Modulation of the inflammatory response benefits treatment-resistant bipolar depression: A randomized clinical trial

Halaris, Angelos; Cantos, Adriana; Johnson, Katherine; Hakimi, Michael; Sinacore, James

doi:10.1016/j.jad.2019.10.021

Cited by 40 publications

(42 citation statements)

References 39 publications

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“…The present study was approved by the Ethics Committee of were diagnosed with BPD, based on the DSM-IV classification, and met the criteria for TRBPD. TRBPD is defined as having failed attempts to achieve remission after 8 weeks each of two or more separate monotherapies or one monotherapy with one combination treatment (Halaris et al, 2020).…”

Section: Patientsmentioning

confidence: 99%

“…Treatment‐resistant depressive symptoms (TRDS), which are commonly found among patients with chronic bipolar disorder (BPD), have been associated with increased morbidity and disability among such patients (Baldessarini, Salvatore, et al, 2010; Baldessarini, Vieta, Calabrese, Tohen, & Bowden, 2010; Goodwin & Jamison, 2007; Tondo & Baldessarini, 2014; Tondo, Vázquez, & Baldessarini, 2014). The patients with bipolar disease who present with treatment‐resistant depressive symptoms are diagnosed with treatment‐resistant bipolar depression (TRBPD; Halaris, Cantos, Johnson, Hakimi, & Sinacore, 2020). Although consensus guidelines and experts have advocated for the use of monotherapy among patients with BPD, adjunctive therapy is considered for patients who relapse during maintenance treatment (Baldessarini, 2013; Baldessarini, Pérez, Salvatore, Trede, & Maggini, 2014; Tondo et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

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Transient effects of multi‐infusion ketamine augmentation on treatment‐resistant depressive symptoms in patients with treatment‐resistant bipolar depression – An open‐label three‐week pilot study

et al. 2020

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Introduction While the psychiatric benefits of ketamine have been verified through clinical trials, there is limited information about ketamine augmentation in patients with treatment‐resistant bipolar depression (TRBPD). Hence, in the present study, we investigate the therapeutic efficacy and functional brain alterations associated with multi‐infusion ketamine augmentation in patients with TRBPD. Methods The present three‐week study included 38 patients with TRBPD, all of whom received a series of nine ketamine injections over the study period. The Hamilton Depression Rating Scale (HAMD) was used to assess the effects of multi‐infusion ketamine combined with mood stabilizers. Brain function was evaluated by global functional connectivity density (gFCD). Results Adjunctive treatment with multiple infusions of ketamine, when combined with a mood stabilizer, could effectively alleviate depressive symptoms for one week, yet the symptoms began to relapse during the second week. Functional brain alterations were detected via gFCD. Specifically, gFCD reductions were mainly found in the bilateral insula, right caudate nucleus, and bilateral inferior frontal gyrus, while increased gFCD was mainly located in the bilateral postcentral gyrus, subgenual anterior cingulate cortex, bilateral thalamus, and cerebellum. Although gFCD alterations were sustained for up to three weeks after the first ketamine infusion, the antidepressant effects of ketamine augmentation sharply declined from the end of the second week of treatment. Conclusions Multi‐infusion ketamine augmentation can rapidly alleviate depressive symptoms in patients with TRBPD. The clinical effects were primarily visible in the first week after treatment and partially sustained for two weeks; however, the therapeutic effects and related functional brain alterations sharply decreased from the end of the second week. Based on these findings, we demonstrated that the clinical efficacy and functional brain alterations induced by ketamine augmentation are transient.

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Section: Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Transient effects of multi‐infusion ketamine augmentation on treatment‐resistant depressive symptoms in patients with treatment‐resistant bipolar depression – An open‐label three‐week pilot study

et al. 2020

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“…Celecoxib is a cyclooxygenase 2 inhibitor. Halaris et al investigated the potential of its anti-inflammatory properties as a treatment for TRBD, 45 analyzing data from 47 participants with BD who were using escitalopram and were randomized to celecoxib or placebo. The participants were also using a mood stabilizer (other than lithium) and/or an atypical antipsychotic.…”

Section: Celecoxibmentioning

confidence: 99%

Treatment-resistant bipolar depression: concepts and challenges for novel interventions

Diaz

Fernandes

Quevedo

et al. 2022

Braz. J. Psychiatry

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Treatment-resistant bipolar depression (TRBD) has been reported in about one-quarter of patients with bipolar disorders, and few interventions have shown clear and established effectiveness. We conducted a narrative review of the published medical literature to identify papers discussing treatment-resistant depression concepts and novel interventions for bipolar depression that focus on TRBD. We searched for potentially relevant English-language articles published in the last decade. Selected articles (based on the title and abstract) were retrieved for a more detailed evaluation. A number of promising new interventions, both pharmacological and non-pharmacological, are being investigated for TRBD treatment, including ketamine, lurasidone, D-cycloserine, pioglitazone, N-acetylcysteine, angiotensin-converting enzyme inhibitors, angiotensin II type 1 receptor blockers, cyclooxygenase 2 inhibitors, magnetic seizure therapy, intermittent theta-burst stimulation, deep transcranial magnetic stimulation, vagus nerve stimulation therapy, and deep brain stimulation. Although there is no consensus about the concept of TRBD, better clarification of the neurobiology associated with treatment non-response could help identify novel strategies. More research is warranted, mainly focusing on personalizing current treatments to optimize response and remission rates.

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“…Chronic treatment with celecoxib attenuated depressive-like behavior and significantly reversed biochemical alterations associated with obesity in mice [48]. It has also been shown to protect against depressive states in mice injected with beta amyloid peptide and prevent the reduction in prefrontal serotonin content [49]. In 2006, the addition of celecoxib to reboxetine for the treatment of depression yielded significantly lower HAM-D (Hamilton Depression Rating Score) scores compared with controls [50].…”

Section: Managementmentioning

confidence: 99%

Rheumatoid Arthritis, Depression, and the Role of Celecoxib

Al-Baz

Karim

2020

SN Compr. Clin. Med.

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Rheumatoid arthritis (RA) is a chronic autoimmune disease, causing joint destruction and associated physical, mental, and financial distress. Depression is not uncommonly found in patients with RA as both disorders share sociodemographic, functional, and biologic factors. There is growing evidence on the role of anti-inflammatory agents in managing depression, particularly celecoxib, which has been shown to significantly alleviate depressive symptoms as an augmenting agent. Compared with traditional nonsteroidal anti-inflammatory drugs (tNSAIDs), however, celecoxib offers modest improvement in clinical symptoms, with uncertain results for pain management, physical function, and adverse effects in patients with RA. Further research is needed to assess the effectiveness of celecoxib in the management of RA, particularly in patients suffering from comorbid depression.

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Modulation of the inflammatory response benefits treatment-resistant bipolar depression: A randomized clinical trial

Cited by 40 publications

References 39 publications

Transient effects of multi‐infusion ketamine augmentation on treatment‐resistant depressive symptoms in patients with treatment‐resistant bipolar depression – An open‐label three‐week pilot study

Transient effects of multi‐infusion ketamine augmentation on treatment‐resistant depressive symptoms in patients with treatment‐resistant bipolar depression – An open‐label three‐week pilot study

Treatment-resistant bipolar depression: concepts and challenges for novel interventions

Rheumatoid Arthritis, Depression, and the Role of Celecoxib

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