934 articles - 10.09.10
1: Eur J Pharmacol. 2010 Sep 3; [Epub ahead of print]
Laino CH, Fonseca C, Sterin-Speziale N, Slobodianik N, Reines A.
Instituto de Investigaciones en Ciencias de la Salud Humana (IICSHUM), Departamento de Ciencias Exactas, Fisicas y Naturales, Universidad Nacional de La Rioja, Argentina.
Despite the advances in psychopharmacology, the treatment of depressive disorders is still not satisfactory. Side effects and resistance to antidepressant drugs are the greatest complications during treatment. Based on recent evidence, omega-3 fatty acids may influence vulnerability and outcome in depressive disorders. The aim of this study was to further characterize the omega-3 antidepressant-like effect in rats in terms of its behavioral features in the depression model forced swimming test either alone or in combination with antidepressants fluoxetine or mirtazapine. Ultimately, we prompted to determine the lowest dose at which omega-3 fatty acids and antidepressant drugs may still represent a pharmacological advantage when employed in combined treatments. Chronic diet supplementation with omega-3 fatty acids produced concentration-dependent antidepressant-like effects in the forced swimming test displaying a behavioral profile similar to fluoxetine but different from mirtazapine. Fluoxetine or mirtazapine at antidepressant doses (10 and 20mg/kg/day, respectively) rendered additive effects in combination with omega-3 fatty acid supplementation (720mg/kg/day). Beneficial effects of combined treatment were also observed at sub-effective doses (1mg/kg/day) of fluoxetine or mirtazapine, since in combination with omega-3 fatty acids (720mg/kg/day), antidepressants potentiated omega-3 antidepressant-like effects. The antidepressant-like effects occurred in the absence of changes in brain phospholipid classes. The therapeutic approach of combining omega-3 fatty acids with low ineffective doses of antidepressants might represent benefits in the treatment of depression, especially in patients with depression resistant to conventional treatments and even may contribute to patient compliance by decreasing the magnitude of some antidepressant dose-dependent side effects. Copyright (c) 2010. Published by Elsevier B.V.
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PMID: 20826148 [PubMed - as supplied by publisher]2: Prostaglandins Leukot Essent Fatty Acids. 2010 Sep 1; [Epub ahead of print]
McNamara RK, Jandacek R, Rider T, Tso P, Cole-Strauss A, Lipton JW.
Department of Psychiatry, University of Cincinnati College of Medicine, 260 Stetson Street, Suite 3306, Cincinnati, OH 45219-0516, USA.
Omega-3 (n-3) fatty acid deficiency, elevated inflammatory signaling, and central serotonin (5-HT) turnover have separately been implicated in the pathophysiology of major depressive disorder (MDD). In the present study we investigated the interrelationship between n-3 fatty acid status, pro-inflammatory signaling activity, and central 5-HT turnover in vivo. Rats were fed diets with or without the n-3 fatty acid precursor alpha-linolenic acid (ALA) during perinatal development (E0-P100), and a subset of rats fed the ALA- diet were switched to the ALA+ diet post-weaning (P21-P100, repletion). In adulthood (P100), plasma interleukin-6 (IL-6), tumor necrosis factor-alpha (TNFalpha), and C-reactive protein (CRP) levels were measured. Additionally, indices of liver n-6 fatty acid biosynthesis, erythrocyte fatty acid composition, and regional brain monoamine turnover were determined. Indices of liver delta-6 desaturase activity were up-regulated in n-3-deficient rats, and were associated with greater erythrocyte membrane arachidonic acid (AA, 20:4 n-6) composition. Plasma IL-6 (p=0.001), TNFalpha (p=0.02), and CRP (p=0.001) concentrations were significantly greater in n-3-deficient rats relative to controls. The 5-HIAA/5-HT ratio was significantly greater in frontal cortex, hypothalamus, and ventral striatum of n-3-deficient rats relative to controls. Changes in membrane n-3 and n-6 fatty acid composition, elevations in plasma IL-6 and TNFalpha, and increased central 5-HT turnover were all prevented by normalization of n-3 fatty acid status. Erythrocyte docosahexaenoic acid (DHA, 22:6 n-3) was inversely correlated, and AA and the AA/DHA and AA/eicosapentaenoic acid ratios were positively correlated, with plasma IL-6, TNFalpha, and CRP levels. Plasma IL-6 levels were positively correlated with 5-HIAA/5-HT ratios in all brain regions. These preclinical data provide evidence for a functional link between n-3 fatty acid deficiency, elevated peripheral inflammatory signaling, and increased central 5-HT turnover. Copyright (c) 2010 Elsevier Ltd. All rights reserved.
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PMID: 20817496 [PubMed - as supplied by publisher]3: Pharmacotherapy. 2010 Sep;30(9):928-41.
