Mood In Older Adults Research Articles

The mediating role of catastrophizing in the relationship between pain intensity and depressed mood in older adults with persistent pain: A longitudinal analysis

Background and aimsDepression is common in older adults with persistent pain. Cognitive-behavioural models of pain propose that the relationship between pain and depression is influenced or mediated by interpretations of events (cognitions), rather than by the event itself. Almost exclusively, the evidence for this position has come from studies of people aged less than 65 years. The role of cognitions in the pain experience of older adults has been unclear due to the limited and conflicting evidence available. The aim of our study was to examine the role of catastrophizing in mediating the relationship between pain intensity and depressed mood in older adults with persistent pain using reliable and valid measures for this population. MethodsIn a two-wave longitudinal design, a sample of 141 patients (89 women, 52 men) 65 years and over with persistent pain participating in an evaluation of a pain self-management programme completed questionnaires measuring usual level of pain intensity (NRS), depressed mood (DASS-21) and the catastrophizing factors of magnification and helplessness (PRSS) at the beginning of the programme and 6 months later. Demographic data and pain history were collected by self-completion questionnaires, which were mailed to patients prior to participating in the programme and returned by post. ResultsChange scores for usual level of pain intensity (NRS), depressed mood (DASS-21) and the magnification and helplessness factors on the PRSS-Catastrophizing were calculated by subtracting the scores at 6 months after completion of the study (Time 2) from the scores at the beginning of the study (Time 1). In the longitudinal analyses of mediation, using a series of regression analyses, change scores for both factors (magnification, helplessness) of the measure of catastrophizing (PRSS) totally and significantly mediated the relationship between change scores for pain intensity and depressed mood. The significant relative magnitude of beta between pain intensity and depression reduced from 0.22 to 0.13 and became non-significant after introducing magnification as a mediating variable, whilst the significant relative magnitude of beta reduced from 0.22 to 0.12 and also became non-significant after introducing helplessness as a mediating variable. ConclusionsThese results support a cognitive-behavioural model and highlight the importance of cognitive factors, in this case catastrophizing, in the relationship between pain intensity and depressed mood in older adults with persistent pain. ImplicationsThese findings also have important clinical implications for the treatment of older adults with persistent pain. They highlight the importance of targeting interventions to reduce the influence of catastrophizing as a prerequisite for reducing depressive symptoms in this growing population.

The effect of D-serine administration on cognition and mood in older adults.

BackgroundD-serine is an endogenous co-agonist of the N-Methyl D-Aspartate Receptor (NMDAR) that plays a crucial role in cognition including learning processes and memory. Decreased D-serine levels have been associated with age-related decline in mechanisms of learning and memory in animal studies. Here, we asked whether D-serine administration in older adults improves cognition.ResultsD-serine administration improved performance in the Groton Maze learning test of spatial memory and learning and problem solving (F(3, 38)= 4.74, p = 0.03). Subjects that achieved higher increases in plasma D-serine levels after administration improved more in test performance (r2=−0.19 p = 0.009). D-serine administration was not associated with any significant changes in the other cognitive tests or in the mood of older adults (p > 0.05).MethodsFifty healthy older adults received D-serine and placebo in a randomized, double blind, placebo-controlled, crossover design study. We studied the effect of D-serine administration on the performance of cognitive tests and an analogue mood scale. We also collected blood samples to measure D-serine, L-serine, glutamate and glutamine levels.ConclusionsD-serine administration may be a strategy to improve spatial memory, learning and problem solving in healthy older adults. Future studies should evaluate the impact of long-term D-serine administration on cognition in older adults.

