Dosage Of Antidepressant Medication Research Articles

Data from ‘Critical Slowing Down as a Personalized Early Warning Signal for Depression’

We present a dataset of a single (N = 1) participant diagnosed with major depressive disorder, who completed 1478 measurements over the course of 239 consecutive days in 2012 and 2013. The experiment included a double-blind phase in which the dosage of anti-depressant medication was gradually reduced. The entire study looked at momentary affective states in daily life before, during, and after the double-blind phase. The items, which were asked ten times a day, cover topics like mood, physical condition and social contacts. Also, depressive symptoms were measured on a weekly basis using the Symptom Checklist Revised (SCL-90-R). The data are suitable for various time-series analyses and studies in complex dynamical systems.

Primary Care Physicians' Attitudes Regarding Collaborating with Home-Based Depression Care Management Providers

Symptom Checklist-20 [HSCL-20], PHQ-9), disability (World Health Organization Disability Assessment Schedule-II, WHODAS-II), and satisfaction. Results: No participants dropped out. Depression care specialists engaged in an average of 2.4 phone calls and 6.3 faxes per client to the contact person (e.g., receptionist, nurse) at each client’s primary care clinic. In these phone calls and faxes, depression care specialists made an average of 5.4 requests per client, and physicians responded to an average of 3 requests. Each client’s physician responded to at least one collaboration request (e.g., initiating or changing dosage of antidepressant medication; reducing sleep, anxiolytic, and antipsychotic medication; changing pain medication; initiating thyroid medication). Six clients achieved meaningful reductions in PHQ-9 scores at the end of active treatment (i.e., 50% reduction, 5/6 in full remission). In paired t-tests, HSCL-20 and WHODAS-II scores improved from baseline to end of active DCM and from baseline to three months after active DCM (p 0.025). Satisfaction ratings also were favorable. Conclusions: Results of this pilot study suggest that augmenting an existing DCM protocol with a collaboration intervention is feasible to implement by depression care specialists and can improve physician collaboration and client outcomes. Larger scale research is required to determine whether augmenting home-based DCM with the collaboration intervention is more effective than DCM alone. Such research could have implications for theories and models of collaboration across service systems.

Vascular and extravascular immunoreactivity for intercellular adhesion molecule 1 in the orbitofrontal cortex of subjects with major depression: Age-dependent changes

Vascular and immune alterations in the prefrontal cortex may contribute to major depression in elderly subjects. Intercellular adhesion molecule-1 (ICAM-1), major inflammatory mediator in vessels and astrocytes, could be altered in geriatric depression, but little is known about its age-dependent expression in subjects with depression and its relationship to astrocytes identified by the marker glial fibrillary acidic protein (GFAP), found to be reduced in depression. We measured the percentage of gray matter area fraction covered by ICAM-1 immunoreactivity in blood vessels and in extravascular accumulations of ICAM-1 immunoreactivity in 19 non-psychiatric comparison subjects and 18 subjects with major depression, all characterized by postmortem psychological diagnosis. Association of extravascular ICAM-1 to GFAP-positive astrocytes was investigated by double-labeling immunofluorescence. Vascular and extravascular fractions of ICAM-1 immunoreactivity were lower in subjects with MDD than in non-psychiatric comparison subjects. Non-psychiatric comparison subjects older than 60 experienced dramatic increase in extravascular ICAM-1 immunoreactivity, but this increase was attenuated in elderly subjects with MDD, particularly in those dying by suicide. Most extracellular ICAM-1 immunoreactivity was coextensive with GFAP-immunoreactive astrocytes in both groups. Heterogeneity in type and dosage of antidepressant medication. Difficulty in determining the exact onset of depression in subjects older than 60 at the time of death. Routine cerebrovascular pathological screening may miss subtle subcellular and molecular changes. There is significant attenuation of extravascular and vascular ICAM-1 immunoreactivity in elderly subjects with major depression suggesting an astrocyte-associated alteration in immune function in the aging orbitofrontal cortex of subjects with MDD.

Tricyclic antidepressant medication use and non-Hodgkin lymphoma: A Danish population-based cohort study

8578 Background: An increased risk of non-Hodgkin lymphoma (NHL) has been reported among long-term users of tricyclic antidepressants. Methods: We calculated the incidence of NHL among all 43,932 users (≥2 prescriptions) of antidepressant medication in the county of North Jutland, Denmark, during 1989–2003 and compared with NHL incidence in the population of North Jutland not using antidepressant medication (<2 prescriptions) using Poisson regression analysis adjusted for age, gender, period, use of immunosuppressive drugs, corticosteroids or NSAIDs. Results: Use of tricyclic antidepressants was associated with an overall increased incidence of NHL (adjusted incidence rate ratio (IRR): 1.53; 95% confidence interval (CI): 1.06–2.21) compared with non-use. The IRR in users with ≥10 prescriptions and five or more years of follow-up was 2.50 (95% CI: 1.43–4.34). In users of SSRI the overall IRR of NHL was 1.25 (95% CI, 0.88, 1.79) but when excluding the first year of follow-up there was no excess incidence and no trend was observed with either number of prescriptions or length of follow-up. Conclusions: Our results indicate an increased risk of NHL among long-term users of tricyclic antidepressant medications. Antidepressant use is prevalent and this finding warrants additional studies with sufficient power to investigate risk by type and dosage of antidepressant medication as well as by lymphoma subgroups. No significant financial relationships to disclose.