Showing posts with label antidepressants. Show all posts
Showing posts with label antidepressants. Show all posts

Wednesday, February 28, 2018

Journal, and patient blog updates - Beyond one virus: vaccination against hepatitis B after hepatitis C treatment.

Read the latest journal and viral hepatitis updates from patient bloggers who work hard to educate and inspire us all.

HCV Advocate
HCV Advocate has just published their Monthly Newsletter, check out the latest "March issue."

Judy Stone
Given the experience in Indiana, which saw a spike in STDs, Hepatitis C and HIV, Walensky expects the HIV/Hepatitis C to “go up in lock-step with those” other sexually transmitted diseases. Walensky raised interesting points regarding HIV medications as well, noting “In the past 2-3 years, the cost of first line antiretroviral ...

Gilead Sciences Canada, Inc. (Gilead Canada) today recognizes the Ontario Ministry of Health and Long-Term Care for its leadership in the expansion of access to therapies that treat chronic hepatitis C virus infection under the Ontario Drug Benefit (ODB) Program. Today, all eligible ODB recipients will have greater access to treatment, regardless of the severity of disease (fibrosis level), to achieve a cure and improve their quality of life. Patients with chronic hepatitis C will no longer have to wait for their disease to progress before starting treatment.

Specialty Pharmacy Times
A study published by Clinical Infectious Diseases suggests that screening all adults for HCV may be cost-effective and could also identify more patients with the infection than current recommendations.

In The Journals
Volume 18, No. 3, p246–247, March 2018
New treatments for hepatitis C virus (HCV) infection with direct-acting antivirals provide an extraordinary cure rate. A recent Article by Xavier Forns and colleagues1 shows an outstanding 99% sustained virological response among all viral genotypes.

Developing a universal influenza vaccine — a vaccine that can provide durable protection for all age groups against multiple influenza strains, including those that might cause a pandemic — is a priority for the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. Writing in the Journal of Infectious Diseases, NIAID officials detail the Institute’s new strategic plan for addressing the research areas essential to creating a safe and effective universal influenza vaccine. They describe the scientific goals that will be supported to advance influenza vaccine development. The strategic plan builds upon a workshop NIAID convened in June 2017 that gathered scientists from academia, industry and government who developed criteria for defining a universal influenza vaccine, identified knowledge gaps, and delineated research strategies for addressing those gaps.

Journal Of Hepatology
«The times they are a’changin’» – Positioning the European Association for the Study of the Liver in the changing landscape of hepatology
Bob Dylan’s words hold relevance for several forces currently acting upon hepatology and the European Association for the Study of the Liver (EASL). The arrival of direct-acting antivirals, which marked the definitive transformation of hepatitis C virus infection into a curable disease with a new focus on public health represents only one of the changes. Fuelled by demographic changes of an ageing population, by migration movements in and beyond Europe, as well as by lifestyle changes and the explosion of the metabolic syndrome, other areas are in rapid expansion. The most pronounced of which are related to non-alcoholic fatty liver disease (NAFLD), hepatitis B virus infection, alcoholic disease and hepatocellular carcinoma (HCC). Moreover, tremendous dynamics in science and drug development now offer treatment options for patients with rare diseases that are also increasing in prevalence. Major trends at the societal level also have an impact on EASL.

Foster GR, et al. Hepatol. 2018;doi:10.1002/hep.29852.
February 27, 2018
Zepatier demonstrated high efficacy among patients with hepatitis C genotype 3, regardless of treatment experience or baseline resistance-associated substitutions, according to recently published data.

Healio Gastroenterology
Ira M. Jacobson, MD
The field of hepatology has seen revolutionary changes occuring within hepatitis C therapy over the past few years. This extraordinary newfound ability to cure almost all patients with chronic HCV raises many questions about clinical outcomes.

“Herbal and dietary supplement-induced liver injury is an increasing healthcare problem,” Lucena said. “The present study is a comprehensive analysis of all HILI cases reported to the Spanish DILI Registry to date. This study provides relevant information about clinical features associated with HILI, and highlights the importance of identifying all medicinal products, prescription drugs as well as herbal and dietary supplement products, taken by patients who develop liver abnormalities.”

