Drug Therapy For Depression Research Articles

Prospects for the pharmacological validation of the use of platelets as a “peripheral model” of neurons

Depressive disorders often occur in patients with cardiovascular pathologies and are a predictor of the development of thrombotic events, such as myocardial infarction, acute ischemic cerebrovascular accident, and pulmonary embolism. These are believed to be caused by the structural and biochemical relationship between platelets and brain neurons, which allows us to consider platelets as a marker of central nervous system (CNS) pathologies. This review aimed to assess the relationship between the hemostasis system and the development of depressive disorders using platelets as a “peripheral model” of neurons and evaluate the effectiveness of drugs for the treatment of depression. The study was conducted in accordance with the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A systematic literature search was conducted using PubMed, Cochrane, and CINAHL databases from 2018 to 2023, according to the following keywords: “hemostasis,” “acute cerebrovascular accident,” “depression,” “depressive disorders,” “platelets,” “cardiovascular diseases.” The data obtained indicate both a clinical link between depressive disorders and vascular events and the commonality of platelets and CNS cells because of the commonality of the following proteins: transporters and receptors of serotonin or 5-hydroxytryptamine, amyloid precursor protein, and brain neurotrophic factor, which were previously considered specific neural proteins. In addition, a relationship exists between hemostasis dynamics and drug therapy for depression. In this review, changes in hemostasis in terms of platelet activation in patients with depression and vascular disease were critically analyzed. The literature presents diverse mechanisms of platelet induction, which require further study. A rational study of the pathways of platelet activation in patients with depressive disorders will provide a comprehensive understanding of the molecular mechanisms underlying the relationship between hemostasis and depression in various vascular pathologies. Platelet activation in patients with depression and the dynamics of changes in hemostasis parameters during the treatment of depressive disorders allow us to consider hemostasis as a peripheral marker of the CNS and pharmacotherapy.

Acori Tatarinowii Rhizoma prevents the fluoxetine-induced multiple-drug resistance of Escherichia coli against antibiotics

BackgroundIn treating depression, the residual anti-depressant in gut interacts with the microbiome, leading to the appearance of multiple drug resistant (MDR) mutants, which poses a challenge for the treatment of infectious complications. Strategy is needed to combat this issue. Acori Tatarinowii Rhizoma (ATR, rhizome of Acorus tatarinowii Schott, Araceae), a traditional Chinese medicine, has been widely used for treatment of neurological disorders and gastrointestinal digestive disease in China. Here, ATR was demonstrated an excellent MDR-preventing effect in fluoxetine-induced Escherichia coli (E. coli). Aim of the studyThis study aimed to reveal the effective role of ATR and its signaling cascades involved in preventing fluoxetine-induced MDR. Materials and methodsThe water extract of ATR was co-applied with sub-minimum inhibitory concentration (100 mg/l) of fluoxetine in E. coli to evaluate its anti-MDR potential. Formation of reactive oxygen species (ROS) and expression of MDR-related genes in bacteria were measured by dichloro-dihydro-fluorescein diacetate assay and real-time PCR, respectively. Two fluorescent dyes, 1-N-phenylnapthylamine and 3,3′-dipropylthiadicarbocyanine were used to analyze the outer membrane permeability and inner membrane depolarization of E. coli. The accumulation of fluoxetine in the treated E. coli was determined via HPLC. The active fraction of ATR was identified. ResultsThe water extract of ATR significantly decreased the number of MDR mutants induced by fluoxetine and had half effective concentrations (EC50) of 55.5 μg/ml and 16.8 μg/ml for chloramphenicol and tetracycline, respectively. ATR robustly reversed the fluoxetine-induced superoxide response and membrane damage in E. coli. In addition, the inclusion of ATR significantly reduced the accumulation of fluoxetine in E. coli. After further fractionation, the polysaccharide of ATR was demonstrated as the fraction with the most significant anti-MDR activity. ConclusionsThis is the first report to investigate the MDR-preventing effect of ATR. The results of this study proposed ATR as an excellent herbal product to prevent MDR issues, as induced by fluoxetine, with the potential to reduce the side effects during the drug therapy of depression.

