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Lithium Depression

Nathalie Brunkhorst-Kanaan, Katharina Klatt-Schreiner, Juliane Hackel, Katrin Schröter, Sandra Trautmann, Lisa Hahnefeld, Sabine Wicker, Andreas Reif, Dominique Thomas, Gerd Geisslinger, Sarah Kittel-Schneider, Irmgard Tegeder
Changes of sphingolipid metabolism were suggested to contribute to the patho-etiology of major depression (MD) and bipolar disorder (BD). In a pilot study we assessed if lipid allostasis manifested in pathological plasma concentrations of bioactive lipids i.e. endocannabinoids, sphingolipids, ceramides, and lysophosphatidic acids. METHODS: Targeted and untargeted lipidomic analyses were performed according to GLP guidelines in 67 patients with unipolar or bipolar disorders (20-67 years, 36 male, 31 female) and 405 healthy controls (18-79 years, 142 m, 263 f), who were matched according to gender, age and body mass index...
April 4, 2019: Metabolism: Clinical and Experimental
Kyohei Kin, Takao Yasuhara, Satoshi Kawauchi, Masahiro Kameda, Kakeru Hosomoto, Yousuke Tomita, Michiari Umakoshi, Ken Kuwahara, Ittetsu Kin, Naoya Kidani, Jun Morimoto, Tatsuya Sasaki, Isao Date
Wistar Kyoto (WKY) rats are a useful animal model of treatment-resistant depression. Lithium is effective for treating recurrent mood disorders or treatment-resistant depression, and lithium augmentation treatment is also useful for treatment-resistant depression. However, the treatment effect of lithium on the depressive behavior of WKY rats remains poorly understood, and whether lithium augments the treatment effect of antidepressants in WKY rats is also unknown. In this study, we evaluated the treatment effect of lithium in WKY rats...
April 3, 2019: Brain Research
Víctor Navarro, Ilham Boulahfa, Amadeu Obach, Dídac Jerez, Maribel Diaz-Ricart, Cristóbal Gastó, Joana Guarch
PURPOSE/BACKGROUND: According to available international clinical guides, tricyclic antidepressants are our first- or second-line treatment of choice for severe unipolar major depression. However, the therapeutic option after an unsuccessful response to a tricyclic antidepressant drug in unipolar major depression is still unclear. METHODS/PROCEDURES: This 10-week randomized open-label study assessed the effectiveness of add-on lithium (adjusted to plasma levels) compared with add-on citalopram (30 mg/d) in 104 severe unipolar major depressive patients after a 10-week unsuccessful imipramine (adjusted to plasma level)...
March 28, 2019: Journal of Clinical Psychopharmacology
Pichit Buspavanich, Joachim Behr, Thomas Stamm, Peter Schlattmann, Tom Bschor, Christoph Richter, Rainer Hellweg, Andreas Heinz, Maximilian Berger, Claudia Hindinger, Johannes Rentzsch, Walter de Millas, Maria-Christiane Jockers-Scherübl, Peter Bräunig, Mazda Adli, Roland Ricken
BACKGROUND: Lithium augmentation (LA) of antidepressants is an effective strategy for treatment-resistant depression (TRD). Nevertheless, it is rarely used in geriatric patients. The purpose of this study was to investigate treatment response of LA in geriatric compared to non-geriatric patients. METHOD: In a prospective multicenter cohort study, severity of depression was measured weekly in 167 patients with unipolar depression (nage≥65years  = 22; nage<65years  = 145) at baseline and over at least four weeks of LA...
March 20, 2019: Journal of Affective Disorders
Jong-Hyun Jeong, Won-Myong Bahk, Young Sup Woo, Jung Goo Lee, Moon-Doo Kim, InKi Sohn, Se-Hoon Shim, Duk-In Jon, Jeong Seok Seo, Won Kim, Hoo-Rim Song, Kyung Joon Min, Bo-Hyun Yoon
The objective of this study was to compare recommendations of the Korean Medication Algorithm Project for Bipolar Disorder 2018 (KMAP-BP 2018) with other recently published guidelines for treating bipolar disorder. We reviewed a total of five recently published global treatment guidelines and compared treatment recommendation of the KMAP-BP 2018 with those of other guidelines. For initial treatment of mania, there were no significant differences across treatment guidelines. All guidelines recommended mood stabilizer (MS) or atypical antipsychotic (AAP) monotherapy or a combination of an MS with an AAP as a first-line treatment strategy for mania...