Of Interest @ Healio
By some estimates, there are between 50,000 and 200,000 apps intended to serve a medical need. These apps claim to manage symptoms of depression, improve care in patients with irritable bowel disease, manage diabetes as well as help patients with a myriad of other medical uses.

Read today's news or a nice summary of notable headlines published in the latest issue of "The Weekly Bull."

Hepatitis B
AGA Blog
Gastroenterology and Clinical Gastroenterology and Hepatology.
Dr. Kristine Novak
NVR3–778, a capsid assembly modulator, reduces serum levels of hepatitis B virus (HBV) DNA and HBV RNA in mice with humanized livers and stable HBV infection, researchers report in the February issue of Gastroenterology. The combination of NVR3–778 and interferon prevented viral replication and HBV RNA particle production to a greater extent than....

Hep B Blog
Hepatitis B Foundation
February 28, 2018
Welcome to “Journey to the Cure” This is a web series that chronicles the progress at the Hepatitis B Foundation and Baruch S. Blumberg Institute towards finding the cure for hepatitis B.

Hepatitis C
In a recent publication in Clinical Infectious Diseases, CHERISH trainee Dr. Shashi Kapadia, CHERISH staff member Philip Jeng, CHERISH director Dr. Bruce Schackman and CHERISH research affiliate Dr. Yuhua Bao characterize variation in DAA utilization among states and explore the association between changes in Medicaid treatment eligibility criteria and trends in DAA utilization.

Life Beyond Hep C
Connie M. Welch
Hep C Patient John, shares his conquering story from hepatitis C, end stage liver disease, liver cancer and liver transplant. Connie: John, Thank you for being with us this week and sharing your awesome story of how you’ve come through this battle with liver disease.

Hep Blogs
By Connie M. Welch 
February 28, 2018 
The guiding principle of the national transplant system has been; locals first. Most organs stay in the areas where they are donated, even if sicker patients are waiting in other parts of the country.

Hep - Forums 
Welcome to the Hep Forums, a round-the-clock discussion area for people who have Hepatitis B, C or a co-infection, their friends and family and others with questions about hepatitis and liver health. Check in frequently to read what others have to say, post your comments, and hopefully learn more about how you can reach your own health goals.
By Kimberly Morgan Bossley
February 27, 2018
Working has always been my “thing” you can say. I started very young and have never not had a job or career. During the Spring of 2005, I was running three individual companies. All...

By Daryl Luster
February 26, 2018
Yes I know, a sensational title. I apologize for the dramatic tone. The thing is that we are inclined to do this bracing thing in preparation for storms, difficult events, or things...

By Kimberly Morgan Bossley
February 23, 2018
Stop complaining about your situation and start doing things to change it. How many times have we all heard this through our journey in life? I know for myself growing up it... - Forums
Talk about it - privately
Have questions? Want to talk about Hep C? Connect with others privately in our forums!

Nature Blogs
Amy Maxmen
Several vaccines and drugs for preventing the spread of HIV are showing signs of success in clinical trials, three decades after scientists began the search. But some researchers fear that progress will stall without a coordinated strategy to ensure that the most promising therapies to prevent infection win support from policymakers and reach the people who need them.

The new edition of "HIV update is now online."
Untreated hepatitis C can cause serious liver disease, including fibrosis (a build-up of fibrous scar tissue, leading to a ‘stiff’ liver) and cirrhosis (serious scarring that blocks blood flow through the liver, kills liver cells and interferes with liver function). The more advanced the fibrosis and cirrhosis, the greater the risk of serious illness and death. Successful hepatitis C treatment can clear the virus from the body. But less is known about its long-term impact on fibrosis or cirrhosis.

Women and Viral Hepatitis
A systematic review and meta-analysis revealed that maternal viral load among mothers with hepatitis B was a significant risk factor for mother-to-child transmission, and was dose-dependent with HBV transmission incidence.

Rates of hepatitis C infections are on the rise among adults in the United States, and some of those adults are pregnant women.

Healthy You
Stanford Medicine 
February 26, 2018
There's a wide debate surrounding the use of antidepressants. Do they really work? If so, how well? And how do you know which one to select?