Ng RC, Hirata CK, Yeung W, Haller E, Finley PR.
Department of Clinical Pharmacy, School of Pharmacy, University of California at San Francisco, San Francisco, California 94118, USA.
During the past decade, the medical community has expressed a growing concern over the high prevalence of postpartum depression and the tragic repercussions of untreated illness. However, many questions persist about the pathogenesis of postpartum depression, the natural course of the illness, and the safety and effectiveness of available treatments. To summarize the data on pharmacologic treatments for postpartum depression, we performed a systematic review of four major databases to identify original research published from 1960-September 2009 that featured pharmacologic treatments for depression detected in women during the 12 months after delivery. Pharmacologic treatments included prescription drugs (antidepressants and hormones), herbal remedies, and dietary supplements. Case reports, studies examining the prevention of postpartum depression, and those including diagnosed episodes of depression preceding the postpartum period (i.e., antepartum onset) were excluded. Treatment randomization or the presence of a control group was not required for inclusion in this review. Fourteen investigations met inclusion criteria. Nine studies examined the effects of prescription antidepressants, two investigated hormones, and three featured omega-3 fatty acid supplementation. Significant heterogeneity was evident in study design and prevented a pooled quantitative analysis of treatment effects. The power of most investigations was limited, and numerous confounding biases were evident. Therapeutic effects were documented for prescription antidepressants and hormone supplementation (estrogen derivatives). Tolerability of the interventions in depressed mothers and breastfed infants was not well described. The effectiveness of omega-3 fatty acids was not evident in postpartum depression trials, although significant limitations in study methodology were apparent. Postpartum depression is a common and serious medical problem, but most cases go undetected and untreated. The need to identify safe, effective, and convenient treatments for postpartum depression is urgent, but the current state of the medical literature describing pharmacologic interventions is not impressive. Preliminary evidence documenting the effectiveness of serotonergic antidepressants and hormone supplementation should serve as an impetus for rigorous controlled investigations in the future.
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PMID: 20795848 [PubMed - in process]4: Schizophr Res. 2010 Aug 19; [Epub ahead of print]
Preti A, Cella M.
Centro Medico Genneruxi, Via Costantinopoli 42, 09129 Cagliari, Italy.
As an extension of the early intervention in psychosis paradigm, different focused treatments are now offered to individuals at ultra high risk of psychosis (UHR) to prevent transition to schizophrenia, however the effectiveness of these treatments is unclear. A systematic literature search in PubMed/Medline and PsycINFO was performed to derive information on randomized control trials (RCTs) in UHR samples. Seven reports were identified detailing results from five independent RCT studies. Two studies used antipsychotic drugs (one in combination with cognitive behavior therapy); one study employed cognitive therapy; one study used a two-year program of intensive community care with family psychoeducation; one study assessed the effectiveness of 3-months omega-3 polyunsaturated fatty acids (Omega-3 PUFAs) supplementation. Intensive community care and the Omega-3 PUFAs supplementation were effective in reducing the transition to psychosis at 12months. Overall, rates of transition to psychosis at 1year were 11% for focused treatment groups (n=180) and 31.6% for control UHR groups (n=157). Receiving any of the focused treatment was associated with a lower risk of developing psychosis if compared with no treatment or treatment as usual (Relative Risk=0.36; 95%CI: 0.22-0.59). The available evidence at 2/3years follow-up indicates that the effects of focused treatments are not stable after intervention cessation and when treatment is delivered over a restricted time (e.g. 6months or less), it may achieve only a delay in psychosis onset. Due to the heterogeneity in the interventions considered, the current results do not allow recommendation for any specific treatment. Copyright (c) 2010 Elsevier B.V. All rights reserved.
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PMID: 20727717 [PubMed - as supplied by publisher]5: Psychosom Med. 2010 Aug 17; [Epub ahead of print]
Carney RM, Freedland KE, Stein PK, Steinmeyer BC, Harris WS, Rubin EH, Krone RJ, Rich MW.
Departments of Psychiatry (R.M.C., K.E.F., B.C.S., E.H.R.) and Medicine (P.K.S., R.J.K., M.W.R.), Washington University School of Medicine, Saint Louis, Missouri; Cardiovascular Health Research Center (W.S.H.), Sanford Research, University of South Dakota, Sioux Falls, South Dakota.
