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The ability to critically read a research paper is a skill that all postgraduate students and academicians require because the findings of a study must be interpreted in the context of its strengths and limitations. This article summarizes a recent study on continuation vs. discontinuation of antidepressants during pregnancy; preterm birth and low-birth weight were the outcomes of interest. The strengths and limitations of the study are considered, as are the best and worst case scenarios related to antidepressant use during pregnancy. It is hoped that this exercise will increase the reader's awareness of statistical and methodological issues that emerge when a study is critically examined.

This article describes a method for the modification of paper with single-wall carbon nanohorns (SWCNHs) to form stable suprastructures. The SWCNHs form stable dahlia-like aggregates in solution that are then self-assembled into superior structures if the solvent is evaporated. Dipping paper sections into a dispersion of SWCNHs leads to the formation of a thin film that can be used for microextraction purposes. The coated paper can be easily handled with a simple pipette tip, paving the way for disposable extraction units. As a proof of concept, the extraction of antidepressants from urine and their determination by direct infusion mass spectrometry is studied. Limits of detection (LODs) were 10 ng/L for desipramine, amitriptyline, and mianserin, while the precision, expressed as a relative standard deviation, was 7.2%, 7.3%, and 9.8%, respectively.

All socioeconomic classes are impacted by the COVID-19 epidemic, with stress being one of the biggest symptoms causing indigestion, breathlessness, heart disease, obesity, and many more. The most commonly used selective serotonin reuptake inhibitors (SSRIs) drugs include, escitalopram, sertraline, paroxetine, and fluoxetine are provided by doctors. If the medicines are not taken in the recommended dosage, at the correct intervals, which can occasionally be fatal because persons with depression are susceptible to mood fluctuations. There are no appropriate ways to monitor high dosages in clinical laboratories, the requirement for simple, novel material with cutting-edge technology to do so is essential. Herein, we report the application of a single fluorescent probe, Tyrosine-GQDs for the detection of SSRI drugs. Upon addition of SSRI drugs into the Tyrosine-GQDs, the fluorescence emission intensity of Tyrosine-GQDs decreased due to the complex formation through H-bonding which is evidenced by the rise of new peaks in fluorescence spectra and lifetime measurements. The calculated detection limit proves that the designed nanoprobe is highly sensitive and selective towards escitalopram, sertraline, paroxetine, and fluoxetine are 0.13 × 10−6 M, 0.15 × 10−6 M, 0.07 × 10−6 M, and 0.07 × 10−6 M, respectively. A paper-based fluorescent sensor is fabricated using the designed probe which is efficient in the detection of the dosage of SSRI drugs. [Display omitted] • Tyrosine-GQDs are employed for the spectrophotometric detection of SSRI drugs. • The limit of detection for the SSRI drugs is quantified in sub-micromolar concentration. • The effect of interference shows that the complex formed between the Tyrosine-GQDs and drugs is highly stable. • The H-bond formation between the drugs and Tyrosine-GQDs dominates the mechanism responsible for the fluorescence quenching. • The fluorescent paper sensor is effective in determining the SSRI drugs. [ABSTRACT FROM AUTHOR]

The article discusses adults on antidepressants for mild-to-moderate depression, and mentions yoga improves several aspects of quality of life.

The article discusses adults on antidepressants for mild-to-moderate depression, and mentions yoga improves several aspects of quality of life.

This work describes the production of alternative adsorbents from industrial residues and their application for the removal of a highly consumed antidepressant (citalopram) from water. The adsorbents were produced by pyrolysis of both primary and biological paper mill sludge at different temperatures and residence times. The original sludge and the produced chars were fully characterized by elemental and proximate analyses, total organic carbon, specific surface area (BET), N2 isotherms, FTIR, 13C and ¹H solid state NMR and SEM. Batch kinetic and equilibrium experiments were carried out to describe the adsorption of citalopram onto the produced materials. The fastest kinetics and the highest adsorption capacity were obtained using primary sludge pyrolysed at 800 °C during 150 min. The use of pyrolysed paper mill sludge for the remediation of contaminated waters might constitute an interesting application for the valorization of those wastes. [ABSTRACT FROM AUTHOR]

• Unmodified laboratory filter paper is used for simultaneous extraction of ten basic drugs. • Simultaneous preparation of 16 samples within 90 min increases the sample throughput. • Minimal consumption of reagents, solvents and reduced waste generation. • The limit of detection as low as 0.003 µg mL−1 could be achieved. • Method has been applied for analysis of basic drugs from real blood samples. Aiming towards simplifying sample preparation procedure, the present work explores use of unmodified laboratory filter paper as sorbent for extraction of nine basic drugs (five antidepressants, four benzodiazepines, and ketamine) from human blood samples and their analysis by gas chromatography-mass spectrometry (GC-MS). The procedure termed as cellulose paper sorptive extraction (CPSE) is straightforward. It involves adsorption of target analytes from deproteinized diluted blood samples on the unmodified cellulose paper followed by elution into 2 mL of methanol. Multivariate optimization, consisting of Placket-Burman design (PBD) and central composite design (CCD), was used to screen and optimize significant factors for CPSE. The proposed method follows the principles of green analytical chemistry (GAC), as the unmodified filter paper used as the sorbent is inexpensive and biodegradable. The technique is easy to perform and requires only 2 mL of MeOH during the entire extraction procedure. Under the optimized conditions, the limit of detection and quantification for the target analytes were estimated to be in the range of 0.003–0.035 and 0.010–0.117 µg mL−1, respectively. In contrast, the relative standard deviations were consistently below 10 %. The calibration curves were linear in the range of 0.015–2 µg mL−1 with a coefficient of determination (R2) in the range of 0.995–0.999.Satisfactory recoveries ranging from 87 to 99 % was achieved. As proof of concept, the analysis of nine drugs in blood samples from the patients was performed to demonstrate the potential application of the proposed method. [ABSTRACT FROM AUTHOR]