Seasonal and meteorological associations with depressive symptoms in older adults: A geo-epidemiological study

BackgroundGiven increased social and physiological vulnerabilities, older adults may be particularly susceptible to environmental influences on mood. Whereas the impact of season on mood is well described for adults, studies rarely extend to elders or include objective weather data. We investigated the impact of seasonality and meteorological factors on risk of current depressive symptoms in older adults. MethodsWe used data on 8027 participants from the first wave of The Irish Longitudinal Study of Ageing, a population-representative cohort of adults aged 50+. Depressive symptoms were recorded using the Centre for Epidemiological Studies Depression Scale. Season was defined according to the World Meteorological Organisation. Data on climate over the preceding thirty years, and temperature and rain over the preceding month, were provided by the Irish Meteorological Service and linked using Geographic Information Systems techniques to participant's geo-coded locations at a resolution of one kilometre. ResultsThe highest levels of depressive symptoms were reported in winter and the lowest in spring (mean 6.56 [CI95% 6.09, 7.04] vs. 5.81 [CI95%: 5.40, 6.22]). In fully adjusted linear regression models, participants living in areas with higher levels of rainfall in the preceding and/or current calendar month had greater depressive symptoms (0.04 SE 0.02; p=0.039 per 10mm additional rainfall per month) while those living in areas with sunnier climates had fewer depressive symptoms (−2.67 SE 0.88; p=0.003 for every additional hour of average annual daily sunshine). LimitationsThis was a cross-sectional analysis thus causality cannot be inferred; monthly rain and temperature averages were available only on a calendar month basis while monthly local levels of sunshine data were not available. ConclusionsEnvironmental cues may influence mood in older adults and thus have relevance for the recognition and treatment of depression in this age group.

Changes in Mood in New Enrollees at a Program of All-Inclusive Care for the Elderly.

To examine changes in mood after nine months of enrollment in a Program of All-Inclusive Care for the Elderly (PACE). Cohort study. Alexian Brothers PACE, St. Louis, Missouri. Newly enrolled patients 55 years of age and older, living in the PACE service area, eligible for nursing facility care and able to live safely in the community, with continuous care, for at least nine months (N = 182). Geriatric Depression Scale (GDS)-15 score at the pre-admission evaluation (PAE) and the nine-month evaluation (9ME). Of the 182 patients evaluated, 27% (n = 49) met the definition of depression as defined by the GDS-15 score of ≥ 6 at the PAE. At the 9ME, only 11% of patients met the depression criteria (P < 0.001). Of the patients who met the criteria for depression at the PAE, 80% of patients (n = 39) no longer met these criteria at the 9ME (P = 0.029). Similar findings were observed by age, gender, and race. Greater improvement was observed among those who were depressed at the PAE; the depressed cohort improved by 5.0 points (P < 0.001) on the GDS-15 scale from the PAE to the 9ME, whereas the nondepressed cohort improved by 0.6 points (P = 0.003). The use of PACE as an alternative intervention may be a good option to improve mood in older adults.

Vitamin D and Age-Related Health Outcomes: Movement, Mood, and Memory.

It has long been recognized that vitamin D plays an important role in calcium homeostasis and musculoskeletal health. More recent evidence supports a role of vitamin D in physical and cognitive function and depressive symptoms through direct effects on skeletal muscle and the brain as well as indirectly through its reported roles in chronic conditions such as cardiovascular disease and diabetes, conditions that frequently lead to declines in physical and cognitive function and depressed mood. The purpose of this review is to summarize the prospective cohort and randomized controlled trial evidence for vitamin D on physical and cognitive function and depressed mood in older adults. Results from both prospective cohort studies and randomized controlled trials of vitamin D supplementation are mixed. Thus, controversy remains over the optimal vitamin D concentration for physical and cognitive function and depressed mood and whether vitamin D supplementation is beneficial for these outcomes.

A prospective physiotherapy clinical pathway for the assessment of pain, function and mood in older adults with or without dementia

short-term (6-month) outcome. For self-report physical function, quadriceps strength predicted only short-term outcome (P< 0.001). In contrast, kinesiophobia predicted both shortand long-term (1-year) functional outcomes. Specifically, an interquartile range increase in kinesiophobia was associated with 0.57 times (95%CI, 0.30–0.99 times; P= 0.045) the odds of higher 6-month self-report physical function and 0.34 times (95%CI, 0.18–0.67 times; P< 0.01) the odds of higher 1-year function. Conclusion(s):Goodmuscle strength was not necessarily related to less kinesiophobia, and kinesiophobia was predictive of physical function–in particular, long-term self-report physical function. Quadriceps strength and kinesiophobia conjointly and independently influenced physical function. Future studies could replicate our study with a more physically and psychologically challenging performance-based physical function assessment to better define the association between kinesiophobia and physical function. Implications: Clinicians should address both muscle strength and kinesiophobia when optimizing functional outcomes in patients with ACLR.

