Depression

When Treating Depression and Insomnia, Consider the Gut-brain Axis

When Treating Depression and Insomnia, Consider the Gut-brain Axis

Major depressive disorder is one of the leading causes of disability, morbidity and mortality worldwide. The disorder affects approximately one in five people at any stage of their lifespan. It is generally agreed upon that depression is induced by the cumulative effect of genetic information and environmental stresses. Certain genes and psychological features might predispose some people to depression and stressful life events including early-life stress are important inducements of depression. Research has indicated that the gut microbiota also play a crucial part in the pathophysiology of depression.

Modern Medicine – Issue 4 2019

August 5, 2019 by CNS Depression Insomnia

Cognitive Tests Predict Antidepressant Response

Cognitive Tests Predict Antidepressant Response – MM1610

Major depressive disorder (MDD) is a prevalent and disabling condition with
a high frequency of non-recovery and recurrence, leading to substantial
mortality and morbidity. Only a subset of individuals with MDD (30-40%)
reaches symptomatic remission after adequate treatment with a first-line
antidepressant. Many do not reach premorbid levels of psychosocial functioning and a significant proportion present with residual symptoms.
More recent findings have raised hopes for identifying cognitive tests for predicting antidepressant clinical response, which would have the distinct advantage of being quick and easy to administer in a doctor’s office.

Modern Medicine – October 2016

October 31, 2016 by CNS Depression

Emotional Blunting and Depression | Symptom or Side Effect?

Emotional Blunting and Depression | Symptom or Side Effect? – MM1609

When treating a patient for depression, doctors need to provide relief from the depressive symptoms, restore functioning, enhance quality of life and develop relapse prevention strategies. The main focus is on the reduction of depression symptoms. Emotional blunting, or the inability to experience usual emotions can be a side effect of many antidepressants. This emotional blunting can have a profound impact on the patient’s quality of life. It needs to be distinguished from residual depressive symptoms and if distressing the patient, may warrant a change of treatment.

Modern Medicine – September 2016

October 6, 2016 by Depression Psychiatry

Adult Depression A step-by-step guide to treatment

Adult Depression A step-by-step guide to treatment – MM1605

A stepwise approach to the early detection and management of depression, guided by severity of presentation and treatment response, encourages more timely access to evidence-based treatments, including easily accessed and destigmatising e-mental health interventions. Evidence-based treatments range from e-mental health apps, psychological therapy and medication to neurostimulation.

With the overall similarities in efficacy of antidepressants, the most important considerations when initiating pharmacotherapy are tolerability and safety. For patients with difficult-to-treat depression, an algorithmic management approach with steps that include increasing the antidepressant dose, switching antidepressants, augmenting with a non-antidepressant treatment and combining antidepressants improves the chance of patient recovery. Neurostimulatory treatments such as electroconvulsive therapy and repetitive transcranial magnetic stimulation have an expanding role in the evidence based treatment of severe depression.

Modern Medicine – May 2016

May 31, 2016 by CNS Depression Psychiatry

Vortioxetine A new option for depression

Vortioxetine A new option for depression – MM1604

Vortioxetine has been approved for treatment of adults with major depressive disorder. It adds to the repertoire of antidepressants available for individualising treatment and may have particular benefits for patients with cognitive impairment associated with depression.

In vitro studies indicate that it is an inhibitor of serotonin reuptake and acts as an agonist at the serotonin 5-HT1A receptor, partial agonist at the 5-HT1B receptor and antagonist at the 5-HT1D, 5-HT3 and 5-HT7 receptors.

In adults, the usual starting dose of vortioxetine is 10mg once daily, taken with or without food at any time of day.

Modern Medicine – April 2016

April 21, 2016 by Depression

Bupropion for Depression Improves Day-to-day Functioning

Bupropion for Depression Improves Day-to-day Functioning – MM1511

Bupropion is a dopamine–norepinephrine reuptake inhibitor that is effective not only for depressive disorders but also for nicotine dependence. Due to the lack of serotonergic activity, it has less propensity to induce sexual dysfunction, weight gain and a psychological side effect of apathy syndrome than selective serotonin reuptake inhibitors (SSRIs). These adverse events are important because they are the primary reasons of SSRI discontinuation.

Modern Medicine – November 2015

November 24, 2015 by CNS Depression

Detecting and Managing Depression in Patients with Cardiac Disease

Detecting and Managing Depression in Patients with Cardiac Disease – MM1503

Depression is common in patients with cardiac disease, is associated with increased risk of mortality and morbidity and is the major driver of quality of life. Depression is also a major determinant of adherence to treatment strategies. It is therefore important that depressive symptoms are recognised and treated early in patients with cardiac disease.

Modern Medicine – March 2015

March 31, 2015 by Cardiology CNS Depression Psychiatry
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