Major depressive disorder (MDD) is a heritable disease with a heavy personal and socio-economic burden. Antidepressants of different classes are prescribed to treat MDD, but reliable and reproducible markers of efficacy are not available for clinical use. Further complicating treatment, the diagnosis of MDD is not guided by objective criteria, resulting in the risk of under- or overtreatment. A number of markers of MDD and antidepressant response have been investigated at the genetic, epigenetic, gene expression and protein levels. Polymorphisms in genes involved in antidepressant metabolism (cytochrome P450 isoenzymes), antidepressant transport (ABCB1), glucocorticoid signalling (FKBP5) and serotonin neurotransmission (SLC6A4andHTR2A) were among those included in the first pharmacogenetic assays that have been tested for clinical applicability. The results of these investigations were encouraging when examining patient-outcome improvement. Furthermore, a nine-serum biomarker panel (includingBDNF, cortisol and soluble TNF-α receptor type II) showed good sensitivity and specificity in differentiating between MDD and healthy controls. These first diagnostic and response-predictive tests for MDD provided a source of optimism for future clinical applications. However, such findings should be considered very carefully because their benefit/cost ratio and clinical indications were not clearly demonstrated. Future tests may include combinations of different types of biomarkers and be specific for MDD subtypes or pathological dimensions. [ABSTRACT FROM PUBLISHER]

Introduction and aim. According to the World Health Organization (WHO), depression is a leading cause of disability worldwide, affecting people of all ages. It is estimated that approximately 5% of the global adult population manifests symptoms of one type of depressive disorders (DDs), of which major depressive disorder (MDD) is the most common. Moreover, DDs are a risk factor for annual suicides (suicide ideation and/or attempts are reported in up to 60% of depressed patients). This study aimed to discuss the clinical safety and efficacy of esketamine as a novel fast-acting antidepressant. Material and methods. Review paper based on scientific articles published in different medical database. Analysis of literature. Pharmacological treatment of depression is mainly based on drugs that modulate monoaminergic neurotransmission, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). However, these antidepressants require long administration times to achieve equivalent therapeutic effects with severe side effects. Conclusion. As approved by the Food and Drug Administration (FDA) in 2019, esketamine (SPRAVATO®, a non-selective and non-competitive antagonist of the N-methyl-D-aspartate (NMDA) receptor) is a novel drug recommended for pharmacotherapy for treatment-resistant depression (TRD). In addition, regulation of glutamate receptor function (ionotropic and metabotropic) is a promising molecular target for antidepressant strategies. [ABSTRACT FROM AUTHOR]

Background: Despite peer review, publications in scientific journals are not always well written, sometimes contain errors, and often exhibit deliberate or unintended biases. It is necessary to learn how to identify such limitations. It is also necessary to learn how to read between and beyond the lines of papers no matter how well written they are and no matter how highly ranked the journal is. Materials and Methods: This paper critically examines an important article in a leading journal with a view to help the reader learn how to place the findings of a study in perspective, understand its limitations, and glean information beyond that actually presented and discussed in the text. Results: Several issues are examined; these relate to case-control research designs, confounding, propensity matching, absolute risk, confidence intervals, interpretation of findings, real-world relevance, ecological validity, and definition of a cause-effect relationship. Conclusions: The issues examined in this paper reflect common themes in research, and a reader aware of these themes will more easily identify them in his future readings. [ABSTRACT FROM AUTHOR]

Psychiatric drugs have been a mainstay of treatment for a range of behavioral and emotional problems over the past 6 decades in the United States and around the world. Although their use has skyrocketed, the problems they purport to alleviate have not diminished but, in fact, have increased (Whitaker, 2010a). This article summarizes current evidence for the efficacy of antidepressants, antipsychotics, and stimulants. Findings from meta-analyses, reviews, and major trials do not support widespread use of these drugs. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although previous study has demonstrated that brain-derived neurotrophic factor (BDNF) is involved in the antidepressant-like effect of oleanolic acid, there is little information regarding the details of the molecular mechanism involved in this effect. METHODS: We used a chronic unpredictable mild stress (CUMS) model to test the antidepressant-like effect of oleanolic acid on depressant-like behaviour, miR-132 expression and synaptic protein expression in the male mouse hippocampus. Furthermore, we explored the possible signalling pathways associated with miR-132 expression that mediate the effect of oleanolic acid on neuronal proliferation. RESULTS: The results demonstrated that a 3-week treatment with oleanolic acid ameliorated CUMS-induced anhedonic and anxiogenic behaviours. Furthermore, we found that oleanolic acid led to the BDNF-related phosphorylation and activation of extracellular signal-regulated kinases (ERK) and cyclic adenosine monophosphate response element binding protein (CREB), which was associated with the upregulation of miR-132 and hippocampal neuronal proliferation. Moreover, experiments with an miR-132 antagomir revealed that targeting miR-132 led to inhibition of neuronal proliferation and the postsynaptic density protein 95, but did not affect presynaptic protein synapsin I. LIMITATIONS: Several other stimuli can also induce CREB phosphorylation in the hippocampus. Thus, regulation of miR-132 may not be restricted to neurotrophic signalling. CONCLUSION: Our results show that oleanolic acid induces the upregulation of miR-132, which serves as an important regulator of neurotrophic actions, mainly through the activation of the hippocampal BDNF-ERK-CREB signalling pathways. [ABSTRACT FROM AUTHOR]

