Depression Treatment: Escitalopram for the Management of Major Depressive Disorder: A Review of Its Efficacy, Safety, and Patient Acceptability.

Escitalopram for the management of major depressive disorder: a review of its efficacy, safety, and patient acceptability.

Filed under: Depression Treatment

Patient Prefer Adherence. 2012; 6: 853-61
Kirino E

Escitalopram (escitalopram oxalate; Cipralex(®), Lexapro(®)) is a selective serotonin reuptake inhibitor (SSRI) used for the treatment of major depressive disorder (MDD) and anxiety disorder. This drug exerts a highly selective, potent, and dose-dependent inhibitory effect on the human serotonin transport. By inhibiting the reuptake of serotonin into presynaptic nerve endings, this drug enhances the activity of serotonin in the central nervous system. Escitalopram also has allosteric activity. Moreover, the possibility of interacting with other drugs is considered low. This review covers randomized, controlled studies that enrolled adult patients with MDD to evaluate the efficacy of escitalopram based on the Montgomery-Asberg Depression Rating Scale and the Hamilton Depression Rating Scale. The results showed that escitalopram was superior to placebo, and nearly equal or superior to other SSRIs (eg, citalopram, paroxetine, fluoxetine, sertraline) and serotonin-noradrenaline reuptake inhibitors (eg, duloxetine, sustained-release venlafaxine). In addition, with long-term administration, escitalopram has shown a preventive effect on MDD relapse and recurrence. Escitalopram also showed favorable tolerability, and associated adverse events were generally mild and temporary. Discontinuation symptoms were milder with escitalopram than with paroxetine. In view of the patient acceptability of escitalopram, based on both a meta-analysis and a pooled analysis, this drug was more favorable than other new antidepressants. The findings indicate that escitalopram achieved high continuity in antidepressant drug therapy.
HubMed – depression

Frequency of cognitive impairment and depression in Parkinson’s disease: A preliminary case-control study.

Filed under: Depression Treatment

Niger Med J. 2012 Apr; 53(2): 65-70
Ojo OO, Okubadejo NU, Ojini FI, Danesi MA

This study aimed to determine the frequency of cognitive impairment and depression in our Parkinson’s Disease (PD) and their relationship with disease severity and disability.A total of 40 PD patients and 40 age-, sex-, and educationally matched controls were studied. The Unified Parkinson Disease Rating Scale (UPDRS) Motor and Activities of Daily Living (ADL) scores and the Hoehn and Yahr (HY) stage were documented. Depression was assessed using the Zung Self-Rating Depression Scale (ZSDS), while cognition was evaluated using a composite score of the mini-mental state examination (MMSE) score and category fluency score.A total of 55% (22/40) of PD and 10% (4 of 40) of controls had depression (P<0.001). A total of 60% of PD (24/40) and 5% of controls (2/40) had cognitive impairment (P<0.001). Both NMS coexisted in 16 of 40 PD (40%) compared with none of the controls (P<0.001). UPDRS (motor and ADL) scores and HY stage were significantly worse with impaired ZSDS scores - P 0.001. UPDRS ADL was significantly impaired by the presence of cognitive impairment. Coexisting depression and cognitive impairment were associated with significant worsening of all scores of severity and disability.Cognitive impairment and depression accompany our PD and are related to disability and worsening disease severity. HubMed – depression

Infarct Size Determines Myocardial Uptake of CD34+ Cells in the Peri-Infarct Zone: Results from a Study of 99mTc-extamatazime-labeled Cells Visualization Integrated with Cardiac Magnetic Resonance Infarct Imaging.

Filed under: Depression Treatment

Circ Cardiovasc Imaging. 2012 Dec 27;
Musialek P, Tekieli L, Kostkiewicz M, Miszalski-Jamka T, Klimeczek P, Mazur W, Szot W, Majka M, Banys RP, Jarocha D, Walter Z, Krupinski M, Pieniazek P, Olszowska M, Zmudka K, Pasowicz M, Kereiakes DJ, Tracz W, Podolec P, Wojakowski W

BACKGROUND: -Effective progenitor cell recruitment to ischemic injury zone is a prerequisite for any potential therapeutic effect. Cell uptake determinants in humans with recent MI are not defined. We tested the hypothesis that myocardial uptake of autologous CD34(+) cells delivered intracoronary after recent MI is related to LVEF and infarct size (IS). METHODS AND RESULTS: -Thirty-one subjects (age 36-69 years, 28 men) with pPCI-treated anterior STEMI and significant myocardial injury (peak TnI 138 [58-356ng/dL]; median [limits]) and sustained LVEF depression at ?45%) were recruited. On day 10 [7-12], 4.3×10(6) [0.7-9.9×10(6)] (99m)Tc-extametazime-labeled autologous bone-marrow CD34(+) cells (activity 77 [45.9-86.7]MBq) were administered transcoronary (LAD). (99m)Tc-MIBI-SPECT prior to cell delivery showed 7 [2-11] (of 17) segments with definitely-abnormal/absent perfusion. Gadolinium late-enhanced infarct core (LGE(CORE)) mass was 21.7 [4.4-45.9]g and infarct border-zone mass (LGE(IBZ)) was 29.8 [3.9-60.2]g (full-width-at-half-maximum, FWHM, signal intensity thresholding algorithm). One hour after administration, 5.2% [1.7-9.9%] of labeled cells activity localized in the myocardium (whole-body planar ?-scan). Image fusion of labeled cells SPECT with LV perfusion SPECT or with cMRI infarct imaging indicated cell uptake in the peri-infarct zone. Myocardial uptake of labeled cells activity correlated in particular with LGE(IBZ) (r=0.84, p<0.0001) and with peak TnI (r=0.76, p<0.001); it also correlated with severely-abnormal/absent perfusion segments number (r=0.45, p=0.008 and LGE(CORE) (r=0.58 and r=0.84, p<0.0001) but not with echo-LVEF (r=-0.07, p=0.68) or GSPECT-LVEF (r=-0.28, p=0.16). The correlation with cMRI-LVEF was weak (r=-0.38, p=0.04). CONCLUSIONS: -This largest human study with labeled bone marrow CD34(+) cells transcoronary transplantation after recent STEMI found that myocardial cell uptake is determined by infarct size rather than LVEF, and it occurs preferentially in the peri-infarct zone. HubMed – depression

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