Challenges of prescribing antidepressants for the elderly: a scoping review

Abstract Objectives With a shift in global demographic trends favouring the older population, depression, which is increasingly common to older adults, is fast becoming a significant public health phenomenon that can result in rising healthcare costs, co-morbidities and fatalities. In particular, challenges to prescribing antidepressants to older people given their altered pharmacodynamic and pharmacokinetic profiles is of major concern to healthcare providers. We aimed to review the challenges encountered by prescribers when diagnosing and selecting older patients suited to receive an antidepressant. Methods English articles published between 2011 and 2021 were searched from the three databases which were MEDLINE, Cochrane Library and EMBASE to identify studies related to challenges in prescribing antidepressants for older people with the combination of search keywords such as depression, antidepressants, elderly and challenges, but not limited to them. Studies were excluded if the age of the participant is below 65 years old. The relevancy of the studies to be included were examined initially based on their titles and abstracts. Additional articles were searched from the reference lists of relevant articles. Key findings Out of 2500 studies, 11 articles was included in this study. The challenges were classified into three themes: challenges associated with the ageing processes, difficulty in recognising depressive symptoms and challenges in distinguishing depression from cognitive impairment. Conclusions Antidepressant prescribing in the elderly is complicated, in which there is a lack of proof for beneficial approaches. The study highlighted pertinent challenges to prescribers when older patients seek drug therapy for depression. This could have easily led to many depression cases gone undiagnosed or misdiagnosed.

The important roles of microRNAs in depression: new research progress and future prospects.

MicroRNAs (miRNAs) are non-encoding, single-stranded RNA molecules of about 22 nucleotides in length encoded by endogenous genes involved in posttranscriptional gene expression regulation. Studies have shown that miRNAs participate in a series of important pathophysiological processes, including the pathogenesis of depression. This article systematically summarized the research results published in the field of miRNAs and depression, which mainly involved three topics: circulating miRNAs as markers for diagnosis and prognosis of depression, the regulatory roles of miRNAs in the pathogenesis of depression, and the roles of miRNAs in the mechanisms of depression treatment. By summarizing and analyzing the research literature in recent years, we found that some circulating miRNAs can be potential biomarkers for the diagnosis and prognostic evaluation of depression. miRNAs that disorderly expressed during the disease play important roles in the depression pathogenesis, and miRNAs also play roles in the mechanisms of psychotherapy and drug therapy for depression. Elucidating the important roles of miRNAs in depression will bring people's understanding of the pathogenesis of depression to a new level. In addition, these miRNAs may be developed as new biomarkers for diagnosing depression, or as drug targets, or these molecules may be used as new drugs, which may provide new means for the treatment of depression. KEY MESSAGES: • The research results of miRNAs and depression are reviewed. • Circulating miRNAs can be potential biomarkers for depression. • MiRNAs play important roles in the depression pathogenesis. • MiRNAs play important roles in drug therapy for depression.

Current Issues of the Treatment Tactics of Family Physician at Patients with Depression (from the Experience of Slovenia and Croatia)

In classical family practice with an average number of registered patients up to 2 thousand, the prevalence rate of depression is 5%, moreover, two patients are hospitalized annually due to depression, and one day a patient commits suicide. The goal is to analyze urgent issues of drug therapy for depression and examination of patients within the competence of a primary care physician. According to the WHO, in 2025, depression will be the first cause of disability due to illness according to the DALY indicator (including years lost due to early death and disability). Depression is one of the biggest health problems. The solution to depression is the introduction of good education, appropriate management of depressed patients, as well as realistic expectations from therapy, given that only 20% of patients have only one episode of depression, and 30% of patients do not respond to therapy. A family doctor with his team can manage the treatment of 80% of patients with mild to moderate depression. However, there are situations when you need to turn to specialist – a psychiatrist. In the medical treatment of depressive disorders, three phases are distinguished at the PMC stage: the treatment of an acute depressive episode, the phase of stabilization of the therapeutic effect and the prevention of a new episode of the disease. Treatment most often begins with the appointment of an antidepressant, which in the previous episode or in a close family member showed positive effects.

Mental Depression Drug Therapy in Presence of Ascorbic Acid: Clinical Study

Clinical prospective double blind study was carried out to investigate the effect of ascorbic acid on mental depression therapy and the possible therapeutic interaction with the pharmacotherapy of the disease. The study involves twenty two outpatients. The psychiatrist assessed diagnostic status according to diagnostic and statistical manual of mental disorders 4th edition (DSM-IV) and prescribes a suitable antidepressant drugs to the patients. Patients were assessed at baseline before medication started and after eight-week. The principal measure of the outcome was Hamilton Rating Scale for Depression (HAM-D 17-item). The mean decrease in HAM-D score from baseline was used as the main outcome measure of response of depression to treatment. The physical examination and clinical laboratory investigations including a complete urine analysis, biochemical, haematology analysis, and plasma ascorbic acid was measured, at baseline and after eight-week of receiving both ascorbic acid or placebo.

