The role of dopaminergic agents in improving quality of life in major depressive disorder

IsHak, Waguih William; Davis, Michael C.; Jeffrey, Jessica; Balayan, Konstantin; Pechnick, Robert N.; Bagot, Kara; Rapaport, Mark Hyman

doi:10.1007/s11920-009-0076-z

Cited by 20 publications

(12 citation statements)

References 43 publications

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“…Dopamine acts on the mesolimbic and mesocortical circuits in the brain and is responsible for the experience of pleasurable feelings [65–67]. The 5-HT systems of Serotonin extend throughout the brain and are thought to be involved in many functions such as mood, aggression, feeding and sleep.…”

Section: Resultsmentioning

confidence: 99%

Biological Markers in Noninvasive Brain Stimulation Trials in Major Depressive Disorder

Fidalgo¹,

Morales-Quezada²,

Muzy³

et al. 2014

The Journal of ECT

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Objectives The therapeutic effects of Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) in patients with major depression have shown promising results; however, there is a lack of mechanistic studies using biological markers (BM) as an outcome. Therefore, our aim was to review non-invasive brain stimulation trials in depression using BM. Method The following databases were used for our systematic review: MEDLINE, Web of Science, Cochrane, and SCIELO. We examined articles published before November 2012 that used TMS and tDCS as an intervention for depression and had BM as an outcome measure. The search was limited to human studies written in English. Results Of 1234 potential articles, 52 papers were included. Only studies using TMS were found. BM included immune and endocrine serum markers, neuroimaging techniques and electrophysiological outcomes. In 12 articles (21.4%) endpoint BM measurements were not significantly associated with clinical outcomes. All studies reached significant results in the main clinical rating scales. BM outcomes were used as predictors of response, to understand mechanisms of TMS, and as a surrogate of safety. Conclusions fMRI, SPECT, PET, MRS, cortical excitability and BDNF consistently showed positive results. BDNF was the best predictor of patients’ likeliness to respond. These initial results are promising; however, all studies investigating BM are small, used heterogeneous samples, and did not take into account confounders such as age, gender or family history. Based on our findings we recommend further studies to validate BM in non-invasive brain stimulation trials in MDD.

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Section: Resultsmentioning

confidence: 99%

Biological Markers in Noninvasive Brain Stimulation Trials in Major Depressive Disorder

Fidalgo¹,

Morales-Quezada²,

Muzy³

et al. 2014

The Journal of ECT

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“…Interventions that appear in published original research and/or literature reviews, and are postulated to improve QOL include: cognitive behavioral therapy (28), future-directed therapy (29), combined psychotherapy and pharmacotherapy (30), occupational/vocational therapy (31), dopaminergic agents (32), nutrition and nutritional supplements (33), augmentation with omega-3 (34), exercise (35), meditation and yoga (36), humor (37), massage (38), and music (39). QOL interventions could also include the treatment of possible comorbid medical and psychiatric conditions (40, 41), and treatment of sexual dysfunction (42, 43).…”

Section: Discussionmentioning

confidence: 99%

Quality of life in major depressive disorder before/after multiple steps of treatment and one‐year follow‐up

IsHak

Mirocha

James

et al. 2014

Acta Psychiatr Scand

102

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Objective This study examines the impact of Major Depressive Disorder (MDD) and its treatment on Quality of Life (QOL). Method From the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial, we analyzed complete data of 2,280 adult MDD outpatients at entry/exit of each level of antidepressant treatments and after 12-months of entry to follow-up. QOL was measured using the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). The proportions of patients scoring ‘within-normal’ QOL (within 10% of Q-LES-Q community-norms) and those with ‘severely-impaired’ QOL (>2SD below Q-LES-Q community-norms) were analyzed. Results Before treatment, no more than 3% of MDD patients experienced ‘within-normal’ QOL. Following treatment, statistically significant improvements were detected, however the proportion of patients achieving ‘within-normal’ QOL did not exceed 30%, with>50% of patients experiencing ‘severely-impaired’ QOL. Although remitted-patients had greater improvements compared to non-remitters, 32%-60% continued to experience reduced QOL. 12-month follow-up data revealed that the proportion of patients experiencing ‘within-normal’ QOL show a statistically significant decrease in non-remitters. Conclusion Symptom-focused treatments of MDD may leave a misleading impression that patients have recovered when, in fact, they may be experiencing ongoing QOL deficits. These findings point to the need for investigating specific interventions to ameliorate QOL in MDD.

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“…Whether these effects are mediated through midbrain DA neurons and their powerful regulation by the LHb and RMTg is not yet known but merits further investigation. Certainly interest in the potential contribution of the DA system to the pathophysiology and treatment of major depressive disorder has re-emerged in the clinical literature (Kapur and Mann, 1992; Dunlop and Nemeroff, 2007; Montgomery, 2008; IsHak et al, 2009). In any case, the fact that the LHb is a target for deep brain stimulation treatment of major depression (Sartorius et al, 2010) indicates a clear need to understand more precisely the connectivity of this region and its ability to regulate the activity of RMTg GABA cells, midbrain DA neurons, and other direct and indirect downstream targets.…”

Section: Discussionmentioning

confidence: 99%

The inhibitory influence of the lateral habenula on midbrain dopamine cells: Ultrastructural evidence for indirect mediation via the rostromedial mesopontine tegmental nucleus

et al. 2011

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The lateral habenula (LHb) provides an important source of negative reinforcement signals to midbrain dopamine (DA) cells in the substantia nigra and ventral tegmental area (VTA). This profound and consistent inhibitory influence involves a disynaptic connection from glutamate neurons in the LHb to some population of γ-aminobutyric acid (GABA) cells that, in turn, innervates DA neurons. Previous studies demonstrated that the GABA cells intrinsic to the VTA receive insufficient synaptic input from the LHb to serve as the primary source of this intermediate connection. In this investigation, we sought ultrastructural evidence supporting the hypothesis that a newly identified region of the brainstem, the rostromedial mesopontine tegmental nucleus (RMTg), is a more likely candidate for inhibiting midbrain DA cells in response to LHb activation. Electron microscopic examination of rat brain sections containing dual immunoreactivity for an anterograde tracing agent and a phenotypic marker revealed that: 1) more than 55% of the synapses formed by LHb axons in the RMTg were onto GABA-labeled dendrites; 2) more than 80% of the synapses formed by RMTg axons in the VTA contacted dendrites immunoreactive for the DA synthetic enzyme tyrosine hydroxylase; and 3) nearly all RMTg axons formed symmetric synapses and contained postembedding immunoreactivity for GABA. These findings indicate that the newly identified RMTg region is an intermediate structure in a disynaptic pathway that connects the LHb to VTA DA neurons. The results have important implications for understanding mental disorders characterized by a dysregulation of reward circuitry involving LHb and DA cell populations.

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The role of dopaminergic agents in improving quality of life in major depressive disorder

Cited by 20 publications

References 43 publications

Biological Markers in Noninvasive Brain Stimulation Trials in Major Depressive Disorder

Biological Markers in Noninvasive Brain Stimulation Trials in Major Depressive Disorder

Quality of life in major depressive disorder before/after multiple steps of treatment and one‐year follow‐up

The inhibitory influence of the lateral habenula on midbrain dopamine cells: Ultrastructural evidence for indirect mediation via the rostromedial mesopontine tegmental nucleus

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