41 research outputs found
Strategies and Practices in Off-Label Marketing of Pharmaceuticals: A Retrospective Analysis of Whistleblower Complaints
Aaron Kesselheim and colleagues analyzed unsealed whistleblower complaints
against pharmaceutical companies filed in US federal fraud cases that contained
allegations of off-label marketing, and develop a taxonomy of the various
off-label practices
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Resting state cortico-thalamic-striatal connectivity predicts pesponse to dorsomedial prefrontal rTMS in major depressive disorder
Despite its high toll on society, there has been little recent improvement in treatment efficacy for Major Depressive Disorder (MDD). The identification of biological markers of successful treatment response may allow for more personalized and effective treatment. Here we investigate whether resting state functional connectivity predicted response to treatment with rapid transcranial magnetic stimulation (rTMS) to dorsomedial prefrontal cortex (dmPFC). Twenty five individuals with treatment-refractory MDD underwent a 4-week course of dmPFC-rTMS. Before and after treatment, subjects received resting state functional MRI scans and assessments of depressive symptoms using the Hamilton Depresssion Rating Scale (HAMD17). We found that higher baseline cortico-cortical connectivity (dmPFC-subgenual cingulate and subgenual cingulate to dorsolateral PFC) and lower cortico-thalamic, cortico-striatal and cortico-limbic connectivity were associated with better treatment outcomes. We also investigated how changes in connectivity over the course of treatment related to improvements in HAMD17 scores. We found that successful treatment was associated with increased dmPFC-thalamic connectivity and decreased sgACC-caudate connectivity, Our findings provide insight into which individuals might respond to rTMS treatment and the mechanisms through which these treatments work
“Snake-oil,” “quack medicine,” and “industrially cultured organisms:” biovalue and the commercialization of human microbiome research
Controversies concerning the diagnosis and treatment of bipolar disorder in children
This commentary grows out of an interdisciplinary workshop focused on controversies surrounding the diagnosis and treatment of bipolar disorder (BP) in children. Although debate about the occurrence and frequency of BP in children is more than 50 years old, it increased in the mid 1990s when researchers adapted the DSM account of bipolar symptoms to diagnose children. We offer a brief history of the debate from the mid 90s through the present, ending with current efforts to distinguish between a small number of children whose behaviors closely fit DSM criteria for BP, and a significantly larger number of children who have been receiving a BP diagnosis but whose behaviors do not closely fit those criteria. We agree with one emerging approach, which gives part or all of that larger number of children a new diagnosis called Severe Mood Dysregulation or Temper Dysregulation Disorder with Dysphoria
Effectiveness and cost-effectiveness of transmural collaborative care with consultation letter (TCCCL) and duloxetine for major depressive disorder (MDD) and (sub)chronic pain in collaboration with primary care: design of a randomized placebo-controlled multi-Centre trial: TCC:PAINDIP
__Abstract__
Background: The comorbidity of pain and depression is associated with high disease burden for patients in terms
of disability, wellbeing, and use of medical care. Patients with major and minor depression often present
themselves with pain to a general practitioner and recognition of depression in such cases is low, but evolving.
Also, physical symptoms, including pain, in major depressive disorder, predict a poorer response to treatment. A
multi-faceted, patient-tailored treatment programme, like collaborative care, is promising. However, treatment of
chronic pain conditions in depressive patients has, so far, received limited attention in research. Cost effectiveness
of an integrated approach of pain in depressed patients has not been studied.
This article describes the aims and design of a study to evaluate effects and costs of collaborative care with the
antidepressant duloxetine for patients with pain symptoms and a depressive disorder, compared to collaborative
care with placebo and compared to duloxetine alone
Mirtazapine added to selective serotonin reuptake inhibitors for treatment-resistant depression in primary care (MIR trial): study protocol for a randomised controlled trial
Nutritional psychiatry research: an emerging discipline and its intersection with global urbanization, environmental challenges and the evolutionary mismatch
A systematic appraisal of allegiance effect in randomized controlled trials of psychotherapy
BRIDGE Study warrants critique
David M. Allen, Peter I. Parry, Robert Purssey, Glen I. Spielmans, Jon Jureidini, Nicholas Z. Rosenlicht, David Healy, Irwin Feinber