Levels of interlukin-2, interlukin-6 and its soluble receptors in the first episode depression of Uygur patients before and after treatment with venlafaxine

Objective To investigate the action of interlukin-2(IL-2), interlukin-6(IL-6) and its soluble receptors(sIL-2R, sIL-6R) in the first episode of depression in the patients of Uyghur nationality and the differences in IL-2, IL-6 and sIL-2R, sIL-6R levels between the responsive depressed patients and the refractory depressed patients treated with venlafaxine. Methods A case-control study design was conducted.57 first-episode patients with depression (patient group) and 55 healthy people matched with gender and age (control group) were recruited in the study.An intervention with sustained-releasing venlafaxine tablets at fixed dose of 150 mg/d was performed in the patient group.The severity of the illness was evaluated by using the Hamilton's depression scale (HAMD-17) before and after the therapy.And by calculating the reduction rate of HAMD-17 (≥ 50% or <50%), the patients were divided into the responsive or refractory groups.The serum levels of IL-2, IL-6, sIL-2R and sIL-6R in patients and controls were tested by ELISA, and a re-test was done with the patients after treatment. Results There were statistical significant differences of the levels of serum IL-2, IL-6 and sIL-2R, sIL-6R between the patients and the control group (P 0.05). There were positive correlations between HAMD, serum IL-2(r=0.677; P=0.000) and IL-6(r=0.197; P=0.033)before treatment in all patients. Conclusion Serum IL-2 and IL-6 may play a role in the onset of the depression.The efficacy of venlafaxine is negatively correlated with the levels of serum IL-2 and IL-6.Regulating the imbalanced inflammatory cytokines and the immune system may be one of the mechanisms of drug therapy of depression. Key words: Depression; Antidepressant; Interleukin-2; Interleukin-6

Prescription of antidepressants to patients on opioid maintenance therapy – a pharmacoepidemiological study

Background and aims: Depression and anxiety are commonly reported among patients in opioid maintenance treatment (OMT). The aim of the present study was to describe aspects of prescription of antidepresant drug therapy among patients on OMT. Our research questions were: 1) What is the prevalence of antidepressant use according to age and gender? 2) Which antidepressants are used? 3) How are antidepressants used in terms of reimbursement codes, dispensed dose and duration of therapy?Methods: Pharmacoepidemiological data were retrieved from the complete national Norwegian Prescription Database which contains information on all prescription drugs (such as Anatomical Theraputical Chemical (ATC)-code, Defined Daily Dose (DDDs)), dispensed at pharmacies to individual patients. Norwegian OMT-patients (N=4374, 3035 men and 1339 women) who received methadone mixture, buprenorphine capsules or combined buprenorphine-naloxone capsules for at least 6 months in 2009 were included. Prevalence of antidepressant use in the studied patients was measured in terms of retrieval of prescriptions.Results: During 2009 21.7% of the studied patients filled at least one prescription for an antidepressant drugs (men: 21.2%; women: 22.9%). The subgroup of antidepressants most frequently dispensed was selective serotonin reuptake inhibitors (SSRIs) (33%), followed by the sedative antidepressants mianserin and mirtazapin (22%) and tricyclic antidepressants (TCAs) (20%). Except for TCAs, prescriptions of all antidepressant subgroups were reimbursed for either anxiety or depression in 90% of the cases. Overall, 46.9% of the antidepressant users were prescribed antidepressants in the category &lt; 1 DDD per day and/or treatment &lt; 3 months, with no gender difference.Conclusions: About one out of five OMT-patients filled a prescription for an antidepressant drug in 2009. Above 90% had their prescriptions reimbursed for either depression or anxiety. Use at low doses and/or sporadic use among half of the antidepressant users may reflect poor compliance or use for other maladies than the reimbursed disease code. Drug therapy for depression and anxiety among OMT-patients seems to be in line with recommendations for use; the SSRIs constitute the recommended drugs of choice due to their better effect/side effect profile, compared to the older antidepressants such as the TCAs.

