RESUMEN
BACKGROUND: In this study, we aimed to evaluate the effects of electroconvulsive therapy (ECT) on cardiac autonomic functions (CAF) in patients with major depressive disorder (MDD) using heart rate variability (HRV) analysis. METHOD: Fourteen men joined the study. Nine ECTs were administered. Holter monitoring was performed before treatment and at the end of the first, third and sixth weeks of the treatment. The Hamilton Depression Rating Scale (HAM-D) was used to assess symptom severity. RESULTS: Seven patients responded to ECT. There was a change of 2-hour resting HF, pNN50 and RMSSD scores between week 0 and week 6. This change was not significant after week 1 and week 3. HRV values did not differ when we grouped the patients as responders and non-responders to ECT except the 2-hour resting HF value of responders between week 0 and week 6 and the 24-hour HF value of non-responders between week 1 and week 6. All observed changes showed a decrease in parameters. Overall, the LF/HF ratio did not change significantly in either analysis. HRV values did not correlate with HAM-D scores and no relation was found between treatment response and HRV analysis. After Benferroni-adjustment none of the changes were found statistically significant. LIMITATIONS: The limitations of the study are the small sample size and the absence of healthy controls. CONCLUSIONS: A consistent change in HRV was not observed in response to ECT in patients with MDD. Accepting the HRV as a promising surrogate marker of autonomic activity, ECT does not cause a significant change in nine male treatment resistant MDD patients cardiac autonomic functions.
Asunto(s)
Sistema Nervioso Autónomo/fisiología , Trastorno Depresivo Mayor/terapia , Terapia Electroconvulsiva , Frecuencia Cardíaca/fisiología , Adulto , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
OBJECTIVE: Although conflicting results have been obtained regarding P300 amplitude and latency in major depressive patients, most studies have reported that major depressive patients have smaller P300 amplitudes and longer latencies than healthy people. This study aimed to investigate the relationship between P300 and treatment response in major depressive disorder patients. METHODS: Twenty-eight patients suffering from major depression who completed 12 weeks of follow-up appointments and 28 healthy people, whose age and gender were matched with patients, were included in the study. Event-related potentials (P300) were recorded for patients before and after treatment with sertraline (50-200 mg/day) for 12 weeks. Treatment response was defined as a 50% or greater decrease in a given patient's total Hamilton Depression Rating Scale score. Pre-treatment and post-treatment P300 amplitude and latency values were compared for responders (n=18), non-responders (n=10) and healthy subjects. RESULTS: No significant difference was found between the P300 amplitude values of responders, non-responders and healthy subjects before or after treatment. Pre-treatment P300 latencies of non-responders were significantly longer than latencies of responders and healthy subjects. After treatment for depression, P300 latency values of responders were normalized, but non-responders still maintained longer P300 latencies than responders and healthy subjects. CONCLUSION: These findings suggest that delayed P300 latency may be related to a non-response to sertraline treatment. No relation was found between P300 amplitude and treatment response.
Asunto(s)
Antidepresivos/uso terapéutico , Trastorno Depresivo Mayor/fisiopatología , Potenciales Relacionados con Evento P300 , Estimulación Acústica , Adulto , Estudios de Casos y Controles , Trastorno Depresivo Mayor/tratamiento farmacológico , Potenciales Relacionados con Evento P300/efectos de los fármacos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: There is an interaction between the immune system and the central nervous system by means of hormones, peptides, and neurotransmitters. The aims of the present study were to determine whether the serum neopterin levels in patients with major depression (MD) differ from a healthy control group and to investigate the relationship between previous MD episodes and serum neopterin levels. METHODS: Thirty patients who were admitted to the GATA Psychiatry Outpatient Clinics and were diagnosed with MD according to DSM-IV, and who agreed to participate in the study, were included in the study. Twenty-six healthy volunteers matched for age, gender, and level of education who agreed to participate in the study were served as controls. Peripheral venous blood samples were obtained from the patients and the control group for complete blood count, routine biochemistry, and the detection of serum neopterin levels. The analyses were performed in the laboratory of the GATA Department of Biochemistry. RESULTS: There was no significant difference between the MD group and the healthy controls with respect to age, level of education, smoking, and gender. Serum neopterin levels of the MD group who had experienced two or more episodes were higher than the first-episode group and the control group. Age of onset and the number of previous episodes had an independent impact on serum neopterin levels in MD patients, while smoking did not show any effect. CONCLUSION: In the present study, the neopterin levels of patients who had experienced two or more episodes were higher than the first-episode depressive group and healthy control group. It was also found that the number of previous depressive episodes and the ages of the MD cases had an independent effect on serum neopterin levels.
Asunto(s)
Trastorno Depresivo Mayor/sangre , Trastorno Depresivo Mayor/fisiopatología , Neopterin/sangre , Adulto , Intervalos de Confianza , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Oportunidad Relativa , Índice de Severidad de la EnfermedadRESUMEN
Depression may relapse during pregnancy in women with a history of depression. Treatments which may be effective for mothers may be harmful to the fetus. Electroconvulsive therapy (ECT) has been widely used in patients with different medical illnesses. It is safe, and its efficacy is well established. In our example, the patient was a 34-year-old white woman who was at 13 weeks' gestation at the time of admission to our hospital. Over a 1-month period, the patient underwent a total of 13 ECTs (3 times a week) and 3 more ECTs monthly until the birth of her child. After 10th ECT, the Hamilton Depression Rating Scale score was reduced from 33 before ECT to 7. After 3 more weekly ECTs, the patient was discharged from the hospital with a Hamilton Depression Rating Scale score of 3. The patient was instructed to continue maintenance treatment with ECT sessions monthly. Except for pelvic pain and transient fetal arrhythmias, no complications were reported. Thus, acute and maintenance ECT may be the choice of treatment in severely depressed or psychotic pregnant patients.