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Depression: HELP
Articles by Michael E. Thase
Based on 223 articles published since 2008
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Between 2008 and 2019, M. Thase wrote the following 223 articles about Depression.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9
1 Editorial Recommendations for Screening for Depression in Adults. 2016

Thase, Michael E. ·Perelman School of Medicine, Department of Psychiatry, University of Pennsylvania, Philadelphia2Corporal Michael J. Crescenz VAMC, Philadelphia, Pennsylvania. ·JAMA · Pubmed #26813206.

ABSTRACT: -- No abstract --

2 Editorial Large-scale study suggests specific indicators for combined cognitive therapy and pharmacotherapy in major depressive disorder. 2014

Thase, Michael E. ·Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia2Department of Psychiatry, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania3Department of Psychiatry, University of Pittsburgh Medical C. ·JAMA Psychiatry · Pubmed #25142013.

ABSTRACT: -- No abstract --

3 Editorial Comparative effectiveness of psychodynamic psychotherapy and cognitive-behavioral therapy: it's about time, and what's next? 2013

Thase, Michael E. · ·Am J Psychiatry · Pubmed #24030607.

ABSTRACT: -- No abstract --

4 Editorial Rapid improvement in affective information processing after acute administration of reboxetine. 2009

Thase, Michael E. · ·Am J Psychiatry · Pubmed #19797440.

ABSTRACT: -- No abstract --

5 Review Computer-Assisted Cognitive-Behavior Therapy for Depression in Primary Care: Systematic Review and Meta-Analysis. 2018

Wells, Michael J / Owen, Jesse J / McCray, Laura W / Bishop, Laura B / Eells, Tracy D / Brown, Gregory K / Richards, Derek / Thase, Michael E / Wright, Jesse H. ·Department of Family and Geriatric Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA. · Department of Counseling Psychology, University of Denver, Denver, CO 80208. jesse.owen@du.edu. · Department of Counseling Psychology, University of Denver, Denver, Colorado, USA. · Family Medicine Residency Program, University of Vermont Medical Center, Burlington, Vermont, USA. · Internal Medicine and Pediatrics Residency Program, University of Louisville School of Medicine, Louisville, Kentucky, USA. · Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, Kentucky, USA. · Clinical Psychology in Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. · E-mental Health Research Group, School of Psychology, Trinity College Dublin, University of Dublin, Dublin, Ireland. · SilverCloud Health, Dublin, Ireland. · Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. · Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA. ·Prim Care Companion CNS Disord · Pubmed #29570963.

ABSTRACT: Objective: To examine evidence for the effectiveness of computer-assisted cognitive-behavior therapy (CCBT) for depression in primary care and assess the impact of therapist-supported CCBT versus self-guided CCBT. Methods: A search for randomized studies of CCBT compared to control groups for treating depression in primary care settings was conducted using Ovid MEDLINE, PsycINFO, PubMed, and Scopus. We extracted the following information from the studies that met inclusion criteria: mean depression rating scale scores before and after treatment, number of patients, type of control group and CCBT program, therapist support time and method of support, and treatment completion rate. Meta-analyses compared differences between posttreatment mean scores in each condition, as well as mean scores at follow-up. Study quality and possible bias also were assessed. Results: Eight studies of CCBT for depression in primary care met inclusion criteria. The overall effect size was g = 0.258, indicating a small but significant advantage for CCBT over control conditions. Therapist support was provided in 4 of the 8 studies. The effect size for therapist-supported CCBT was g = 0.372-a moderate effect. However, the effect size for self-guided CCBT was g = 0.038, indicating little effect. Conclusions: Implementation of therapist-supported CCBT in primary care settings could enhance treatment efficiency, reduce cost, and improve access to effective treatment for depression. However, evidence to date suggests that self-guided CCBT offers no benefits over usual primary care.

