DULOXETINE IN MAJOR DEPRESSED PATIENTS RESISTANT TO SSRIS AND/OR VENLAFAXINE

Several acute depression trials suggest that only 35% of the patients achieve remission state with antidepressant monotherapy. An increasing body of evidence is emerging suggesting that multi-action antidepressants might be more effective in treatmentresistant depressed patients than single-action agents. In this context, the purpose of the study was to assess the effectiveness of duloxetine in treatment-resistant major depressed outpatients. We performed a retrospective study assessing the efficacy of duloxetine in major depressed outpatients who did not achieve full symptom remission (CGI-S (severity) ≥ 3) after treatment of adequate dose and duration (more than 8 weeks) with at least either one SSRI or the SNRI venlafaxine. We excluded patients with a severe medical illness and a personality disorder. CGI-S was used as a measure of symptom severity and administered before the prescription of duloxetine and 6 weeks later. The sample included 29 patients (9 M, 20 F). We observed a very significant decrease in CGI-S scores (4,86 ± 0.51 to 2,17 ± 1,44, p<0.0001) after treatment with duloxetine (dose between 60 and 120 mg). Remission was achieved in 48 % of the patients. The tolerance was excellent. This study suggests the potential interest of duloxetine in some treatment-resistant depressed patients

Evaluatie van de activiteit van capsules droogextract van passiebloem, volgens een "ster"-model.

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Dépression et neuroplasticité.

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Mismatch negativity is not correlated with neuroendocrine indicators of catecholaminergic activity in healthy subjects.

The identification of the brain structures and neurotransmitters responsible for the generation and/or modulation of the mismatch negativity (MMN) may contribute to a clearer understanding of its functional significance, and may have clinical implications. In this context, some findings suggest that the scalp-recorded MMN reflects activity from multiple neuronal ensembles within or in the immediate vicinity of the primary auditory cortex and with possible contribution from the frontal cortex. However, few data are available concerning the influence of neurotransmitter systems on the MMN. In this study, the relationship between both noradrenergic and dopaminergic systems and the MMN were investigated in 34 healthy volunteers. Noradrenergic and dopaminergic activities were assessed with the apomorphine and clonidine challenge tests. The results showed no significant relationship between either growth hormone (GH) responses to apomorphine or clonidine and the MMN amplitude or latency. Therefore, this study does not demonstrate the implication of dopaminergic and noradrenergic activities as assessed by GH response to apomorphine and clonidine for the generation and/or the modulation of the MMN. However, given the complexity of the central neurotransmitter systems, these results cannot be considered as definitive evidence against a relationship between dopaminergic and noradrenergic activity and the MMN

The lack of relationship between DST nonsuppression in the dexamethasone suppression test and EEG abnormalities.

peer reviewedAs a recent study suggested a relationship between cortisol escape following dexamethasone suppression test (DST) and electroencephalogram (EEG) abnormalities, we tried to replicate these findings in 52 major depressive inpatients. A total of 23 patients exhibited DST nonsuppression (44%) and 18 patients had EEG abnormalities (35%). No relationship existed between DST and EEG results

Dépression et neuroplasticité : des découvertes neuroanatomiques aux nouvelles stratégies thérapeutiques.

peer reviewedThe antidepressants action cannot be understood only by the neurochemical approach and the monoaminergic theory. In particular, that model does not explain the time lag between the acute chemical modulations induced by the antidepressants and the delayed clinical response. Many hypothesis have been developped to specify the antidepressants action, each of them implicating different mechanisms of receptors regulation. In the same way, the advanced knowledge in neuroanatomy leads towards the existence of specifical lesions in this pathology. Indeed, there is, in depression, a neuronal loss focused on some regions forming the cortico-striato-pallido-limbic-thalamic tract. These anatomical changes are reduced after antidepressant treatment. Accordingly, in the last decade, a new pathophysiological concept of affective disorders has emerged. This concept integrates preferentially molecular and cellular antidepressants-induced changes leading to rehabilitation of synaptic activity and neuronal trophism. In this article, we synthesize the current knowledge about the anatomical abnormalities observed in depression, and about the pathophysiological mechanisms that account for these ones. The central phenomenon in neuroplasticity turns around neurogenesis. This process takes place in the dentelate gyrus of hippocampus, where promoter cells enter in division, differentiate and become able to migrate to specifical regions of the central nervous system and to integrate into it. Neurogenesis is stimulated by neurotrophic factors, including the BDNF (brain derived neurotrophic factor) and by a lot of environmental situations. An inhibition of neurogenesis is attributed to the excess of glucocorticoids seen in stress situations like depression. Moreover, the neuronal loss in major depression is also caused by an excessive concentration of glutamate in synapsis that can lead cells to apoptotic process. Recently, it has been demonstrated that the clinical effects of the antidepressants are correlated to an elevation of neurogenesis in the dentelate gyrus. In this article, we finally present some potentially therapeutic straregies actually being studied, being aware that neuroplasticity is still a new concept (if the anxio-depressive pathology is considered) and that it thus must be seen with that reserve