Objective: To determine whether omega-3 fatty acid (FA) increases the natural log of very low frequency (lnVLF) power, an index of heart rate variability (HRV), and reduces 24-hour heart rate (HR) in depressed patients with coronary heart disease (CHD). Low intake of omega-3 FAs is associated with depression and with low HRV, and all three are associated with an increased risk of death in patients with CHD. Methods: Thirty-six depressed patients with CHD randomized to receive 50 mg of sertraline and 2 g of omega-3/day, and 36 randomized to sertraline and a placebo, had 24-hour HRV measured at baseline and after 10 weeks of treatment. Results: There was a significant treatment x time interaction for covariate adjusted lnVLF (p = .009), for mean 24-hour HR (p = .03), and for 1-minute resting HR (p = .02). The interaction was not significant for three other measures of HRV. LnVLF did not change over time in the omega-3 arm but decreased in the placebo arm (p = .002), suggesting that omega-3 may have prevented or slowed deterioration in cardiac autonomic function. Conclusions: The effects of omega-3 FAs on lnVLF and HR, although modest, were detected after only 10 weeks of treatment with 2 g per day of omega-3. Whether a longer course of treatment or a higher dose of omega-3 would further decrease HR, improve other indices of HRV, or reduce mortality in depressed CHD patients should be investigated.
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PMID: 20716712 [PubMed - as supplied by publisher]6: Pediatrics. 2010 Sep;126(3):e623-30. Epub 2010 Aug 16.
Murakami K, Miyake Y, Sasaki S, Tanaka K, Arakawa M.
Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-0033, Japan. kenmrkm@m.u-tokyo.ac.jp.
BACKGROUND: Epidemiologic evidence on the role of fish and long-chain n-3 polyunsaturated fatty acid intake on depression during adolescence is sparse. OBJECTIVE: We examined the association between fish, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) intake and depressive symptoms in a group of adolescents. SUBJECTS AND METHOD: This cross-sectional study, conducted in all public junior high schools in Naha City and Nago City, Okinawa, Japan, included 3067 boys and 3450 girls aged 12 to 15 years (52.3% of the eligible sample). Dietary intake was assessed by using a validated, self-administered diet-history questionnaire. Depressive symptoms were defined as present when participants had a Center for Epidemiologic Studies Depression scale score of >/=16. RESULTS: The prevalence of depressive symptoms was 22.5% for boys and 31.2% for girls. For boys, fish intake was inversely associated with depressive symptoms (adjusted odds ratio [OR] for depressive symptoms in the highest [compared with the lowest] quintile of intake: 0.73 [95% confidence interval (CI): 0.55-0.97]; P for trend = .04). EPA intake showed an inverse association with depressive symptoms (OR: 0.71 [95% CI: 0.54-0.94]; P = .04). DHA intake also showed a similar inverse, albeit nonsignificant, association (OR: 0.79 [95% CI: 0.59-1.05]; P = .11). In addition, intake of EPA plus DHA was inversely associated with depressive symptoms (OR: 0.72 [95% CI: 0.55-0.96]; P = .08). Conversely, no such associations were observed among girls. CONCLUSIONS: Higher intake of fish, EPA, and DHA was independently associated with a lower prevalence of depressive symptoms in early male, but not female, adolescents.
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PMID: 20713476 [PubMed - in process]7: Ann Clin Psychiatry. 2010 Aug;22(3):157-63.
Fiedorowicz JG, Hale N, Spector AA, Coryell WH.
Departments of Psychiatry and Epidemiology, Carver College of Medicine, The University of Iowa, Iowa City, IA, USA. jess-fiedorowicz@uiowa.edu
BACKGROUND: Omega-3 fatty acid (O3FA) levels and dimensional personality measures have been associated with major depression and the course of depressive illness. We sought to study the utility of O3FA levels and dimensional personality measures as predictors of early improvement with escitalopram. METHODS: Twenty-four participants were enrolled in an open-label trial of escitalopram 10 mg/d for 4 weeks. Baseline erythrocyte O3 levels and dimensional personality assessments were obtained. RESULTS: Using a conservative, intention-to-treat analysis, baseline neuroticism (r = -0.57; P = .007), as measured by the Revised NEO Personality Inventory but not erythrocyte O3 levels, was correlated with improvements on escitalopram. A facet analysis of the neuroticism domain showed the relationship with antidepressant response to be focused on trait anxiety (r = -0.65; P = .002). CONCLUSIONS: Anxiety may have important prognostic implications on subsequent response to selective serotonin reuptake inhibitors, such as escitalopram.
Publication Types: Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't
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PMID: 20680188 [PubMed - in process]8: Nutr Neurosci. 2010 Aug;13(4):161-9.
Davis PF, Ozias MK, Carlson SE, Reed GA, Winter MK, McCarson KE, Levant B.
Department of Pharmacology, Toxicology, and Therapeutics, University of Kansas Medical Center. Kansas City, Kansas, USA.
