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Zinc supplementation augments efficacy of imipramine in treatment resistant patients: a double blind, placebo-controlled study.

BACKGROUND One of the main problems in the therapy of depression is the limited efficacy of antidepressants and the limited utility of augmentation strategies. Zinc, a non competitive NMDA receptor antagonist exhibits preclinical antidepressant efficacy. Moreover, a preliminary clinical report suggests augmentation of antidepressant therapy by zinc in depression. METHODS A placebo-controlled, double blind study of zinc supplementation in imipramine therapy was conducted in sixty, 18-55-year old, unipolar depressed patients fulfilling the DSM-IV criteria for major depression without psychotic symptoms. After a one week washout period, patients were randomized into two groups treated with imipramine (approximately 140 mg/day) and receiving once daily either placebo (n=30) or zinc supplementation (n=30, 25 mgZn/day) for 12 weeks. RESULTS No significant differences in CGI, BDI, HADRS and MADRS scores were demonstrated between zinc-supplemented and placebo-supplemented antidepressant treatment non-resistant patients. However, zinc supplementation significantly reduced depression scores and facilitated the treatment outcome in antidepressant treatment resistant patients. CONCLUSION Zinc supplementation augments the efficacy and speed of onset of therapeutic response to imipramine treatment, particularly in patients previously nonresponsive to antidepressant pharmacotherapies. These data suggest the participation of disturbed zinc/glutamatergic transmission in the pathophysiology of drug resistance.

Serum zinc level in depressed patients during zinc supplementation of imipramine treatment

BACKGROUND Recurrent major depression is associated with decreased blood zinc concentrations that may be increased by effective antidepressant therapy. Some clinical investigations point to alterations of the zinc level in blood as a potential marker of depression. METHODS A placebo-controlled, double blind study of zinc supplementation to imipramine therapy was conducted on sixty patients fulfilling the DSM-IV criteria for major depression (18-55 years old, 40 females, 20 males). Moreover, a group of 25 healthy volunteers was recruited (16 females, 9 males). Blood samples were drawn for the assay of serum zinc once from the control subjects and four times (before, and then 2, 6 and 12 weeks after the beginning of treatment) from the depressed subjects. RESULTS We report that: 1) the serum zinc level was significantly lower (by 22%) in depressed patients than in healthy volunteers, 2) all groups demonstrated a gradual increase in zinc concentrations over the period of imipramine treatment with or without zinc supplementation, 3) treatment-resistant patients demonstrated lower concentrations of zinc (by 14%) than treatment-non-resistant patients, 4) zinc concentrations were higher in zinc-supplemented patients than in placebo-supplemented patients, 5) zinc supplementation increased zinc concentrations over the period of treatment, and 6) at a 12-week imipramine treatment, a significant negative correlation was demonstrated between the Montgomery-Asberg Depression Rating Scale and the serum zinc level together with a concomitant increase in serum zinc in patients in remission. CONCLUSIONS Serum zinc is a state marker of depression.

The Impact of Depressive Illness on Spouses of Depressed Patients

This study examines the impact of major depressive illness on spouses of depressed patients. The aim of the study was to attempt to conceptualize the gender differences in the manner in which spouses experience their partnera’s disorder. Forty-eight spouses of depressed patients (22 females and 26 males) and 48 married couples with no mental health diagnosis were selected to participate in this study. The occurrence of depressive symptoms was assessed through the use of the Hamilton Depression Rating Scale (HDRS) and the Beck Depression Inventory (BDI). Thinking styles were assessed using the Rosenberg Scale (RS), Hopelessness Scale (HS), and the Automatic Thoughts Questionnaire (ATQ). Perception of the marital relationships was evaluated with the Dyadic Adjustment Scale (DAS) Results indicate more depressive symptomatology and distorted thinking patterns with the female spouses of depressed patients. The perceived quality of marital relationships by female spouses was rated to be poorer than that of male counterparts and controls. The results suggest that there exist clear differences in thinking style and perception of marital relationships between female and male spouses who are married to depressed partners.