6 Review Monitoring for antidepressant-associated adverse events in the treatment of patients with major depressive disorder: An international consensus statement. 2018

Dodd, Seetal / Mitchell, Philip B / Bauer, Michael / Yatham, Lakshmi / Young, Allan H / Kennedy, Sidney H / Williams, Lana / Suppes, Trisha / Lopez Jaramillo, Carlos / Trivedi, Madhukar H / Fava, Maurizio / Rush, A John / McIntyre, Roger S / Thase, Michael E / Lam, Raymond W / Severus, Emanuel / Kasper, Siegfried / Berk, Michael. ·a School of Medicine, Barwon Health , Deakin University, IMPACT SRC (Innovation in Mental and Physical Health and Clinical Treatment - Strategic Research Centre) , Geelong , Australia. · b Department of Psychiatry , University of Melbourne , Melbourne , Australia. · c Mental Health Drug and Alcohol Services , University Hospital Geelong, Barwon Health , Geelong , Australia. · d Orygen The National Centre of Excellence in Youth Mental Health , Parkville , Australia. · f School of Psychiatry , University of New South Wales, and Black Dog Institute , Sydney , Australia. · g Department of Psychiatry and Psychotherapy , University Hospital Carl Gustav Carus, Technische, Universität Dresden , Dresden , Germany. · h Department of Psychiatry , University of British Columbia , British Columbia , BC , Canada. · i Department of Psychological Medicine , Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK & South London and Maudsley NHS Foundation Trust , London , UK. · j Department of Psychiatry , University of Toronto , Toronto , ON , Canada. · k Department of Psychiatry & Behavioral Sciences , School of Medicine, Stanford University , Stanford , CA , USA. · l Department of Psychiatry , Universidad de Antioquia , Medellín , Colombia. · m Department of Psychiatry , University of Texas Southwestern Medical Center , Dallas , TX , USA. · n Division of Clinical Research , Massachusetts General Hospital and Harvard Medical School , Boston , MA , USA. · o Duke-National University of Singapore Medical School , Singapore , Singapore. · p Mood Disorders Psychopharmacology Unit, University of Toronto , Toronto , ON , Canada. · q Brain and Cognition Discovery Foundation , Toronto , ON , Canada. · r Department of Psychiatry, Perelman School of Medicine , University of Pennsylvania , Pennsylvania , PA , USA. · s Department of Psychiatry and Psychotherapy , Medical University of Vienna , Wien , Austria. · e The Florey Institute of Neuroscience and Mental Health , Parkville , Australia. ·World J Biol Psychiatry · Pubmed #28984491.

ABSTRACT: OBJECTIVES: These recommendations were designed to ensure safety for patients with major depressive disorder (MDD) and to aid monitoring and management of adverse effects during treatment with approved antidepressant medications. The recommendations aim to inform prescribers about both the risks associated with these treatments and approaches for mitigating such risks. METHODS: Expert contributors were sought internationally by contacting representatives of key stakeholder professional societies in the treatment of MDD (ASBDD, CANMAT, WFSBP and ISAD). The manuscript was drafted through iterative editing to ensure consensus. RESULTS: Adequate risk assessment prior to commencing pharmacotherapy, and safety monitoring during pharmacotherapy are essential to mitigate adverse events, optimise the benefits of treatment, and detect and assess adverse events when they occur. Risk factors for pharmacotherapy vary with individual patient characteristics and medication regimens. Risk factors for each patient need to be carefully assessed prior to initiating pharmacotherapy, and appropriate individualised treatment choices need to be selected. Some antidepressants are associated with specific safety concerns which were addressed. CONCLUSIONS: Risks of adverse outcomes with antidepressant treatment can be managed through appropriate assessment and monitoring to improve the risk benefit ratio and improve clinical outcomes.

7 Review Guidelines for the recognition and management of mixed depression. 2017

Stahl, Stephen M / Morrissette, Debbi A / Faedda, Gianni / Fava, Maurizio / Goldberg, Joseph F / Keck, Paul E / Lee, Yena / Malhi, Gin / Marangoni, Ciro / McElroy, Susan L / Ostacher, Michael / Rosenblat, Joshua D / Solé, Eva / Suppes, Trisha / Takeshima, Minoru / Thase, Michael E / Vieta, Eduard / Young, Allan / Zimmerman, Mark / McIntyre, Roger S. ·1Department of Psychiatry,University of California,San Diego,California,USA. · 3Neuroscience Education Institute,Carlsbad,California,USA. · 4Lucio Bini Mood Disorders Center,New York,New York,USA. · 5Department of Psychiatry,Massachusetts General Hospital,Boston,Massachusetts,USA. · 6Department of Psychiatry,Icahn School of Medicine at Mount Sinai,New York,New York,USA. · 7Research Institute at the Lindner Center of HOPE,Mason,Ohio,USA. · 8Mood Disorders Psychopharmacology Unit,University Health Network,Toronto,Ontario,Canada. · 10Department of Psychiatry,University of Sydney,Sydney,Australia. · 11Centro Lucio Bini,Rome,Italy. · 12VA Palo Alto Health Care System,Palo Alto,California,USA. · 14Hospital Clinic,Institute of Neuroscience,University of Barcelona,IDIBAPS,CIBERSAM,Barcelona,Catalonia,Spain. · 15Psychiatry Clinic,Sainen,Kanazawa City,Ishikawa Prefecture,Japan. · 16Department of Psychiatry,Perelman School of Medicine,University of Pennsylvania, and the Corporal Michael J. Crescenz Veterans Affairs Medical Center,Philadelphia,Pennsylvania,USA. · 17Department of Psychological Medicine,Kings College,London,United Kingdom. · 18Department of Psychiatry,Rhode Island Hospital,Providence,Rhode Island,USA. ·CNS Spectr · Pubmed #28421980.

