A Review of the Clinical, Economic, and Societal Burden of Treatment-Resistant Depression: 1996–2013

Mrazek, David A.; Hornberger, John; Altar, C. Anthony; Degtiar, Irina

doi:10.1176/appi.ps.201300059

Cited by 470 publications

(326 citation statements)

References 74 publications

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“…TRD significantly affects the patients' quality of life and adds substantially to the societal burden of this disease. An economic study by Mrazek et al (2014), covering the period between 1996 and 2013, estimated the costs associated with TRD in the US amounted to $29 -48$ billion. As the combination of MAO inhibitors with other antidepressants is critical and may result in serotonin syndrome, as discussed earlier, a combination therapy should be only pursued under close supervision and care of an experienced clinician in psychiatry.…”

Section: Depressionmentioning

confidence: 99%

Monoamine Oxidase Inhibitors—Revisiting a Therapeutic Principle

Entzeroth¹,

Ratty²

2017

OJD

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Over more than 60 years, monoamine oxidase (MAO) inhibitors are available for therapy of central nervous diseases. Although they have shown to be efficacious specifically in the treatment of major depressive disorders and treatment-resistant depression, they became less a therapeutic choice for the physicians mostly due to severe side effects, such as liver failure and hypertensive crisis associated specifically with the first generation of inhibitors. Nevertheless, this class of drugs is still being used for treatment specifically as more selective and reversible inhibitors became available and will provide clinicians with additional treatment options. The current review revisits monoamine oxidase inhibitors and their potential in the treatment of human diseases, such as anxiety, depression, mood and personality disorders, and pain and introduces current ideas and developments.

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Section: Depressionmentioning

confidence: 99%

Monoamine Oxidase Inhibitors—Revisiting a Therapeutic Principle

Entzeroth¹,

Ratty²

2017

OJD

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“…Studies have also shown that life transitions strongly predict the onset of first and subsequent episodes of depression (Kendler, Karkowski, & Prescott, 1999). Major depression is one of the leading causes of disability worldwide (Ferrari et al, 2013) and poses a significant economic burden (Mrazek, Hornberger, Altar, & Degtiar, 2014). Therefore maintaining wellbeing and preventing the onset of depression in response to such life transitions is a public health priority.…”

Section: Introductionmentioning

confidence: 99%

Stressful life transitions and wellbeing: A comparison of the stress buffering hypothesis and the social identity model of identity change

Praharso

Tear

Cruwys

2017

Psychiatry Research

150

118

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The relationship between stressful life transitions and wellbeing is well established, however, the protective role of social connectedness has received mixed support. We test two theoretical models, the Stress Buffering Hypothesis and the Social Identity Model of Identity Change, to determine which best explains the relationship between social connectedness, stress, and wellbeing. Study 1 (N=165) was an experiment in which participants considered the impact of moving cities versus receiving a serious health diagnosis. Study 2 (N=79) was a longitudinal study that examined the adjustment of international students to university over the course of their first semester. Both studies found limited evidence for the buffering role of social support as predicted by the Stress Buffering Hypothesis; instead people who experienced a loss of social identities as a result of a stressor had subsequent decline in wellbeing, consistent with the Social Identity Model of Identity Change. We conclude that stressful life events are best conceptualized as identity transitions. Such events are more likely to be perceived as stressful and compromise wellbeing when they entail identity loss. Keywords

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“…It is well established that these treatment-resistant patients become progressively less likely to improve with subsequent antidepressant trials [1,2,3,4]. As a result, treatment resistance among depressed patients generates significant personal, financial, and societal burdens, as measured by higher treatment and health care utilization costs, disability, missed work, and decreased productivity [5]. …”

Section: Introductionmentioning

confidence: 99%

“…When provided to clinicians in an actionable report, this information might be expected to augment treatment responsiveness or decrease health care utilizations that accompany failed medication trials [5,18,19]. …”

Section: Introductionmentioning

confidence: 99%

Clinical Utility of Combinatorial Pharmacogenomics-Guided Antidepressant Therapy: Evidence from Three Clinical Studies

Altar¹,

Carhart²,

Allen³

et al. 2015

Complex Psychiatry

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DNA of 258 patients with treatment-resistant depression was collected in three 8-10 week, two-arm, prospective clinical trials. Forty-four allelic variations were measured in genes for the cytochrome P450 (CYP) enzymes CYP2D6, CYPC19, and CYP1A2, the serotonin transporter (SLC6A4), and the 5-HT_2A receptor (HTR2A). The combinatorial pharmacogenomic (CPGx™) GeneSight test results were provided to clinicians to support medication changes from baseline (guided arm), or they were provided at the end of each study to clinicians of unguided patients who were treated as usual (TAU). TAU subjects who at baseline were prescribed medications genetically discordant for them showed only a 12% symptom improvement, far less than the 32.5% or 28.5% improvements of the TAU subjects on yellow-category (‘use with caution'; p = 0.002) or green-category medications (‘use as recommended'; p = 0.02), respectively. The odds of a clinical response were increased 2.3-fold among all GeneSight-guided compared to all TAU subjects (p = 0.004), and overall, the guided group had a 53% greater improvement in depressive symptoms (p = 0.0002), a 1.7-fold relative improvement in response (p = 0.01), and a number needed to treat for one clinical response above that seen in the TAU group of 6.07.

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A Review of the Clinical, Economic, and Societal Burden of Treatment-Resistant Depression: 1996–2013

Cited by 470 publications

References 74 publications

Monoamine Oxidase Inhibitors—Revisiting a Therapeutic Principle

Monoamine Oxidase Inhibitors—Revisiting a Therapeutic Principle

Stressful life transitions and wellbeing: A comparison of the stress buffering hypothesis and the social identity model of identity change

Clinical Utility of Combinatorial Pharmacogenomics-Guided Antidepressant Therapy: Evidence from Three Clinical Studies

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