Fit & strong! Promotes physical activity and well-being in older cancer survivors.

Physical activity reduces fatigue and depression while improving quality of life in cancer survivors. Exercise is generally considered safe and is recommended to survivors of all ages. Despite the high prevalence of cancer in the elderly, few studies address physical activity interventions targeting this older population. Fit & Strong! is an evidence-based physical activity program shown to improve level of physical activity, exercise-self-efficacy, and mood in older adults with osteoarthritis. This study tests the feasibility and short-term impact of the Fit & Strong! exercise program adapted for older cancer survivors. Participants were cancer survivors at least 50 years of age who were not on active treatment with intravenous chemotherapy or radiation. They participated in the 8-week Fit & Strong! program, which included three 90-min sessions per week; 60 min of group physical activity and 30 min of education. Education on osteoarthritis was removed from the Fit & Strong! program and replaced with relevant topics on cancer survivorship issues. Feasibility was measured by the ability to recruit and retain older cancer survivors. Pre and post-intervention surveys evaluated the effect of the intervention on physical activity and quality of life. The study enrolled 72 cancer survivors to participate in an 8-week exercise program. The mean age of participants was 70. Over two-thirds (68%) of participants completed the program and with a mean attendance rate of 75% (18 of 24 sessions). No safety issues occurred. Improvements from baseline to post-intervention were observed for self-reported minutes of physical activity per week, self-efficacy for aerobic exercise, and symptoms related to depression and anxiety. This study was successful in recruiting and retaining a population of older cancer survivors to participate in a group exercise program. Significant improvement in level of physical activity and mood suggests this evidence-based physical activity intervention can be adapted to promote health benefits in cancer survivors. Additional studies are necessary to confirm efficacy and assess long-term benefits.

Relationship between self-esteem and depressive mood in old age: Results from a six-year longitudinal study

The reciprocal nature of the relationship between depression and personality traits (e.g., self-esteem, neuroticism) is still elusive (e.g., vulnerability and scar models). The aim of this study was to examine the longitudinal reciprocal effects between self-esteem and depressive mood in older adults. 757 participants aged 64–97years assessed 4 times over a six-year period. Cross-lagged models were estimated using SEM. Our findings showed a relative stability over a six-year period of both self-esteem and depressive mood. There were no cross-lagged reciprocal effects between self-esteem and depressive mood over time, thereby rejecting both vulnerability and scar models. It means that self-esteem and depressive mood do not predate each other in old age. These results suggest a developmental phenomenon in which self-esteem and depressive mood follow two parallel and stable developmental trajectories through old age.

Factor structures of a Japanese version of the Geriatric Depression Scale and its correlation with the quality of life and functional ability

We investigated the 15-item Geriatric Depression Scale (GDS-15) with regard to its factors and, reproducibility, as well as its relationship to activities of daily living, social factors, medical conditions, and quality of life for community-dwelling elderly people in Japan. The study population consisted of 736 community-dwelling elderly participants aged 65 or older. Exploratory factor analysis of the data and correlation coefficients between factors and activities of daily living, quality of life, social factors, and medical conditions were calculated for two consecutive years. The reproducibility of the results was also evaluated. As the result, GDS-15 had three reproducible factors specified as follows: factor I, “energy loss and pessimistic outlook”; factor II, “positive mental status (reversed)”; and factor III, “empty feeling.” Comparing our findings with a review of research in this area, positive items (excluding “feel full of energy”) seem to compose an universal factor. Factor I correlated best with quality of life, factor II with activities of daily living, and factor III with subjective cognitive function. These results suggest the GDS-15 can be used to assess the functional ability and quality of life, as well as depressive mood in older adults.