Decreased tissue levels of n-3 (omega-3) fatty acids, particularly docosahexaenoic acid (DHA), are implicated in the etiologies of non-puerperal and postpartum depression. This study examined the effects of a diet-induced loss of brain DHA content and concurrent reproductive status on dopaminergic parameters in adult female Long-Evans rats. An alpha-linolenic acid-deficient diet and breeding protocols were used to produce virgin and parous female rats with cortical phospholipid DHA levels 20-22% lower than those fed a control diet containing adequate alpha-linolenic acid. Decreased brain DHA produced a significant main effect of decreased density of ventral striatal D(2)-like receptors. Virgin females with decreased DHA also exhibited higher density of D(1)-like receptors in the caudate nucleus than virgin females with normal DHA. These receptor alterations are similar to those found in several rodent models of depression, and are consistent with the proposed hypodopaminergic basis for anhedonia and motivational deficits in depression.
Publication Types: Research Support, N.I.H., Extramural
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PMID: 20670471 [PubMed - in process]9: Neuropsychopharmacology. 2010 Jul 28; [Epub ahead of print]
Lu DY, Tsao YY, Leung YM, Su KP.
Graduate Institute of Neural and Cognitive Sciences, China Medical University, Taichung, Taiwan.
Accumulating evidence suggests that the pathophysiology of depression might be associated with neuroinflammation, which could be attenuated by pharmacological treatment for depression. Omega-3 polyunsaturated fatty acids (PUFAs) are anti-inflammatory and exert antidepressant effects. The aim of this study was to identify the molecular mechanisms through which docosahexaenoic acid (DHA), the main omega-3 PUFA in the brain, modulates oxidative reactions and inflammatory cytokine production in microglial and neuronal cells. The results of this study showed that DHA reduced expressions of tumor necrosis factor-alpha, interleukin-6, nitric oxide synthase, and cyclo-oxygenase-2, induced by interferon-gamma, and induced upregulation of heme oxygenase-1 (HO-1) in BV-2 microglia. The inhibitory effect of DHA on nitric oxide production was abolished by HO-1 inhibitor zinc protoporphyrin IX. In addition, DHA caused AKT and ERK activation in a time-dependent manner, and the DHA-induced HO-1 upregulation could be attenuated by PI-3 kinase/AKT and MEK/ERK inhibitors. DHA also increased IKKalpha/beta phosphorylation, IkappaBalpha phosphorylation, and IkappaBalpha degradation, whereas both nuclear factor-kappaB and IkappaB protease inhibitors could inhibit DHA-induced HO-1 expressions. The other major n-3 PUFA, eicosapentaenoic acid, showed similar effects of DHA on inflammation and HO-1 in repeated key experiments. In connecting with inflammation hypothesis of depression and clinical studies supporting the antidepressant effects of omega-3 PUFAs, this study provides a novel implication of the antidepressant mechanisms of DHA.Neuropsychopharmacology advance online publication, 28 July 2010; doi:10.1038/npp.2010.98.
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PMID: 20668435 [PubMed - as supplied by publisher]10: Prostaglandins Leukot Essent Fatty Acids. 2010 Jul 26; [Epub ahead of print]
Polyunsaturated fatty acids deficits are associated with psychotic state and negative symptoms in patients with schizophrenia.
Sethom MM, Fares S, Bouaziz N, Melki W, Jemaa R, Feki M, Hechmi Z, Kaabachi N.
UR05/08-08 and LR99ES11, Department of Biochemistry, Rabta Hospital, Tunis, Tunisia.
The study was aimed to examine membrane polyunsaturated fatty acids (PUFAs) profile in patients with schizophrenia (SZ) before and after antipsychotic medication and test their association with psychopathology. Erythrocyte membrane fatty acids were analysed by gas chromatography in 36 drug-free patients with SZ and 36 controls. Psychometric evaluation and blood sampling were achieved at baseline and after 3 months of antipsychotic treatment. At enrolment, levels of total PUFAs and arachidonic (AA) and docosahexaenoic (DHA) acids were significantly lower, but omega6/omega3 PUFAs ratio was higher in patients. AA and DHA were negatively related to the Andreason's scale for assessment of negative symptoms (SANS) score. DHA was inversely related to "alogia", "anhedonia", "avolition", and "blunted affect" subitems of SANS. After 3 months under typical antipsychotic drugs, fatty acid profile turned into comparable to controls in parallel with psychopathology improvement. Data indicate that PUFAs deficits are associated with psychotic state and negative symptoms of SZ. Copyright (c) 2010 Elsevier Ltd. All rights reserved.
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PMID: 20667702 [PubMed - as supplied by publisher]11: Prog Neuropsychopharmacol Biol Psychiatry. 2010 Jul 23; [Epub ahead of print]
McNamara RK, Able JA, Rider T, Tso P, Jandacek R.
Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH 45267, United States.