Les antidépresseurs tricycliques et les IMAO ont-ils encore une place dans le traitement de la dépression?

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A French translation of the obsessive-compulsive drinking scale for craving in alcohol-dependent patients: a validation study in Belgium, France, and Switzerland

The Obsessive-Compulsive Drinking Scale (OCDS) is an instrument developed to measure cognitive aspects of alcohol craving. The aim of this study was to validate the French translation of the OCDS according to the international methodology as published by Hunt and coworkers (see text), including forward-backward translations, patient interviews (9 patients), patient's perception of acceptability (15 patients), and final validation within a treatment program (50 patients). All 74 patients were native French-speaking alcohol-dependent patients from Belgium, France, and Switzerland. The derived aggregated total (TOT) score and both subscores corresponding to the obsessive (OB) and compulsive (CP) dimensions were shown to be asymptomatically normal. Good internal consistencies were found, with Cronbach alpha: TOT = 0.88; OB = 0. 82; CP = 0.79. The test-retest procedure was used to examine intrarater reliability (r = 0.81). The construct validity was examined with linear correlation of the two main components: r(OB, CP) = 0.62; r(OB, TOT) = 0.86; r(CP, TOT) = 0.92. Principal-components analysis revealed two main factors: the first factor representing the total scale score, while the obsessive and compulsive subscale scores were distributed along factor two. The translated scale seems to be psychometrically as valid as the original English scale and confirms the psychometric properties of the OCDS. [Ed.]]]> eng oai:serval.unil.ch:BIB_F7D93BF6D7F8 2022-05-07T01:30:22Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_F7D93BF6D7F8 Langue, Littérature et Altérité Janz, N. (ed.) Vernand, D. (ed.) info:eu-repo/semantics/book book 1992 fre oai:serval.unil.ch:BIB_F7DA4CD40334 2022-05-07T01:30:22Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_F7DA4CD40334 Landslides and debris-flows: Analysis, monitoring, modeling and hazard assessment Jaboyedoff, M. Crosta, G.B. Arattano, M. Jaboyedoff, M. (ed.) Crosta, G.B. (ed.) Arattano, M. (ed.) info:eu-repo/semantics/book book 2005 eng oai:serval.unil.ch:BIB_F7DA82AC327E 2022-05-07T01:30:22Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_F7DA82AC327E Doit-on modifier le traitement anticoagulant avant des extractions dentaires? [Dental extractions in patients taking anticoagulants: is alteration of the anticoagulant regime necessary?] info:eu-repo/semantics/altIdentifier/pmid/15997980 Madrid, C. info:eu-repo/semantics/review article 2005 Revue Médicale Suisse, vol. 1, no. 21, pp. 1418, 1421-1422, 1424 info:eu-repo/semantics/altIdentifier/pissn/1660-9379 <![CDATA[A major concern in the management of patients under anticoagulants is the potential for excessive bleeding after dental procedures. Recommendations for the administration of oral anticoagulants in conjunction with oral surgery range from complete withdrawal of anticoagulants to the maintenance of an unchanged therapy. Rising evidences show that the alteration of anticoagulation is not necessary for patients with INR of 4 or less previous to tooth extractions. Topical antifibrinolytics as tranexamic acid control successfully alveolar bleeding. It is time to stop interrupting anticoagulant therapy for oral surgery. A theoretical risk of hemorrhage after dental surgery in patients at therapeutic levels of anticoagulation exists but it is minimal and is greatly overweighed by the risk of thromboembolism after alteration of the anticoagulant therapy

Cognitive topography imbalance in alcoholism and psychiatric comorbidity

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