Sleep Architecture and Mental Health Among Community-Dwelling Older Men.

To investigate the association of mood and anxiety symptoms with sleep architecture (the distribution of sleep stages) in community-dwelling older men. We used in-home unattended polysomnography to measure sleep architecture in older men. Men were categorized into 4 mental health categories: (a) significant depressive symptoms only (DEP+ only, Geriatric Depression Scale ≥ 6), (b) significant anxiety symptoms only (ANX+ only, Goldberg Anxiety Scale ≥ 5), (c) significant depressive and anxiety symptoms (DEP+/ANX+), or (d) no significant depressive or anxiety symptoms (DEP-/ANX-). Compared with men without clinically significant symptomology, men with depressive symptoms spent a higher percentage of time in Stage 2 sleep (65.42% DEP+ only vs 62.47% DEP-/ANX-, p = .003) and a lower percentage of time in rapid eye movement sleep (17.05% DEP+ only vs 19.44% DEP-/ANX-, p = .0005). These differences persisted after adjustment for demographic/lifestyle characteristics, medical conditions, medications, and sleep disturbances, and after excluding participants using psychotropic medications. The sleep architecture of ANX+ or DEP+/ANX+ men did not differ from asymptomatic men. Depressed mood in older adults may be associated with accelerated age-related changes in sleep architecture. Longitudinal community-based studies using diagnostic measures are needed to further clarify relationships among common mental disorders, aging, and sleep.

Effect of music-based multitask training on cognition and mood in older adults

in a secondary analysis of a randomised controlled trial, we investigated whether 6 months of music-based multitask training had beneficial effects on cognitive functioning and mood in older adults. 134 community-dwellers aged ≥65 years at increased risk for falling were randomly assigned to either an intervention group (n = 66) who attended once weekly 1-h supervised group classes of multitask exercises, executed to the rhythm of piano music, or a control group with delayed intervention (n = 68) who maintained usual lifestyle habits, for 6 months. A short neuropsychological test battery was administered by an intervention-blinded neuropsychologist at baseline and Month 6, including the mini-mental state examination (MMSE), the clock-drawing test, the frontal assessment battery (FAB) and the hospital anxiety (HADS-A) and depression scale. intention-to-treat analysis showed an improvement in the sensitivity to interference subtest of the FAB (adjusted between-group mean difference (AMD), 0.12; 95% CI, 0.00 to 0.25; P = 0.047) and a reduction in anxiety level (HADS-A; AMD, -0.88; 95% CI, -1.73 to -0.05; P = 0.039) in intervention participants, as compared with the controls. Within-group analysis revealed an increase in MMSE score (P = 0.004) and a reduction in the number of participants with impaired global cognitive performance (i.e., MMSE score ≤23; P = 0.003) with intervention. six months of once weekly music-based multitask training was associated with improved cognitive function and decreased anxiety in community-dwelling older adults, compared with non-exercising controls. Studies designed to further delineate whether training-induced changes in cognitive function could contribute to dual-task gait improvements and falls reduction, remain to be conducted.

The effectiveness of Paro robot therapy on mood of older adults: a systematic review

1Tzu Chi College of Technology, Hualien, Taiwan, 2Tzu Chi University, Hualien, Taiwan, 3Taiwanese Centre for Evidence-based Health Care, Taiwan

The effects of spending time outdoors in daylight on the psychosocial wellbeing of older people and family carers: a comprehensive systematic review protocol