Omega-3 (n-3) polyunsaturated fatty acids (PUFA) and fluoxetine (FLX) have additive effects in the treatment of major depressive disorder, and FLX up-regulates genes that regulate fatty acid biosynthesis in vitro. Although these data suggest that FLX may augment n-3 fatty acid biosynthesis, the in vivo effects of FLX treatment on PUFA biosynthesis and peripheral and central membrane compositions are not known. In the present study, male and female rats were treated with FLX (10mg/kg/day) through their drinking water for 30days (P60-P90). Plasma FLX and norfluoxetine (NFLX) concentrations were determined by liquid chromatography tandem mass spectrometry, and erythrocyte and prefrontal cortex (PFC) fatty acid composition determined by gas chromatography. To confirm central effects of FLX, serotonin turnover in the PFC was determined by high performance liquid chromatography. Chronic FLX treatment resulted in clinically-relevant plasma FLX concentrations in male and female rats, and significantly decreased serotonin turnover in the PFC. After correcting for multiple comparisons, chronic FLX treatment did not significantly alter erythrocyte fatty acid composition in male or female rats. Chronic FLX treatment significantly and selectively increased docosapentaenoic acid (22:5n-6) in the PFC of female rats, but not in male rats. These preclinical findings do not support the hypothesis that chronic FLX treatment increases n-3 fatty acid biosynthesis or membrane composition. Copyright (c) 2010 Elsevier Inc. All rights reserved.
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PMID: 20655971 [PubMed - as supplied by publisher]12: Eur J Med Res. 2009 Dec 7;14 Suppl 4:248-54.
Wilczynska-Kwiatek A, Bargiel-Matusiewicz K, Lapinski L.
Institute of Psychology, University of Silesia, Poland. Agnieszkawk@hotmail.com
BACKGROUND: Growing evidence supports comorbidity of asthma and allergies with mood disorders and various connections between these diseases. It still remains unclear whether this comorbidity is caused by the same pathophysiological factors or whether there are other links between asthma and depression. There is no definite answer to the question of an optimal treatment to deal with both asthma and depression, when they occur simultaneously. Epidemiological and clinical trials on the influence of nutrition on certain diseases suggest the effects of omega3 polyunsaturated fatty acids (PUFAs) in aiding treatment of mood disorders and inflammatory conditions. OBJECTIVE: This is an overview showing the connections between asthma, allergic disease, and mood disorders, and the influence of nutrition on these conditions. Evidence indicates positive correlations between consumption of PUFAs and mood correction. Several analyses show the connection between diet and asthma. They may form a basis for potential recommending omega3 PUFAs as an adjuvant in prevention and treatment of mental disorders, asthma, and allergy.
Publication Types: Review
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PMID: 20156766 [PubMed - indexed for MEDLINE]13: Prog Neuropsychopharmacol Biol Psychiatry. 2010 Jul 4; [Epub ahead of print]
An intriguing and hitherto unexplained co-occurrence: Depression and chronic fatigue syndrome are manifestations of shared inflammatory, oxidative and nitrosative (IO&NS) pathways.
Maes M.
There is a significant 'comorbidity' between depression and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Depressive symptoms frequently occur during the course of ME/CFS. Fatigue and somatic symptoms (F&S), like pain, muscle tension, and a flu-like malaise, are key components of depression. At the same time, depression and ME/CFS show major clinical differences, which allow to discriminate them with a 100% accuracy. This paper aims to review the shared pathways that underpin both disorders and the pathways that discriminate them. Numerous studies have shown that depression and ME/CFS are characterized by shared aberrations in inflammatory, oxidative and nitrosative (IO&NS) pathways, like systemic inflammation and its long-term sequels, including O&NS-induced damage to fatty acids, proteins and DNA; dysfunctional mitochondria; lowered antioxidant levels, like zinc and coenzyme Q10; autoimmune responses to neoepitopes formed by O&NS; lowered omega-3 polyunsaturated fatty acid levels; and increased translocation of gram-negative bacteria. Some IO&NS-related pathways, like the induction of indoleamine 2-3-dioxygenase, neurodegeneration and decreased neurogenesis, are more specific to depression, whereas other pathways, like the 2'-5' oligoadenylate synthetase/RNase L pathway, are specific to ME/CFS. Most current animal models of depression, e.g. those induced by cytokines, are not reminiscent of human depression but reflect a mixture of depressive and F&S symptoms. The latter symptoms, sometimes called sickness behavior, differ from depression and ME/CFS because the former is a (sub)acute response to infection-induced pro-inflammatory cytokines that aims to enhance recovery, whereas the latter are characterized by long-term sequels in multiple IO&NS pathways. Depression and ME/CFS are not 'comorbid' disorders, but should be regarded as 'co-associated disorders' that are clinical manifestations of shared pathways. Copyright (c) 2010 Elsevier Inc. All rights reserved.
