Die Akutbehandlung depressiver Episoden

Holsboer‐Trachsler, Edith; Hättenschwiler, Josef; Beck, Johannes; Brand, Serge; Hemmeter, Ulrich; Keck, Martin E.; Rennhard, Stefan; Hatzinger, Martin; Merlo, Marco; Bondolfi, Guido; Preisig, Martin; Gehret, Anouk; Bielinski, Daniel; Seifritz, Erich

doi:10.4414/smf.2016.02704

Cited by 7 publications

(5 citation statements)

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“…Hence, a hypothesis could be that people already suffering from depression may not notice the decline in social contact brought on by COVID-19 as much compared to healthy populations. Additionally, in the current sample, the participants were not in their everyday environment, but in in-patient treatment where social interactions are provided and encouraged (Holsboer-Trachsler et al, 2016). Another noteworthy point regarding psychosocial stress levels is that the current population had high levels of perceived stress in both groups.…”

Section: Discussionmentioning

confidence: 93%

Psychosocial Health and Physical Activity in People With Major Depression in the Context of COVID-19

Cody

Kreppke

Beck

et al. 2021

Front. Sports Act. Living

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Introduction: Major depression is a psychiatric disease associated with physical inactivity, which in turn affects mental and physical health. A randomized controlled trial is being implemented to facilitate physical activity in people with major depression. In March 2020, Swiss state authorities temporarily legislated a lockdown to contain the Coronavirus disease-19 (COVID-19), which influenced health, behavior and research. The aim of this study was to find out whether data gathered before and during/after the lockdown among in-patients with major depression differ with regard to psychosocial health, physical activity and related attitudes and to establish whether baseline data have been affected by the lockdown.Methods: This is a cross-sectional analysis within a randomized controlled trial. Physically inactive, adult in-patients diagnosed with major depression were recruited from four Swiss psychiatric clinics between January 2019 and December 2020. Psychosocial health was measured with questionnaires pertaining to stress, sleep and health-related quality of life. Physical activity was measured with the Simple Physical Activity Questionnaire. Explicit attitudes were measured with seven questionnaires pertaining to physical activity-related motivation and volition. Implicit attitudes toward physical activity were captured with a single target implicit association test.Results: The sample consisted of 165 participants (n = 119 before lockdown, n = 46 during/after lockdown). No statistically significant differences were found between in-patients with major depression assessed before and during/after the COVID-19 lockdown with regard to psychosocial health (stress, p = 0.51; sleep, p = 0.70; physical component of health-related quality of life, p = 0.55; mental component of health-related quality of life, p = 0.64), self-reported physical activity (p = 0.16) and explicit as well as implicit attitudes toward physical activity (p = 0.94). Hence, the COVID-19-induced lockdown seems not to have led to group differences.Conclusion: Baseline data gathered in in-patients suffering from major depression who are physically inactive upon admission to in-patient treatment in Switzerland seem to be unaffected by the COVID-19-induced lockdown. To assess changes in said population regarding psychosocial health and physical activity patterns over time, longitudinal data are needed.

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Section: Discussionmentioning

confidence: 93%

Psychosocial Health and Physical Activity in People With Major Depression in the Context of COVID-19

Cody

Kreppke

Beck

et al. 2021

Front. Sports Act. Living

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“…The primary endpoint is defined as the rate of response to the antidepressant therapy at the end of week 4 of the treatment phase. This time point was chosen based on the recommendations of the SGAD, which advise to assess clinical effectiveness after four weeks of antidepressant pharmacotherapy [ 3 ]. Moreover, the response is determined as a reduction in the Hamilton Depression (HAM-D) Scale score of at least 50% from the baseline score [ 18 ].…”

Section: Methods: Participants Interventions and Outcomesmentioning

confidence: 99%

“…Successful treatment of depression remains challenging, considering the fact, that only 50% of patients suffering from major depressive disorders respond to the first-line antidepressant treatment [ 1 , 2 ]. Furthermore, a drug exposure of at least 4 weeks is necessary to assess clinical treatment response [ 3 ], possibly making the trial and error approach time-consuming and exhausting for the patient.…”

Section: Introductionmentioning

confidence: 99%

“…The aforementioned Clinical Pharmacogenetics Implementation Consortium (CPIC, https://cpicpgx.org/ ) and the Dutch Pharmacogenetics Working Group (DPWG, https://www.knmp.nl/patientenzorg/medicatiebewaking/farmacogenetica ) are publishing guidelines on genotype-guided drug dosing and/or drug selection, which currently includes recommendations for tricyclic antidepressants and selective serotonin reuptake inhibitors. Besides, the Swiss Society for Anxiety and Depression (SGAD) recommends genotyping of ABCB1 upon antidepressant treatment failure [ 3 ]. The latter gene encodes for p-glycoprotein an efflux transporter known for its function in the extrusion of drug molecules and xenobiotics at the blood-brain barrier.…”

