Biomarkers and the Future of Treatment for Depression.

Biomarkers and the Future of Treatment for Depression.

Cerebrum. 2012 5; 2012: 6
Toups M, Trivedi MH

Doctors have a variety of drug options for treatment of depression. But there is currently no way to determine which antidepressant will work best for a given patient, which means that many people continue to suffer while their doctors try a series of medications. As Marisa Toups and Madhukar H. Trivedi write, however, many researchers have focused their efforts on developing biomarkers for depression-tests for aspects of a patient’s physiology that can predict a clinical outcome. In the future, doctors may be able to screen patients to determine which treatment options will work for them, reducing the time a patient must continue to live with the effects of depression. HubMed – depression

The external validity of MRI-defined vascular depression.

Int J Geriatr Psychiatry. 2013 Feb 28;
Pimontel MA, Reinlieb ME, Johnert LC, Garcon E, Sneed JR, Roose SP

OBJECTIVE: Multiple diagnostic criteria have been used to define vascular depression (VD). As a result, there are discrepancies in the clinical characteristics that have been established for the illness. The aim of this study was twofold. First, we used empirically established diagnostic criteria to determine the clinical characteristics of magnetic resonance imaging (MRI)-defined VD. Second, we assessed the agreement between a quantitative and qualitative method for identifying the illness. METHOD: We examined the baseline clinical and neuropsychological profile of 38 patients from a larger, double-blind, randomized, 12-week clinical trial comparing nortriptyline with sertraline in depressed older adults. Ten patients met quantitative criteria for MRI-defined VD based on the highest quartile of deep white matter hyperintensity (DWMH) volume. Fourteen patients met qualitative criteria for MRI-defined VD based on a DWMH score of 2 or higher on the Fazekas’ modified Coffey rating scale. RESULTS: Age, gender, cumulative illness rating scale-geriatric (CIRS-G) score, two measures of psychomotor retardation [the psychomotor retardation item of the Hamilton Rating Scale for Depression (HRSD) as well as performance on the Purdue Pegboard], and performance on the Stroop Color/Word test (a measure of the response inhibition component of executive functioning) were significantly different between those with VD and non-VD. CONCLUSIONS: Patients with VD have a distinct clinical and neuropsychological profile that is mostly consistent across different methods for identifying the illness. These findings support the notion that MRI-defined VD represents a unique and valid subtype of late-life depression. Copyright © 2013 John Wiley & Sons, Ltd. HubMed – depression

Does antidepressant medication use affect persistence with diabetes medicines?

Pharmacoepidemiol Drug Saf. 2013 Feb 28;
Caughey GE, Preiss AK, Vitry AI, Gilbert AL, Ryan P, Shakib S, Esterman A, McDermott RA, Roughead EE

PURPOSE: This study aimed to examine the effect of antidepressant use on persistence with newly initiated oral antidiabetic medicines in older people. METHODS: A retrospective study of administrative claims data from the Australian Government Department of Veterans’ Affairs, from 1 July 2000 to 30 June 2008 of new users of oral antidiabetic medicines (metformin or sulfonylurea). Antidepressant medicine use was determined in the 6?months preceding the index date of the first dispensing of an oral antidiabetic medicine. The outcome was time to discontinuation of diabetes therapy in those with antidepressant use compared with those without. Competing risks regression analyses were conducted with adjustment for covariates. RESULTS: A total of 29?710 new users of metformin or sulfonylurea were identified, with 7171 (24.2%) dispensed an antidepressant. Median duration of oral antidiabetic medicines was 1.81?years (95% CI 1.72-1.94) for those who received an antidepressant at the time of diabetes medicine initiation, by comparison to 3.23?years (95% CI 3.10-3.40) for those who did not receive an antidepressant. Competing risk analyses showed a 42% increased likelihood of discontinuation of diabetes medications in persons who received an antidepressant (subdistribution hazard ratio 1.42, 95% CI 1.37-1.47, p?HubMed – depression

White matter integrity affected by depressive symptoms in migraine without aura: a tract-based spatial statistics study.

NMR Biomed. 2013 Feb 27;
Yu D, Yuan K, Zhao L, Dong M, Liu P, Yang X, Liu J, Sun J, Zhou G, Xue T, Zhao L, Cheng P, Dong T, von Deneen KM, Qin W, Tian J

Previous studies have proven that migraine and depression are bidirectionally linked. However, few studies have investigated white matter (WM) integrity affected by depressive symptoms in patients suffering from migraine without aura (MWoA). Forty patients with MWoA were divided into two groups according to their self-rating depression scale (SDS) score in the present study, including 20 in the SDS (+) (SDS?>?49) group and 20 in the SDS (-) (SDS???49) group. Forty healthy participants were also recruited as the control group. Tract-based spatial statistics analyses with multiple diffusion tensor imaging-derived indices [fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD)] were employed collectively to investigate WM integrity between all patients with MWoA and all healthy controls, between each subgroup (SDS (-) group and SDS (+) group) and healthy controls, and between the SDS (-) and SDS (+) groups. Compared with healthy controls, decreased AD was shown in several WM tracts of the whole MWoA group, SDS (-) group and SDS (+) group. In addition, compared with the SDS (-) group, the SDS (+) group showed decreased FA and increased MD and RD, with conserved AD, including the genu, body and splenium of the corpus callosum, bilateral superior longitudinal fasciculi, the right anterior corona radiata and some other WM tracts, similar to previous findings in depression disorder. Furthermore, mean FA and RD in some of the above-mentioned WM tracts in the SDS (+) group were correlated significantly with SDS scores, including the genu and splenium of the corpus callosum, the right anterior corona radiata and the superior longitudinal fasciculi. Our results suggest that WM integrity may be affected by both depression symptoms (more sensitive as RD) and migraine (more sensitive as AD). The findings may serve as a sensitive biomarker of depression severity in MWoA. Copyright © 2013 John Wiley & Sons, Ltd. HubMed – depression

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