Evidence for the treatment of moderate depression: a systematic review

Aherne, Declan; Fitzgerald, Amanda; Aherne, Cian; Fitzgerald, Niamh; Slattery, Marcia J.; Whelan, Nuala

doi:10.1017/ipm.2017.10

Cited by 7 publications

(8 citation statements)

References 34 publications

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“…Pharmacological interventions are the most used therapeutic strategy to treat major depressive disorder (MDD). However, about 50% of treatments are unsuccessful in preventing relapse, leading to recurrent MDD (Aherne et al, 2017; Monroe and Harkness, 2011). MDD is a heterogeneous disorder and the understanding of its neurobiology is essential for the development of more efficient treatments (Jha and Trivedi, 2018; Mora et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Changes in inflammatory biomarkers are related to the antidepressant effects of Ayahuasca

et al. 2020

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Background: Ayahuasca is a traditional Amazon brew and its potential antidepressant properties have recently been explored in scientific settings. We conducted a double-blind placebo-controlled trial of ayahuasca with treatment-resistant depression patients ( n = 28) and healthy controls ( n = 45). Aims: We are evaluating the blood inflammatory biomarkers: C-reactive protein and interleukin 6, as a potential consequence of ayahuasca intake and their correlation with serum cortisol and brain-derived neurotrophic factor levels. Blood samples were collected at pre-treatment and 48 hours after substance ingestion to assess the concentration of inflammatory biomarkers, together with administration of the Montgomery-Åsberg Depression Rating Scale. Results: At pre-treatment, patients showed higher C-reactive protein levels than healthy controls and a significant negative correlation between C-reactive protein and serum cortisol levels was revealed ( rho = –0.40, n = 14). C-reactive protein in those patients was not correlated with Montgomery-Åsberg Depression Rating Scale scores. We observed a significant reduction of C-reactive protein levels across time in both patients and controls treated with ayahuasca, but not with placebo. Patients treated with ayahuasca showed a significant correlation ( rho = + 0.57) between larger reductions of C-reactive protein and lower depressive symptoms at 48 hours after substance ingestion (Montgomery-Åsberg Depression Rating Scale). No significant result with respect to interleukin 6 and brain-derived neurotrophic factor was found. Furthermore, these biomarkers did not predict the antidepressant response or remission rates observed. Conclusions: These findings enhance the understanding of the biological mechanisms behind the observed antidepressant effects of ayahuasca and encourage further clinical trials in adults with depression.

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Section: Introductionmentioning

confidence: 99%

Changes in inflammatory biomarkers are related to the antidepressant effects of Ayahuasca

et al. 2020

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“…There has been some recent debate about the efficacy of currently available antidepressants (Cipriani et al, 2018; Hengartner and Plöderl, 2018). Antidepressant drugs appear to act more efficiently than placebo mainly in severe major depression, while in patients with mild or moderate depression they have reduced benefit after drug treatment (Aherne et al, 2017). Moreover, the latency between administration and antidepressant response can take weeks (Strawn et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Modulation of Serum Brain-Derived Neurotrophic Factor by a Single Dose of Ayahuasca: Observation From a Randomized Controlled Trial

et al. 2019

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Serotonergic psychedelics are emerging as potential antidepressant therapeutic tools, as suggested in a recent randomized controlled trial with ayahuasca for treatmentresistant depression. Preclinical and clinical studies have suggested that serum brainderived neurotrophic factor (BDNF) levels increase after treatment with serotoninergic antidepressants, but the exact role of BDNF as a biomarker for diagnostic and treatment of major depression is still poorly understood. Here we investigated serum BDNF levels in healthy controls (N = 45) and patients with treatment-resistant depression (N = 28) before (baseline) and 48 h after (D2) a single dose of ayahuasca or placebo. In our sample, baseline serum BDNF levels did not predict major depression and the clinical characteristics of the patients did not predict their BDNF levels. However, at baseline, serum cortisol was a predictor of serum BDNF levels, where lower levels of serum BDNF were detected in a subgroup of subjects with hypocortisolemia. Moreover, at baseline we found a negative correlation between BDNF and serum cortisol in volunteers with eucortisolemia. After treatment (D2) we observed higher BDNF levels in both patients and controls that ingested ayahuasca (N = 35) when compared to placebo (N = 34). Furthermore, at D2 just patients treated with ayahuasca (N = 14), and not with placebo (N = 14), presented a significant negative correlation between serum BDNF levels and depressive symptoms. This is the first double-blind randomized placebo-controlled clinical trial that explored the modulation of BDNF in response to a psychedelic in patients with depression. The results suggest a potential link between the observed antidepressant effects of ayahuasca and changes in serum BDNF, which contributes to the emerging view of using psychedelics as an antidepressant. This trial is registered at http://clinicaltrials.gov (NCT02914769).

