Major depressive disorder: mechanism-based prescribing for personalized medicine

Saltiel, Philip F; Silvershein, Daniel I

doi:10.2147/ndt.s73261

Cited by 55 publications

(37 citation statements)

References 116 publications

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“…However, we found that the most improvement in SDS and FSS scores was at the same therapy phase, which was between 9th and 12th week of therapy. This is consistent with the report that depression was one cause of fatigue 36. Moreover, Mills et al37 reported that the collapse of upper airway could increase not only local inflammation but also systemic inflammation.…”

Section: Discussionsupporting

confidence: 91%

Effect of adherence on daytime sleepiness, fatigue, depression and sleep quality in the obstructive sleep apnea/hypopnea syndrome patients undertaking nasal continuous positive airway pressure therapy

Wang

Luo

et al. 2017

PPA

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ObjectivesThe aims of this study were to describe changes in day- and nighttime symptoms and the adherence to nasal continuous positive airway pressure (nCPAP) during the first 3-month nCPAP therapy among newly diagnosed patients with obstructive sleep apnea/hypopnea syndrome (OSAS) and to identify the effect of adherence on the changes in day- and nighttime symptoms during the first 3 months.MethodsNewly diagnosed OSAS patients were consecutively recruited from March to August 2013. Baseline clinical information and measures of the Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Zung’s Self-Rating Depression Scale (SDS) and the Pittsburgh Sleep Quality Index (PSQI) at baseline and the end of 3rd, 6th, 9th and 12th week of therapy were collected. Twelve weeks’ adherence was calculated as the average of each 3-week period. Mixed model was used to explore the effect of adherence to nCPAP therapy on ESS, FSS, SDS and PSQI in each 3-week phase.ResultsSeventy-six patients completed the 12-week follow-up. The mixed-effects models showed that under the control of therapy phase adherence in the range of <4 hours per night, using nCPAP could independently improve daytime sleepiness, in terms of ESS (coefficient, [95% confidence interval] unit; −4.49 [−5.62, −3.36]). Adherence at 4–6 hours per night could independently improve all variables of day- and nighttime symptoms included in this study, namely ESS −6.69 (−7.40, −5.99), FSS −6.02 (−7.14, −4.91), SDS −2.40 (−2.95, −1.85) and PSQI −0.20 (−0.52, −0.12). Further improvement in symptoms could be achieved at ≥6 hours per night using nCPAP, which was ESS −8.35 (−9.26, −7.44), FSS −10.30 (−11.78, −8.83), SDS −4.42 (−5.15, −3.68) and PSQI −0.40 (−0.82, −0.02). The interaction between adherence level and therapy phase was not significant in day- and nighttime symptoms.ConclusionThe effect of adherence on the above-mentioned symptoms is stable through the first 3 months. Under the control of therapy phase, the nCPAP therapy effectively improves day- and nighttime symptoms with ≥4 hours adherence, and the patients can achieve a further improvement with ≥6 hours adherence.

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Section: Discussionsupporting

confidence: 91%

Effect of adherence on daytime sleepiness, fatigue, depression and sleep quality in the obstructive sleep apnea/hypopnea syndrome patients undertaking nasal continuous positive airway pressure therapy

Wang

Luo

et al. 2017

PPA

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“…Además, se han detectado diferencias en biomarcadores, con cambios específicos en los perfiles de serotonina y triptófano en pacientes con TDM-P y TDM-IC (Keller et al, 2017). A pesar de la falta de información sobre sus vías neurológicas, los clínicos tratan la sintomatología con farmacoterapia dopaminérgica o serotoninérgica (Saltiel y Silvershein, 2015). El componente genético ha mostrado ser esencial en la investigación de los trastornos por uso de sustancias (Yang, Han, Kranzler, Farrer y Gelernter, 2011).…”

Section: Discussionunclassified

Trastorno por uso de cocaína y depresión: Cuando el diagnóstico clínico no es suficiente