ABSTRACT: A significant minority of people presenting with a major depressive episode (MDE) experience co-occurring subsyndromal hypo/manic symptoms. As this presentation may have important prognostic and treatment implications, the DSM-5 codified a new nosological entity, the "mixed features specifier," referring to individuals meeting threshold criteria for an MDE and subthreshold symptoms of (hypo)mania or to individuals with syndromal mania and subthreshold depressive symptoms. The mixed features specifier adds to a growing list of monikers that have been put forward to describe phenotypes characterized by the admixture of depressive and hypomanic symptoms (e.g., mixed depression, depression with mixed features, or depressive mixed states [DMX]). Current treatment guidelines, regulatory approvals, as well the current evidentiary base provide insufficient decision support to practitioners who provide care to individuals presenting with an MDE with mixed features. In addition, all existing psychotropic agents evaluated in mixed patients have largely been confined to patient populations meeting the DSM-IV definition of "mixed states" wherein the co-occurrence of threshold-level mania and threshold-level MDE was required. Toward the aim of assisting clinicians providing care to adults with MDE and mixed features, we have assembled a panel of experts on mood disorders to develop these guidelines on the recognition and treatment of mixed depression, based on the few studies that have focused specifically on DMX as well as decades of cumulated clinical experience.

8 Review Adverse Effects of Second-Generation Antipsychotics as Adjuncts to Antidepressants: Are the Risks Worth the Benefits? 2016

Thase, Michael E. ·Mood and Anxiety Treatment and Research Program, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 670, Philadelphia, PA 19104-3309, USA. Electronic address: thase@mail.med.upenn.edu. ·Psychiatr Clin North Am · Pubmed #27514300.

ABSTRACT: Over the past decades, several adjunctive therapies have been introduced for treatment-resistant depression (TRD), and these strategies have ebbed and flowed in popularity. Currently, adjunctive therapy with the second-generation antipsychotics (SGAs) is most commonly used by psychiatrists. Four SGAs are FDA approved for indications related to TRD (aripiprazole, brexpiprazole, olanzapine, and quetiapine extended release); some evidence also supports use of risperidone and ziprasidone as adjunctive therapies. This article briefly reviews the role of adjunctive therapy with SGAs in contemporary algorithms for TRD, considering both the evidence of benefit and the adverse effects.

9 Review A meta-analysis of randomized, placebo-controlled trials of vortioxetine for the treatment of major depressive disorder in adults. 2016

Thase, Michael E / Mahableshwarkar, Atul R / Dragheim, Marianne / Loft, Henrik / Vieta, Eduard. ·University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. Electronic address: thase@mail.med.upenn.edu. · Takeda Development Center Americas, Deerfield, IL 60015, USA. · H. Lundbeck A/S, Copenhagen, Denmark. · Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain. ·Eur Neuropsychopharmacol · Pubmed #27139079.