Harvard Health
Christopher Bullock, MD, Carolyn A. Bernstein, MD, FAHS
Getting regular exercise is one of the best actions you can take to improve or maintain your overall health. Fitting exercise into your life is not as difficult as it might seem, but it does require some planning.

Also @ Harvard Health - Diet and depression

Tuesday February 27 2018
A new UK study investigated levels of inappropriate antibiotic prescribing by GPs in England. This was defined as prescribing antibiotics where guidelines say they're of little to no benefit.

Thanks for stopping by.

Thursday, September 14, 2017

Antidepressants associated with significantly elevated risk of death, researchers find

Antidepressants associated with significantly elevated risk of death, researchers find
McMaster University

HAMILTON, ON, CANADA, Sept. 14, 2014 - Antidepressant medications, most commonly prescribed to reduce depression and anxiety, increase the risk of death, according to new findings by a McMaster-led team of researchers.

It's widely known that brain serotonin affects mood, and that most commonly used antidepressant treatment for depression blocks the absorption of serotonin by neurons. It is less widely known, though, that all the major organs of the body--the heart, kidneys, lungs, liver--use serotonin from the bloodstream.

Antidepressants block the absorption of serotonin in these organs as well, and the researchers warn that antidepressants could increase the risk of death by preventing multiple organs from functioning properly.

The researchers reviewed studies involving hundreds of thousands of people and found that antidepressant users had a 33% higher chance of death than non-users. Antidepressant users also had a 14% higher risk of cardiovascular events, such as strokes and heart attacks. The findings were published today in the journal Psychotherapy and Psychosomatics.

"We are very concerned by these results. They suggest that we shouldn't be taking antidepressant drugs without understanding precisely how they interact with the body," says author Paul Andrews, an associate professor at McMaster University who led the research team.

Taken by one in eight adult Americans, antidepressants are among the most frequently used medications. They are often prescribed by family doctors without a formal diagnosis of depression, on the assumption they are safe. Since depression itself can be deadly--people with depression are at an increased risk of suicide, stroke and heart attack--many physicians think that antidepressants could save lives by reducing depressive symptoms.

However, McMaster researcher and co-author Marta Maslej, says, "Our findings are important because they undermine this assumption. I think people would be much less willing to take these drugs if they were aware how little is known about their impact outside of the brain, and that what we do know points to an increased risk of death."

Benoit Mulsant, a psychiatrist at the University of Toronto who was also involved in the study, says the findings point to the need for more research on how antidepressants actually do work.

"I prescribe antidepressants even though I do not know if they are more harmful than helpful in the long-term. I am worried that in some patients they could be, and psychiatrists in 50 years will wonder why we did not do more to find out," Mulsant says.

Interestingly, the news about antidepressants is not all bad. The researchers found that antidepressants are not harmful for people with cardiovascular diseases such as heart disease and diabetes. This makes sense since these antidepressants have blood-thinning effects that are useful in treating such disorders. Unfortunately, this also means that for most people who are in otherwise good cardiovascular health, antidepressants tend to be harmful.

Tuesday, February 11, 2014

Hepatitis C-Antidepressants for prevention of Interferon-associated depression

International Journal of Clinical Practice

Prevention of Interferon-Alpha-Associated Depression With Antidepressant Medications in Patients With Hepatitis C Virus

A Systematic Review and Meta-analysis
M. Ehret, D. M. Sobieraj
Int J Clin Pract. 2014;68(2):255-261.

