- |||||||||| Gender-Affirming Hormones and Psychiatry () - Oct 19, 2022 - Abstract #AACAP2022AACAP_411;
Conclusions Existing research shows that gender-affirming hormone treatment has largely positive effects on mental health, perhaps by helping to alleviate the incongruence between the physical body and internal experience. There are significant limitations with existing research; more high-quality research is needed on the impact of gender-affirming hormones on mental health and psychotropic medications.
- |||||||||| Know Your CYPs! Meaningful Cytochrome p450 Interactions in the Treatment of Psychosis () - Oct 19, 2022 - Abstract #AACAP2022AACAP_286;
Some CYP1A2 substrates include olanzapine, clozapine, propranolol, and caffeine...Conclusions Many medications prescribed for patients experiencing early psychosis have important cytochrome p450 interactions. Knowledge of these interactions is important for providers at all levels.
- |||||||||| Trintellix (vortioxetine) / Lundbeck, Takeda, Viibryd (vilazodone) / AbbVie
Clinical Pharmacogenetic Guideline Updates for Antidepressants () - Oct 19, 2022 - Abstract #AACAP2022AACAP_58;
Data evaluations by CPIC provide evidence grading and recommendations regarding whether important PK or PD genes should be considered if PGx information is available. CPIC and FDA evidence evaluations are helpful resources for the interpretation of pharmacogenetic information for commonly used antidepressants.
- |||||||||| sertraline / Generic mfg., escitalopram / Generic mfg.
Pharmacogenetic Research in Child and Adolescent Psychiatry () - Oct 19, 2022 - Abstract #AACAP2022AACAP_57;
Conclusions Pharmacogenes are associated with pharmacokinetics, response, and tolerability in youth treated with antidepressants in retrospective studies. Child and adolescent psychiatrists should know the evidence behind these studies as they consider how to use pharmacogenetic testing in their clinical practice.
- |||||||||| sertraline / Generic mfg., escitalopram / Generic mfg.
Journal: Generalizability of treatment outcome prediction in major depressive disorder using structural MRI: A NeuroPharm study. (Pubmed Central) - Oct 18, 2022
Although our primary findings in the NeuroPharm cohort support some, but limited value in using pretreatment structural brain MRI to predict drug treatment outcome in MDD, the models did not generalize to an independent cohort suggesting limited clinical applicability. This study emphasizes the importance of assessing model generalizability for establishing clinical utility.
- |||||||||| escitalopram / Generic mfg.
Review, Journal: Psilocybin Efficacy and Mechanisms of Action in Major Depressive Disorder: a Review. (Pubmed Central) - Oct 14, 2022
One clinical trial has been conducted against a reference treatment (escitalopram) without showing a significant superiority of psilocybin in the main outcome...Psilocybin represents a promising alternative in the treatment of depression. Further research with larger sample sizes, particularly against reference treatments, is needed to better understand the neurobiological factors of its effects and to investigate its potential for use in everyday practice.
- |||||||||| duloxetine / Generic mfg., escitalopram / Generic mfg.
Hippocampus volume and memory function in major depressive disorder - sensitivity to mood or treatment: a Neuropharm study (Corner 1 (Hall X1) [IN-PERSON]) - Oct 13, 2022 - Abstract #ECNP2022ECNP_1595;
Sixteen patients with inadequate effect at week four switched to 30-120mg duloxetine.Depression severity was assessed with the Hamilton Depression Scale (HAMD17), verbal memory performance by the Verbal Affective Memory Test-26 (VAMT, n=85), and hippocampus volume (HPV) by MRI-scanning (3T, T1-weighted images) before treatment...Consistent with reports from young adults we find a negative relationship between left HPV and memory performance before treatment, however, we did not find that pre-treatment left HPV was associated with improvement in change performance. Pre-treatment hippocampal volume may be a possible biomarker of antidepressant treatment for depression, but less likely memory dysfunction.
- |||||||||| escitalopram / Generic mfg.
Dynamic functional connectivity in major depressive disorder and its association with pharmacological treatment response – a NeuroPharm study (Corner 2 (Hall X1) [IN-PERSON]) - Oct 13, 2022 - Abstract #ECNP2022ECNP_1518;
Here we compared measures of dynamic functional brain connectivity (dFC) in patients with MDD to healthy controls and assessed them as biomarkers associated with change in depressive symptoms. Eighty-nine medication-free patients with a moderate-to-severe depressive episode completed an open-label, eight-week treatment with escitalopram...Further analysis is needed to determine whether these brain states are also predictive biomarkers of change in depressive symptoms, i.e., cross-validated predictive performance. Our findings highlight the potential of a data-driven strategy for mapping functional brain states onto depression and antidepressant treatment response.