Review question/objective The overall objective of this research is to undertake a systematic review of the effects of spending time outdoors in daylight on the psychosocial wellbeing of older adults and family carers. The specific objectives to be addressed are: Which aspects of psychosocial wellbeing are affected by spending time outdoors in daylight in older adults and family carers? To what extent is spending time outdoors in the daylight effective for improving aspects of psychosocial wellbeing in older adults and family carers? Inclusion criteria Types of participants This review will consider studies that include all older adults aged 55 years or more, including those living in a community setting or a residential aged care facility. In addition, this review will consider family carers, who are defined as unpaid relatives or friends of an older person, who help that individual with their activities of daily living. No further inclusion criteria will be applied. Types of intervention(s)/phenomena of interest The intervention or phenomenon of interest is spending time outdoors in daylight. ‘Outdoors in daylight’ is a broad term that encompasses all outdoor environments where participants are exposed, directly or indirectly, to daylight in a natural setting while participating in any type of outdoor activity. For our review, the definition of outdoor activity is simply ‘being outdoors’ in order to capture all types of engagement with outdoor environments. Studies will be excluded if they utilise artificial ‘bright’ light sources or modify the indoor environment to improve light exposure. An absence of activity or indoors activity with no exposure to daylight will be used as a comparator. Types of outcomes This review will consider studies that include objective and/ or subjective measures of the following outcomes: Older adults: • psychosocial well-being: o behavioural disturbances; o cognition; o mood levels; o quality of life; o satisfaction with service provision; and o social interaction. Family carer health: o carer satisfaction; and o carer stress.

Exercise for late-life depression? It depends

Exercise for late-life depression? It depends

Catastrophizing Mediates the Relationship Between Pain Intensity and Depressed Mood in Older Adults With Persistent Pain

This study examined the role of catastrophizing in mediating the relationship between pain intensity and depressed mood in older adults with persistent pain using reliable and valid measures for this population. A convenience sample of 669 patients 61 years and over attending a tertiary-level referral pain center completed questionnaires measuring pain intensity, depressed mood, and catastrophizing as part of a clinical assessment process. The catastrophizing subscale of the Pain-Related Self-Statements scale (PRSS-Catastrophizing) was examined for internal consistency and factor structure. Mediation was tested for each factor from the optimal model of the PRSS-Catastrophizing scale using regression analyses, which included measures of pain intensity and depressed mood. The PRSS-Catastrophizing scale was found to be a reliable measure of pain-related catastrophizing. A 2-factor solution (magnification, helplessness) was identified. Both factors partially and significantly mediated the relationship between pain intensity and depressed mood. This study highlights the importance of cognitive factors—in this case catastrophizing—in the persistent pain experience of older adults. It also demonstrates that pain-related catastrophizing can be reliably measured in this population. These findings have important clinical implications. They emphasize the importance of using interventions to reduce catastrophizing to modify the pain experience of older adults with persistent pain. PerspectiveThis study confirms the mediating role of catastrophizing in the relationship between pain intensity and depressed mood in older adults with persistent pain using psychometrically sound measures. These findings indicate that clinicians should address catastrophizing to improve treatment outcomes with this population.

Exploring the Relationship Among the Undesired Self, Health, and Mood in Older Adults1

Longitudinal data from older adults were analyzed to examine the impact of health factors on undesired and ideal self‐discrepancies; and the association of these 2 self‐discrepancies on moods. Results showed that after controlling for self‐assessed health (SAH), fatigue/lack of energy was associated with the undesired but not the ideal self. A second set of analyses revealed that the undesired self‐discrepancy predicted moods only at high levels of SAH. The ideal self was only associated with anxiety, but only at low levels of SAH. This evidence supports the idea that health‐related factors are relevant for the self‐discrepancies of older adults, especially the undesired self‐discrepancy. We expanded prior evidence by demonstrating that the effects of self‐discrepancies on mood are moderated by SAH.

Assessing mood in older adults: a conceptual review of methods and approaches

Accurate measures of mood state are important for understanding and optimizing health and well-being in later life. A range of different mood assessment measures is available, reflecting the variety of ways in which mood has been conceptualized and the different purposes for which measures have been developed. We undertook a conceptual review of the literature relating to mood and its assessment in older populations. Moods are subjective states of mind that are typically described and quantified using self-report measures. Moods can be conceptually differentiated from the related psychological concepts of emotion, well-being, quality of life, and depression. Quantitative tools for assessing mood state include single-item mood ratings, composite factor scales, and clinical depression assessments. Mood assessments may be administered retrospectively or contemporaneously to the mood state of interest. The method and temporal perspective used to assess mood state will impact on the nature and precision of the mood data that are collected, and the types of research questions that can be addressed. No single mood assessment technique can be considered optimal for all situations. Rather, both the type of tool and the temporal perspective taken must be selected according to the nature of the study design and the research question being addressed. More thorough and frank reporting of the rationale for, and limitations of, mood assessment techniques are also essential for continued development of mood research with older adults.