Abstract and Discussion Only
Objective: To conduct a systematic review and meta-analysis evaluating the efficacy and safety of antidepressant medications for the prevention of interferon-alpha (INF-α)-associated depression in patients with chronic hepatitis C virus (HCV).
Data sources: Medline, Cochrane Central and PsycInfo from inception to September 2012, without limitations using terms describing hepatitis C and the individual drug names.
Study selection: We reviewed 132 citations for inclusion using the following criteria: randomised controlled trials in patients with chronic HCV initiating INF-α comparing prophylactic use of an antidepressant vs. placebo and reporting at least one outcome of interest [depression, completion of antiviral therapy, sustained virologic response (SVR), and serious adverse events and bleeding].
Data extraction: Trial characteristics, assessment of risk of bias and data needed for analyses were extracted by two independent investigators using a standard extraction form. Disagreements were reviewed by a third investigator.
Results: A DerSimonian and Laird random-effects model was used for analysis. Heterogeneity and publication bias were evaluated where applicable. Of the seven included trials, the risk of bias was low in four and unclear in the remaining three. All trials evaluated selective serotonin reuptake inhibitors (SSRIs). Prophylactic use of a SSRI significantly reduced the risk of depression by 41% compared with placebo [RR, relative risk 0.59 (0.37–0.93)]. The impact of SSRIs on completion of antiviral therapy, SVR and serious adverse events was not found to be significant.
Conclusions: SSRIs prevent depression in patients with HCV treated with INF-α therapy. The impact of SSRIs on completion of antiviral therapy or on the development of adverse events is less clear.

Discussion Only
To our knowledge, this is the first systematic review and meta-analysis analysing the use of SSRIs for the prevention of INF-α-associated depression in patients with chronic HCV. The trials which have previously evaluated this clinical practice have had differing results. The trials were all very similar in terms of interventions, outcomes assessment and follow up. Although the sample sizes varied and most were small, two of the smallest trials concluded SSRIs were not effective as did two of the larger trials. By using methods of systematic review and meta-analysis, we were able to pool the results of these trials to discern an overall effect of SSRIs in this population. In our analysis, the prophylactic use of a SSRI during INF-α-based therapy in patients with HCV reduced the risk of depression during antiviral treatment. However, the severity of depressive symptoms as measured by the MADRS score did not differ. SSRI therapy was initiated at least 2 weeks prior to antiviral therapy and was continued throughout the duration of antiviral therapy. Although SSRI therapy was successful in reducing depression risk, this did not translate into differences in completion rates of antiviral therapy or achievement of SVR. Safety outcomes were not frequently reported and therefore the overall safety of this practice is unclear.

