Behavior and oxidative stress parameters in rats subjected to the animal's models induced by chronic mild stress and 6-hydroxydopamine.

Major depressive disorder (MDD) is one of the most prevalent forms of mental illness also affecting older adults. Recent evidence suggests a relationship between MDD and neurodegenerative diseases, including Parkinson's disease (PD). Individuals with PD have a predisposition to developing MDD, and both neurobiological conditions are associated with oxidative stress. Thus, we conducted this study to investigate depressive-like behavior and oxidative stress parameters using both animal models of PD and stress. Adult Wistar rats were subjected to chronic mild stress (CMS) protocol by 40 days and then it was used 6-hydroxydopamine (6-OHDA) as a model of PD, into the striatum. The experimental groups were: Control + Sham, Stress + Sham, Control+6-OHDA, and Stress+6-OHDA. Depressive like-behavior was evaluated by the forced swimming test (FST) and spontaneous locomotor activity by open-field test. Oxidative stress parameters were measured in the striatum, hippocampus, and prefrontal cortex (PFC). The results showed effects to increase immobility and decrease climbing times in the FST in Stress + Sham, Control+6-OHDA, and Stress+6-OHDA groups. The number of crossings and rearings were decreased in the Stress+6-OHDA group. The lipid peroxidation was increased in the PFC of Stress + Sham, and the hippocampus and striatum of Stress + Sham and Control+6-OHDA groups. Carbonyl protein levels increased in the PFC of Stress + Sham and striatum in Control+6-OHDA. Nitrite/Nitrate concentration was elevated in the PFC of Stress + Sham, in the hippocampus of Control+6-OHDA, the striatum of Stress + Sham, and Control+6-OHDA groups. Myeloperoxidase (MPO) activity was increased in the PFC and hippocampus of Stress + Sham and Control+6-OHDA groups. The activity of catalase decreased in the PFC of the Stress + Sham group. The activity of the superoxide dismutase (SOD) was decreased in the PFC of the Stress + Sham group, in the hippocampus of Stress + Sham and Control+6-OHDA groups, and the striatum of Control+6-OHDA group. These findings suggest that both stress and 6-OHDA induce depressive-like behavior and oxidative stress in the brain. The joining models have little evidence of the effects. Thus these findings suggest that other pathways are involved in the common point of the pathophysiology of PD and MDD.

Psychiatric disorders as "hidden" contraindications for presurgical VEEG in patients with refractory epilepsy: A retrospective cohort study in a tertiary center.

Given the high frequency of psychiatric disorders (PDs) observed among patients with epilepsy, studies have highlighted the necessity of psychiatric evaluation for these patients, especially for those with refractory temporal lobe epilepsy with mesial temporal sclerosis (TLE-MTS) who are surgical candidates. Current evidence highlights the safety of video-electroencephalography (VEEG) as a means of investigation in patients with TLE-MTS and PDs. However, the presence of such disorders has still been seen as a contraindication for presurgical evaluation with VEEG in some epilepsy centers mainly because of the risk of negative behavioral events. The present retrospective cohort study performed in a Brazilian tertiary epilepsy center aimed to identify whether the presence of a PD remains a contraindication for presurgical VEEG. Clinical, sociodemographic, and psychiatric data from 41 patients who underwent VEEG as part of their presurgical evaluation were compared to data from 32 patients with refractory TLE-MTS who had not undergone VEEG. Psychiatric diagnoses were determined using the DSM-IV and ILAE criteria. Psychiatric disorders were diagnosed in 34 patients (46.6%). Major depressive disorder was the most frequent PD and was observed in 22 patients (30.1%). Anxiety disorders were observed in 14 patients (19.2%). Of the 41 patients (56.2%) who underwent presurgical VEEG, only 12 (29.2%) were found to have a PD during the presurgical psychiatric evaluation compared to 22 of the 32 (68.7%) who did not undergo VEEG (p=0.001; RR=2.35). The present findings suggest that the presence of a PD alone should not be a contraindication for VEEG monitoring and epilepsy surgery.