et al. 2020

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Antecedentes: El consumo de cocaína es un creciente problema de salud en todo el mundo. Además, los pacientes con trastorno por consumo de cocaína (TCC) presentan una alta comorbilidad con el trastorno depresivo mayor (TDM). Estos pacientes pueden presentar dos tipos de TDM: trastorno depresivo mayor primario (TDM-P) y trastorno depresivo mayor inducido por cocaína (TDM-IC). El objetivo de este estudio es evaluar las diferencias en la sintomatología depresiva (TDM-P vs. TDM-IC) en los pacientes con TCC para mejorar su tratamiento. Métodos: Se llevó a cabo un análisis secundario en una muestra transversal de 160 pacientes que presentaban TCC y algún TDM. La evaluación clínica, así como el diagnóstico diferencial entre TDM-P y TDM-IC, se realizó utilizando la entrevista PRISM. Resultados: Los hombres representaron el 80% de la muestra con una edad media de 38,61 años y el 64,5% sólo tenía estudios primarios. El diagnóstico de TDM-IC (61,3%) fue más frecuente que el de TDM-P (38,7%). Los pacientes con TDM-IC mostraron una edad de aparición más temprana para el TCC. El 79,4% de los pacientes cumplían criterios para otro trastorno por consumo de sustancias. Únicamente el criterio "Cambios en el peso o en el apetito" fue estadísticamente más prevalente (57,1%) en los pacientes con TDM-P.Conclusiones: Existen diferencias en el criterio "Cambios en el peso o en el apetito" entre TDM-P y TDM-IC. Se necesita más investigación a fin de obtener un diagnóstico diferencial entre los dos tipos de depresión y proporcionar un mejor tratamiento para los pacientes con TCC. Palabras clave: Patología dual; Trastorno por uso de cocaína; Trastornos relacionados con el uso de cocaína; Trastorno depresivo; Trastorno depresivo inducido. Background: Cocaine use is a growing global health problem and patients with cocaine use disorders (CUD) present several complications, including high rates of major depression. These subjects present two types of major depressive disorder (MDD): primary major depressive disorder (P-MDD) and cocaine-induced major depressive disorder (CI-MDD). To improve treatment, it is necessary to distinguish between both types. The aim of this study was to assess the differences in depressive symptomatology criteria (P-MDD vs CI-MDD) in CUD patients. Methods: Secondary data analysis was carried out with a cross-sectional sample of 160 patients presenting CUD and MDD. Clinical assessment was performed using the Psychiatric Research Interview for Substance and Mental Disorders (PRISM). A differential diagnosis was obtained between P-MDD and CI-MDD. Results: Menrepresented 80% of the sample, the mean age was 38.61 years, and 64.5% had elementary studies. CI-MDD diagnosis (61.3%) was more frequent than P-MDD (38.7%). There was a younger age of CUD onset in CI-MDD patients. In addition, 79.4% of the patients had another substance use disorder diagnosis. The criterion "Changes in weight or appetite" was more prevalent (57.1%) in P-MDD group. Conclusions:We found differences in the criterion "Changes in weight or appetite".Fur...

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“…Depression is the most common psychiatric disorder and a leading cause of disability worldwide (Saltiel & Silvershein, 2015). First-line treatment options for depression include selective serotonin reuptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors, and norepinephrine–dopamine reuptake inhibitors (Saltiel & Silvershein, 2015).…”

Section: Girk Channels In Cns Disordersmentioning

confidence: 99%

“…First-line treatment options for depression include selective serotonin reuptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors, and norepinephrine–dopamine reuptake inhibitors (Saltiel & Silvershein, 2015). Although monoaminergic pathways are the primary targets of antidepressants, altered GIRK signaling may also be involved in their therapeutic action, considering that GIRK channels are the main inhibitory effectors of 5-HT 1A receptors.…”

Section: Girk Channels In Cns Disordersmentioning

confidence: 99%

Behavioral and Genetic Evidence for GIRK Channels in the CNS

Mayfield

Blednov

Harris

2015

International Review of Neurobiology

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G protein-coupled inwardly rectifying potassium (GIRK) channels are widely expressed throughout the brain and mediate the inhibitory effects of many neurotransmitters. As a result, these channels are important for normal CNS function and have also been implicated in Down syndrome, Parkinson’s disease, psychiatric disorders, epilepsy, and drug addiction. Knockout mouse models have provided extensive insight into the significance of GIRK channels under these conditions. This review examines the behavioral and genetic evidence from animal models and genetic association studies in humans linking GIRK channels with CNS disorders. We further explore the possibility that subunit-selective modulators and other advanced research tools will be instrumental in establishing the role of individual GIRK subunits in drug addiction and other relevant CNS diseases and in potentially advancing treatment options for these disorders.

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Major depressive disorder: mechanism-based prescribing for personalized medicine

Cited by 55 publications

References 116 publications

Effect of adherence on daytime sleepiness, fatigue, depression and sleep quality in the obstructive sleep apnea/hypopnea syndrome patients undertaking nasal continuous positive airway pressure therapy

Effect of adherence on daytime sleepiness, fatigue, depression and sleep quality in the obstructive sleep apnea/hypopnea syndrome patients undertaking nasal continuous positive airway pressure therapy

Trastorno por uso de cocaína y depresión: Cuando el diagnóstico clínico no es suficiente

Behavioral and Genetic Evidence for GIRK Channels in the CNS

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