- |||||||||| escitalopram / Generic mfg.
Effects of personalized dosing based on drug plasma level quantification on effectiveness and safety of escitalopram treatment (Corner 1 (Hall X1) [IN-PERSON]) - Oct 13, 2022 - Abstract #ECNP2022ECNP_1469;
There was no statistically significant increase in ADR frequencies in the dose augmentation group either, which is in concordance with the hypothesis that dose increase in underdosed patients does not lead to the increase of ADR frequency and severity. Noteworthy, since this report represents interim analysis on a sample which is approximately one fourth of the planned cohort, the Conclusion s are not yet unequivocal.
- |||||||||| modafinil / Generic mfg.
Modafinil Use-Induced Psychosis: Case Report (Poster area [ONLINE]) - Oct 13, 2022 - Abstract #ECNP2022ECNP_1366;
In the follow-up of the patient, close follow-up in divided doses is required. Therefore, patients prescribed modafinil should be carefully monitored for the development of psychosis, even when they are previously healthy and at low doses [3].
- |||||||||| duloxetine / Generic mfg., escitalopram / Generic mfg.
Predicting antidepressant treatment outcome in major depressive disorder using multi-domain data: A NeuroPharm study (Corner 2 (Hall X1) [IN-PERSON]) - Oct 13, 2022 - Abstract #ECNP2022ECNP_1220;
P1
When looking at the contribution of individual biomarkers to the logistic model, we saw some evidence that, EEG-vigilance, orbitofrontal cortex thickness and cognition was associated with response at week 8 (p-values between 0.01–0.097 before adjustment, equal or above 0.09 after adjustment). Conclusion : While we found evidence that some candidate biomarkers may help predict response in patients with MDD, we were not able to obtain reliable or clinically relevant probabilities of response for any time point. Indeed, the associations between individual biomarkers and response status were highly variable across the three time points, emphasizing that follow-up time points or trajectory-based outcomes should be chosen with great care in future precision medicine studies.
- |||||||||| Trintellix (vortioxetine) / Lundbeck, Takeda
Clinical effectiveness of vortioxetine in postcovid syndrome (Poster area [IN-PERSON]) - Oct 13, 2022 - Abstract #ECNP2022ECNP_1145;
We examined 58 patients with postcovid syndrome, of whom 22 received vortioxetine (main group) at a dose of 5-10 mg per day, and 36 (comparison group) - other antidepressants, including escitalopram, sertraline, paroxetine and fevarin, in the average therapeutic doses. the use of vortioxetine can improve the clinical consequences of Post-COVID-19 Syndrome
- |||||||||| ketamine / Generic mfg., escitalopram / Generic mfg.
The influence of serotonin reuptake inhibition on diffusivity in cortical grey matter (Poster area [IN-PERSON]) - Oct 13, 2022 - Abstract #ECNP2022ECNP_1111;
While it is notable that this investigation was limited to healthy participants and a treatment duration of three weeks, our data still stands in contrast to ketamine data in the rat [1] and suggests that alternative modes of action might be more likely as explanation for the antidepressant effects of SSRIs. Nevertheless, one should consider that this does not categorically rule out a role of these underlying mechanisms in patients with depression.
- |||||||||| Korean guidelines for the treatment of panic disorder: initial and maintenance pharmacological treatment strategies for panic disorder (Poster area [IN-PERSON]) - Oct 13, 2022 - Abstract #ECNP2022ECNP_819;
The Result s imply that tolerability becomes a more important factor when choosing a pharmacological treatment of PD compared with Korean medication algorithm in 2008.This study will provide information about recent consensus among Korean experts regarding appropriate treatment strategies for patients with PD. In the future, the new guidelines should contain more systematic reviews and updated treatment strategies with sufficient evidence to validate the Result s.
- |||||||||| amphetamine / Generic mfg.
Depression-associated Negr1 gene-deficiency induces alterations in the monoaminergic neurotransmission enhancing time-dependent sensitization to amphetamine in mice (Poster area [IN-PERSON]) - Oct 13, 2022 - Abstract #ECNP2022ECNP_735;
Upregulation of transcripts encoding for dopamine and serotonin transporters and higher levels of several monoamines, and their metabolites was evident in distinct brain areas of Negr1−/− mice. Chronic (22 days) escitalopram-induced reduction of serotonin and dopamine turnover is enhanced in Negr1−/− mice and escitalopram could rescue reduced hippocampus weight in Negr1−/− mice. Conclusion : The current study is the first to show alterations in the brain monoaminergic system in a mouse model deficient of NEGR1 protein suggesting that these neural circuits could underlay both depressive and obesity-related phenotypes linked with NEGR1 gene.