May 31, 2019: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
Adam J Walker, J Blair Price, Kristin Borreggine, Shari L Sutor, Andrea Gogos, Jane A McGillivray, Mark A Frye, Susannah J Tye
Lithium has been shown to have some therapeutic efficacy as an adjunctive treatment for intractable forms of major depression. Activation of mammalian target of rapamycin (mTOR) and inhibition of glycogen synthase kinase-3β (GSK3β) have been implicated in its putative mechanisms of action. These proteins are integral components of the insulin signaling pathway, which may serve as a critical co-regulator of drug action. Utilizing an animal model of tricyclic antidepressant resistance, we investigated the relationship between insulin signaling and antidepressant response to lithium augmentation...
March 15, 2019: Translational Psychiatry
Christoph U Correll, Piyali Chatterjee, Susan H Gitzinger, Jovana Lubarda, Marcello Morgan
BACKGROUND: Among adults in the US, bipolar disorder affects 2.6% or 5.7 million individuals; 83% of cases are considered to be severe. Even when an accurate diagnosis of bipolar disorder is established, its treatment remains suboptimal, and those with the disorder often fail to receive any care or evidence-based care.IntroductionA continuing medical education (CME)-certified 25-item, multiple choice clinical practice assessment survey was developed to assess recognition and treatment of bipolar disorder, specifically, the use of LAIs in these patients...
February 2019: CNS Spectrums
Sara Costi, Laili Soleimani, Andrew Glasgow, Jess Brallier, John Spivack, Jaclyn Schwartz, Cara F Levitch, Samantha Richards, Megan Hoch, Elizabeth Wade, Alison Welch, Katherine A Collins, Adriana Feder, Dan V Iosifescu, Dennis S Charney, James W Murrough
The N-methyl-D-aspartate (NMDA) receptor antagonist ketamine is associated with rapid but transient antidepressant effects in patients with treatment resistant unipolar depression (TRD). Based on work suggesting that ketamine and lithium may share overlapping mechanisms of action, we tested lithium compared to placebo as a continuation strategy following ketamine in subjects with TRD. Participants who met all eligibility criteria and showed at least an initial partial response to a single intravenous infusion of ketamine 0...
March 11, 2019: Neuropsychopharmacology
Alexandra K Gold, Gustavo Kinrys
PURPOSE OF REVIEW: Disruptions in circadian rhythms are believed to underlie the illness course of bipolar disorder (BD). This review evaluates recent studies on the treatment of circadian dysfunction in BD. RECENT FINDINGS: Targeted social rhythm therapy may be useful for bipolar depression though some studies suggest that a non-targeted psychosocial or pharmacological intervention may be just as efficacious. Lithium holds potential for addressing circadian dysfunction in BD...
March 2, 2019: Current Psychiatry Reports
Eduardo D Espiridion, Allison Daniel, Joshua R Van Allen
Ehlers-Danlos syndrome is a group of connective tissue disorders that most commonly causes joint hypermobility, skin hyperextensibility, and tissue fragility. Patients diagnosed with Ehlers-Danlos syndrome (EDS) frequently suffer from chronic pain and other comorbid conditions. In addition, there is an increased incidence of psychiatry conditions in this patient population, such as anxiety, depression, and personality disorders. We present the case of a 25-year-old female who presented to a community hospital with frequent thoughts of suicide and major depression...
December 21, 2018: Curēus
Laura M Lyall, Nagore Penades, Daniel J Smith
BACKGROUND: People with bipolar disorder typically require long-term pharmacological treatment to prevent episodes of depression or mania. However, evidence-based guidelines are often not followed by prescribers and, in some countries, prescribing of lithium is in decline. Polypharmacy is also common in bipolar disorder.AimsTo employ a data linkage approach to describe and evaluate prescribing patterns in bipolar disorder in Scotland between 2009 and 2016. METHOD: By linking prescribing data to the electronic Scottish Morbidity Records, we identified a cohort of 23 135 patients with bipolar disorder who were prescribed psychotropic medication between 2009 and 2016...
February 28, 2019: British Journal of Psychiatry: the Journal of Mental Science
Katherine McLean, Kellie E Murphy, Ariel Dalfen, Alison K Shea
The objective of this study is to determine whether maternal antidepressant use during pregnancy influences uteroplacental hemodynamics, thereby affecting fetal growth and gestational age at delivery. The secondary aim was to determine the incidence of neonatal abstinence syndrome (NAS) among infants exposed to antidepressant medications. The charts of women who received obstetrical care and had a history of depression from January 2014 to December 2016 at Mount Sinai Hospital in Toronto, Canada, were reviewed...
February 23, 2019: Archives of Women's Mental Health
Mirjana Valdes, Sara Bertolin, Hong Qian, Hubert Wong, Raymond W Lam, Lakshmi N Yatham
BACKGROUND: Risperidone, an atypical antipsychotic medication, is recommended as a first line treatment for acute mania in patients with bipolar disorder I (BD I). It is unknown if continuing treatment with risperidone adjunct to lithium or valproate after remission of the manic episode offers additional benefit in prevention of mood episode relapse. METHODS: A post-hoc subgroup analysis was conducted using data from a 52-week, double-blind, placebo controlled trial involving 93 patients treated with oral risperidone adjunct to mood stabilizer, randomized to arms discontinuing risperidone at entry ("0-week arm"), 24 weeks after entry ("24-week arm") or continuing risperidone ("52-week arm")...