The article presents a paper on the effectiveness of Selective Serotonin Reuptake Inhibitors (SSRIs) to treat children and adolescents with major depressive disorder (MDD) and anxiety disorders (AD). Based from the medical records, the number needed to treat (NNT) patients with AD acquired the percentage rating of 25%. Moreover, the author provides an overview on how the Canadian Academy Child and Adolescent Psychiatry (CACAP) has developed its information resources management to conduct several randomized clinical trials. A chart is presented depicting a comprehensive explanation on how the antidepressants works efficiently in the human bodies.

Objectives To examine the acceptability of fluoxetine in elderly depressed patients with chronic obstructive pulmonary disease (COPD). Setting A university teaching hospital. Method Single-blinded (open) study. One hundred and thirty-seven outpatients (69 male) with symptomatic irreversible, moderate to severe COPD were recruited. Major depression was diagnosed using the Geriatric Mental State Schedule. Quality of life was assessed by the Breathing Problems Questionnaire, physical disability by the Manchester Respiratory Activities of Daily Living Questionnaire and severity of depression using the Montgomery Asberg Depression Rating Scale. Exclusion criteria were: use of oral steroids within 6 weeks, acute or chronic confusion, known cancer and known psychosis. Results Fifty-seven patients (42%) (25 males) with a mean age of 72 years (range 60–89 years) were depressed. Fourteen (six male) agreed to undergo therapy with fluoxetine 20 mg/day for 6 months, while 36 (72%) refused antidepressant drug therapy. Only seven subjects completed the trial; of these, four (57%) responded to fluoxetine therapy. Five subjects withdrew because of side-effects. Twenty-two of those who refused treatment (61%) agreed to be interviewed, and of these 19 (86%) were still depressed. Conclusion Patient acceptance of fluoxetine was poor. The reasons for refusing treatment varied but were largely due to misapprehension by the patient. Untreated depression became chronic. Offering antidepressants to COPD patients with depression is not an effective strategy. Why this might be so is discussed. Copyright © 2001 John Wiley & Sons, Ltd [ABSTRACT FROM AUTHOR]

• Paper surface was modified for direct ionization on mass spectrometry analysis. • RAM-PSI-MS method was compared to traditional PSI-MS and LC-MS. • Catecholamines and antidepressants were determined in human plasma by RAM-PSI-MS. • RAM-PSI-MS is an accurate method for biomonitoring biomarkers and drugs in plasma. In the present study, a fast, accurate and reliable mass spectrometry methodology without any sample pretreatment step and low solvent consumption for catecholamines and antidepressants determination in plasma samples is reported. An internal surface reversed-phase restrict access material was synthesized onto a paper surface and applied to the extraction of dopamine, epinephrine, diazepam, nortriptyline, and fluoxetine from human plasma following direct desorption by paper spray mass spectrometry (PSI-MS). The developed methodology showed to be accurate, precise and linear in a concentration range from the limit of quantification to 1000 ng mL−1. The limits of quantification for all analytes ranged from 1.4 to 5.3 ng mL−1. According to the results, the developed methodology could be a powerful tool for drug levels monitoring in clinical or urgent care. [ABSTRACT FROM AUTHOR]

The ability to critically read a research paper is a skill that all postgraduate students and academicians require because the findings of a study must be interpreted in the context of its strengths and limitations. This article summarizes a recent study on continuation vs. discontinuation of antidepressants during pregnancy; preterm birth and low-birth weight were the outcomes of interest. The strengths and limitations of the study are considered, as are the best and worst case scenarios related to antidepressant use during pregnancy. It is hoped that this exercise will increase the reader's awareness of statistical and methodological issues that emerge when a study is critically examined. [ABSTRACT FROM AUTHOR]

The article presents abstracts of research related to pharmacy in the U.S. which include the assessment of basic medication management knowledge for individuals with diabetes and hypertension in an indigent care setting, assessment of pharmacists' confidence in Ohio in giving pharmaceutical care to children in a community setting and assessment of patient perceptions related to antidepressants and depression in the community pharmacy practice.