ABSTRACT: The efficacy and safety of vortioxetine, an antidepressant approved for the treatment of adults with major depressive disorder (MDD), was studied in 11 randomized, double-blind, placebo-controlled trials of 6/8 weeks׳ treatment duration. An aggregated study-level meta-analysis was conducted to estimate the magnitude and dose-relationship of the clinical effect of approved doses of vortioxetine (5-20mg/day). The primary outcome measure was change from baseline to endpoint in Montgomery-Åsberg Depression Rating Scale (MADRS) total score. Differences from placebo were analyzed using mixed model for repeated measurements (MMRM) analysis, with a sensitivity analysis also conducted using last observation carried forward. Secondary outcomes included MADRS single-item scores, response rate (≥50% reduction in baseline MADRS), remission rate (MADRS ≤10), and Clinical Global Impressions scores. Across the 11 studies, 1824 patients were treated with placebo and 3304 with vortioxetine (5mg/day: n=1001; 10mg/day: n=1042; 15mg/day: n=449; 20mg/day: n=812). The MMRM meta-analysis demonstrated that vortioxetine 5, 10, and 20mg/day were associated with significant reductions in MADRS total score (Δ-2.27, Δ-3.57, and Δ-4.57, respectively; p<0.01) versus placebo. The effects of 15mg/day (Δ-2.60; p=0.105) were not significantly different from placebo. Vortioxetine 10 and 20mg/day were associated with significant reductions in 9 of 10 MADRS single-item scores. Vortioxetine treatment was also associated with significantly higher rates of response and remission and with significant improvements in other depression-related scores versus placebo. This meta-analysis of vortioxetine (5-20mg/day) in adults with MDD supports the efficacy demonstrated in the individual studies, with treatment effect increasing with dose.

10 Review Critical appraisal of selegiline transdermal system for major depressive disorder. 2016

Cristancho, Mario A / Thase, Michael E. ·a The Mood and Anxiety Disorders Treatment and Research Program, Department of Psychiatry, Perelman School of Medicine , University of Pennsylvania , Philadelphia , PA , USA. · b Department of Psychiatry , Philadelphia Veterans Affairs Medical Center , Philadelphia , PA , USA. ·Expert Opin Drug Deliv · Pubmed #26837935.

ABSTRACT: INTRODUCTION: Although safer and easier to use antidepressants (ie.,SSRIs/SNRIs) have largely displaced MAOIs, these medications still have a role in difficult to treat conditions. Efforts to improve MAOIs benefit-risk profile resulted on the reversible MAOI and in the first antidepressant patch (selegiline transdermal delivery system-STS). The later had been available in the US since 2006. Thus a review on its safety profile and comparative efficacy is timely. AREAS COVERED: This review provides an overview of STS's clinical pharmacology and summarizes what has been learned across nearly a decade of experience. Product labels and the search engine PubMed were used to obtain relevant information. EXPERT OPINION: STS remains a unique treatment option. It is the only FDA-approved antidepressant for patients with significant problems ingesting, tolerating, or absorbing oral medications. It remains the only MAOI that can be initiated without dietary restrictions at a therapeutic dose and has a low incidence of side effects when compared to other MAOIs. STS also provides an interesting option for depressed patients suffering from Parkinson's disease. However these advantages are counterweighted by drawbacks including the need for wash-out periods and the lack of convincing data illustrating its utility for treatment of more severe, treatment refractory depression.

11 Review Managing medical comorbidities in patients with depression to improve prognosis. 2016

Thase, Michael E. ·Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, 3535 Market St, Philadelphia, PA 19104 thase@mail.med.upenn.edu. ·J Clin Psychiatry · Pubmed #26829434.

ABSTRACT: Medical comorbidities contribute to poor antidepressant response, treatment resistance, and poor outcomes in many patients with depression. Depression can co-occur with thyroid conditions, chronic pain conditions, central nervous system disorders, and more. Inflammatory conditions such as diabetes and obesity are also associated with depression, and the connection between inflammation and depression may lead to testing that could better match patients to specific antidepressant treatment. Interventions for patients with depression and a comorbid medical condition include careful selection of antidepressant therapy as well as psychotherapy and adjunctive agents.

12 Review Vortioxetine: a New Treatment for Major Depressive Disorder. 2016

Connolly, K Ryan / Thase, Michael E. ·a Philadelphia Veterans Affairs Medical Center , Philadelphia , PA , 19104 , USA. · b Department of Psychiatry , University of Pennsylvania , Philadelphia , PA 19104 , USA. ·Expert Opin Pharmacother · Pubmed #26679430.