Selective serotonin reuptake inhibitors work by inhibiting 5-HT reuptake and thus increasing serotoninergic transmission. This is opposite to the proposed mechanism by which INF-α is thought to cause depression (decreasing tryptophan and 5-HT levels, increasing 5-HT reuptake and thus decreasing synaptic availability of 5-HT and 5-HT transmission). [21,22] SSRIs have high rates of success in treating IFN-α-induced depression, beyond that typically observed in RCTs in major depression. [23] Although SSRIs have considerably less adverse effects compared with other antidepressant classes, several major concerns should be considered prior to use, including an increased risk of bleeding and development of manic episodes. [24–26] Other mild and transient adverse effects include sexual dysfunction, gastrointestinal distress, anxiety, sweating, and headache. [27] Despite these limitations, SSRIs should be considered the first choice for the prevention of IFN-α-induced depression because of their excellent efficacy, favourable adverse effect profile, minimal hepatic toxicity and few drug–drug interactions. [23]
Although the use of SSRIs did decrease the risk of depression by 41%, there was no significant difference in the change of MADRS scores from baseline to follow up in those treated with SSRIs vs. placebo. It would be expected that a reduction in the diagnosis of depression would equate to a decrease in the change score for those treated with SSRIs. There was a higher level of statistical heterogeneity seen between the studies in this analysis, with disagreement in both magnitude and direction of effect, which may be related to the small number of participants in the studies and type II error. Additionally, the MADRS was developed to measure the overall severity of depressive symptoms in patients with a diagnosis of major depressive disorder. [28] It does not focus on the somatic symptoms of depression, which are included in the DSM-IV criteria used to diagnose depression in six of the seven included studies. The neurovegetative and somatic symptoms of depression, such as anorexia, fatigue and altered sleep and pain, typically develop with the first few weeks of treatment with IFN-α and are less responsive to antidepressants. While, depressed mood, anxiety and cognitive dysfunction typically develop later (i.e. 12 weeks) during IFN-α treatment and are more responsive to antidepressants. [29]
There are several limitations to the analysis and literature base that are worth noting. The patient population evaluated in the included trials represented four HCV genotypes (1–4) although slightly more than half of the population had genotype 1. In 2011, two protease inhibitors were approved in the United States for the treatment of HCV, genotype 1, in combination with pegylated INF-α and ribavirin: boceprevir (Victrelis®) and telaprevir (Incivek®). Most recent guidelines from the American Association for the Study of Liver Disease recommend this triple therapy for patients with genotype 1. [30] Although our current analysis does not reflect the use of triple therapy to treat HCV, we do not anticipate a difference in SSRI treatment effect since the protease inhibitors are not known to cause depression as a side effect. [31,32] However, it is noteworthy that the package insert for both protease inhibitors does warn of a potential drug interaction with escitalopram and that 'SSRIs such as escitalopram have a wide therapeutic index, but doses may need to be adjusted when combined'. [31,32] The populations of the included trials may in fact have been diverse. Although the studies excluded patients with a current depressive episode, previous depressive episodes were not used as an exclusion criterion which could have diversified the population of subjects. Previous studies have demonstrated rates of neuropsychiatric symptoms of 12–41% in those that excluded patients with psychiatric histories while those studies without this exclusion criteria report an incidence of 17–58%. [33] This diverse population could account for different rates of changes in MADRS scores and the heterogeneity seen within the studies. Additional research should focus on each population, those with and those without psychiatric histories, separately in determining the use of antidepressants in preventing depressive symptoms. Although we sought to identify trials evaluating other antidepressant, none was found in the peer reviewed literature. Therefore, little is known about whether or not other types of antidepressants, which have varying types of adverse effects, such as the serotonin norepinephrine reuptake inhibitors, mirtazapine, or bupropion, may decrease the development of depression in this population. There is also a lack of reported information on adverse effects from the use of the SSRIs in this population. Bleeding is a potential issue with the use of SSRIs because of the ability to decrease intraplatelet 5-HT content and inhibit platelet function. [24] This is a significant concern in those with liver dysfunction who are at an increased risk of gastrointestinal bleeding. Included trials did not routinely report liver function tests or markers of liver function to know the severity of liver dysfunction. Although the true risk vs. benefit is unclear, a retrospective analysis recently found an overall rate of 0.3% of bleeding in those with hepatitis C treated with SSRIs, suggesting a low risk. [34]
Patients receiving SSRIs had a lower risk of developing depression vs. placebo in those with HCV treated with INF-α-plus ribavirin. Future research should focus on the evaluation of other antidepressants and the safety of antidepressant use in this patient population.


Friday, January 3, 2014

In Most Cases Antidepressant-Induced Liver Injury Is Unpredictable

"Dr. Perlemuter and colleagues say that antidepressants with a higher potential for hepatotoxicity should be used with caution in elderly patients, in patients with coprescriptions, and in patients with substantial alcohol use, illicit substance use, or evidence of chronic liver disease."
Antidepressant-Induced Liver Injury Underestimated
Megan Brooks
December 31, 2013

All antidepressant drugs may potentially cause liver injury, even at recommended doses, and some groups are more vulnerable than others, French researchers report.

"Antidepressant liver toxicity has been underestimated in the scientific literature," say Gabriel Perlemuter, MD, PhD, from AP-HP Hôpital Bicêtre, Kremlin-Bicêtre, France, and colleagues.

In some cases, antidepressant-induced liver injury can be irreversible. Given that there currently is no strategy available to prevent antidepressant-induced liver injury, "early detection and prompt drug discontinuation remain critical," they say.

Their research was published online December 20 in the American Journal of Psychiatry.

Liver Injury Unpredictable

The investigators reviewed clinical data on antidepressant-induced liver injury from 158 reports, including 88 case reports, 38 original articles, and 32 reviews.

They calculate that 0.5% to 3% of patients treated with antidepressants may develop asymptomatic mild elevation of serum alanine aminotransferase (ALT) levels.

In most cases, liver damage is "idiosyncratic and unpredictable, and it is generally unrelated to drug dosage," they say. Liver damage may occur between several days and 6 months after initiation of an antidepressant.

