Depression Treatment: Hypoxic Ventilatory Response in Tac1 -/- Neonatal Mice Following Exposure to Opioids.

Hypoxic ventilatory response in Tac1 -/- neonatal mice following exposure to opioids.

Filed under: Depression Treatment

J Appl Physiol. 2012 Oct 11;
Berner J, Shvarev Y, Zimmer A, Wickström R

Morphine is the dominating analgetic drug used in neonates, but opioid-induced respiratory depression limits its therapeutic use. In this study, we examined acute morphine effects on respiration during intermittent hypoxia in newborn Tac1-gene knock-out mice (Tac1 -/-) lacking substance P and neurokinin A. In vivo, plethysmography revealed a blunted hypoxic ventilatory response (HVR) in Tac1 -/- mice. Morphine (10mg/kg) depressed the HVR in wild type animals through an effect on respiratory frequency, whereas it increased tidal volumes in Tac1 -/- during hypoxia, resulting in increased minute ventilation. Apneas were reduced during the first hypoxic episode in both morphine-exposed groups, but were restored subsequently in Tac1 -/- mice. Morphine did not affect ventilation or apnea prevalence during baseline conditions. In vitro, morphine (50 nM) had no impact on anoxic response of brainstem preparations of either strain. In contrast, it suppressed the inspiratory rhythm during normoxia and potentiated development of post-hypoxic neuronal arrest, especially in Tac1 -/-. Thus, this phenotype has a higher sensitivity to the depressive effects of morphine on inspiratory rhythm generation, but morphine does not modify the reactivity to oxygen deprivation. In conclusion, although Tac1 -/- mice are similar to wild-type animals during normoxia, they differed by displaying a reversed pattern with an improved HVR during intermittent hypoxia both in vivo and in vitro. These data suggest that opioids and the substance P-ergic system interact in the hypoxic ventilatory response and that reducing the activity in the tachykinin system may alter the respiratory effects of opioid treatment in newborns.
HubMed – depression

[Emotional Impact of Facial Palsy.]

Filed under: Depression Treatment

Laryngorhinootologie. 2012 Oct 12;
Dobel C, Miltner WH, Witte OW, Volk GF, Guntinas-Lichius O

Facial palsy is not only a movement disorder but leads also to an emotional and communicative disorder in chronic stage but also in some patients already during the acute phase of the disease. The present review describes the current knowledge of the neurobiological and psychological fundamentals on the relation of facial movement and its emotional context. So far there is not much knowledge on the impact of a facial palsy on the interaction between facial movement, emotional processing and communicative skills of the patient. The emotional contagion seems to be reduced in patients with facial palsy. The ability to express emotions seems also to be reduced. Moreover, the patients feel to be perceived negatively. In fact, most of the expressions of patients with facial palsy are allocated with a negative affect even when the patients are smiling. Patients with facial palsy react with negative stress, anxiety and depression. The patients avoid social contacts. In turn, this reinforces the communicative disorder. The otorhinolaryngologist can use the Facial Disability Index as a simple questionnaire to detect such dysfunctions. Diagnostics that are necessary to develop a therapy program are presented in this review. Standardized therapy concepts that are not only treat the movement disorder but also the emotional context is missing so far. Finally, the review will give an outlook on potential therapy strategies.
HubMed – depression

An Update on Antidepressant Use in Bipolar Depression.

Filed under: Depression Treatment

Curr Psychiatry Rep. 2012 Oct 16;
Sidor MM, Macqueen GM

The effective treatment of depression in people with bipolar disorder remains a clinical challenge. The role of antidepressant medication in treating bipolar depression has been controversial. While early studies and meta-analyses supported a role for antidepressant medication, more recent, high quality randomized controlled trials in bipolar depression have generally not demonstrated efficacy for antidepressant medications. Although the risk of affective switch and long-term de-stabilization remains a concern when using antidepressant medications in bipolar disorder, the magnitude of this risk has been difficult to ascertain with confidence. Maintenance use of antidepressant medication has generally not demonstrated a favorable risk-benefit ratio. Future studies should explore the patient characteristics and response patterns that predict a more favorable response profile to antidepressants amongst patients with bipolar disorder so that the medications can be rationally used in those who are most likely to benefit.
HubMed – depression

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