ABSTRACT: INTRODUCTION: Vortioxetine is a structurally novel medication that has recently been approved for treatment of major depressive disorder (MDD). This medication is a serotonin reuptake inhibitor that also has a number of other potentially relevant effects on serotoninergic receptors, which may differentiate the drug's effects from those of current first-line antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs). AREAS COVERED: This article will review the basic clinical pharmacology of vortioxetine, summarize the major clinical trials that were performed prior to approval by the US Food and Drug Administration (FDA), discuss relevant post-marketing studies of this drug, and offer expert commentary on the significance of this new agent in clinical practice. Pre-approval studies were identified as all randomized, placebo-controlled studies of vortioxetine listed on clinicaltrials.gov. Other referenced studies were identified via a MEDLINE database literature search in August 2015 using the key search terms, vortioxetine and Lu AA21004, combined with additional terms that included pharmacological profile, pharmacokinetics, drug interactions, adverse effects, side effects, safety, major depression, and major depressive disorder. We identified relevant systematic reviews, meta-analyses, randomized trials and preclinical studies of importance. EXPERT OPINION: Results of placebo-controlled trials suggest efficacy and an overall safety profile comparable to existing first-line antidepressants. The most common side effects are nausea, vomiting and constipation. Results of several studies indicate that vortioxetine may have therapeutic effects on cognition (e.g., memory and executive functioning) that exceed that of standard antidepressants. Disadvantages include cost and the current paucity of long-term efficacy data from large clinical trials. The authors suggest that vortioxetine is currently a good second-line antidepressant option and shows promise, pending additional long-term data, to become a first-line antidepressant option.

13 Review Peripheral vascular endothelial growth factor as a novel depression biomarker: A meta-analysis. 2015

Carvalho, André F / Köhler, Cristiano A / McIntyre, Roger S / Knöchel, Christian / Brunoni, André R / Thase, Michael E / Quevedo, João / Fernandes, Brisa S / Berk, Michael. ·Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil. Electronic address: andrefc7@terra.com.br. · Memory Research Laboratory, Brain Institute (ICe), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil. · Departments of Psychiatry and Pharmacology, University of Toronto, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University of Toronto, Toronto, ON, Canada. · Laboratory of Neurophysiology and Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe Universität, Frankfurt/Main, Germany. · Interdisciplinary Center for Applied Neuromodulation (CINA), University Hospital, University of São Paulo, São Paulo, Brazil; Service of Interdisciplinary Neuromodulation (SIN), Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil. · Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market St, Ste 670, Philadelphia, PA 19104, USA. · Center for Experimental Models in Psychiatry, Department of Psychiatry and Behavioral Sciences, The University of Texas Medical School at Houston, Houston, TX, USA; Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, Criciúma, SC, Brazil. · IMPACT Strategic Research Centre, Deakin University, School of Medicine and Barwon Health, Geelong, VIC, Australia; Laboratory of Calcium Binding Proteins in the Central Nervous System, Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. · IMPACT Strategic Research Centre, Deakin University, School of Medicine and Barwon Health, Geelong, VIC, Australia; Department of Psychiatry, Florey Institute of Neuroscience and Mental Health, Orygen, The National Centre of Excellence in Youth Mental Health and Orygen Youth Health Research Centre, University of Melbourne, Parkville, VIC, Australia. ·Psychoneuroendocrinology · Pubmed #26210676.

ABSTRACT: BACKGROUND: The neurotrophic hypothesis of major depressive disorder (MDD) postulates that the pathology of this illness incorporates a down-regulation of neurotrophin signaling. Brain-derived neurotrophic factor (BDNF) is the most studied neurotrophic mediator regarding the neurobiology of MDD. Nevertheless, emerging evidence has implicated the multi-competent angiogenic and neurogenic molecule - vascular endothelial growth factor (VEGF) - in hippocampal neurogenesis and depression pathophysiology. OBJECTIVE: To compare peripheral levels of VEGF between individuals with MDD and healthy controls. METHODS: We performed a systematic review and meta-analysis of original studies measuring peripheral levels of VEGF in participants with MDD compared to healthy controls. We searched the Pubmed/MEDLINE, EMBASE and PsycInfo databases for studies published in any language through December 16th, 2014. RESULTS: Fourteen studies met eligibility criteria (N=1633). VEGF levels were significantly elevated in individuals with MDD when compared to healthy controls (Hedges's g=0.343; 95% CI: 0.146-0.540; P<0.01). Funnel plot inspection and the Egger's test did not provide evidence of publication bias. A significant degree of heterogeneity was observed (Q=38.355, df=13, P<0.001; I(2)=66.1%), which was explored through meta-regression and subgroup analyses. Overall methodological quality, sample for assay (plasma versus serum), as well as the matching of MDD and control samples for age and gender emerged as significant sources of heterogeneity. CONCLUSIONS: Taken together, extant data indicate that VEGF shows promise as a biomarker for MDD, and supports that this mediator may be involved in neuroplasticity mechanisms underlying the pathophysiology of MDD.

