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Depression is common in caregivers of children with asthma and is associated with poor outcomes in their child. No prior studies have longitudinally examined caregiver depression remission as a predictor of improvement in child asthma control.

Preclinical and clinical research indicates that excess corticosteroid is associated with adverse effects on the hippocampus. Animal model data suggest that N-methyl-D-aspartate (NMDA) receptor antagonists may block corticosteroid effect on the hippocampus. This translational clinical trial investigated the effect of memantine vs. placebo on hippocampal subfield volume in humans receiving chronic corticosteroid therapy. Men and women (N= 46) receiving chronic prescription corticosteroid therapy were randomized to memantine or placebo in a double-blind, crossover design (two 24-week treatment periods, separated by a 4-week washout) for 52 weeks. Structural magnetic resonance imaging was obtained at baseline and after each treatment. Data were analyzed using repeated measures analysis of variance. Mean corticosteroid dose was 7.69 ± 6.41 mg/day and mean duration 4.90 ± 5.61 years. Controlling for baseline volumes, the left DG/CA3 region was significantly larger following memantine than placebo (p= .011). The findings suggest that an NMDA receptor antagonist attenuates corticosteroid effect in the same hippocampal subfields in humans as in animal models. This finding has both mechanistic and clinical implications. Attenuation of the effect of corticosteroids on the human DG/CA3 region implicates the NMDA receptor in human hippocampal volume losses with corticosteroids. In addition, by suggesting a drug class that may, at least in part, block the effects of corticosteroids on the human DG/CA3 subfield, these results may have clinical relevance for people receiving prescription corticosteroids, as well as to those with cortisol elevations due to medical or psychiatric conditions.

Depression is common in asthma and is associated with poor outcomes. However, antidepressant therapy in depressed patients with asthma has been the topic of little research.

Alcohol use disorder is a major societal and individual burden that exacerbates health outcomes, decreases quality of life, and negatively affects U.S. healthcare spending. Although pharmacological treatments are available for alcohol use disorder, many of them are limited by small effect sizes and used infrequently. Citicoline is a widely available over‐the‐counter supplement with a favorable side effect profile. It acts through cholinergic pathways and phospholipid metabolism. The current report examines the effect of oral citicoline on alcohol use, craving, depressive symptoms, and cognitive outcomes in individuals with alcohol use disorder. A 12‐week, randomized, double‐blind, parallel‐group, placebo‐controlled, pilot study of citicoline (titrated to 2,000 mg/d) in 62 adults (age 18 to 75) with alcohol use disorder was conducted. Alcohol use, such as number of drinking days, amount used, and number of heavy drinking days, was assessed using the Timeline Followback method and liver enzymes, while alcohol craving was measured using the Penn Alcohol Craving Scale. A neurocognitive battery (e.g., Rey Auditory Verbal Learning Test) and depressive symptoms scale (e.g., Inventory of Depressive Symptomatology Self‐Report) scores were also collected. Data were analyzed using a random regression analysis. The primary outcome analysis was conducted in the intent‐to‐treat sample and consisted of 55 participants (78.2% men and 21.8% women, mean age of 46.47 ± 9.15 years). In the assessment period, the drinking days, on average, represented 77% of the assessed days. Significant between‐group differences were not observed on alcohol use, craving, and cognitive or depressive symptom measures. Citicoline was well tolerated. This proof‐of‐concept study observed that citicoline was well tolerated, but was not associated with a reduction in alcohol use or other outcomes, as compared to placebo. The favorable effects reported with citicoline for cocaine use, cognitive disorders, and other conditions do not appear to extend to alcohol use disorder.

Pediatric asthma is associated with increased health services utilization, missed school days and diminished quality of life. Children with asthma also report more frequent depressive and anxiety symptoms than non-asthmatic children, which may further worsen asthma outcomes.

Preclinical literature suggests that icariin, a flavonoid found in Epimedium, may have potential for medical and psychiatric conditions. The objective of this study was to examine the safety, tolerability, and pharmacokinetics of orally administered icariin at doses of 100 to 1,680 mg/day in 24 healthy adult participants. Cognition, mood, and side effects were assessed over 5 days. Multiple blood samples were obtained over 24 hours to assess bioavailability and pharmacokinetics. Data were analyzed using a Wilcoxon signed rank test and Mann-Whitney U test. At all doses, either very low or undetectable blood levels of icariin were observed, demonstrating the low bioavailability of the oral formulation and preventing a determination of pharmacokinetic properties. No significant between-group differences were observed on side effect scales, either by self-report, or on cognitive assessments. A statistically significant, but not clinically significant, increase in self-reported depressive symptom severity was observed with icariin relative to placebo. Tolerability of icariin was good except at the highest dose. Two participants receiving 1,680 mg of icariin discontinued the study drug due to gastrointestinal symptoms. Bioavailability of oral icariin appears to be low at all doses tested. Although icariin appears generally to have a favorable tolerability profile, the highest doses may be associated with gastrointestinal distress. Different drug formulation and delivery method may be needed to assess the pharmacokinetic profile of icariin adequately.