Background: Second-generation antidepressants dominate the management of major depressive disorder, dysthymia, and subsyndromal depression. Evidence on the comparative benefits and harms is still accruing. Purpose: To compare the benefits and harms of second-generation antidepressants (bupropion, citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, mirtazapine, nefazodone, paroxetine, sertraline, trazodone, and venlafaxine) for the treatment of depressive disorders in adults. Data Sources: MEDLINE, EMBASE, PsychLit, Cochrane Central Register of Controlled Trials, and International Pharmaceutical Abstracts from 1980 to April 2007, limited to English-language articles. Reference lists of pertinent review articles were manually searched and the Center for Drug Evaluation and Research database was explored to identify unpublished research. Study Selection: Abstracts and full-text articles were independently reviewed by 2 persons. Six previous good- or fair-quality systematic reviews or meta-analyses were included, as were 155 good- or fair-quality double-blind, placebo-controlled, or head-to-head randomized, controlled trials of at least 6 weeks' duration. For harms, 35 observational studies with at least 100 participants and follow- up of at least 12 weeks were also included. Data Extraction: Using a standard protocol, investigators abstracted data on study design and quality-related details, funding, settings, patients, and outcomes. Data Synthesis: If data were sufficient, meta-analyses of head-tohead trials were conducted to determine the relative benefit of response to treatment and the weighted mean differences on specific depression rating scales. If sufficient evidence was not available, adjusted indirect comparisons were conducted by using meta-regressions and network meta-analyses. Secondgeneration antidepressants did not substantially differ in efficacy or effectiveness for the treatment of major depressive disorder on the basis of 203 studies; however, the incidence of specific adverse events and the onset of action differed. The evidence is insufficient to draw conclusions about the comparative efficacy, effectiveness, or harms of these agents for the treatment of dysthymia and subsyndromal depression. Limitation: Adjusted indirect comparisons have methodological limitations and cannot conclusively rule out differences in efficacy. Conclusion: Current evidence does not warrant the choice of one second-generation antidepressant over another on the basis of differences in efficacy and effectiveness. Other differences with respect to onset of action and adverse events may be relevant for the choice of a medication. [ABSTRACT FROM AUTHOR]

This article seeks to establish an interactive dialogue with clinicians regarding the diagnosis and treatment of mental depression patients in practice. The goal is, over time, to create an in-clinic application of the American Psychiatric Association's guidelines, which directs physicians to select antidepressant therapy based on side effect profiles, since all agents are equal in their efficacy. Patient typing presupposes a determination of depression as a diagnosis and then seeks to highlight characteristics of the presentation, which would serve to stratify the specific antidepressant therapy most likely to provide the best outcome for the patient. Seven patient types are presented which may form the beginnings of a new construct, which will be useful in choosing the most effective treatment for a patient's specific symptoms.

This review considers evidence for the efficacy of pharmacotherapy among primary care patients with depressive disorders and reviews knowledge regarding the effectiveness of current practice. Strong evidence supports the efficacy of antidepressant pharmacotherapy for primary care patients with major depression and dysthymia with some evidence for pharmacotherapy of less severe depression. In general, available antidepressants appear equal in both efficacy and effectiveness. Treatment selection for any individual patient remains largely empirical, with few clinical characteristics predicting better or worse response to specific treatments. Strong evidence supports continuation treatment (i.e., at least six months of pharmacotherapy) for all patients and maintenance treatment (i.e., at least 24 months of pharmacotherapy) for those with chronic or recurrent depression. Unfortunately, few patients in primary care or specialty practice receive recommended levels of pharmacotherapy or recommended frequency of follow-up care. A number of recent studies have evaluated strategies to improve the quality of antidepressant treatment in primary care. Educational programs (including academic detailing and continuous quality improvement) have had little impact on patient outcomes. Key elements of effective care improvement programs include specific, evidence-based treatment protocols, organized patient education and active follow-up care. [Copyright &y& Elsevier]

Episode-related factors and antidepressant treatment adequacy may be important determinants of recovery from a major depressive episode (MDE). We compared recovered and nonrecovered patients on baseline sociodemographic, clinical and episode-related measurements. Twenty-five inpatients with recurrent major depressive disorder diagnosed by SADS-L participated in this naturalistic, prospective, longitudinal study. Recovery, which was defined as a sustained return to non-depressed status lasting ≥ 8 consecutive weeks, was assessed at 6- and 12-month follow-up with the Streamlined Longitudinal Interval Continuation Evaluation (SLICE). Thirteen (52%) patients met recovery criteria. The cumulative proportion remaining depressed for at least 52 weeks was 42.5%. Recovered patients had shorter episodes preceding the index hospitalization (P = .01). Despite adequate antidepressant pharmacotherapy, the length of the current episode remains the most important correlate of recovery from MDE recurrence. Our small sample size and the uncontrolled nature of treatment may limit the generalizability of these findings. Depression and Anxiety 12:40–43, 2000. © 2000 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Introduction and aim. Depressive disorders are a serious mental disorder, the incidence of which is constantly increasing, and thus the socio-economic cost of the disease. Research conducted since the 1960s on depression has not provided either comprehensive information on the mechanisms of the disease or provided highly effective and safe antidepressants. Recent evidence links the dysfunction of the bidirectional communication pathway between the gut microbiome and the central nervous system (known as the microbiota-gut-brain axis) to depressive disorders. Alterations in the composition and function of the intestinal microflora are observed in patients with depression. The aim of this study is to review the current knowledge on the role of the microbiota-gut-brain axis in the pathomechanism of depressive disorders and to discuss potential therapeutic implications. We will explore the use of probiotics, prebiotics, and other nutritional interventions, as well as the development of psychobiotics and other novel pharmacological agents targeting the gut microbiota, for the treatment of depressive disorders. Material and methods. Literature search: A comprehensive literature search was conducted using electronic databases such as PubMed, Embase, and Cochrane Library. The search was conducted using keywords such as "microbiota-gut-brain axis", "depressive disorders", "probiotics", "prebiotics", "psychobiotics" and "pharmacological agents targeting the gut microbiota". Study selection: Studies were included in this review if they investigated the association between the microbiota- gut-brain axis and depressive disorders. Only articles published in English and peer-reviewed were included. Data extraction: Data were extracted from the included studies, including study design, sample size, age range of participants, diagnostic criteria for depressive disorders, methods for assessing gut microbiota, and results. Analysis of literature. The results of the studies were analyzed and synthesized to provide an overview of the current knowledge on the role of the microbiota-gut-brain axis in the pathomechanism of depressive disorders. Results. The findings of the studies were discussed in the context of potential therapeutic implications. The use of probiotics, prebiotics, and other nutritional interventions, as well as the development of psychobiotics and other novel pharmacological agents targeting the gut microbiota, were explored for the treatment of depressive disorders Conclusion. The war negatively changed lifestyle of Ukrainian student via forced relocation and disability to continue education in universities. Among students were detected severe and extremely severe depression, low level of QL due to changes in mental health during war in Ukraine. [ABSTRACT FROM AUTHOR]