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PMID: 20609377 [PubMed - as supplied by publisher]14: Prog Neuropsychopharmacol Biol Psychiatry. 2010 Jun 30; [Epub ahead of print]
Song C, Wang H.
In patients with major depression or in animal models of depression, significantly increases in the concentrations of pro-inflammatory cytokines have been consistently reported. Proinflammatory cytokines can stimulate the hypothalamic-pituitary-adrenal (HPA) axis to release stress hormone, glucocorticoids. As a consequence of excessive inflammatory response triggered by pro-inflammatory cytokines in the periphery, free radicals, oxidants and glucocorticoids are over-produced, which can affect glial cell functions and damage neurons in the brain. Indeed, decreased neurogenesis and the dysfunction of neurotrophic system (up- or down-regulations of neurotrophins and their receptors) have been recently found. Effective treatments for depressive symptoms, such as antidepressants and omega-3 fatty acids can increase or modulate neurotrophic system and enhance neurogenesis. However, the relationship between glial cells; microglia (mostly involved in neuroinflammation) and astrocytes (producing neurotrophins), and the contribution of inflammation to decreased neurogenesis and dysfunction of neurotrophic system are almost unknown. This review first introduces changes in behavior, neurotransmitter, cytokine and neurogenesis aspects in depressed patients and several animal models of depression, secondly explores the possible relationship between pro- and anti-inflammatory cytokines and neurogenesis in these models, then discusses the effects of current treatments on inflammation, neurotrophic system and neurogenesis, and finally pointes out the limitations and future research directions. Copyright (c) 2010 Elsevier Inc. All rights reserved.
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PMID: 20600462 [PubMed - as supplied by publisher]15: J Am Coll Nutr. 2010 Feb;29(1):55-64.
Rondanelli M, Giacosa A, Opizzi A, Pelucchi C, La Vecchia C, Montorfano G, Negroni M, Berra B, Politi P, Rizzo AM.
Department of Applied Health Sciences, Section of Human Nutrition and Dietetics, Faculty of Medicine, University of Pavia, Pavia, Italy. serv.nutrizione@asppavia.it or mariangela.rondanelli@unipv.it
OBJECTIVE: In elderly individuals, depression is one of the most frequently missed diagnoses with negative effects on quality of life. The authors investigated whether a supplement containing long-chain omega-3 polyunsaturated fatty acids (n-3 LCPUFA) improves depressive symptoms and health-related quality of life (HRQoL) in depressed elderly patients. DESIGN: Eight-week, randomized, double-blind, placebo-controlled trial. SETTING: Nursing home in Pavia, Italy. PARTICIPANTS: Forty-six depressed women, aged 66-95 years. INTERVENTION: Twenty-two depressed women were included in the intervention group (n-3 group, which received 2.5 g/d of n-3 LCPUFA, with 1.67 g of eicosapentaenoic acid [EPA] and 0.83 g of docosahesaenoic acid [DHA]), and 24 patients were included in the placebo group. The primary endpoint was the improvement of depressive symptoms, as evaluated by the Geriatric Depression Scale (GDS). Secondary endpoints were the evaluation of HRQoL, by using the Short-Form 36-Item Health Survey (SF-36), and modifications of erythrocyte membrane phospholipids fatty acid profile. All variables were assessed before and after the treatment period of 8 weeks. RESULTS: The mean GDS at 8 weeks was significantly lower compared with the n-3 group. The SF-36 physical and mental components were significantly increased in the intervention group. Compliance was good, as confirmed by erythrocyte membrane phospholipid FA concentrations, with a significant increase of EPA and DHA in the intervention group. CONCLUSION: Supplementation with n-3 LCPUFA is efficacious in the amelioration of depressive symptoms and quality of life in the treatment of depressed elderly female patients.
Publication Types: Research Support, Non-U.S. Gov't
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PMID: 20595646 [PubMed - in process]16: Expert Rev Neurother. 2010 Jul;10(7):1117-29.
Rocha Araujo DM, Vilarim MM, Nardi AE.
Federal University of Rio de Janeiro, RJ, Brazil. danielemarano@yahoo.com.br
This systematic review aims to identify the effect of polyunsaturated fatty acid omega-3 on depressive disorder. A bibliographical search was conducted in the databases SciELO, PubMed and ISIWEB. The keywords used were: "depression" and "omega-3 fatty acids", "depression" and "omega-3 polyunsaturated fatty acid", "depression" and "n-3 fatty acids". A total of 19 studies were identified: four double-blind randomized studies, four cohorts, two cross-sectional lines and nine case-controls. Only five studies presented dropout of less than 30% and controlled for the most important confounding variables. Of the evaluated studies, 13 showed a significant positive association between omega-3 and depression, while six studies did not show a relationship between the referred variables. Therefore, future studies with similar methodology would aid in determining the precise effect of omega-3 on depressive disorders.