- |||||||||| escitalopram / Generic mfg.
Association between CYP2C19 genotype and body weight with escitalopram exposure – a cross sectional study (Poster area [IN-PERSON]) - Oct 13, 2022 - Abstract #ECNP2022ECNP_665;
The absence of significant effects was likely due to still limited power of the study. Since this interim analysis includes only approximately one third of patients compared with what had been originally planned, it is expected that firmer Conclusion s related to the combined effect of CYP2C19 genotype and body weight on escitalopram exposure will emerge after all planned patients are included.
- |||||||||| escitalopram / Generic mfg.
Systemic DNA and RNA damage from oxidation after serotonergic treatment of unipolar depression (Poster area [IN-PERSON]) - Oct 13, 2022 - Abstract #ECNP2022ECNP_621;
Patients were subsequently treated for 8 weeks with escitalopram in flexible doses of 5-20 milligrams; At week 8, 82 patients were followed up clinically and with measurements of 8-oxodG/8-oxoGuo...Surprisingly, patients had similar levels of 8-oxodG excretion and lower levels of 8-oxoGuo excretion at baseline compared to the controls. Conclusion We conclude that an intervention with serotonin reuptake inhibitors in unipolar depression is associated with a reduction in systemic DNA and RNA damage from oxidation. To our knowledge, this to date the largest intervention study to characterize this phenomenon, and the first to include a marker of RNA oxidation.
- |||||||||| duloxetine / Generic mfg., escitalopram / Generic mfg.
Hippocampus volume and memory function in major depressive disorder - sensitivity to mood or treatment: a Neuropharm study (Poster area [IN-PERSON]) - Oct 13, 2022 - Abstract #ECNP2022ECNP_585;
Sixteen patients with inadequate effect at week four switched to 30-120mg duloxetine.Depression severity was assessed with the Hamilton Depression Scale (HAMD17), verbal memory performance by the Verbal Affective Memory Test-26 (VAMT, n=85), and hippocampus volume (HPV) by MRI-scanning (3T, T1-weighted images) before treatment...Consistent with reports from young adults we find a negative relationship between left HPV and memory performance before treatment, however, we did not find that pre-treatment left HPV was associated with improvement in change performance. Pre-treatment hippocampal volume may be a possible biomarker of antidepressant treatment for depression, but less likely memory dysfunction.
- |||||||||| CYP2C19 slow metabolizer phenotype is associated with lower antidepressant efficacy and tolerability: clinical study on 102 inpatients (Poster area [IN-PERSON]) - Oct 13, 2022 - Abstract #ECNP2022ECNP_525;
Therefore, it is likely that SM group does not receive the appropriate treatment under standard psychiatric practice, which is in most cases unaware of the patients’ CYP2C19 genotype. Even though this study does not have sufficient power for an unequivocal Conclusion related to the need of pre-emptive CYP2C19 genotyping of antidepressant treated patients, it contributes to the body of already existing evidence on the clinical usefulness of CYP2C19 genotyping in psychiatry.
- |||||||||| escitalopram / Generic mfg.
Effects of personalized dosing based on drug plasma level quantification on effectiveness and safety of escitalopram treatment (Poster area [IN-PERSON]) - Oct 13, 2022 - Abstract #ECNP2022ECNP_517;
There was no statistically significant increase in ADR frequencies in the dose augmentation group either, which is in concordance with the hypothesis that dose increase in underdosed patients does not lead to the increase of ADR frequency and severity. Noteworthy, since this report represents interim analysis on a sample which is approximately one fourth of the planned cohort, the Conclusion s are not yet unequivocal.
- |||||||||| escitalopram / Generic mfg.
Dynamic functional connectivity in major depressive disorder and its association with pharmacological treatment response – a NeuroPharm study (Poster area [IN-PERSON]) - Oct 13, 2022 - Abstract #ECNP2022ECNP_497;
Here we compared measures of dynamic functional brain connectivity (dFC) in patients with MDD to healthy controls and assessed them as biomarkers associated with change in depressive symptoms. Eighty-nine medication-free patients with a moderate-to-severe depressive episode completed an open-label, eight-week treatment with escitalopram...Further analysis is needed to determine whether these brain states are also predictive biomarkers of change in depressive symptoms, i.e., cross-validated predictive performance. Our findings highlight the potential of a data-driven strategy for mapping functional brain states onto depression and antidepressant treatment response.