Estilo específico de pensamiento genérico y el curso de la depresión mayor en hombres y mujeres: un estudio de tres años en Polonia

El presente estudio tiene por objeto evaluar los cambios en el tiempo de algunas variables clave de hombres y mujeres en el diagnostico de depresion mayor; 40 pacientes hospitalizados que cumplieron con los criterios del DSM III-R para la depresion (21 mujeres y 19 hombres) fueron sometidos a un estudio prospectivo de tres anos de duracion. Se realizaron evaluaciones estandarizadas al inicio y al final de la hospitalizacion, y posteriormente, al primer, segundo y tercer anos despues del alta. Un ano despues del alta las mujeres se encontraban marcadamente mas deprimidas, tenian un nivel de autoestima inferior y un estilo atribucional mas negativo. Estas diferencias aumentaron a traves del tiempo, alcanzando significacion estadistica al tercer ano despues del alta. Las mujeres tendieron a estar cronicamente deprimidas, mostraron un marcado deterioro funcional, y requirieron de intervenciones farmacologicas, mientras que los hombres tendieron a manifestar una mejoria en el estilo de pensamiento, menos depresion y necesitaron de menor medicacion. El presente estudio proporciona mas evidencia sobre las diferencias especificas de genero en el curso longitudinal de la depresion mayor y apoya firmemente la utilizacion de escalas de calificacion objetivas en el manejo clinico de los pacientes deprimidos

Marital functioning in patients with major depression

Abstract The aim of our study was to characterize marital relationships in patients with major depression over follow-up. The study included 36 patients (19 men and 17 women) two years after their discharge from hospital. We assessed current depressive symptoms using the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS), course of depression during follow-up and marital relationships (general satisfaction, support, consensus, affection, respect, confidence, arguments, sexual life, value system, engagement in household rule) using semistructured interviews and the Revised Dyadic Adjustment Scale (RDAS). In the whole group, irrespective of the course of the illness, sexual impairment and increase in arguments persisted. Other aspects of marital functioning assessed in our study differed significantly between moderately/severely depressed and mildly depressed/non-depressed subjects and between the study and control groups. The influence of the illness on marital functioning differed...

Application of fatty acid and lipid measurements in neuropsychiatry

Abstract The importance of lipids in the understanding of disease states is constantly increasing. Whilst the link between metabolic disorders and lipids seems to be clear, interpreting lipid regulation in the context of neuropsychiatric disorders is a new approach. Mental disorders account for almost 15% of the total global disease burden with Alzheimer’s disease, depression or schizophrenia being amongst the most widespread mental disorders in the general population. For this reason rapid and early diagnosis is crucial and finding the right biomarkers is of great importance. Lipids appear to be essential in learning the aetiopathology of neuropsychiatric diseases as well as in biomarker research as they are most abundantly present in the brain. This study discusses recent findings in neuropsychiatry in the context of lipid analysis.

A perception of social support in the aspect of a cognitive style of patients with affective disorders.

UNLABELLED According to Aaron Beck, dysfunctional thinking patterns appear also in euthymic patients, after withdrawal of acute diseases symptoms. Patients have a disordered, negative image of themselves, of their future and the surrounding world. It has been shown that a way a man perceives possessed social support has a basic meaning for him. AIM The purpose of the research was to analyze the relationship between perceived social support and the patients cognitive style. METHOD The study group consisted of euthymic outpatients diagnosed with recurrent depressive disorder (UID) or bipolar affective disorder (BID). Assessment of a cognitive style was made according to the Rosenberg Scale, Hopelessness Scale HS-20 and Automatique Thoughts Questionnaire ATQ 30, assessment of the amount of received support - according to Cohens ISEL. RESULTS AND CONCLUSIONS The presented study revealed that, in both groups of patients, a thinking style is disturbed and that there is a link between a cognitive style and the perception of the level of received support. The link was stronger in the group of patients with unipolar affective disorder. In both groups, correlations concerning emotional support were the highest.