Polypharmacy With Antidepressants in Children and Adolescents.

Polypharmacy with antidepressants in children and adolescents.

Filed under: Depression Treatment

Int J Neuropsychopharmacol. 2012 Nov 29; 1-20
Díaz-Caneja CM, Espliego A, Parellada M, Arango C, Moreno C

The aim of this study was to review current epidemiological data on the use of antidepressants in co-prescription with other psychotropic drugs in children and adolescents, as well as available efficacy and safety information. A Medline search from inception until February 2012 was performed to identify epidemiological and clinical studies, reviews and reports containing potentially relevant information on polypharmacy with antidepressants in young people. There has been an increase in polypharmacy in children and adolescents involving antidepressants in recent years. Antidepressants have become one of the drug classes most frequently prescribed in combination and are commonly co-prescribed with stimulants and antipsychotics. Most information regarding efficacy and safety of polypharmacy patterns was provided by case series and open-label studies. Efficacy studies gave some support for the use of a combination of antidepressants and antipsychotics in the management of refractory obsessive-compulsive disorder and some residual symptoms in major depressive disorder. Even less empirical support was found for a combination of stimulants and antidepressants in co-morbid attention deficit hyperactivity disorder and mood or anxiety disorders. Adverse events were similar to those found with individual medication groups, with severe adverse events mostly reported by individual case reports. The use of polypharmacy with antidepressants has become a regular practice in clinical settings. Although there is still little efficacy and safety information, preliminary evidence points to the potential clinical usefulness of some polypharmacy patterns. Further research on patients with co-morbidities or more severe conditions is needed, in order to improve knowledge of this issue.
HubMed – depression

 

The Antidepressant-like Effect of Physical Activity in the Voluntary Running Wheel.

Filed under: Depression Treatment

Med Sci Sports Exerc. 2012 Nov 27;
Cunha MP, Oliveira A, Pazini FL, Machado DG, Bettio LE, Budni J, Aguiar AS, Martins DF, Santos AR, Rodrigues AL

PURPOSE: Physical activity is currently being considered an effective alternative in the treatment of depression. At preclinical level, voluntary running wheel is a useful method of increasing physical activity in rodents and induces an antidepressant-like effect in some behavioral paradigms. METHODS: This study investigated the effect of physical activity in voluntary running wheel in mice submitted to the forced swimming test (FST) and tail suspension test (TST), two predictive tests of antidepressant properties. Moreover, the influence of the inhibition of serotonin and noradrenaline synthesis as well as the inhibition of protein kinase A (PKA) and calcium/calmodulin-dependent protein kinase II (CAMK-II) activity by pharmacological agents in the antidepressant-like action of physical activity was investigated. RESULTS: Physical activity in voluntary running wheel by 21 days produced a reduction in the immobility time in the FST and TST, without producing alteration on locomotor activity in the open-field test. The antidepressant-like effect in the FST elicited by physical activity lasted for 7 days after removal of the running wheel. The anti-immobility effect of physical activity was prevented by the pretreatment of mice with p-chlorophenylalanine methyl ester (PCPA, 100 mg/kg, i.p., once a day, for four consecutive days, inhibitor of serotonin synthesis), ?-methyl-p-tyrosine (AMPT, 100 mg/kg, i.p., an inhibitor of noradrenaline and dopamine synthesis), H-89 (1 ?g/site, i.c.v., a protein kinase A inhibitor, PKA) and KN-62 (1 ?g/site, i.c.v., a calcium/calmodulin-dependent protein kinase II inhibitor, CAMK-II). CONCLUSIONS: Taken together, these results firstly suggest that the effect of physical activity on the FST is dependent on either the increase in the bioavailability of monoamines in the synaptic cleft or an activation of intracellular signaling pathways mediated by PKA and CAMK-II.
HubMed – depression

 

Survey of depression by beck depression inventory in uremic patients undergoing hemodialysis and hemodiafiltration.

Filed under: Depression Treatment

Ther Apher Dial. 2012 Dec; 16(6): 573-9
Su SF, Ng HY, Huang TL, Chi PJ, Lee YT, Lai CR, Lin YH, Huang PC, Lee CT

High prevalence of depression has been reported in patients with end stage kidney disease and depression is associated with increased morbidity and mortality. We aimed to investigate the prevalence of depression in patients receiving standard hemodialysis (SHD) and hemodiafiltration (HDF) and compare the associated factors between these treatment modalities. The Beck Depression Inventory (BDI) was used to survey for major depressive symptoms. Demographic and biochemical data were reviewed and collected. Point prevalence of depression in HDF patients was significantly lower than SHD patients (23.9% vs. 43.1%, P?HubMed – depression

 

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