All antidepressants can induce hepatotoxicity, especially in elderly patients and those who take multiple pharmaceutical agents. However, there is not enough evidence to draw "rigorous conclusions" about the prevalence and severity of antidepressant-induced liver injury, the investigators say.

Based on the evidence, the antidepressants associated with highest risk for hepatotoxicity are monoamine oxidase (MAO) inhibitors, tricyclic/tetracyclic antidepressants, nefazodone, bupropion, duloxetine, and agomelatine. Those with seemingly lower risks are citalopram, escitalopram, paroxetine, and fluvoxamine.

Life-threatening or severe drug-induced liver injury has been reported for some antidepressants, including MAO inhibitors, tricyclic/tetracyclic antidepressants, venlafaxine, duloxetine, sertraline, bupropion, nefazodone, trazodone, and agomelatine, Dr. Perlemuter and colleagues report.

Although no dose-response relationship has been clearly demonstrated, it is best to stick to the minimum effective dosages of antidepressants to reduce the risk for liver injury, they advise.

Use With Caution

Dr. Perlemuter and colleagues say that antidepressants with a higher potential for hepatotoxicity "should be used with caution in elderly patients, in patients with coprescriptions, and in patients with substantial alcohol use, illicit substance use, or evidence of chronic liver disease."

"Systematic pretherapeutic screening and regular assessment of hepatic enzymes during treatment may be useful for antidepressants with a high potential for hepatotoxicity and for patients with known risk factors," they add.

It is also important to tell patients taking an antidepressant about the possibility of liver abnormalities, to encourage them to report any clinical symptoms suggestive of liver problems, and to stop treatment if jaundice develops, the researchers say.

Antidepressants "should be discontinued immediately" in any patient with suspected drug-induced liver injury, they write.

Dr. Perlemuter has received travel funds from Janssen, Gilead, and Roche, consulting fees from Bayer, Biocodex, Physiogenex, and Servier, and royalties from Elsevier-Masson. The original article contains a complete list of author disclosures.

Am J Psychiatry. Published online December 20, 2013. Abstract

Tuesday, November 12, 2013

News-Hepatitis C Found During ER Visits, Late relapse after SVR and SSRIs During Treatment

Hepatology: New At Healio

High prevalence of HCV found in baby Boomers via emergency room screening


SSRIs may reduce treatment-associated depression in HCV patients
Nov 12
Hou XJ. PLoS One. 2013;doi:10.1371/journal.pone.0076799.

Prophylactic use of selective serotonin reuptake inhibitors may significantly reduce the incidence of depression associated with pegylated interferon alfa-2a or 2b with ribavirin combination treatment for chronic hepatitis C, researchers from China reported.

Although pegylated interferon alfa-2a or alfa 2b (Peg-IFN a-2a or a-2b) with ribavirin is considered to be the most effective regimen for chronic hepatitis, the treatment is associated with “an approximately 70% incidence of mild to moderate depressive syndromes and 20% to 40% incidence of major depression” in patients with HCV infection, according to the researchers.
More »

Late relapse after SVR may not be new HCV infection
Nov 11
Hara K. J Infect Dis. 2013;doi:10.1093/infdis/jit541.

Patients with hepatitis C who relapse after achieving sustained virological response may be having a relapse of the initial infection rather than a reinfection with a different strain, recent data published in the Journal of Infectious Diseases suggest.

“In a few individuals, hepatitis C has found a sanctuary site and can remain dormant for a length of time,” Theo Heller, MD, chief of the translational hepatology unit at the Liver Diseases Branch of the National Institute of Diabetes & Digestive & Kidney Diseases, told Infectious Disease News. “This is important both biologically and clinically, even in the approaching era of direct-acting antivirals, where relapse may still be a problem. We already know it can and does occur.”
More »

Ongoing phase 2 trial finds RVR from all-oral regimen for HCV patients
November 11, 2013
WASHINGTON — An investigational, all-oral combination of protease inhibitor faldaprevir, non-nucleoside NS5B inhibitor deleobuvir and NS5A inhibitor PPI-668 with and without ribavirin has consistently demonstrated rapid virologic response among the hepatitis C genotype 1a population, a speaker said here.