Publication Types: Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't
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PMID: 20586692 [PubMed - in process]17: J Clin Psychiatry. 2010 Jun 15; [Epub ahead of print]
Lesperance F, Frasure-Smith N, St-Andre E, Turecki G, Lesperance P, Wisniewski SR.
Department of Psychiatry, Centre Hospitalier de l'Universite de Montreal, 1560 Sherbrooke E, Montreal, Quebec H2L 4M1, Canada. francois.lesperance@umontreal.ca.
OBJECTIVE: To document the short-term efficacy of omega-3 supplementation in reducing depressive symptoms in patients experiencing a major depressive episode (MDE). METHOD: Inclusive, double-blind, randomized, controlled, 8-week, parallel-group trial, conducted October 17, 2005 through January 30, 2009 in 8 Canadian academic and psychiatric clinics. Adult outpatients (N = 432) with MDE (Mini-International Neuropsychiatric Interview, version 5.0.0, criteria) lasting at least 4 weeks, including 40.3% taking antidepressants at baseline, were randomly assigned to 8 weeks of 1,050 mg/d of eicosapentaenoic acid (EPA) and 150 mg/d of docosahexaenoic acid (DHA) or matched sunflower oil placebo (2% fish oil). The primary outcome was the self-report Inventory of Depressive Symptomatology (IDS-SR(30)); the secondary outcome was the clinician-rated Montgomery-Asberg Depression Rating Scale (MADRS). RESULTS: The adjusted mean difference between treatment and placebo was 1.32 points (95% CI, -0.20 to 2.84; P = .088) on the IDS-SR(30) and 0.97 points (95% CI, -0.012 to 1.95; P = .053) on the MADRS. Planned subgroup analyses revealed a significant interaction of comorbid anxiety disorders and study group (P = .035). For patients without comorbid anxiety disorders (n = 204), omega-3 supplementation was superior to placebo, with an adjusted mean difference of 3.17 points on the IDS-SR(30) (95% CI, 0.89 to 5.45; P = .007) and 1.93 points (95% CI, 0.50 to 3.36; P = .008) on the MADRS. CONCLUSIONS: In this heterogeneous sample of patients with MDE, there was only a trend toward superiority of omega-3 supplementation over placebo in reducing depressive symptoms. However, there was a clear benefit of omega-3 supplementation among patients with MDE without comorbid anxiety disorders. TRIAL REGISTRATION: controlled-trials.com Identifier: ISRCTN47431149. (c) Copyright 2010 Physicians Postgraduate Press, Inc.
Links http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?cmd=Retrieve&db=PubMed&list_uids=20584525&dopt=ExternalLink
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PMID: 20584525 [PubMed - as supplied by publisher]18: J Clin Psychiatry. 2010 Jun;71(6):682-8.
Freeman MP, Mischoulon D, Tedeschini E, Goodness T, Cohen LS, Fava M, Papakostas GI.
Perinatal and Reproductive Psychiatry Program, Massachusetts General Hospital, 185 Cambridge St, 2nd Floor, Boston, MA 02114, USA. mfreeman@partners.org
OBJECTIVE: To compare patient characteristics, placebo-response rates, and outcome differences in active treatment compared to placebo in randomized controlled trials (RCTs) of complementary and alternative medicine (CAM) and standard antidepressants for major depressive disorder (MDD). DATA SOURCES: Eligible studies were first identified using searches of PubMed/MEDLINE, restricted to English, by cross-referencing the search term placebo with each of the antidepressants (those that had received letters of approval by the US, Canadian, or EU drug regulatory agencies for the treatment of MDD) and selected CAM agents. These searches were limited to articles published between January 1, 1980, and September 15, 2009 (inclusive). Reference lists from identified studies were also searched for studies eligible for inclusion. STUDY SELECTION: We selected RCTs for MDD that included validated diagnostic assessment and baseline/outcome measures of illness severity. Assessment was limited to widely used CAM agents most frequently studied in RCTs with pill placebo: St John's wort, omega-3 fatty acids, and S-adenosyl-L-methionine (SAMe). DATA SYNTHESIS: Of eligible publications, 173 reported results of 1 trial, and 5 included > 1 trial, representing a total of 185 RCTs. Patient variables, including illness severity, were similar across CAM and antidepressant RCTs, except for a higher proportion of women in CAM studies (P = .0003). Random-effects meta-analysis indicated that both antidepressant and CAM monotherapy resulted in superior response rates compared with placebo. Placebo-response rates were significantly lower for patients enrolled in CAM versus antidepressant RCTs (P = .002). Meta-regression analyses yielded no significant differences in the relative risk of prematurely discontinuing therapy due to any reason between active treatment and placebo for antidepressant and CAM RCTs, although discontinuation due to adverse events was higher in antidepressant RCTs compared to CAM RCTs (P = .007). CONCLUSIONS: Participants in CAM trials were more likely to be female and to have a lower placebo-response rate compared to those in standard antidepressant trials for MDD. Trials of standard antidepressants and CAM therapies were composed of patients with similar depression severity. 2010 Physicians Postgraduate Press, Inc.