March 1, 2019: Journal of Affective Disorders
Elisa M T Melloni, Sara Poletti, Benedetta Vai, Irene Bollettini, Cristina Colombo, Francesco Benedetti
BACKGROUND: Cognitive deficits are a core feature of bipolar disorder (BD), and persist during the euthymic phase. White matter (WM) microstructural abnormalities are widely considered a structural marker of BD. Features of illness chronicity, such as illness duration and number of mood episodes, have been associated with worsening of both clinical profile and brain structural alterations. This study examined the role of WM integrity as a possible mediator between illness duration and cognitive performances in a sample of BD patients...
February 8, 2019: Journal of Affective Disorders
Jian Liu, Han-Xiao Zhu, Wan-Li Fu, Xin-Wei Xu, Jun-Zhe Yang, Dan Dai, Yun Li
OBJECTIVE:  To investigate the expression of brain-derived neurotrophic factor(BDNF) and tyrosine kinase B (TrkB) protein in the hippocampus of model rats of comorbid epilepsy and depression. METHODS: A rat model of epilepsy was established using lithium chloride.pilocarpine. Among these epileptic rats, those with comorbid depression were selected by a battery of behavioral tests starting on the 14th day after establishing the epilepsy model. A depression group was established by unpredicted chronic mild stress (UCMS) and separate housing...
February 11, 2019: Neurological Research
Jorge Palacios, Ayşegül Yildiz, Allan H Young, Matthew J Taylor
BACKGROUND: Tamoxifen is an oral medication that has been proposed as a potential treatment for bipolar disorder. Tamoxifen acts to inhibit the intracellular action of protein kinase C, which is also an action of well-established treatments such as lithium and valproate. Here we aimed to identify randomised controlled trials (RCTs) of tamoxifen in the treatment of bipolar disorder and synthesise their results using meta-analysis. METHODS: RCTs were identified by searching of electronic databases and from discussion with experts in the field...
February 2019: Journal of Psychopharmacology
Alannah Miranda, Tatyana Shekhtman, Michael McCarthy, Anna DeModena, Susan G Leckband, John R Kelsoe
BACKGROUND: Bipolar disorder is a neuropsychiatric disorder that is characterized by fluctuations between manic and depressive phases. Lithium is the original and best mood stabilizing treatment for bipolar disorder. While its mechanism is not well understood, it is believed to have a strong genetic component, as several studies suggest that lithium responsiveness, in bipolar disorder, is heritable. In this study we aimed to identify genetic variants that are associated with lithium responsiveness in bipolar disorder...
January 15, 2019: Journal of Affective Disorders
Tammas Kelly
Lithium is the oldest and most-studied treatment for bipolar depression. Many treatment guidelines place Lithium as a top treatment recommendation for bipolar depression; yet some guidelines don't recommend lithium at all. These discrepancies were explored by examining the following errors: the Woozle effect (evidence by citation), reference inflation (overreporting the findings of cited studies) and belief perseverance (maintaining a belief despite new contradictory evidence) as possible causes for these discrepancies...
February 9, 2019: Bipolar Disorders
Wonju Kim, Seong-Yeon Won, Bong-June Yoon
BACKGROUND: Genetic and physiological studies have implicated the striatum in bipolar disorder (BD). Although Glycogen synthase kinase 3 beta (GSK3β) has been suggested to play a role in the pathophysiology of BD since it is inhibited by lithium, it remains unknown how GSK3β activity might be involved. Therefore we examined the functional roles of GSK3β and one of its substrates, CRMP2, within the striatum. METHODS: Using CRISPR-Cas9 system, we specifically ablated GSK3β in the striatal neurons in vivo and in vitro...
February 15, 2019: Journal of Affective Disorders
Juan Undurraga, Kang Sim, Leonardo Tondo, Ariel Gorodischer, Emilio Azua, Kai Hong Tay, David Tan, Ross J Baldessarini
BACKGROUND: The potential value of lithium treatment in particular aspects of unipolar major depressive disorder remains uncertain. METHODS: With reports of controlled trials identified by systematic searching of Medline, Cochrane Library, and PsycINFO literature databases, we summarized responses with lithium and controls followed by selective random-effects meta-analyses. RESULTS: We identified 36 reports with 39 randomized controlled trials: six for monotherapy and 12 for adding lithium to antidepressants for acute major depression, and 21 for long-term treatment...
February 2019: Journal of Psychopharmacology
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