In a review of an article published in JAMA Psychiatry in early March 2016, Dr. Steven Dubovsky writes about encouraging findings about treatment efficacy of patients with major depression from a large study in Denmark. In the study, researchers reviewed 10 years worth of national data from the extensive population records capped in Denmark which provides nearly universal access to …
Norepinephrine dopamine and depression
In an elegant set of studies published in February 2016 in Nature Neuroscience the team of Bruno Giros, a researcher at the Douglas Mental Health University Institute and Professor of Psychiatry at McGill University, reports the first-ever connection between noradrenergic neurons and vulnerability to depression. The study involved research using probably the most well developed animal model for depression – chronic or …
Buprenorphine for Depression – A Combination Approach
While we were in the midst of a seeming epidemic of concern about opiate prescribing and possible overuse of opiates by physicians, it is ironic that we are also seeing a small stream of articles being published about the potential effectiveness of opiate agonists in treating patients with treatment resistant depression. I’ve been interested in this topic since Enoch Callaway, …
Pramipexole in Unipolar and Bipolar Depression
For many years we’ve been impressed with the response in some patients with bipolar depression to relatively high doses of pramipexole. Pramipexole is an agent that enhances dopamine neurotransmission and has been approved for the treatment of Parkinson’s disease. There are relatively few medications that significantly affect dopamine, one of the three monoamine neurotransmitters associated with depression and pramipexole is …
Rapastinel for Depression
The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation to rapastinel, which follows the medication receiving a 2014 Fast Track Designation from the FDA. Rapastinel, an investigational medication for adjunctive treatment of major depressive disorder, is an intravenous drug that is a novel NMDA receptor agonist. It is being developed by Allergan. The Breakthrough Therapy designation is a new …
SSRI Dose Response
It has long been unclear whether higher doses of SSRIs are associated with greater response. What has been clear is that higher doses are associated with significantly increased side effects. In fact previous research, whether individual studies or meta-analyses have failed to find a significant dose response with the result that many have felt that there is a flat dose response …
Vortioxetine for Cognitive Impairment in Depression
Takeda and Lundbeck announced that the Food and Drug Administration (FDA)’s Psychopharmacologic Drug Advisory Committee (PDAC) voted to support the efficacy of vortioxetine (Brintellix) for treating cognitive dysfunction in adults with major depressive disorder (MDD). The advisory committee also reviewed evidence to suggest that cognitive dysfunction in people with major depressive disorder was an appropriate target for treatment. Several recent …
New Antidepressant Stimulates Neuron Growth
The results of a clinical trial published in December in Molecular Psychiatry suggest that a new medication (NSI-189) which has been shown to increase the production of cells in the hippocampus and the amygdala in pre-clinical studies may help treat major depression. The results highlight the evidence that has been accumulating that stimulating the production of new cells in the hippocampus (neurogenesis) …
Lurasidone for Depression with Mixed Features
Lurasidone (Latuda) May Treat Depression with Mixed Features A recently published clinical trial suggests that lurasidone, which is an atypical antipsychotic with strong evidence for efficacy in treating bipolar depression, may be associated with response in patients who, according to DSM5, do not meet criteria for bipolar disorder, but do have evidence of mixed features. The study points to the importance …
Psychotherapy for Depression – New Data
Many reviews have pointed out that there is a significant “publication bias” that affects studies of antidepressants: because studies that don’t find an effect tend not to be published a review of the published literature would suggest that these medications are more effective than they really are. Indeed this is been the basis of a great debate in the popular and …