Basically, humans desire nothing but to be happy. Humans exert much effort to make their lives meaningful and worth living. For humans, obtaining the meaning of existence is the foundation of happiness. However, despite humans' desire to be happy, an ugly truth still remains: life is a tragedy. Friedrich Nietzsche argues that life is a constant struggle and that to live is to suffer. By seeing this ugly picture of life, humans gradually fall into depression. "Depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure . . . and may lead to suicide (WHO, 2021)." More so, science contends that specific brain dysfunctions cause depression, and various solutions are offered to address this, like taking anti-depressants and undergoing psychotherapy, but amidst all these, depression remains. In this case, what other means can be utilized to address the problem of depression? Using the philosophical-qualitative method, this paper will attempt to address the perennial issue of depression. This paper attempts to understand the problem of depression by tracing it to the degradation of meaning and will resolve it by explaining the essential role aesthetics plays in man's existence. [ABSTRACT FROM AUTHOR]

This article built on previous results of the author's experience in the treatment of elderly people with depression admitted under his care in 1949 and 1951. The article presents a followup investigation of a further consecutive series over the age of 60 receiving care in 1966 and 1967. The progress of 92 depressives over the age of 60 after discharge from hospital was compared with that of 81 subjects of an earlier follow up study. On account mainly of earlier and presumably often successful treatment in the community, the recent sample or hospital patients turned out to be more seriously and persistently ill. In spite of this, long-term results were similar to those obtained during an earlier period, possibly because of more effective aftercare and maintenance therapy with antidepressant drugs, which had in the meantime been introduced.

This article describes a method for the modification of paper with single-wall carbon nanohorns (SWCNHs) to form stable suprastructures. The SWCNHs form stable dahlia-like aggregates in solution that are then self-assembled into superior structures if the solvent is evaporated. Dipping paper sections into a dispersion of SWCNHs leads to the formation of a thin film that can be used for microextraction purposes. The coated paper can be easily handled with a simple pipette tip, paving the way for disposable extraction units. As a proof of concept, the extraction of antidepressants from urine and their determination by direct infusion mass spectrometry is studied. Limits of detection (LODs) were 10 ng/L for desipramine, amitriptyline, and mianserin, while the precision, expressed as a relative standard deviation, was 7.2%, 7.3%, and 9.8%, respectively. [ABSTRACT FROM AUTHOR]

In 1996, when I was prescribed an antidepressant, there was already published research that showed selective serotonin reuptake inhibitors (SSRIs), commonly known as antidepressants, caused withdrawal effects.[1] However, at that time, the Defeat Depression campaign had successfully created a narrative adopted by most prescribers, in which anxiety or depression were described to the patient as caused by a "chemical imbalance in the brain" and that SSRIs were safe, effective, and non-addictive. This systematic review establishes that more than half (56%) of people who attempt to come off antidepressants experience withdrawal effects, with nearly half (46%) of people experiencing withdrawal effects describing them as severe. [Extracted from the article]

Background. The subject of this article is the role of forensic toxicology in post-mortem examinations using immunofluorescence methods, its implications and its role in providing conclusive evidence for both criminal and civil proceedings. The aim of the study is to verify the correlation between the mode of death and the ingestion of exogenous substances and, if positive, to identify the category of substances ingested and assess their role in the cause of death. Materials and methods. A laboratory study was carried out, consisting of several phases: pre-analytical phase; analytical phase; post-analytical phase. The variables analyzed were sex, cause of death, age. Abused substances tested: amphetamines, methamphetamines, barbiturates, benzodiazepines, cocaine, methadone, opiates, tricyclic antidepressants, delta-9-tetrahydrocannabinol (cannabis), alcohol. Conclusions. Retrospective analysis was performed on a total sample of 55 cases. The most relevant data emerged: cocaine with an incidence of 7.3% (4 cases out of 55), amphetamines with 5.4% (3 cases in total). The results of the screening tests were then subjected to confirmatory tests. There is an association between the use of certain exogenous substances and an increased risk of certain causes of death, such as overdose, traffic accidents, cardiovascular deaths, etc. This paper has highlighted the possibility of using first level immunological tests, such as immunofluorescence, to provide preliminary answers to the judicial authority immediately after autopsy, and a quantitative deepening with further second level tests, such as gas chromatography, as a gold standard to determine the cause of death. [ABSTRACT FROM AUTHOR]