Agomelatine: relief ensured at each and every stage of depression

In the recent years the aim of drug therapy in depression was redefined and specified. According to this, the main goal of antidepressant treatment goes beyond achieving some degree of response, or full response in the sense of 50% reduction of a depression score, but to remission in the global sense as well as on a more differentiated level, which means almost complete relief of depressive symptoms or at least almost complete relief of the core or most relevant symptoms of depression. This redefinition of the major therapeutic goal of antidepressive treatment was necessary, because several long-term studies demonstrated, that only remission and in this context the relief of the core or most relevant symptoms of depression can guarantee with a reasonably high probability a positive outcome under long-term aspects. The presentation will focus especially on the issue of relief of the core or the most relevant symptoms of depression and the respective efficacy of drug treatment with the recently licensed antidepressant agomelatine. Traditionally, especially depressed mood and lack of interest were seen as the core symptoms of depression. This is also mirrored in the current diagnostic manuals. However, considering the frequency and clinical relevance of sleep disturbances, and interpreting this in the context of the aetiopathogenetic hypothesis of disturbed circadian rhythm, sleep disorders can be interpreted as a core symptom in another sense. The same might be true for anxious symptoms, given the high neurogenetic association of depressive and anxious symptoms. Agomelatine has demonstrated powerful antidepressive efficacy, amongst others in terms of improvement of depressive mood and in terms of remission. According to its neurobiological mood of action, agomelatine has a special efficacy focus on disturbances of circadian rhythms and demonstrates clinical efficacy in this respect. Given the high frequency of anxious symptoms in depression and the comorbidity between depression and anxiety disorder, the efficacy of agomelatine in anxious symptoms also seems to be a beneficial aspect of the efficacy profile. Taken together, these findings show that agomelatine qualifies as an efficient option in the treatment of depression based on its broad efficacy on the full spectrum of depressive symptoms, including those occurring early as well as those that tend to persist late over the course of the disorder.

Cost of drug therapy for depression increasing in Canada

Cost of drug therapy for depression increasing in Canada

Cost of drug therapy for depression increasing in Canada

Cost of drug therapy for depression increasing in Canada

Couple therapy preferable to drug therapy in depression

Couple therapy preferable to drug therapy in depression

Molecular neuroanatomy of human monoamine oxidases A and B revealed by quantitative enzyme radioautography and in situ hybridization histochemistry

Monoamine oxidases are key enzymes in the metabolism of amine neurotransmitters and neuromodulators and are targets for drug therapy in depression, Parkinson's and Alzheimer's diseases. Knowledge of their distribution in the brain is essential to understand their physiological role. To study the regional distribution and abundance of monoamine oxidases A and B in human brain, pituitary and superior cervical ganglion, we used quantitative enzyme radioautography with radioligands [ 3H]Ro41-1049 and [ 3H]lazabemide, respectively. Furthermore, 35S-labelled oligonucleotides complementary to isoenzyme messenger RNAs were used to map the cellular location of the respective transcripts in adjacent sections by in situ hybridization histochemistry. A markedly different pattern of distribution of the isoenzymes was observed. Highest levels of monoamine oxidase A were measured in the superior cervical ganglion, locus coeruleus, interpeduncular nucleus and ventromedial hypothalamic nucleus. The corresponding messengerRNA was detected only in the noradrenergic neurons of the superior cervical ganglion and locus coeruleus. In contrast to rat brain, monoamine oxidase B was much more abundant in most human brain regions investigated. Highest levels were measured in the ependyma of ventricles, stria terminalis and in individual hypothalamic neurons. Monoamine oxidase B transcripts were detected in serotoninergic raphe neurons, histaminergic hypothalamic neurons and in dentate gyrus granule cells of the hippocampal formation. We conclude that [ 3H]Ro41-1049 and [ 3H]lazabemide are extremely useful radioligands for high-resolution analyses of the abundance and distribution of catalytic sites of monoamine oxidases A and B, respectively, in human brain sections. From levels of messenger RNA detected, the cellular sites of synthesis of the isoenzymes are the noradrenergic neurons of the locus coeruleus (for monoamine oxidase A) and the serotoninergic and histaminergic neurons of the raphe and posterior hypothalamus, respectively (for monoamine oxidase B). The combination of quantitative enzyme radioautography with in situ hybridization histochemistry is a useful approach to study, with high resolution, both the physiology and pathophysiology of monoamine oxidases in human brain.

Drug therapy for depression in the elderly.

Depression is common in the geriatric population, but recovery rates are gratifying. Safe treatment requires attention to the effects of aging on pharmacokinetics and close monitoring. Antidepressants are the drugs most commonly used; to the standard tricyclic drugs have now been added a tetracyclic and a triazolopyridine. Monoamine oxidase inhibitors and lithium are second-choice options; a benzodiazepine is not generally required. Dosages should be lower than conventionally prescribed. Side effects of antidepressant drugs are common, the most important being slowing of cardiac conduction times and the most common being anticholinergic manifestations, such as dry mouth and tachycardia. Some of the more recently introduced antidepressants may have more advantageous side-effect profiles than the older agents.

Turning off Depression

Turning off Depression

Treatment of depression: a comparative study of E.C.T. and six drugs.

Since the introduction of drug therapy in depression, a wide range of pharmacological substances has been made available. It is possible to show that many of these substances are more effective than a placebo in the treatment of depression, but it is not an easy matter to evaluate them in relation to one another.