14 Review Using biomarkers to predict treatment response in major depressive disorder: evidence from past and present studies. 2014

Thase, Michael E. ·Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA; University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. ·Dialogues Clin Neurosci · Pubmed #25733957.

ABSTRACT: Major depressive disorder (MDD) is a heterogeneous condition with a variable response to a wide range of treatments. Despite intensive efforts, no biomarker has been identified to date that can reliably predict response or non-response to any form of treatment, nor has one been identified that can be used to identify those at high risk of developing treatment-resistant depression (ie, non-response to a sequence of treatments delivered for adequate duration and intensity). This manuscript reviews some past areas of research that have proved informative, such as studies using indexes of hypercortisolism or sleep disturbance, and more recent research findings using measures of inflammation and different indicators of regional cortical activation to predict treatment response. It is concluded that, although no method has yet been demonstrated to be sufficiently accurate to be applied in clinical practice, progress has been made. It thus seems likely that--at some point in the not-too-distant future--it will be possible to prospectively identify, at least for some MDD patients, the likelihood of response or non-response to cognitive therapy or various antidepressant medications.

15 Review An overview of vortioxetine. 2014

Schatzberg, Alan F / Blier, Pierre / Culpepper, Larry / Jain, Rakesh / Papakostas, George I / Thase, Michael E. · ·J Clin Psychiatry · Pubmed #25551236.

ABSTRACT: Six clinicians provide an overview of the serotonergic antidepressant vortioxetine, which was recently approved for the treatment of major depressive disorder in adults. They discuss the pharmacologic profile and receptor-mediated effects of vortioxetine in relation to potential outcomes. Additionally, they summarize the clinical trials, which demonstrate vortioxetine's efficacy, and discuss findings related to safety and tolerability that have high relevance to patient compliance.

16 Review Proceed with caution: off-label ketamine treatment for major depressive disorder. 2014

Sisti, Dominic / Segal, Andrea G / Thase, Michael E. ·Department of Medical Ethics & Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA, sistid@mail.med.upenn.edu. ·Curr Psychiatry Rep · Pubmed #25308395.

ABSTRACT: Ketamine offers a promising new option for the treatment of depression, but its increasing off-label use is ethically and clinically inappropriate at the moment.

17 Review Drug safety evaluation of olanzapine/fluoxetine combination. 2014

Cristancho, Mario A / Thase, Michael E. ·Perelman School of Medicine of the University of Pennsylvania, Department of Psychiatry , Philadelphia, PA 19104-3309 , USA. ·Expert Opin Drug Saf · Pubmed #24972823.

ABSTRACT: INTRODUCTION: Bipolar disorder and treatment-resistant depression (TRD) are common and recurrent conditions associated with significant disability, morbidity and mortality. Despite the clear need for effective treatments, only a few medications have been approved in the US for these indications. The combined formulation of olanzapine-fluoxetine (OFC) has been available for a decade now, thus a review on its safety profile and comparative efficacy is timely and can help clinicians to determine the benefit/risk profile of OFC within the context of other treatment alternatives. AREAS COVERED: This paper summarizes the rationale and evidence supporting the use of OFC for both bipolar I depressive episodes and TRD with a focus on safety and tolerability. Product labels and the search engine PubMed was used to obtain relevant information on this subject. EXPERT OPINION: Although further comparative studies are needed, the literature confirms that the OFC is an effective treatment for bipolar I depressive episodes, as well as major depressive episodes that have not responded to several adequate courses of antidepressant therapy. Its use as a first-line treatment for bipolar I depressive episodes and at a higher rung of algorithms for patients with TRD is limited by its propensity to cause weight gain and associated metabolic symptoms.

18 Review Translating clinical science into effective therapies. 2014

Thase, Michael E. ·From the Department of Psychiatry, PerelmanSchool of Medicine, University of Pennsylvania, Philadelphia. ·J Clin Psychiatry · Pubmed #24922489.

ABSTRACT: Identifying a patient with treatment-resistant depression involves ensuring that at least 2 evidence-based antidepressant trials from two different pharmacologic classes have been undertaken and determining their impact on patients' symptoms, functioning, quality-of-life and social relationships as outcomes. When assessing depressive symptoms throughout the course of treatment, clinical judgment should be supplemented by using standardized tools such as the 9-item Patient Health Questionnaire (PHQ-9) and the Quick Inventory of Depressive Symptomatology (QIDS). Adjunctive treatment strategies preserve the benefits of first-line antidepressants in partial responders and potentially enhance the initial antidepressant's effect through complementary mechanisms of action. Novel "multimodal" pharmacotherapies with diverse potentially beneficial mechanisms of action are in development, which have varying degrees of activity across multiple monoamine systems including those regulated by serotonin, dopamine, and glutamate.