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Chronic pain is one of the main leading causes of disability in the world at present. A variety in the symptomatology, intensity and duration of this phenomenon has led to an ever-increasing demand of pharmacological treatment and relief. This demand for medication, ranging from well-known groups, such as antidepressants and benzodiazepines, to more novel drugs, was followed by a rise in safety concerns of such treatment options. The validity, frequency, and diversity of such concerns are discussed in this paper, as well as their possible effect on future prescription practices. A specific caution is provided towards the psychological safety and toll of these medications, regarding suicidality and suicidal ideation. Most significantly, this paper highlights the importance of pharmacovigilance and underscores the necessity of surveillance programs when considering chronic pain medication. [ABSTRACT FROM AUTHOR]

Background: Depression is a mental disorder characterized by a pervasive low mood and loss of pleasure or interest in usual activities, and often results in cognitive dysfunction. The disturbance of cognitive processes associated with depression, especially the impairment of learning and memory, exacerbates illness and increases recurrence of depression. XingPiJieYu (XPJY) is one of the most widely clinical formulas of traditional Chinese medicine (TCM) and can improve the symptoms of depression, including learning and memory. However, its regulatory effects haven't been comprehensively studied so far. Recently, some animal tests have indicated that the cyclic adenosine monophosphate (cAMP)-protein kinase A (PKA)-cAMP response element-binding protein (CREB)-brain derived neurotrophic factor (BDNF) signaling pathway in hippocampus is closely related to depression and the pathogenesis of cognitive function impairments. The present study was performed to investigate the effect and mechanism of XPJY on depression and learning and memory in animal model. Materials: The rat model of depression was established by chronic unpredictable stress (CUS) for 21 days. The rats were randomly divided into six groups: control group, CUS group, CUS + XPJY (1.4 g/kg, 0.7 g/kg and 0.35 g/kg) groups, and CUS + sertraline (10 mg/kg) group. The sucrose preference, open field exploration and Morris water maze (MWM) were tested. The expression of cAMP, CREB, PKA and BDNF protein in hippocampus was examined with Elisa and Western Blot. The mRNA level of CREB and BDNF in hippocampus was measured with PCR. Results: The results demonstrated that rats subjected to CUS exhibited decreases in sucrose preference, total ambulation, percentage of central ambulation, rearing in the open field test and spatial performance in the MWM. CUS reduced the expression of cAMP, PKA, CREB and BDNF in hippocampus of model rats. These effects could be reversed by XPJY. Conclusion: The results indicated that XPJY can improve depression and related learning and memory and the effect of XPJY is partly exerted through the cAMP-PKA-CREB-BDNF signaling pathway. [ABSTRACT FROM AUTHOR]

Background: Depression is a highly heterogeneous disorder, often resulting in suboptimal response and remission rates. This underscores the need for more nuanced clinical characterization of patients to tailor individualized treatment plans. Emerging evidence highlights the critical role of cognitive and emotional dysfunction in major depression, prompting the exploration of novel therapeutic interventions that target these specific symptom domains. Main text: Vortioxetine, a multimodal antidepressant, enhances serotonergic activity while also modulating several other neurotransmitter systems involved in depressive symptoms such as emotional blunting, anhedonia, and cognitive dysfunction. Numerous randomized, placebo-controlled trials have demonstrated vortioxetine's efficacy and safety in treating depression, particularly in specific subgroups of depressed patients, including those with cognitive deficits and comorbid anxiety symptoms or disorders. Although not randomized or placebo-controlled, studies have also shown vortioxetine's efficacy in depressed patients with emotional blunting or anhedonia. Vortioxetine's ability to effectively treat a range of depressive symptoms, including anhedonia, emotional blunting, anxiety, and cognitive dysfunction, provides an individualized treatment solution for depressed individuals suffering from these symptoms. The purpose of this paper is to identify clinical profiles of patients who may benefit from vortioxetine, with the goal of optimizing therapeutic outcomes. Conclusion: Vortioxetine has been shown to be effective for patients with depression and symptoms such as anhedonia, emotional blunting, anxiety, and cognitive dysfunction. Tailoring treatment plans to individual needs and personalizing treatment choices based on the specific symptoms presented by depressed patients improve treatment outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Residency training may lead to the development of depressive conditions with possible academic and professional consequences. We determined the levels of depression in resident medical doctors (RMDs) and assess the factors influencing depression. Methods: This prospective cross-sectional questionnaire study was conducted on RMDs working in tertiary research hospital in İstanbul. Participation in the study was voluntary. A questionnaire was distributed to the RMDs participating in the study, and the Beck Depression Inventory-II (BDI-II) was used to measure depression levels. This study was presented as a paper at the 5th Eurasian Congress on Emergency Medicine and 12th Turkish Emergency Medicine Congress, November 10-13, 2016 (Antalya, Turkey). Results: A total of 161 RMDs were included in the study (participation rate: 68.8%). Of the RMDs, 65 (40.4%) had depressive symptoms (BDI-II >13). An exploratory analysis of possible risk factors showed that working night shifts, length of residency, and department in which the resident worked were factors for the development of depressive symptoms. There was no association between BDI-II scores and age, gender, marital status, number of children, living alone, recent loss of a loved one, presence of chronic illness, diagnosis of depression, or use of antidepressant medication. Conclusion: There is a high prevalence of depressive symptoms among RMDs, especially night workers, who have less experience in their residency. Active assessment of these RMDs to evaluate their depressive symptoms is important. Preventive measures and educational programmes to improve working conditions need to be reviewed. [ABSTRACT FROM AUTHOR]