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“…The recognition and uses of alternative and complementary therapies of pharmacological treatments, such as psychotherapy, physical exercise, nutraceutical and psychedelic substances, have been increasing in the management of depressive symptoms [1][2][3][4][5]. Despite antidepressants are still the most adopted treatment for Major Depressive Disorder (MDD), patients have shown a signi cant preference for psychotherapies over pharmacotherapy [6,7], probably due to the relative low e cacy of these drugs, which are not e cient to all patients [8][9][10], and due to the induction of undesirable side effects, which may imply a reduction in adherence to treatment [11]. Consequently, the MDD prevalence has increased worldwide [8,10,12].…”

Section: Introductionmentioning

confidence: 99%

Psychophysiological responses to group cognitive-behavioral therapy in depressive patients

et al. 2021

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Background Cognitive-Behavioral Therapy (CBT) has a signi cant adjunctive effect in the treatment of Major Depressive Disorder (MDD), however its uses as monotherapy is less explored, mainly the group-based approaches. Methods We assessed the responses of distinct psychophysiological domains after a intervention using groupbased CBT (gCBT, 16 weeks) in drug-free patients with mild-moderate MDD (n = 20; women = 11) and to compare with a healthy control group (n = 25, women = 13). Results Treatment resulted in 65% of response and 55% of remission rates. Reductions in depressive and anxiety symptoms and increase in self-esteem and sleep quality were observed as responses of gCBT. After treatment patients regulated their previous deregulated salivary cortisol awakening response (CAR) and sleep quality to healthy parameters. These improvements were correlated among themselves and dependent of remission condition. Remitted patients showed large progresses than non-remitted patients, who signi cantly changed only serum cortisol and self-perceived depressive symptoms. Further, better baseline sleep quality was predictor of remission. Conclusion These psychophysiological changes in response of gCBT support its use as tool with low cost and no side effects for treatment of mild-moderate major depression, as well as suggests a stronger exploration of these psychological domains in psychotherapies and stimulates furthers studies of neurobiology of MDD and alternatives treatments. Trial registration U1111-1215-4472. Registered 21 August 2018, http://www.ensaiosclinicos.gov.br/rg/RBR-3npbf8/ [38, 39]. However, studies that have measured the effects of CBT as a monotherapy on cortisol levels of MDD patients are few and inconsistent [40, 41]. Thus, this study investigated the responses of distinct psychophysiological domains, such as depression and anxiety symptoms, self-esteem, sleep quality and cortisol levels (salivary and serum), in MDD patients under group CBT monotherapy treatment. We expected to nd a reduction of depressive and anxious symptoms, associated with increases in self-esteem and in sleep quality, as well as an adjustment of cortisol levels, especially in remitted patients. Methods This open-label trial was conducted at the Federal University of Rio Grande do Norte (UFRN) between 2018-2019. It has been approved by the UFRN Human Ethics Committee (# 2628,202) and registered at http://clinicaltrials.gov (U1111-1215-4472). The procedures of this study comply with the ethical standards of the relevant national and institutional committees for human experimentation and with the Declaration of Helsinki of 1975, revised in 2008. All subjects provided written informed consent prior to participation and it was ensured freedom to withdraw from the study at any time and without any prejudice. All study's information has been kept con dential.

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Evidence for the treatment of moderate depression: a systematic review

Abstract: Given that depression is one of the biggest challenges the world faces at present, further research is required to examine the effectiveness of treatment for different levels of depression severity.

Cited by 7 publications

References 34 publications

Changes in inflammatory biomarkers are related to the antidepressant effects of Ayahuasca

Changes in inflammatory biomarkers are related to the antidepressant effects of Ayahuasca

Modulation of Serum Brain-Derived Neurotrophic Factor by a Single Dose of Ayahuasca: Observation From a Randomized Controlled Trial

Psychophysiological responses to group cognitive-behavioral therapy in depressive patients

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