Differential pattern of response in mood symptoms and suicide risk measures in severely ill depressed patients assigned to citalopram with placebo or citalopram combined with lithium: Role of lithium levels

Khan, Arif; Khan, Shirin; Hobus, Joy; Faucett, James; Mehra, Vishaal; Giller, Earl L.; Rudolph, Richard L.

doi:10.1016/j.jpsychires.2011.06.016

Cited by 44 publications

(23 citation statements)

References 19 publications

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“…Several studies have found only minor associations of antidepressant treatment and suicidal behaviors, mainly with MDD (Beasley et al 1991;Acharya et al 2006;Möller 2006;Tondo et al 2008;Khan et al 2011;Tondo and Baldessarini 2015;Braun et al 2016). Other findings noted increased risk of suicidal acts in juveniles and young adults but decreased risk in older adults (Hammad et al 2006;Laughren et al 2006;Bridge et al 2007;Barbui et al 2009;Saunders and Hawton 2013;Braun et al 2016).…”

Section: Suicide and Treatment With Antidepressantsmentioning

confidence: 99%

Bipolar depression: a major unsolved challenge

Baldessarini

Vázquez

Tondo

2020

Int J Bipolar Disord

155

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Depression in bipolar disorder (BD) patients presents major clinical challenges. As the predominant psychopathology even in treated BD, depression is associated not only with excess morbidity, but also mortality from co-occurring general-medical disorders and high suicide risk. In BD, risks for medical disorders including diabetes or metabolic syndrome, and cardiovascular disorders, and associated mortality rates are several-times above those for the general population or with other psychiatric disorders. The SMR for suicide with BD reaches 20-times above general-population rates, and exceeds rates with other major psychiatric disorders. In BD, suicide is strongly associated with mixed (agitated-dysphoric) and depressive phases, time depressed, and hospitalization. Lithium may reduce suicide risk in BD; clozapine and ketamine require further testing. Treatment of bipolar depression is far less well investigated than unipolar depression, particularly for long-term prophylaxis. Short-term efficacy of antidepressants for bipolar depression remains controversial and they risk clinical worsening, especially in mixed states and with rapid-cycling. Evidence of efficacy of lithium and anticonvulsants for bipolar depression is very limited; lamotrigine has long-term benefit, but valproate and carbamazepine are inadequately tested and carry high teratogenic risks. Evidence is emerging of short-term efficacy of several modern antipsychotics (including cariprazine, lurasidone, olanzapine-fluoxetine, and quetiapine) for bipolar depression, including with mixed features, though they risk adverse metabolic and neurological effects.

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Section: Suicide and Treatment With Antidepressantsmentioning

confidence: 99%

Bipolar depression: a major unsolved challenge

Baldessarini

Vázquez

Tondo

2020

Int J Bipolar Disord

155

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“…Augmentation of the antidepressant citalopram with lithium has also been examined in a study of 80 patients for 4 weeks. 37 Although there was no difference in primary outcomes (suicidal thoughts and behaviors) at the 4-week point, a post hoc analysis showed that patients assigned to citalopram plus lithium had significantly higher Sheehan-Suicidality Tracking Scale remission rates—in these studies and several others summarized in Table 1. The observational studies also show a link between prescription rates of antidepressants and a decrease in the incidence of suicide, but the results of meta-analyses have been mixed.…”

Section: Antidepressants Antipsychotics and Neurostimulatory Technimentioning

confidence: 78%

“…40–42 Suicidal tendencies and thoughts that are conceptualized as part of these depressive conditions appear to remit just as rapidly as the overall syndrome. 37 This may give a rapid acting agent such as ketamine an advantage in the acute management of suicide risk over traditional antidepressants with effects that may be more enduring with consistent daily dosing but take much longer to develop. There may be mechanistic grounds for this rapid effect, as new research connects inflammatory markers of depression with physiologic glutamate agonism in suicidal patients, 38 a clinical state that ketamine’s NMDA antagonism rapidly reverses with potentially protective effects.…”

Section: Ketamine or Ketamine-like Compoundsmentioning

confidence: 99%

Existing and Novel Biological Therapeutics in Suicide Prevention

Griffiths

Zarate

Rasimas

2014

American Journal of Preventive Medicine

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We summarize outcomes for several pharmacologic and neurostimulatory approaches that have been considered potential treatments to reduce suicide risk, namely by reducing suicide deaths, attempts, and ideation in various clinical populations. Available treatments include clozapine, lithium, antidepressants, antipsychotics, electroconvulsive therapy, and transcranial magnetic stimulation. The novel repurposing of ketamine as a potential suicide-risk mitigating agent in the acute setting is also discussed. Research pathways to better understand and treat suicidal ideation and behavior from a neurobiological perspective are proposed in light of this foundation of information and the limitations and challenges inherent in suicide research. Such pathways include trials of fast-acting medications, registry approaches to identify appropriate patients for trials, identification of biomarkers, neuropsychological vulnerabilities, and endophenotypes through the study of known suicide risk–mitigating agents in hope of determining mechanisms of pathophysiology and the action of protective biological interventions.

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“…Selective serotonin (5-HT) reuptake inhibitors (SSRIs) are one of the first-line drug treatments for MDD, although approximately 30% of patients do not respond to SSRI monotherapy (Corya et al, 2006). To overcome treatment resistance in depression, many types of augmentation therapies have been 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 developed to enhance treatment efficacy of conventional antidepressants, such as tricyclics, SSRIs and serotoninnoradrenaline reuptake inhibitors (Nelson and Papakostas., 2009;Whale et al, 2010;Khan et al, 2011). The olanzapinefluoxetine drug combination, one of the most common augmentation therapies, shows more rapid and higher efficacy than SSRI monotherapy (Tohen et al, 2003;Corya et al, 2006;Dub e et al, 2007).…”

Section: Introductionmentioning

confidence: 99%