Is the interferon-α-triggered depressive episode a self-limited kind of depression? Four cases of persistent affective symptoms after antiviral treatment in HCV-infected individuals.

OBJECTIVES: To discuss relevant aspects in a series of cases in which interferon-α-triggered depressive symptoms persisted up to 4 years after therapy cessation in HCV-infected patients. METHODS: Two experienced psychiatrists (AGA and LCQ) identified these four cases in a systematic evaluation program of HCV patients in the Hepatology Unit of the Teaching Hospital at the Federal University of Bahia, Brazil. Lifetime psychiatric diagnoses were confirmed by the Mini International Neuropsychiatric Interview (MINI Plus), and a questionnaire was submitted in order to gather clinical and sociodemographic characteristics. RESULTS: In three out of the four cases identified, major depression diagnosis was reached after more than 12 months of interferon-α therapy interruption and, in one case, depression recurred 6 months after antiviral treatment cessation in a patient on antidepressants. The only case that referred a past history of psychiatric diagnosis reported no offer of mental health care despite the presence of a major depressive episode with psychotic features and suicidal behaviour during the cytokine usage. CONCLUSIONS: Interferon-α-triggered depression may remain undiagnosed even in tertiary university hospitals, may persist years after the antiviral therapy cessation, and may recur even in patients on adequate antidepressant treatment.

Melancholic features related to rimonabant.

INTRODUCTION: Obesity is currently considered a global epidemic and its prevention and treatment is a major public health concern, demanding treatment which may combine a sociocultural approach, lifestyle modification, nutritional, pharmacological or surgical strategies. Rimonabant, an endocannabinoid antagonist, has been proposed as an agent for an average weight loss of 4 kg. However, the development of anxiety and depressive symptoms can be major side effects. CASE REPORT: A 27-year-old businessman, after using rimonabant (20 mg/day) for 1 month for weight loss, developed a major depressive episode with melancholic features, which remitted after the interruption of rimonabant. DISCUSSION: To our knowledge, a major depressive episode with melancholic or atypical features specifier has not been described since the initiation of rimonabant pharmacological trials. The Hospital Anxiety and Depression Scale, used in the rimonabant trials, assesses several key points of depressive patients. However, it neglects the somatic symptoms that correspond to the additional criterion for both of the mentioned features as well as suicidal ideation. The severity of an episode could also be underestimated depending on the assessment tool or on the clinical interview. CONCLUSION: There may be an underestimation of depressive melancholic and atypical side effects related to Rimonabant use, due to the lack of consistent assessment with the appropriate screening tools. Pharmacological strategies should be adjunctive for obesity treatment when there is a failure in the lifestyle and nutritional modification strategies. Moreover, deeper global sociocultural changes should be made in the treatment and control of the global obesity epidemic.

Incidence of psychiatric side effects during pegylated interferon- alpha retreatment in nonresponder hepatitis C virus-infected patients.

OBJECTIVE: Evaluate the incidence of mental disorders using pegylated interferon plus ribavirin retreatment in nonresponder hepatitis C virus-infected patients. METHOD: The Mini-International Neuropsychiatric Interview (MINI) was used to evaluate 30 hepatitis C virus-infected interferon-nonresponder patients at baseline and following 4, 12 and 24 weeks of pegylated interferon retreatment. RESULTS: During the pegylated interferon/ribavirin retreatment, 5(16.6%) patients developed psychiatric side effects: 3(10%) were diagnosed with major depressive disorder, 1(3.3%) had a brief psychotic disorder and 1(3.3%) presented with panic attacks. CONCLUSION: This is the first prospective study evaluating the incidence of neuropsychiatric side effects during interferon retreatment of hepatitis C virus-infected patients, suggesting that the risk of acquiring serious psychiatric symptoms during retreatment with interferon-alpha (IFN-alpha) may not be higher than during the first antiviral therapy. This finding challenges the hypothesis that during a second treatment with IFN-alpha, patients with hepatitis C may be at greater risk for neuropsychiatric side effects than naïve patients.