Tag-arkiv: NIMH

Depression hos småbørn

ycv0809Et nyt studie har undersøgt om småbørn helt ned til tre års alderen kan have depression. Noget tyder på at det er sandsynligt.
Studiet er det første til at vise at svær depression kan være en kronisk lidelse hos selv meget små børn, i modsætning til den stereotype opfattelse af det altid glade børnehavebarn.

Indtil for ganske nylig har “folk virkelig ikke været særlig opmærksom på depressive lidelser hos børn under 6 år,” udtaler den ledende forfatter til artiklen, professor dr. Joan Luby, børnepsykiater ved Washington University i St. Louis. “Man har ikke troet, at det kunne ske … fordi børn under 6 år var for følelsesmæssigt umodne til at opleve det.”

Læs resten

Ketamine treatment for depression?

Experimental Antidepressant Use

According to a National Institute of Mental Health press release on 7 August 2006, a study of 17 patients led by Dr Carlos Zarate Jr. of the NIMH showed that ketamine significantly improved treatment-resistant major depression within two hours of injection. The improvement lasted up to one week after the single dose. The patients in the study were previously treatment resistant, having tried an average of six other treatments that failed. The importance of these findings was articulated by NIMH director Dr Thomas Insel: “This is the first report of any medication or other treatment that results in such a pronounced, rapid, prolonged response.” The researchers apparently attribute the effect to ketamine being an NMDA receptor antagonist.

The study appears in the Archives of General Psychiatry.

(About Ketamine, see: Wikipedia: Ketamine.) Læs resten

High-Dose Pharmaca Treatment Nonresponders to Acute Treatment for Obsessive-Compulsive Disorder

OCD suffers not responding to standard drug and CBT treatment might get greater symptom improvement with high-dose drug treatment. The Journal of Clinical Psychiatry has published a research article about high-dose treatment:

High-Dose Sertraline Strategy for Nonresponders to Acute Treatment for Obsessive-Compulsive Disorder: A Multicenter Double-Blind Trial Objective: To evaluate the efficacy and safety of high-dose sertraline for patients with obsessive-compulsive disorder (OCD) who failed to respond to standard sertraline acute treatment.

Method: Sixty-six nonresponders to 16 weeks of sertraline treatment who met DSM-III-R criteria for current OCD were randomly assigned, in a double-blind continuation phase of a multicenter trial, either to continue on 200 mg/day of sertraline or to increase their dose to between 250 and 400 mg/day for 12 additional weeks. Efficacy measures included the Yale-Brown Obsessive Compulsive Scale (YBOCS), the National Institute of Mental Health Global Obsessive Compulsive Scale (NIMH Global OC Scale), and the Clinical Global Impressions-Severity of Illness and -Improvement (CGI-I) scales. Data were collected from July 26, 1994, to October 26, 1995.

Results: The high-dose (250-400 mg/day, mean final dose= 357, SD = 60, N = 30) group showed significantly greater symptom improvement than the 200-mg/day group (N = 36) as measured by the YBOCS (p=.033), NIMH Global OC Scale (p = .003), and CGI-I (p = .011). Responder rates (decrease in YBOCS score of > = 25% and a CGI-I rating < = 3) were not significantly different for the 200-mg/day versus the high-dose sertraline group, either on completer analysis, 34% versus 52%, or on endpoint analysis, 33% versus 40%. Both treatments showed similar adverse event rates.

Conclusion: Greater symptom improvement was seen in the high-dose sertraline group compared to the 200-mg/day dose group during continuation treatment. Both dosages yielded similar safety profiles. Administration of higher than labeled doses of selective serotonin reuptake inhibitors may be a treatment option for certain OCD patients who fail to respond to standard acute treatment.

(J Clin Psychiatry 2006;67:15-22) The research is rather old, done back in 1995 and another thing is its sponsored by Pfizer, the maker of the SSRI sertraline (Zoloft). At the other hand high-dose treatment is not a new thing and drugs like clomipramine (Anafrenil) and paroxetine (Paxil/Seroxat) have been tested too and proven effective. Evidence-based pharmacotherapy of obsessive-compulsive disorder. Fineberg NA, Gale TM., Int J Neuropsychopharmacol. 2005 Mar;8(1):107-29. Epub 2004 Sep 28. Read the entire article at the journals homepage A qualitative analysis of nonresponse: management of treatment-refractory obsessive-compulsive disorder, Pallanti S, Hollander E, Goodman WK., J Clin Psychiatry. 2004;65 Suppl 14:6-10.

Double-Blind Treatment With Oral Morphine in Treatment-Resistant Obsessive-Compulsive Disorder

For people with obsessive-compulsive disorder (OCD) who have not been helped by standard drug treatments, a weekly dose of oral morphine may ease their symptoms, according to a small pilot study.

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PANDAS

PANDAS, is an abbreviation for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. The term is used to describe a subset of children who have Obsessive Compulsive Disorder (OCD) and/or tic disorders such as Tourette’s Syndrome, and in whom symptoms worsen following strep. infections such as "Strep throat" and Scarlet Fever…

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