- |||||||||| A case of neuroacanthocytosis presented with depression and suicidal thoughts (Poster area [IN-PERSON]) - Oct 13, 2022 - Abstract #ECNP2022ECNP_449;
She had been followed up with the diagnosis of recurrent depression for over 5 years in another centre and her last treatment regimen was fluoxetine 20 mg/daily and lamotrigine 75 mg/daily.On admission, her lips were swollen and ecchymotic due to the biting behaviour...Peripheral blood smear showed acanthocytes in 40-50% of the field.The patient was put on risperidone 2 mg/daily, escitalopram 10 mg/daily and quetiapine 50 mg/daily with the diagnosis of neuroacanthocytosis accompanied by depression...Even though there is no curative treatment for neuroacanthocytosis; symptomatic treatment plays a major role in maintaining quality of life [4]. In Conclusion , in individuals presenting with movement disorders and psychiatric conditions, a peripheral smear for acanthocyte screening must be considered.
- |||||||||| duloxetine / Generic mfg., escitalopram / Generic mfg.
Predicting antidepressant treatment outcome in major depressive disorder using multi-domain data: A NeuroPharm study (Poster area [IN-PERSON]) - Oct 13, 2022 - Abstract #ECNP2022ECNP_434;
P1
When looking at the contribution of individual biomarkers to the logistic model, we saw some evidence that, EEG-vigilance, orbitofrontal cortex thickness and cognition was associated with response at week 8 (p-values between 0.01–0.097 before adjustment, equal or above 0.09 after adjustment). Conclusion : While we found evidence that some candidate biomarkers may help predict response in patients with MDD, we were not able to obtain reliable or clinically relevant probabilities of response for any time point. Indeed, the associations between individual biomarkers and response status were highly variable across the three time points, emphasizing that follow-up time points or trajectory-based outcomes should be chosen with great care in future precision medicine studies.
- |||||||||| Trintellix (vortioxetine) / Lundbeck, Takeda
Enrollment closed, Trial completion date, Trial primary completion date, Head-to-Head: VESPA: Vortioxetine in the Elderly vs. Selective Serotonin Reuptake Inhibitors (SSRIs): a Pragmatic Assessment (clinicaltrials.gov) - Oct 11, 2022
P4, N=362, Active, not recruiting,
Further clinical trials should be conducted to clarify the effects of antidepressants on the severity of COVID-19. Unknown status --> Active, not recruiting | Trial completion date: Jan 2020 --> Sep 2023 | Trial primary completion date: Jul 2019 --> Feb 2023
- |||||||||| imipramine / Generic mfg., ketamine / Generic mfg., escitalopram / Generic mfg.
Transcriptomic prediction of antidepressant treatment response after early-life stress (SDCC Halls B-H) - Oct 10, 2022 - Abstract #Neuroscience2022NEUROSCIENCE_7490;
The results suggest that ELS is associated with altered behavioral response to antidepressant treatment. Overall, our integrated analyses of genome-wide patterns and pharmacology experiments provide biological insights linking ELS with antidepressant response, laying the foundation for more targeted antidepressant treatments for this vulnerable population.
- |||||||||| escitalopram / Generic mfg.
Impact of neonatal escitalopram on affective and social behaviors in adolescence (SDCC Halls B-H) - Oct 10, 2022 - Abstract #Neuroscience2022NEUROSCIENCE_4671;
In adolescence (P35-55) offspring were then assessed for changes in social play, taste novelty learning, and inhibitory/anxiety-like behavior using an open-field conflict test. These preliminary results suggest that neonatal escitalopram can have an effect on behaviors that commonly emerge during adolescence.
- |||||||||| escitalopram / Generic mfg.
Pharmacological manipulation of monoamines modulates the gain between M1 and motor output (SDCC Halls B-H) - Oct 10, 2022 - Abstract #Neuroscience2022NEUROSCIENCE_4541;
Following either caffeine or the selective serotonin reuptake inhibitor escitalopram, modulation decreased 19% (p < 0.001) and 15% (p = 0.001), respectively...Although there were small differences in EMG between sessions, they were much smaller than the changes in cortical modulation and did not change consistently in a direction that could have explained the neural change. These drug-induced changes in modulation were consistent across both motor tasks and provide evidence for the existence of gain control in the motor system and the role serotonin and norepinephrine play in this control.
- |||||||||| escitalopram / Generic mfg.
