Attentional bias in clinical depression and anxiety: The impact of emotional and non-emotional distracting information.

Both anxiety and major depression disorder (MDD) were reported to involve a maladaptive selective attention mechanism, associated with bias toward negative stimuli. Previous studies investigated attentional bias using distractors that required processing as part of task settings, and therefore, in our view, these distractors should be regarded as task-relevant. Here, we applied a unique task that used peripheral distractors that presented emotional and spatial information simultaneously. Notably, the emotional information was not associated in any way to the task, and thus was task-irrelevant. The spatial information, however, was task-relevant as it corresponded with task instructions. Corroborating previous findings, anxious patients showed attentional bias toward negative information. MDD patients showed no indication of this bias. Spatial information influenced all groups similarly. These results indicate that anxiety, but not MDD, is associated with an inherent negative information bias, further illustrating that the two closely related disorders are characterized by different processing patterns.

Phenytoin as an augmentation for SSRI failures: a small controlled study.

BACKGROUND: Lithium augmentation of antidepressant effects in patients unimproved on antidepressants is well documented. We hypothesized that phenytoin, reported to have antimanic, antidepressant and prophylactic effects on affective disorder, might also augment in SSRI failures. METHODS: Twenty five patients were recruited and twenty had data sufficient for analysis between phenytoin and placebo in depression ratings. RESULTS: No effect was found. LIMITATIONS: This study was a small study. CONCLUSIONS: Lithium's ability to augment in antidepressant failures may not be shared with the anticonvulsant mood stabilizers.

A placebo-controlled cross-over trial of adjunctive EPA in OCD.

Several clinical studies showed beneficial effects of omega-3 fatty acids in major affective disorders, including resistant depression. Some antidepressants are also effective, albeit less so, in obsessive-compulsive disorder (OCD). We therefore undertook a preliminary placebo-controlled cross-over trial of adjunctive eicosapentaenoic acid (EPA) in OCD. Eleven patients with current obsessive-compulsive disorder, who were on a stable maximally tolerated dose of SSRI with no further improvement over at least the last two months, were recruited. Subjects were randomly allocated to begin 6 weeks of placebo (2 g liquid paraffin per day) followed by 6 weeks of 2 g of EPA or EPA followed by placebo. Patients continued their prior SSRIs at the same dose. Assessments were performed with the Yale-Brown Obsessive-Compulsive Scale (YBOCS), and the Hamilton Rating Scales for depression (HAM-D) and anxiety (HAM-A). There were no effects of order of treatment. Time had a main effect of YBOCS scores; mean scores declined from 26.0 (+/-5) to 17.6 (+/-6) by week 6 on placebo and to 18.5 (+/-4) on EPA. There were no effects on HAM-D and HAM-A. No clinically relevant side effects were reported. The results of this study suggest that adjunctive EPA is ineffective against OCD.

Smoking habits in bipolar and schizophrenic outpatients in southern Israel.

BACKGROUND: Although rates of cigarette smoking have been found to be higher in schizophrenic and depressed patients than in the general population, data regarding rates in bipolar patients are limited. This study further examines the relationship between bipolar disorder and smoking and compares the rate of smoking in bipolar disorder patients with rates in schizophrenic patients and in the general population. METHOD: Seventy bipolar patients and 64 schizophrenic patients (diagnosed using DSM-IV criteria) treated at the largest specialized public bipolar and schizophrenia clinics in southern Israel were interviewed regarding their smoking habits. The interview included a questionnaire relating to personal information, past and present smoking, and drug abuse and the Fagerstrom scale for nicotine dependence. Data from these patients were also compared with data from the general Israeli population. RESULTS: Data indicate that the rate of smoking does not appear to differ between bipolar (43.0%) and schizophrenic (45.0%) patients, whereas the rate for both patient groups is higher than that for the general Israeli population (27.5%). Smoking intensity was not found to be different between the 2 groups of patients. CONCLUSION: Smoking in patients with schizophrenia was suggested to be related to nicotine cholinergic dysfunction, but this suggestion cannot explain the equally high rates of smoking in bipolar patients. Schizophrenia, bipolar disorder, and smoking may all be related to dopamine transmission, and, therefore, dopaminergic interactions may provide a better explanation for the results.

Inositol monophosphatase activity in brain and lymphocyte-derived cell lines of bipolar patients.

BACKGROUND: Inositol monophosphatase (IMPase) activity was reported to be low in lymphocyte-derived cell lines of bipolar patients. METHODS: IMPase activity was measured spectrophotometrically as inorganic phosphate liberated from inositol-1-phosphate. RESULTS: The previously reported reduction was replicated in a new, small group of bipolar patients. The reduction is not present in cell lines of unipolar or schizophrenic patients. IMPase activity in postmortem frontal and occipital cortical samples of unipolar, bipolar and schizophrenic patients was not different from controls. CONCLUSIONS: A reduction in lymphocyte-derived IMPase activity without a parallel reduction in cortical IMPase activity could be due to the fact that most leukocyte IMPase activity is the product of the IMPA-2 gene.

Olanzapine treatment of clozapine-induced NMS.

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Inositol addition does not improve depression in SSRI treatment failures.

Some antidepressants, such as Lithium, can augment the antidepressant effect of serotonin selective uptake inhibitors (SSRI) in patients who have failed to respond to SSRI. Inositol has demonstrated antidepressant effects but in a controlled double blind augmentation trial did not improve depression in SSRI treatment failures.