A prospective study of mental health care for comorbid depressed mood in older adults with painful osteoarthritis

BackgroundComorbid depression is common among adults with painful osteoarthritis (OA). We evaluated the relationship between depressed mood and receipt of mental health (MH) care services.MethodsIn a cohort with OA, annual interviews assessed comorbidity, arthritis severity, and MH (SF-36 mental health score). Surveys were linked to administrative health databases to identify mental health-related visits to physicians in the two years following the baseline interview (1996-98). Prescriptions for anti-depressants were ascertained for participants aged 65+ years (eligible for drug benefits). The relationship between MH scores and MH-related physician visits was assessed using zero-inflated negative binomial regression, adjusting for confounders. For those aged 65+ years, logistic regression examined the probability of receiving any MH-related care (physician visit or anti-depressant prescription).ResultsAnalyses were based on 2,005 (90.1%) individuals (mean age 70.8 years). Of 576 (28.7%) with probable depression (MH score < 60/100), 42.5% experienced one or more MH-related physician visits during follow-up. The likelihood of a physician visit was associated with sex (adjusted OR women vs. men = 5.87, p = 0.005) and MH score (adjusted OR per 10-point decrease in MH score = 1.63, p = 0.003). Among those aged 65+, 56.7% with probable depression received any MH care. The likelihood of receiving any MH care exhibited a significant interaction between MH score and self-reported health status (p = 0.0009); with good general health, worsening MH was associated with increased likelihood of MH care; as general health declined, this effect was attenuated.ConclusionsAmong older adults with painful OA, more than one-quarter had depressed mood, but almost half received no mental health care, suggesting a care gap.

Erythrocyte polyunsaturated fatty acid status, memory, cognition and mood in older adults with mild cognitive impairment and healthy controls

Polyunsaturated fatty acid (PUFA) levels are altered in adults with cognitive decline and also depression. Depression facilitates progression from mild cognitive impairment (MCI) to dementia. We investigated associations between omega-3 (n-3) and omega-6 (n-6) PUFAs and cognition, memory and depression in 50 adults ≥65 years with MCI and 29 controls. Memory, depressive symptoms and erythrocyte PUFAs (% total fatty acids) were assessed. Eicosapentaenoic acid (EPA) was lower in MCI vs controls (.94% vs 1.26%, p<.01); n-6 PUFAs were higher: dihomo-gamma-linolenic acid (1.51% vs 1.32%, p<.01), arachidonic acid (11.54% vs 10.70%, p<.01), n-6 docosapentaenoic acid (DPA:.46% vs.34%, p<.01), and total n-6 PUFA (24.14% vs 23.37%, p<.05). Higher n-6 DPA predicted poorer mental health. Lower n-3 DPA was associated with higher self-reported bodily pain. Adults with MCI had higher depression scores (3.05±.39 vs 1.33±.24, p<.01). Depressive symptoms associated with elevated n-6 PUFA may contribute to cognitive decline in this population.