19 Review Desvenlafaxine for the treatment of major depressive disorder. 2014

Kornstein, Susan G / McIntyre, Roger S / Thase, Michael E / Boucher, Matthieu. ·Department of Psychiatry and Institute for Women's Health, Virginia Commonwealth University , PO Box 980319, Richmond, VA 23298-0319 , USA +1 804 827 1200 ; +1 804 827 0957 ; skornste@vcu.edu. ·Expert Opin Pharmacother · Pubmed #24914479.

ABSTRACT: INTRODUCTION: Major depressive disorder (MDD) is a chronic and debilitating condition often characterized by inadequate treatment. Notwithstanding the availability of more than a dozen first-line agents across disparate classes (e.g., selective serotonin reuptake inhibitors), the majority of individuals with MDD do not achieve and sustain a recovered state. A substantial percentage of MDD patients require a treatment change due to poor efficacy or tolerability. AREAS COVERED: This review focuses on recent (≤ 5 years) literature describing the pharmacokinetics, efficacy, and tolerability of desvenlafaxine , one of the more recently approved antidepressant drugs. Published papers identified via PubMed search and congress presentations were included. Results from short-term, placebo-controlled, MDD trials and randomized withdrawal trials, as well as post hoc analyses in patient subgroups, are reviewed. EXPERT OPINION: Desvenlafaxine has been shown to be an effective antidepressant with a favorable safety and tolerability profile in the general MDD population and in important patient subgroups. It has several notable differences from other serotonin-norepinephrine reuptake inhibitors, and those differences suggest populations in which it may have the most clinical benefit.

20 Review Levomilnacipran: a newly approved drug for treatment of major depressive disorder. 2014

Mago, Rajnish / Mahajan, Rajeev / Thase, Michael E. ·Department of Psychiatry and Human Behavior, Mood Disorders Program, Jefferson Medical College of Thomas, Jefferson University, Philadelphia, PA, USA. ·Expert Rev Clin Pharmacol · Pubmed #24524592.

ABSTRACT: Levomilnacipran is a novel serotonin and norepinephrine reuptake inhibitor (SNRI) for the treatment of major depressive disorder. This paper reviews up-to-date data on the pharmacology, short- and long-term efficacy, safety and tolerability of levomilnacipran. The drug differs from previously available SNRIs in having twice the potency for norepinephrine versus serotonin reuptake inhibition. In four of the six short-term clinical trials, levomilnacipran was statistically significantly more efficacious than placebo. The only available relapse prevention study did not show reduction in time to relapse, perhaps because relapse rates were low. The commonest adverse events occurring twice as often as on placebo were nausea, hyperhidrosis, constipation, tachycardia, vomiting, erectile dysfunction, palpitations, and ejaculation disorder. In a few patients, hypertension or orthostatic hypotension may occur. Levomilnacipran has been shown to be effective in the short-term treatment of major depressive disorder and may represent an incremental advance. However, further research about its efficacy in subgroups of patients and comparing it to other antidepressants is needed.

21 Review Clinical relevance of fatigue as a residual symptom in major depressive disorder. 2014

Fava, Maurizio / Ball, Susan / Nelson, J Craig / Sparks, Jondavid / Konechnik, Thomas / Classi, Peter / Dube, Sanjay / Thase, Michael E. ·Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. ·Depress Anxiety · Pubmed #24115209.

ABSTRACT: Residual symptoms of major depressive disorder (MDD) following treatment are increasingly recognized as having a negative impact on the patient because of their association with lack of remission, poorer psychosocial functioning, and a more chronic course of depression. Although the effects of specific residual symptoms have not been as systematically studied, several symptoms, including fatigue, sleep disturbance, anxiety, and concentration difficulties, commonly occur as part of the residual state in MDD. In particular, the relatively high prevalence of residual fatigue suggests that this symptom is not being adequately addressed by standard antidepressant therapies. A review of the clinical relevance of residual fatigue was undertaken, using the published literature with respect to its assessment, neurobiology, and treatment implications. The findings of this review suggest that fatigue is highly prevalent as a residual symptom; its response to treatment is relatively poor or delayed; and the presence of residual fatigue is highly predictive of inability to achieve remission with treatment as well as impaired psychosocial functioning. Recognition of the significant consequences of residual fatigue should reinforce the need for further therapeutic interventions to help reduce the impact of this symptom of MDD.

