Arch Gen Psychiat
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Randomized Controlled Trial Clinical Trial
Attenuation of the neuropsychiatric effects of ketamine with lamotrigine: support for hyperglutamatergic effects of N-methyl-D-aspartate receptor antagonists.
The cognitive, behavioral, and mood effects of N-methyl-D-aspartate (NMDA) receptor antagonists, such as phencyclidine and ketamine, have been used to study the effects of NMDA receptor dysfunction. Pharmacological modulation of the effects of NMDA receptor antagonists, such as ketamine, may lead to development of novel therapeutic agents for psychiatric illnesses such as schizophrenia. Preclinical studies indicate that some ketamine effects may be mediated through increased glutamate release. In this study, we tested the hypothesis that lamotrigine, a drug reported to inhibit glutamate release, will reduce the neuropsychiatric effects of ketamine in humans. ⋯ Glutamate release-inhibiting drugs may reduce the hyperglutamatergic consequences of NMDA receptor dysfunction implicated in the pathophysiologic processes of neuropsychiatric illnesses such as schizophrenia. Further study is needed.
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Randomized Controlled Trial Clinical Trial Controlled Clinical Trial
Executive dysfunction and long-term outcomes of geriatric depression.
This study investigated the relationship of executive and memory impairment to relapse, recurrence, and course of residual depressive symptoms and signs after remission of geriatric major depression. ⋯ Executive dysfunction was found to be associated with relapse and recurrence of geriatric major depression and with residual depressive symptoms. These observations, if confirmed, will aid clinicians in identifying patients in need of vigilant follow-up. The findings of this study provide the rationale for investigation of the role of specific prefrontal pathways in predisposing or perpetuating depressive syndromes or symptoms in elderly patients.
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Growing evidence indicates that anxiety and depressive disorder onset may involve a prodromal buildup of symptoms. Also, stressful life events may precipitate gradual symptom increase, leading to the development of full-blown disorders. This study used prospective longitudinal data to examine the theory that, over time, stressful events, such as parent-adolescent disagreements, influence the longitudinal course of adolescents' internalizing symptoms, which in turn predict first onset of a depressive or anxiety disorder. ⋯ Among adolescents, persistent or escalating stressful events, such as disagreements with parents, indirectly increase the risk for internalizing disorder onset through their direct association with high or increasing symptom levels. Chronically high or increasing symptom levels directly increase risk for internalizing disorder.
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Comparative Study
Prefrontal dysfunction and treatment response in geriatric depression.
This study investigated the relationship of clinical, neuropsychological, and electrophysiological measures of prefrontal dysfunction with treatment response in elderly patients with major depression. ⋯ Prefrontal dysfunction was associated with poor or delayed antidepressant response in depressed elderly patients. This observation, if confirmed, may aid clinicians in identifying candidates for aggressive somatic therapies and for interventions offering structure of daily activities.