author(s):  
Giovanni Ostuzzi ◽  
Chiara Gastaldon ◽  
Angelo Barbato ◽  
Barbara D’Avanzo ◽  
Mauro Tettamanti ◽  
...  
Keyword(s):  
Major Depression ◽  
Randomized Trial ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Rating Scales ◽  
Rating Scale ◽  
Good Clinical Practice ◽  
The Elderly ◽  
Tolerability Profile ◽  
Open Label

Abstract Introduction. Depression is a highly prevalent condition in the elderly, with a vast impact on quality of life, life expectancy, and medical outcomes. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed agents in this condition and, although generally safe, tolerability issues cannot be overlooked. Vortioxetine is an antidepressant with a novel mechanism of action. Based on available studies, it may have a promising tolerability profile in the elderly, as it does not adversely affect psychomotor or cognitive performance, and does not alter cardiovascular and endocrine parameters. The present study aims to assess the tolerability profile of vortioxetine in comparison with the SSRIs considered as a single group in elderly participants with depression. The rate of participants withdrawing from treatment due to adverse events after six months of follow-up will be the primary outcome. Methods and analysis. This is a pragmatic, multicentre, open-label, parallel-group, superiority, randomized trial funded by the Italian Medicines Agency (AIFA - Agenzia Italiana del Farmaco). Thirteen Italian Community Psychiatric Services will consecutively enrol elderly participants suffering from an episode of major depression over a period of 12 months. Participants will be assessed at baseline and after 1, 3 and 6 months of follow-up. At each time point, the following validated rating scales will be administered: Montgomery–Åsberg Depression Rating Scale (MADRS), Antidepressant Side-Effect Checklist (ASEC), EuroQual 5 Dimensions (EQ-5D), Short Blessed Test (SBT), and Charlson Age-Comorbidity Index (CACI). Outcome assessors and the statistician will be masked to treatment allocation. A total of 358 participants (179 in each group) will be enrolled. Ethics and dissemination. This study will fully adhere to the ICH E6 Guideline for Good Clinical Practice. Participants’ data will be managed and safeguarded according to the European Data Protection Regulation 2016/679. An external Ethical Advisory Board will help guarantee high ethical standards. Trial registration number. EudraCT number: 2018-001444-66; Clinicaltrials.gov: NCT03779789, first submitted on December 12, 2018 and first posted on December 19th trial status: protocol version 1.5; 09/06/2018. Recruitment started on February 2019 and it is ongoing. It is expected to end approximately on September 30th 2021.

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