Cocaine increases stimulation-evoked accumbal serotonin release (SDCC Halls B-H) - Oct 10, 2022 - Abstract #Neuroscience2022NEUROSCIENCE_3819;
Selectivity to serotonin was further confirmed in vitro in which dopamine was minimally detected by N-FSCV with a serotonin to dopamine response ratio of 1:0.04 (200 nM of serotonin:1 micro-M dopamine ratio; p = 0.0048; n = 5 electrodes).ConclusionsOur results not only reinforce the role of serotonin in the mechanism of action of cocaine but also confirm that N-FSCV can effectively and selectively measure phasic serotonin release in the NAcc. This helps to fill a gap in our knowledge and provide a baseline for future studies in cocaine addiction.
- |||||||||| fluoxetine / Generic mfg., escitalopram / Generic mfg.
Selective serotonin reuptake inhibitors within and near cells: Resolution at the compartmental and temporal levels via genetically encoded biosensors (SDCC Halls B-H) - Oct 10, 2022 - Abstract #Neuroscience2022NEUROSCIENCE_3476;
We interpret these data in light of previous reports that SSRIs both sequester within and perturb some membrane compartments and may reach SERT from the membrane phase. Although the time scale of our experiments is orders of magnitude slower than the “therapeutic lag” of SSRIs, the novel measurements presented here emphasize that pharmacokinetic properties of SSRIs, including their anomalously high volume of distribution, may play roles in both the therapeutic lag and the equally puzzling “antidepressant discontinuation syndrome”.
- |||||||||| diltiazem / Generic mfg., omeprazole / Generic mfg., escitalopram / Generic mfg.
Journal: Complete Heart Block in a Patient Treated With Metoprolol, Diltiazem, Omeprazole, and Escitalopram. (Pubmed Central) - Oct 8, 2022
Although the time scale of our experiments is orders of magnitude slower than the “therapeutic lag” of SSRIs, the novel measurements presented here emphasize that pharmacokinetic properties of SSRIs, including their anomalously high volume of distribution, may play roles in both the therapeutic lag and the equally puzzling “antidepressant discontinuation syndrome”. No abstract available
- |||||||||| Journal: Monoamine control of descending pain modulation after mild traumatic brain injury. (Pubmed Central) - Oct 7, 2022
On the other hand, the serotonin-norepinephrine reuptake inhibitor, duloxetine and the serotonin selective reuptake inhibitor escitalopram both effectively restored DNIC after TBI in both male and female mice. Therefore, enhancing serotonergic signaling as opposed to noradrenergic signaling alone may be an effective pain treatment strategy after TBI.
- |||||||||| anastrozole / Generic mfg., escitalopram / Generic mfg.
Journal: Escitalopram co-prescription in anastrozole-treated breast cancer patients. (Pubmed Central) - Oct 7, 2022
Escitalopram co-prescription resulted in significant increase in plasma anastrozole levels without affecting the serum estradiol levels. Our findings emphasize the need for close monitoring in case of concomitant use of anastrozole and escitalopram, especially in obese patients and the potential role of therapeutic drug monitoring.
- |||||||||| epacadostat (INCB024360) / Incyte
Journal: IDO1 is a therapeutic target for pancreatic cancer-associated depression. (Pubmed Central) - Oct 4, 2022
Epacadostat was effective as an antidepressant for pancreatic cancer-associated depression in mice. These data offer a rationale to consider IDO1 inhibition as a therapeutic strategy to mitigate depressive symptoms in patients with pancreatic cancer.
- |||||||||| escitalopram / Generic mfg.
Journal: Telomerase enzyme activity in patients with major depressive disorder: A pre and post-treatment study. (Pubmed Central) - Oct 4, 2022
The index study concludes that TA is higher in drug naïve patients with MDD than age and sex matched healthy control. The non-responders had significantly higher TA as compared to responders at baseline and post-treatment which indicates TA as a potential biomarker in the underlying biological mechanism of MDD and in response to antidepressant pharmacotherapy.
- |||||||||| sertraline / Generic mfg., fluoxetine / Generic mfg., escitalopram / Generic mfg.
Journal: Improved Serotonin Measurement with Fast-Scan Cyclic Voltammetry: Mitigating Fouling by SSRIs. (Pubmed Central) - Sep 30, 2022
Use of this waveform with bare CFMs alleviated the decrease in faradaic current, indicating decreased electrode fouling. Collectively, our results suggest that fouling considerations are important when designing FSCV experiments that employ SSRIs and that they can be overcome by using the appropriate waveform.
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