ABSTRACT
AIM: Studies on major depressive disorders (MDD) pathophysiology show decreased blood levels of brain-derived neurotrophic factor (BDNF) that increase after antidepressant treatment. The link between BDNF levels and antidepressants is still controversial. In addiction, there is a relationship between MDD and concurrent cognitive function. Hippocampus is linked to memory and learning and BDNF is abundant in this area. For this reason we investigated the presence of any association between paroxetine treatment, BDNF levels and cognitive performances in depressed patients. METHODS: Sixteen patients with MDD were compared with a control group of 18 randomly selected healthy individuals. Blood samples were taken and clinical and neuropsychological assessments were performed at baseline and after two months of treatment. Plasma and serum BDNF levels were measured with the Elisa method. RESULTS: Plasma BDNF levels are lower in depressed patients and increased after treatment. No serum BDNF significant differences were found. Depressed patients showed a mild deficit in prose memory tests that reached normality after antidepressant treatment. No correlations were evidenced between patients plasma BDNF levels and cognitive results. CONCLUSION: To our knowledge this is one of the few studies on the effects of paroxetine treatment on plasma BDNF levels. We confirm literature data regarding the link between BDNF plasma levels, depression and antidepressant treatments. In addiction we found a specific cognitive deficit of depressed patients.
Subject(s)
Antidepressive Agents, Second-Generation/therapeutic use , Brain-Derived Neurotrophic Factor/blood , Cognition/drug effects , Depressive Disorder, Major/drug therapy , Paroxetine/therapeutic use , Selective Serotonin Reuptake Inhibitors/therapeutic use , Adult , Biomarkers/blood , Case-Control Studies , Depressive Disorder, Major/blood , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/psychology , Enzyme-Linked Immunosorbent Assay , Female , Humans , Male , Memory/drug effects , Middle Aged , Neuropsychological Tests , Time Factors , Treatment OutcomeABSTRACT
Anorexia nervosa is a complex mental disorder characterized by altered eating behaviour often resulting in life-threatening weight loss (<85% of expected body weight) associated with amenorrhea and a disturbance of body image. Although classified as mental health disorders, they may lead to serious medical consequences and have the highest rate of premature death of any mental health diagnosis. We report our experience with the use of enteral feeding via percutaneous endoscopic gastrostomy in a 39-year-old woman with chronic restricter anorexia nervosa treated in liaison psychiatry and psychotherapy. On admission to psychiatry unit, the patient presented seriously deteriorated general condition and a body mass index (BMI) of 10 (BMI = weight kg/height m(2)). She refused oral feeding, but eventually accepted nasogastric feeding. In preparation for her continuing long-term (>1 month) enteral feeding at home, a percutaneous endoscopic gastrostomy was performed and a home nutrition support regimen that met her energy-protein intake requirements was prescribed. During the follow-up period, an overall improvement in nutritional status, general condition, mood and cognitive functioning was observed. Patient compliance with refeeding is notoriously problematic; however, enteral feeding interventions may be feasible in the long-term treatment of selected anorexia nervosa patients when closely followed-up by a multidisciplinary medical team.
