The Journal of clinical psychiatry
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Randomized Controlled Trial Comparative Study
Brain-derived neurotrophic factor and initial antidepressant response to an N-methyl-D-aspartate antagonist.
A model has been proposed to explain the pathophysiology of mood disorders based on decreased neurotrophin levels during mood episodes; treatment with antidepressants and mood stabilizers is associated with clinical improvement. This study investigated whether changes in brain-derived neurotrophic factor (BDNF) levels are associated with the initial antidepressant effects of ketamine, a high-affinity N-methyl-D-aspartate (NMDA) antagonist. ⋯ This study demonstrates that ketamine's rapid initial antidepressant effects are not mediated by BDNF. Further studies are necessary to shed light on the neurobiological basis of these effects.
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Untreated early-onset bipolar disorder is associated with higher rates of rapid cycling, more comorbidity, and more severe mania and depression than adult-onset bipolar disorder. Correctly diagnosing bipolar disorder early in its course can prevent exposing a young patient to treatments that may exacerbate or advance the progression of the disorder. Appropriate pharmacologic and psychosocial interventions are necessary in the acute treatment of pediatric bipolar disorder.
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Comparative Study
Current prescription patterns and safety profile of irreversible monoamine oxidase inhibitors: a population-based cohort study of older adults.
To determine the prescription pattern and safety profile for irreversible monoamine oxidase inhibitors (MAOIs) in older adults over the past decade. ⋯ The low prescription rate of MAOIs is not consistent with the continued recommendation of MAOIs by expert opinion leaders and consensus guidelines for use in atypical depression and treatment-refractory depression. While their use appeared safe, heightened awareness of the potential risk of concomitant use of serotonergic agents is necessary. Relative underuse of the MAOIs for a significant subgroup of depressed patients with atypical and treatment-refractory depression remains a concern.