Lamotrigine Reduces Craving and Depressive Symptoms in Cocaine Dependence

Back to table of contents Previous article Next article LettersFull AccessLamotrigine Reduces Craving and Depressive Symptoms in Cocaine DependenceZoran Pavlovic, M.D.Zoran PavlovicSearch for more papers by this author, M.D.Published Online:1 Jan 2011AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: The importance of glutamatergic projections can be seen superficially in neuroimaging studies where blood flow to the anterior cingulate cortex, ventral orbital cortex, and amygdala is increased during craving for a variety of addictive drugs.1,2 Cocaine craving was found to be significantly associated with time-to-relapse.3 Furthermore, several lines of evidence suggest a link between cocaine-primed craving and depressive symptomatology.4 Lamotrigine reduces acute depressive symptoms (epilepsy, treatment-resistant depression)5,6 and has been shown to be effective in reducing cocaine craving in bipolar disorder comorbid with cocaine dependence7 and alcohol use disorders.8 Lamotrigine affects glutamate by inhibiting high-voltage-activated calcium channels that are located presynaptically, and consequently inhibits its release.2,9I present three patients diagnosed with cocaine dependence according to the DSM-IV criteria. They had used cocaine for an average of 5.4 years, and they had made an average of 3.1 quit attempts in their lifetimes. Patients had used cocaine for an average of 12.10 days during the 30 days before completing the baseline assessment battery. Their average baseline Cocaine Craving Questionnaire—Brief10 score was 48 and corresponding Beck Depression Inventory (BDI) score was 17. After 12 weeks on lamotrigine monotherapy, 200 mg/day, the respective scores decreased to 7 on the BDI and 21 on the Cocaine Craving Questionnaire, with no reports of relapse.My results suggest that lamotrigine might have bimodal action by reducing craving and depression symptoms and thus could be a useful drug in preventing relapse in cocaine dependence.Private Practice, Belgrade, Serbia1. Goldstein RA , Volkow ND: Drug addiction and its underlying neurobiological basis: neuroimaging evidence for the involvement of the frontal cortex. Am J Psychiatry 2002; 159:1642–1652Crossref, Medline, Google Scholar2. Uys JD , LaLumiere RT: Glutamate: the new frontier in pharmacotherapy for cocaine addiction. CNS Neurol Disord Drug Targets 2008; 7:482–491Crossref, Medline, Google Scholar3. Paliwal P , Scott M , Hymana MS, et al.: Craving predicts time to cocaine relapse: Further validation of the Now and Brief versions of the cocaine craving questionnaire. Drug Alcohol Depend 2008; 93:252–259Crossref, Medline, Google Scholar4. Elman I , Karlsgodt KH , Gastfriend DR, et al.: Cocaine-primed craving and its relationship to depressive symptomatology in individuals with cocaine dependence. J Psychopharmacol 2002; 16:163–167Crossref, Medline, Google Scholar5. Fakhoury TA , Miller JM , Hammer AE, et al.: Effects of lamotrigine on mood in older adults with epilepsy and comorbid depressive symptoms: an open-label, multicenter, prospective study. Drugs Aging 2008; 25:955–962Crossref, Medline, Google Scholar6. Santos MA , Rocha FL , Hara C: Efficacy and safety of antidepressant augmentation with lamotrigine in patients with treatment-resistant depression: a randomized, placebo-controlled, double-blind study. Prim Care Companion J Clin Psychiatry 2008; 10:187–190Crossref, Medline, Google Scholar7. Brown SE , Perantie DC , Dhanani N, et al.: Lamotrigine for bipolar disorder and comorbid cocaine dependence: a replication and extension study. J Affect Disord 2006; 93: 219–222Crossref, Medline, Google Scholar8. Pavlovic ZM: Case report: long-term treatment and relapse prevention of alcohol and benzodiazepine dependence with lamotrigine (letter). J Neuropsych Clin Neurosciences 2010 Spring; 22:E25–E6 (published online May 2010)Link, Google Scholar9. Xie X , Hagan RM: Cellular and molecular actions of lamotrigine: possible mechanisms of efficacy in bipolar disorder. Neuropsychobiology 1998; 38:119–130Crossref, Medline, Google Scholar10. Sussner BD , Smelson DA , Rodrigues S, et al.: The validity and reliability of a brief measure of cocaine craving. Drug Alcohol Depend 2006; 83, 233–237Crossref, Medline, Google Scholar FiguresReferencesCited byDetailsCited ByNone Volume 23Issue 1 Winter 2011Pages E32-E32 Metrics PDF download History Published online 1 January 2011 Published in print 1 January 2011