Background: Given the inconsistencies in current studies regarding the impact of FKBP5 gene polymorphisms on depression, arising from variations in study methods, subjects, and treatment strategies, this paper provides a comprehensive review of the relationship between FKBP5 gene polymorphisms and genetic susceptibility to depression, as well as their influence on response to antidepressant treatment. Methods: Electronic databases were searched up to April 11, 2023, for all literature in English and Chinese on depression, FKBP5 gene polymorphisms, and antidepressant treatment. Data extraction and quality assessment were performed for key study characteristics. Qualitative methods were used to synthesize the study results. Results: A total of 21 studies were included, with the majority exhibiting average to moderate quality. Six SNPs (rs3800373, rs1360780, rs9470080, rs4713916, rs9296158, rs9394309) were broadly implicated in susceptibility to depression, while rs1360780 and rs3800373 were linked to antidepressant treatment sensitivity. Additionally, rs1360780 was associated with adverse reactions to antidepressant drug treatment. However, these associations were largely unconfirmed in replication studies. Conclusions: Depression is recognized as a polygenic genetic disorder, with multiple genes contributing, each exerting relatively small effects. Future studies should explore not only multiple gene interactions but also epigenetic changes. Presently, research on FKBP5 in affective disorders remains notably limited, highlighting the necessity for further investigations in this domain. [ABSTRACT FROM AUTHOR]

Background: This paper investigates whether age of onset of depression, duration of the last episode, number of episodes, and residual symptoms of depression and anxiety are associated with depression relapse in primary care patients who have been on long–term maintenance antidepressant treatment and no longer meet ICD10 criteria for depression. Methods: An observational cohort using data from ANTLER (N = 478), a double-blind placebo-controlled trial. The primary outcome was time to relapse using the retrospective CIS-R. Participants were followed for 12 months. Results: Primary outcome was available for 468 participants. Time to relapse in those with more than five previous episodes of depression was shorter, hazard ratio (HR) 1.84 (95% confidence interval [CI] 1.23–2.75) compared to people with two episodes; HR 1.57 (95% CI 1.01–2.43) after adjustment. The residual symptoms of depression at baseline were also associated with increased relapse: HR 1.05 (95% CI 1.01–1.09) and HR 1.06 (95% CI 1.01–1.12) in the adjusted model. There was evidence of reduced rate of relapse in older age of onset group: HR 0.86 (95% CI 0.78–0.95); HR attenuated after adjustment HR 0.91 (95% CI 0.81–1.02). There was no evidence of an association between duration of the current episode and residual anxiety symptoms with relapse. Conclusions: The number of previous episodes and residual symptoms of depression were associated with increased likelihood of relapse. These factors could inform joint decision making when patients are considering tapering off maintenance antidepressant treatment or considering other treatments to prevent relapse. [ABSTRACT FROM AUTHOR]

Objective: Depression is associated with increased morbidity, mortality and hospital readmission in patients with heart failure (HF). This systematic review aimed to compile studies examining whether the use of antidepressants could improve outcome in patients with HF and concomitant depression. Methods: The electronic libraries Embase, OVID MEDLINE(R) and PsychInfo were used to search the following terms 'heart failure' AND 'anti-depressants'; 'heart failure' AND 'TCA' OR 'SSRI' OR 'SNRI'. The result of this database search was analysed to select papers that satisfied our inclusion criteria. Results: Of the 180 papers found in the original database search, only three met the inclusion criteria. A further two papers were added from hand-searching through the references. Three of these papers are randomised controlled trials (RCT); the other two, cohort studies. All studies show that antidepressants are well tolerated in this group. There was no significant difference in depressive symptoms between the test and placebo. The cardiac outcomes of patients with HF are not improved by the use of antidepressants relative to placebo. Conclusions: Antidepressants are not associated with increased mortality rate as established in previous papers. However, there is inadequate evidence that the use of antidepressants effects significant improvement in depression or cardiac outcomes. [ABSTRACT FROM AUTHOR]

The author comments on the article "The Broad Spectrum of Bipolar Disorder: Implications for Research and Practice," published within the issue of the journal. He agrees with the thesis suggested by the article's authors regarding the importance of bipolar disorder and the diagnostic concerns hindering its early recognition and treatment. However, he disagrees the observation of the author regarding the treatment of bipolar disorders with antidepressants.

Restless legs syndrome (RLS) is sometimes refractory to drug treatment with benzodiazepines, opioids, or dopaminergic agents. Few reports exist in the literature concerning the effect of antidepressants on RLS. Among the antidepressants, trazodone is reported to increase slow-wave sleep. We report on an elderly patient with RLS whose symptoms did not respond to several previous medications. He was treated with trazodone 100 mg h.s. in addition to clonazepam. Trazodone induced obvious improvement of RLS symptoms in the patient. Trazodone demonstrated favorable effects on all sleep complications of RLS. [ABSTRACT FROM AUTHOR]

The article cites a paper on the use of antidepressants by adults, written by Joanna Moncrieff and Irving Kirsch, published in the "British Medical Journal." According to the authors of the paper, prescribing of antidepressants has increased 253 percent over the last ten years. They suggest that review data from the U.S. National Institute for Health and Clinical Excellence indicate that SSRIs show no clinically meaningful advantage over placebo, consistent with some recent metaanalyses. Furthermore, they assert that claims that antidepressants are more effective for treating severe conditions lack supporting evidence.

