Mehmet Fatih Karaaslan

Combination therapy of imipramine and melatonin: additive antidepressant effect in mouse forced swimming test.

Although there are tools to treat depressive patients, a considerable amount of the cases remains to be untreated. These drug-resistant patients need new drugs or drug combinations to overcome this problem. Thus, the potential synergistic effect of melatonin on a classical drug, imipramine was evaluated in the present study. To test this hypothesis, porsolt swim test, a test predictive of antidepressant-like action, was conducted in mice. Imipramine at doses of 20 and 40 mg/kg caused no alteration and statistically significant reduction in the duration of immobility in forced swim test, respectively. While 5 mg/kg melatonin had no effect, 10 mg/kg melatonin slightly reduced the duration of immobility. When sub-effective doses of imipramine and melatonin (20 and 5 mg/kg, respectively) were co-administered, there was no alteration in responses compared with those of each drug alone. Likewise, the effective dose of melatonin (10 mg/kg) did not cause any increase in responses to 20 mg/kg imipramine. Although combination of imipramine (40 mg/kg) and melatonin (5 mg/kg) did not exert an antidepressant effect above that of imipramine alone, co-administration of the effective doses (10 and 40 mg/kg for melatonin and imipramine, respectively) displayed an additive effect. There were no significant differences between groups in relation with locomotor activity test. The results show that co-administration of imipramine and melatonin exhibits an additive effect and that there seems to be no interaction between the drugs.

Evaluation of Malondialdehyde, Superoxide Dismutase and Catalase Activity in Fetal Cord Blood of Depressed Mothers

Objective The umbilical cord consists of two arteries and one vein and it functions in the transport between the maternal and fetal circulation. Biochemical analysis of fetal cord blood (FCB) during delivery could be beneficial in terms of understanding the fetal environment. In this study, we aimed to investigate oxidative parameters like malondialdehyde (MDA), superoxide dismutase (SOD), and catalase (CAT) levels in FCB during delivery. Methods We collected FCB samples during caesarean section. Our study included 33 depressed mothers and 37 healthy controls. We investigated MDA, SOD, and CAT levels in FCB samples. Results We found no significant difference between groups in terms of MDA (p=0.625), SOD (p=0.940), and CAT (p=0.413) levels. Conclusion Our study reveals probable protective effects of the placenta from oxidative stress. Future studies should include larger samples.

Arterial Stiffness in Patients Taking Second-generation Antipsychotics

Objective That treatment with second-generation antipsychotics (SGAs) causes metabolic side effects and atherosclerosis in patients with schizophrenia and bipolar disorder (BD) is well-known. Increased arterial stiffness is an important marker of arteriosclerosis and has been identified as an independent risk factor for cardiovascular diseases. We measured pulse wave velocity (PWV) as a marker of arteriosclerosis in patients with schizophrenia and BD who use SGAs. Methods Patients and controls were collected from our psychiatry outpatient clinics or family medicine. Mental illness was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Mean age, gender, systolic and diastolic blood pressure, body mass index, Framingham risk score (FRS), etc. were determined. Simultaneous electrocardiography and pulse wave were recorded with an electromyography device. The photo-plethysmographic method was used to record the pulse wave. Inclusion criteria included use of SGAs for at least the last six months. Patients with diseases that are known to cause stiffness and the use of typical antipsychotics were excluded. Results Ninety-six subject (56 patients, 40 controls) were included in our study. There were 49 females, 47 males. Patients had schizophrenia (n=17) and BD (n=39). Their treatments were quetiapine (n=15), risperidone (n=13), olanzapine (n=15), and aripiprazole (n=13). Although differences in mean age, gender, and FRS in the patient and control groups were not statistically significant (p=1), PWV was greater in patients in the antipsychotic group (p=0.048). Conclusion This study supported the liability to stiffness in patients with schizophrenia and BD. Using SGAs may contribute to arterial stiffness in these patients.

Maras Powder Usage Among Turkish Psychiatric Outpatients

A kind of smokeless tobacco known as Maras powder, which is used in the southeastern region of Turkey, causes nicotine dependence. The aim of this study was to determine the usage of Maras powder among psychiatric outpatients and nonpsychiatric controls. The study group consisted of 276 psychiatric patients and 283 nonpsychiatric patients from psychiatry and family medicine outpatient clinics. A socio-demographic form, the Fagerström Test for Nicotine Dependence, and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders–4th Edition were given to the participants. The rates of Maras powder usage in the patient group (10.1%) were significantly higher than those in the control group (5.6%). Men were found to use Maras powder at a higher rate in both groups. The rates of Maras powder usage according to the psychiatric diagnosis were evaluated. This is the first study estimating Maras powder usage rates among psychiatric patients in Turkey. The studys limitations are noted.