“On a preliminary basis, it looks like we have another three-drug combo that’s active in the harder-to-treat [HCV] genotype 1a population,” Jacob P. Lalezari, MD, of the University of California, San Francisco, School of Medicine and director of Quest Clinical Research, said in discussing a late-breaking poster at The Liver Meeting.
More »

Additional headlines from The Liver Meeting 2013 @ Healio

Meeting News Coverage

Gamma-GT levels may predict HCC risk in noncirrhotic patients after SVR
November 8, 2013
Meeting News CoverageVideo

Breath analysis may offer noninvasive means to diagnose alcoholic hepatitis
November 8, 2013
Meeting News CoverageVideo

Triple therapy with sofosbuvir yields high SVR rates among cirrhotic patients with HCV
November 7, 2013
Meeting News CoverageVideo

ARF6 gene associated with biliary atresia
November 7, 2013
Meeting News Coverage

Public education on acetaminophen dangers vitally important
November 6, 2013
Meeting News Coverage

Interferon/ribavirin-free triple therapy highly effective for chronic HCV genotype 1
November 5, 2013
Meeting News Coverage

Immunosuppression, EVR predictive of SVR in liver transplant recipients with HCV
November 5, 2013
Meeting News Coverage

Severe fibrosis, not NAS, predicted disease-specific mortality in NAFLD
November 5, 2013
Meeting News Coverage

ED screening identifies previously undiagnosed patients with HCV
November 5, 2013
Meeting News Coverage

Medication trade-offs significantly associated with readmissions after liver transplant
November 5, 2013

Meeting News Coverage

No benefit from post-HPE corticosteroid therapy in infants with biliary atresia
November 4, 2013
Meeting News Coverage

Hepatotoxicity from herbal, dietary supplements rising
November 4, 2013
Meeting News CoverageVideo

3-D liver reproduction offers new planning, educational opportunities
November 4, 2013
Meeting News Coverage

Longer transplant waits for HCC patients may be beneficial
November 4, 2013
Meeting News CoverageVideo

Cell-based assay may predict liver transplant rejection in children
November 3, 2013
Meeting News Coverage

Accuracy, reproducibility of liver disease assessment poor in morbidly obese patients
November 3, 2013
Meeting News Coverage

Liver Meeting speaker: HCC exceptions contributing to MELD inflation, transplant inequity
November 3, 2013
Meeting News Coverage

Bleeding complications predict, but don’t cause poor outcomes in patients with acute liver failure
November 2, 2013
Meeting News Coverage

Fatty liver disease may overtake HCV as key cause of liver transplant, AASLD president says
November 2, 2013

Monday, April 1, 2013

Brain Scans Give Clues to Antidepressant’s Effects

Brain Scans Give Clues to Antidepressant’s Effects

Brain scans during memory tests might help predict which depressed patients will be helped by a fast-acting drug, a new study reports.

Major depression is marked by feelings of sadness, loss, anger or frustration that can interfere with daily life for many weeks. Symptoms can also include memory loss and trouble focusing.

Most depression-fighting drugs must be taken for several weeks before working, which can cause an agonizing wait for patients. Because different people respond to different medications, patients may need to try several drugs over a month or more before getting symptom relief.

Several years ago, NIH researchers discovered that a drug used to treat motion sickness could also rapidly reduce symptoms of depression. But the drug, called scopolamine, didn’t work in all patients.

To try to predict the drug’s effects, the researchers used MRI to track brain activity in adults with and without major depression. People with major depression are known to have unique patterns of brain activity when asked to pay attention to the emotional content of images. They also tend to remember negative information (such as sadness) better than positive or neutral information.

The researchers found that scopolamine relieved symptoms in 11 of the 15 participants who had major depression. Scopolamine’s effectiveness was linked to activity in a specific brain region when patients were asked to remember the emotions on faces that flashed by. Activity in this same brain region was also altered by infusions of scopolamine.

The findings suggest that activity in this brain region might provide early clues about how well scopolamine will work in different patients. Ongoing studies are exploring how the brain’s response to emotional images might help guide treatment strategies for major depression.