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Introduction: In pregnancy information to guide mothers and nursing practitioners for the treatment of depression is limited. Purpose: The purpose of this study was to investigate the responses to treatment of depression during pregnancy, in order to enable nurses to know the pros and cons of treatment for guiding and advising a pregnant woman properly. Material and method: Systematic review of the literature. The tools for the search of the literature were the electronic databases (PUBMED, GOOGLE SCHOLAR and CINAHL). The keywords used were: depression during pregnancy, perinatal depression, treatment, antidepressants during pregnancy. Results: In addition to drug therapy, there are alternative forms of depression treatment such as acupuncture, the use of morning light, individual psychotherapy, cognitive behavioral therapy, counseling and end psychodynamic therapy. But no one can guarantee their effectiveness. Conclusions: It should be further explored the issue of the treatment of pregnancy depression. [ABSTRACT FROM AUTHOR]

Objectives: In the burning mouth syndrome (BMS), patients experience a burning sensation in the oral cavity with no associated injury or clinical manifestation. The etiology of this condition is still poorly understood, and therefore, treatment is challenging. The aim of this study is to perform a systematic review of treatment possibilities described in the literature for BMS.Materials and methods: PubMed, Embase, and SciELO databases were searched for randomized clinical trials published between 1996 and 2016.Results: Following application of inclusion and exclusion criteria, 29 papers were analyzed and divided into five subcategories according to the type of treatment described: antidepressants, alpha-lipoic acid, phytotherapeutic agents, analgesic and anti-inflammatory agents, and non-pharmacological therapies. In each category, the results found were compared with regard to the methodology employed, sample size, assessment method, presence or absence of adverse effects, and treatment outcomes.Conclusions: The analysis revealed that the use of antidepressants and alpha-lipoic acid has been showing promising results; however, more studies are necessary before we can have a first-line treatment strategy for patients with BMS.Clinical relevance: To review systematically the literature about Burning Mouth Syndrome treatment may aid the clinicians to choose the treatment modality to improve patients symptoms based on the best evidence. [ABSTRACT FROM AUTHOR]

AbstractBackground:Quality of life (QoL) measurement in medicine has gone a long way. It has gained popularity as a more humanitarian outcome measurement. In this paper, a review is given of its historical backgrounds with a special focus on the use of QoL assessment in psychiatry. Different theoretical concepts are discussed. A closer look is taken at the use of QoL measurements in antidepressant trials. Methods:An analysis was performed on the use of QoL measurement in recent antidepressant trials of duloxetine and escitalopram. Results:QoL measurement was found to have abandoned its initial purposes, and to have been used without any theoretical framework. Conclusions:Although frequently used in antidepressant trials, the analysis and reporting of results is virtually non-existent. It remains unclear if QoL measurement, as currently used, gives any information that is not already captured by more formal depression rating scales. The question then remains whether QoL measurement in antidepressant trials has any added value and, if so, whether this is just a story of missed opportunities.Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Depression is a prevalent mental disorder. However, clinical treatment options primarily based on chemical drugs have demonstrated varying degrees of adverse reactions and drug resistance, including somnolence, nausea, and cognitive impairment. Therefore, the development of novel antidepressant medications that effectively reduce suffering and side effects has become a prominent area of research. Polysaccharides are bioactive compounds extracted from natural plants that possess diverse pharmacological activities and medicinal values. It has been discovered that polysaccharides can effectively mitigate depression symptoms. This paper provides an overview of the pharmacological action and mechanisms, intervention approaches, and experimental models regarding the antidepressant effects of polysaccharides derived from various natural sources. Additionally, we summarize the roles and potential mechanisms through which these polysaccharides prevent depression by regulating neurotransmitters, HPA axis, neurotrophic factors, neuroinflammation, oxidative stress, tryptophan metabolism, and gut microbiota. Natural plant polysaccharides hold promise as adjunctive antidepressants for prevention, reduction, and treatment of depression by exerting their therapeutic effects through multiple pathways and targets. Therefore, this review aims to provide scientific evidence for developing polysaccharide resources as effective antidepressant drugs. [ABSTRACT FROM AUTHOR]

Introduction: Current evidence reveals concerning rates of non-adherence to antidepressant treatment, possibly influenced by various relevant determinants such as sociodemographic factors or those related to the health system and their professionals. The aim of this paper is to review the scientific evidence on sociodemographic and clinical predictors of adherence to pharmacological treatment in patients diagnosed with a depressive disorder. Methods: a systematic review (SR) was conducted. The search for a previous SR was updated and de novo searches were performed in Medline, EMBASE, Web of Science (WoS) and PsycInfo (last 10 years). The risk of bias was assessed using the Cochrane tool for non-randomized studies-of Exposure (ROBINS-E). Meta-analyses were conducted. Results: Thirty-nine studies (n = 2,778,313) were included, 24 of them in the meta-analyses. In the initiation phase, no association of adherence was found with any of the predictors studied. In the implementation and discontinuation phases, middle-aged and older patients had better adherence rates and lower discontinuation rates than younger ones. White patients adhered to treatment better than African-American patients. Discussion: Age and ethnicity are presented as the predictive factors of pharmacological adherence. However, more research is needed in this field to obtain more conclusive results on other possible factors. [ABSTRACT FROM AUTHOR]