Section: Introductionmentioning

confidence: 99%

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Pharmacist-guided pre-emptive pharmacogenetic testing in antidepressant therapy (PrePGx): study protocol for an open-label, randomized controlled trial

Stäuble

Lampert

Allemann

et al. 2021

Trials

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Background It is known that only 50% of patients diagnosed with major depressive disorders (MDD) respond to the first-line antidepressant treatment. Accordingly, there is a need to improve response rates to reduce healthcare costs and patient suffering. One approach to increase rates of treatment response might be the integration of pharmacogenetic (PGx) testing to stratify antidepressant drug selection. The goal of PGx assessments is to identify patients who have an increased risk to experience adverse drug reactions or non-response to specific drugs. Especially for antidepressants, there is compiling evidence on PGx influencing drug exposure as well as response. Methods This study is an open-label, randomized controlled trial conducted in two study centers in Switzerland: (1) the Psychiatric Clinic of Solothurn and (2) the Private Clinic Wyss in Münchenbuchsee. Adult inpatients diagnosed with a unipolar moderate or severe depressive episode are recruited at clinic admission and are included in the study. If the adjustment to a new antidepressant pharmacotherapy is necessary, the participants are randomized to either Arm A (intervention group) or Arm B (control group). If no new antidepressant pharmacotherapy is introduced the participants will be followed up in an observational arm. The intervention is the service of pharmacist-guided pre-emptive PGx testing to support clinical decision making on antidepressant selection and dosing. As a comparison, in the control group, the antidepressant pharmacotherapy is selected by the treating physician according to current treatment guidelines (standard of care) without the knowledge of PGx test results and support of clinical pharmacists. The primary outcome of this study compares the response rates under antidepressant treatment after 4 weeks between intervention and control arm. Discussion The findings from this clinical trial are expected to have a direct impact on inter-professional collaborations for the handling and use of PGx data in psychiatric practice. Trial registration ClinicalTrials.govNCT04507555. Registered on August 11, 2020. Swiss National Clinical Trials Portal SNCTP000004015. Registered August 18, 2020.

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“…Additionally, multiple guidelines with genotype-based recommendations for drug dosing and selection have been published and are currently available for tricyclic antidepressants and selective serotonin reuptake inhibitors [ 6 , 7 ]. Furthermore, the Swiss Society for Anxiety and Depression (SGAD) recommends genotyping of the P-glycoprotein (encoded by ABCB1 ) after experiencing antidepressant treatment failure [ 8 ]. The efflux transporter P-glycoprotein has an important gatekeeping role at the blood–brain barrier, where it extrudes xenobiotics and drug molecules including certain antidepressants.…”

Section: Introductionmentioning

confidence: 99%

Pharmacogenetic-Guided Antidepressant Selection as an Opportunity for Interprofessional Collaboration: A Case Report

Stäuble

Lampert

Mikoteit

et al. 2021

Life

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In the herein reported case of a 42-year-old woman diagnosed with anxiety and depression, a long history of antidepressant ineffectiveness and adverse drug reactions was decisive for an in-depth medication review including pharmacogenetic panel testing. In detail, treatment attempts with paroxetine and escitalopram were ineffective and discontinued due to subjective gastrointestinal intolerance. Due to the worsening of the depression after the failed treatment attempts, admission to our clinic became necessary. Herein, owing to the collaboration of psychiatrists with clinical pharmacists, individualized incorporation of pharmacogenetic data into the process of antidepressant selection was enabled. We identified vortioxetine as a suitable therapeutic, namely for being most likely pharmacokinetically unaffected as predicted by pharmacogenetic panel testing and taking into account the current comedication, as well as for its favorable action profile. Herein, our collaborative effort proved to be successful and resulted in the patient’s depression remission and clinic discharge with the interprofessionally selected pharmacotherapy. This exemplary case not only highlights the potential benefits and challenges of pre-emptive pharmacogenetic testing in antidepressant prescription, but also proposes an approach on how to put pharmacogenetics into practice.

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Die Akutbehandlung depressiver Episoden

Cited by 7 publications

References 0 publications

Psychosocial Health and Physical Activity in People With Major Depression in the Context of COVID-19

Psychosocial Health and Physical Activity in People With Major Depression in the Context of COVID-19

Pharmacist-guided pre-emptive pharmacogenetic testing in antidepressant therapy (PrePGx): study protocol for an open-label, randomized controlled trial

Pharmacogenetic-Guided Antidepressant Selection as an Opportunity for Interprofessional Collaboration: A Case Report

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