Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed medication for major depressive disorder (MDD), yet scientists still do not understand why the treatment does not work in nearly thirty percent of patients with MDD. Now, Salk Institute researchers have discovered differences in growth patterns of neurons of SSRI-resistant patients. The work, published in Molecular Psychiatry on March 22, 2019, has implications for depression as well as other psychiatric conditions such as bipolar disorder and schizophrenia that likely also involve abnormalities of the serotonin system in the brain.
“With each new study, we move closer to a fuller understanding of the complex neural circuitry underlying neuropsychiatric diseases, including major depression,” says Salk Professor Rusty Gage, the study’s senior author, president of the Institute, and the Vi and John Adler Chair for Research on Age-Related Neurodegenerative Disease. “This paper, along with another we recently published, not only provides insights into this common treatment, but also suggests that other drugs, such as serotonergic antagonists, could be additional options for some patients.”
The most commonly prescribed antidepressants, selective serotonin reuptake inhibitors (SSRIs), lift the fog of depression for many people. But for around a third of people with major depressive disorder, SSRIs don’t make much of a difference. Now, researchers from the Salk Institute have pinned down a possible reason why — the neurons in at least some of these patients’ brains may become hyperactive in the presence of the drugs. The study appeared in Molecular Psychiatry on January 30, 2019.
“This is a promising step toward understanding why some patients don’t respond to SSRIs and letting us better personalize treatments for depression,” says Salk Professor Rusty Gage, the study’s senior author, president of the Institute, and the Vi and John Adler Chair for Research on Age-Related Neurodegenerative Disease.
Depression affects 300 million people around the world, and more than 6 percent of the US population experiences an episode of major depressive disorder (MDD) in any given year. MDD has been linked to an imbalance in serotonin signaling, although the exact mechanism is not well understood.
Evidence has been mounting that some mental disorders share many of the same genetic risk factors. Now, researchers have discovered that this overlap extends to the molecular level – some of these suspect genes also turn on-and-off similarly in the brains of people with autism spectrum disorder (ASD), schizophrenia, and bipolar disorder. These molecular signatures may hold clues to what goes wrong in the brain in these disorders—and potentially ways to better treat or even prevent them.
In search of such clues, Drs. Daniel Geschwind and Michael Gandalof the University of California Los Angeles (UCLA), and colleagues, examined gene expression in postmortem brains of people who had been diagnosed with autism spectrum disorder (ASD), schizophrenia, bipolar disorder, major depressive disorder, or alcoholism. One of the largest such efforts of its kind to date, the study, funded by the National Institute of Mental Health (NIMH), tapped brain molecular data resources gathered through the NIMH-funded PsychENCODE consortium, a data-sharing collaboration among NIMH grantees.
Recent studies suggest that ketamine, a widely used anesthetic agent, could offer a wholly new approach to treating severe depression — producing an antidepressant response in hours rather than weeks. Two reviews of recent evidence on ketamine and related drugs for treating depression appear in the Harvard Review of Psychiatry, published by Wolters Kluwer.
Ketamine and related drugs may represent a “paradigm shift” in the treatment of major depressive disorder (MDD) and bipolar depression — especially in patients who do not respond to other treatments, according to a review by Carlos A. Zarate, Jr, MD and colleagues at the National Institute of Mental Health. A second article explores evidence on the mechanisms behind ketamine’s rapid antidepressant effects.
People who suffer from depression should participate in yoga and deep (coherent) breathing classes at least twice weekly plus practice at home to receive a significant reduction in their symptoms.
The findings, which appear in the Journal of Alternative and Complementary Medicine, provide preliminary support for the use of yoga-based interventions as an alternative or supplement to pharmacologic treatments for depression.
Major depressive disorder (MDD) is common, recurrent, chronic and disabling. Due in part to its prevalence, depression is globally responsible for more years lost to disability than any other disease. Up to 40 percent of individuals treated with antidepressant medications for MDD do not achieve full remission. This study used lyengar yoga that has an emphasis on detail, precision and alignment in the performance of posture and breath control.
Bipolar disorder is one of the most disabling medical conditions among adolescents worldwide. Similarly, being overweight or obese is common in adolescents and is known to confer risk for cardiovascular disease and other poor health outcomes in adulthood. As a result, the intersection of bipolar disorder and overweight is a matter of clinical and public health concern. Previous studies have demonstrated that overweight and obesity are more prevalent among adults with bipolar disorder as compared to the general population, and that overweight and obesity are associated with proxies of increased bipolar disorder severity, such as suicide attempts and greater symptom burden. Thus far, little is known about overweight among adolescents with bipolar disorder.
A study published in the December 2016 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) is the first to examine this topic in a large, representative sample of the US adolescent population. The NCS-A is a face-to-face survey of mental disorders in a representative sample of adolescents 13-17 years old. Participants included 295 adolescents with bipolar disorder, 1,112 with major depressive disorder, and 8,716 with neither of these conditions. 37.9% of adolescents with bipolar disorder were also overweight, compared to 32.4% of adolescents with major depressive disorder, and 32% of adolescents with neither of these conditions — differences that were not statistically significant.
Having both parents and grandparents with major depressive disorder (MDD) was associated with higher risk of MDD for grandchildren, which could help identify those who may benefit from early intervention, according to a study published online by JAMA Psychiatry.
It is well known that having depressed parents increases children’s risk of psychiatric disorders. There are no published studies of depression examining three generations with grandchildren in the age of risk for depression and with direct interviews of all family members.
Myrna M. Weissman, Ph.D., of Columbia University and New York State Psychiatric Institute, New York, studied 251 grandchildren (average age 18) interviewed an average of two times and their biological parents, who were interviewed an average of nearly five times, and grandparents interviewed up to 30 years.
A potent risk factor for developing major depressive disorder (MDD) during fertility treatment is something health providers are likely not even looking for, according to new research from San Francisco State University.
Fertility treatment patients and their partners are far more likely to experience MDD than the general population, the study found, and a key factor in predicting a patient’s risk is whether he or she has a previous diagnosis of major depression. But past history is something that fertility treatment providers may not routinely screen for, said Sarah Holley, an assistant professor of psychology at SF State and lead author of the study.