The comparison in temperament and character features in pre- and post-treatment of the patients with first episode major depression

Aim: In this study, the association between temperament and character inventory (TCI) subscores and depression scores, and possible changes in temperament dimensions after treatment were explored. Methods: 54 major depressive patients diagnosed according to DSM-IV criteria were enrolled and naturalistic antidepressant treatments were prescribed to the patients. Hamilton Depression Rating Scale (HDRS) and TCI were administered during enrollment and after three months of treatment. Patient group was composed of 31 remitted patients and compared with 75 healthy controls. Results: Comparison of TCI scores of pre-treatment patient group and the control group demonstrated that harm avoidance, self-directedness, and cooperation subscale scores of patients were significantly different from controls (p=0.001, p=0.001 and p=0.001 respectively). The difference between patients and controls persisted even after the treatment. There was no significant difference between pre-treatment and post-treatment TCI outcomes of the patient group (P>0.05). Conclusion: Our findings indicate that harm avoidance, cooperativeness, and self directedness dimensions are not state-related in MDD patients.

The Diagnostic Value of Malondialdehyde, Superoxide Dismutase and Catalase Activity in Drug Naïve, First Episode, Non-Smoker Generalized Anxiety Disorder Patients

Objective Generalized anxiety disorder (GAD) is a common anxiety disorder. Although lots of research done to reveal neurobiological basis of GAD, it is still unclear. Diagnosis of GAD depends on subjective complaints of patients, thus the need for a biological marker is constantly emerging. In this study, we aimed to investigate diagnostic value of malondialdehyde (MDA), superoxide dismutase (SOD) and catalase (CAT) in GAD. Methods We evaluated MDA, SOD, and CAT levels in peripheral blood of 46 patients and 45 controls. MDA was measured with Ohkawa’s methods, SOD was measured with Fridovich method, and CAT was measured with Beutler’s method. Results MDA was significantly increased in patients than controls, medians 4.05 nmol/mg and 1.71 nmol/mg respectively, p<0.001; SOD and CAT activity was significantly decreased in patients than controls, medians of SOD were 159.07 U/mg and 301.87 U/mg, p<0.001 respectively, medians for CAT were 138.47 U/mg and 160.60 U/mg respectively. We found high correlation between Hamilton Anxiety Rating Scale and SOD, MDA r values were 0.723 and 0.715 respectively, p<0.001 for both. Receiver operator characteristic (ROC) curve analysis showed high diagnostic performance for MDA and SOD, low diagnostic performance for CAT, areas under curve were 1.0, 1.0, and 0.648 respectively. Conclusion Our results reveal possible diagnostic value of MDA, less likely of SOD but not CAT. Future studies should investigate diagnostic value of oxidants and antioxidantn enzymes in larger samples and include diagnostic value of these parameters.

Increased Serum G Protein-coupled Estrogen Receptor 1 Levels and Its Diagnostic Value in Drug NaÏve Patients with Major Depressive Disorder

Objective The facts that depression is more prevalent in females than in males and females are exposed to depression more commonly during certain hormonal fluctuating periods indicate the role of sex hormones in physiopathology. Estrogen acts over estrogen receptors alpha and beta and recently identified G protein-coupled estrogen receptor 1 (GPER1). The present study aimed, for the first time, to evaluate serum GPER1 levels in drug-naïve major depressive disorder (MDD) patients. Methods The study included 56 newly diagnosed drug-naïve MDD patients aged between 18 and 50 years and 42 age- and gender-matched healthy volunteers. Medical history was obtained and physical examinations, laboratory tests, and the Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A) were performed. The serum GPER1 levels were measured. Results The HAM-D score was significantly higher in the MDD patients than in the controls. The GPER1 level was significantly higher in the MDD patients than in the controls. A positive correlation was found with GPER1 levels and depression scores. The receiver operating characteristic analysis revealed sensitivity, specificity, positive predictive value, and negative predictive value as 82.1%, 90.5%, 92.0%, and 79.2%, respectively, for the presence of depression, when the serum GPER1 value was ≥0.16. Conclusion This study demonstrated significantly higher serum GPER1 levels in the MDD patients than in the controls, a positive correlation was found between GPER1 levels and depression scores and serum GPER1 level was valuable in predicting the presence of depression.

The psychiatric profile of chronic pruritus patients

Objective: Itching, or pruritus, is an uncomfortable sensation leading to the urge to scratch, and it is the most common symptom in skin diseases. Chronic pruritus may be seen in many skin and systemic diseases as well as in psychiatric disorders. The aim of the present study was to investigate itching features, psychiatric disorders, and depressive symptoms of patients with chronic pruritus due to reasons other than primary skin diseases or systemic diseases that may cause itching. Methods: 126 patients with chronic pruritus were included in the study. Sociodemographic data and disease-related features were recorded on a form. Psychiatric diagnoses were established based on the Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision (DSM-IV-TR) criteria, using the Structured Clinical Interview for DSM-IV, Clinical Version (SCID-I/CV). The Beck Depression Inventory (BDI) was applied. Results: Of the chronic pruritus patients, 70.6% had psychiatric disorders ranging from one to three. The most common psychiatric disorders were depressive disorders, with a rate of 34.1%. The generalized itching and BDI scores were significantly higher in patients with a psychiatric diagnosis as compared to those without (p<0.05). Among all chronic pruritus patients, 62%