Publication Types: Comparative Study Meta-Analysis
Links http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?cmd=Retrieve&db=PubMed&list_uids=20573327&dopt=ExternalLink
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PMID: 20573327 [PubMed - indexed for MEDLINE]19: J Clin Psychiatry. 2010 Jun;71(6):669-81.
Freeman MP, Fava M, Lake J, Trivedi MH, Wisner KL, Mischoulon D.
Center for Women's Mental Health, Massachusetts General Hospital, Boston, MA 02114, USA. mfreeman@partners.org
OBJECTIVE: To review selected complementary and alternative medicine (CAM) treatments for major depressive disorder (MDD). PARTICIPANTS: Authors of this report were invited participants in the American Psychiatric Association's Task Force on Complementary and Alternative Medicine. EVIDENCE: The group reviewed the literature on individual CAM treatments for MDD, methodological considerations, and future directions for CAM in psychiatry. Individual CAM treatments were reviewed with regard to efficacy in MDD, as well as risks and benefits. Literature searches included MEDLINE and PsycINFO reviews and manual reference searches; electronic searches were limited to English-language publications from 1965 to January 2010 (but manual searches were not restricted by language). Treatments were selected for this review on the basis of (1) published randomized controlled trials in MDD and (2) widespread use with important clinical safety or public health significance relevant to psychiatric practice. An action plan is presented based on needs pertaining to CAM and psychiatry. CONSENSUS PROCESS: Consensus was reached by group conferences. Written iterations were drafted and sent out among group members prior to discussion, resolution of any differences of interpretation of evidence, and final approval. CONCLUSIONS: A review of randomized controlled trials for commonly used CAM treatments such as omega-3 fatty acids, St John's wort (Hypericum), folate, S-adenosyl-l-methionine (SAMe), acupuncture, light therapy, exercise, and mindfulness psychotherapies revealed promising results. More rigorous and larger studies are recommended. Each CAM treatment must be evaluated separately in adequately powered controlled trials. At this time, several CAM treatments appear promising and deserve further study. The greatest risk of pursuing a CAM therapy is the possible delay of other well-established treatments. Clinical, research, and educational initiatives designed to focus on CAM in psychiatry are clearly warranted due to the widespread use of CAM therapies. 2010 Physicians Postgraduate Press, Inc.
Publication Types: Review
Links http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?cmd=Retrieve&db=PubMed&list_uids=20573326&dopt=ExternalLink
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PMID: 20573326 [PubMed - indexed for MEDLINE]20: Neurobiol Aging. 2010 Jun 4; [Epub ahead of print]
Samieri C, Feart C, Proust-Lima C, Peuchant E, Dartigues JF, Amieva H, Barberger-Gateau P.
INSERM, U897, Department of Nutritional Epidemiology, Bordeaux, F-33076, France; University Victor Segalen Bordeaux 2, ISPED, 146 Rue Leo Saignat, Bordeaux, 33076, France.
Long-chain omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) may slow cognitive decline. The epsilon4 allele of the ApolipoproteinE (ApoE), the main genetic risk factor for Alzheimer's disease, and depressive symptoms, which are frequently associated with cognitive impairment in older persons, may modify this relationship. We estimated the associations between EPA and DHA plasma levels and subsequent cognitive decline over 7 years, taking into account ApoE-epsilon4 status and depressive symptoms, in a prospective population-based cohort. Participants (>/= 65 years, n = 1,228 nondemented at baseline) were evaluated at least once over three follow-up visits using four cognitive tests. Plasma EPA was associated with slower decline on Benton Visual Retention Test (BVRT) performances in ApoE-epsilon4 carriers, or in subjects with high depressive symptoms at baseline. Plasma DHA was associated with slower decline on BVRT performances in ApoE-epsilon4 carriers only. EPA and DHA may contribute to delaying decline in visual working memory in ApoE-epsilon4 carriers. In older depressed subjects, EPA, but not DHA, may slow cognitive decline. Copyright (c) 2010 Elsevier Inc. All rights reserved.
Links http://www.ncbi.nlm.nih.gov/entrez/queryd.fcgi?cmd=Retrieve&db=PubMed&list_uids=20570406&dopt=ExternalLink
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PMID: 20570406 [PubMed - as supplied by publisher]