22 Review Computer-assisted cognitive-behavior therapy for depression. 2014

Eells, Tracy D / Barrett, Marna S / Wright, Jesse H / Thase, Michael. ·Department of Psychiatry and Behavioral Sciences. · Department of Psychiatry, University of Pennsylvania. ·Psychotherapy (Chic) · Pubmed #24059735.

ABSTRACT: This article reviews the use of computer technology in treating depression as a substitute or adjunct for standard therapy. It discusses advantages and disadvantages of introducing computer technology as a treatment option, problems and barriers to expanded use, the varieties of computer-assisted psychotherapy for major depression, and relevant research. Three specific Internet-based programs are described, assessed and compared: Good Days Ahead, Beating the Blues, and MoodGYM. The authors conclude that these and similar programs are promising. Preliminary outcome studies suggest that these programs produce outcome similar to standard therapy, although methodological shortcomings limit confidence in these findings. Suggestions are offered for practitioners considering the addition of computer assistance to their treatment of depression.

23 Review The multifactorial presentation of depression in acute care. 2013

Thase, Michael E. ·3535 Market St, Ste 670, Philadelphia, PA 19104 thase@mail.med.upenn.edu. ·J Clin Psychiatry · Pubmed #24191971.

ABSTRACT: Depression is by its very nature a heterogeneous disorder; 2 patients with the same diagnosis (ie, major depressive disorder) may have few symptoms in common. This heterogeneity is evidenced by the fact that depression presents in a wide variety forms related to polarity (unipolar vs bipolar), symptoms (melancholic, atypical, psychotic, or anxious), onset (specific events, seasons, or age), recurrence, and severity. These diagnostic specifiers and subgroups can guide treatment decisions in several ways. For example, recognizing a specific depressive subtype in a patient can help the clinician select an appropriate treatment based on that patient's particular presentation. These subtypes can also guide treatment by helping the clinician and patient to identify and discuss factors that help or hinder the achievement of remission and recovery. Although depression specifiers and subtypes are subject to revision and change, many of them provide helpful information about recognition and treatment.

24 Review Antidepressant combinations: cutting edge psychopharmacology or passing fad? 2013

Thase, Michael E. ·Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA. thase@mail.med.upenn.edu ·Curr Psychiatry Rep · Pubmed #24052267.

ABSTRACT: This article reviews the rationale for and history of combining antidepressants, as well as the current state of the evidence, in the treatment of major depression. Although it has long been suggested that some individuals may benefit from regimens that combine two dissimilar antidepressants, enthusiasm for this practice has waxed and waned and there was never a strong empirical foundation to support this practice. The tangibly better safety profiles of the newer generation antidepressants, both singly and in combination, have permitted greater use of such combinations in contemporary practice than ever before. Combinations that pair a selective serotonin reuptake inhibitor (SSRI) or serotonin norepinephrine reuptake inhibitor (SNRI) with a dissimilar antidepressant, such as bupropion or mirtazapine, are now widely used for patients who have not responded to trials of first- or second-line antidepressant monotherapies and have been tested as a potential way of speeding the benefits of treatment. However, there still is no strong evidence that even the most widely used combinations have particular merit and clinicians should be mindful that alternatives exist with more established efficacy. Moreover, aside from selected cases of drug-drug interactions, it may take full therapeutic doses of both drugs across a typically adequate duration of exposure to achieve the desired effects of combined treatment.

25 Review Going beyond antidepressant monotherapy for incomplete response in nonpsychotic late-life depression: a critical review. 2013

Maust, Donovan T / Oslin, David W / Thase, Michael E. ·Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Electronic address: Donovan.Maust@uphs.upenn.edu. ·Am J Geriatr Psychiatry · Pubmed #23567381.

ABSTRACT: Many older adults with major depressive disorder (MDD) do not respond to antidepressant monotherapy. Although there are evidence-based treatment options to support treatment beyond monotherapy for adults, the evidence for such strategies, specifically in late-life MDD, is relatively scarce. This review examines the published data describing strategies for antidepressant augmentation or acceleration studied specifically in older adults, including lithium, stimulants, and second-generation antipsychotics. In addition, the authors suggest strategies for future research, such as study of specific agents, refining understanding of the impact of medical or cognitive comorbidity in late-life depression, and comparative effectiveness to examine methods already used in clinical practice.

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