Browsing by Author "Prudic, Joan"

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    Neurocognitive Effects of Combined Electroconvulsive Therapy (ECT) and Venlafaxine in Geriatric Depression: Phase 1 of the PRIDE Study.
    (The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2019-10-12) Lisanby, Sarah H; McClintock, Shawn M; Alexopoulos, George; Bailine, Samuel H; Bernhardt, Elisabeth; Briggs, Mimi C; Cullum, C Munro; Deng, Zhi-De; Dooley, Mary; Geduldig, Emma T; Greenberg, Robert M; Husain, Mustafa M; Kaliora, Styliani; Knapp, Rebecca G; Latoussakis, Vassilios; Liebman, Lauren S; McCall, William V; Mueller, Martina; Petrides, Georgios; Prudic, Joan; Rosenquist, Peter B; Rudorfer, Matthew V; Sampson, Shirlene; Teklehaimanot, Abeba A; Tobias, Kristen G; Weiner, Richard D; Young, Robert C; Kellner, Charles H; CORE/PRIDE Work Group
    OBJECTIVE:There is limited information regarding the tolerability of electroconvulsive therapy (ECT) combined with pharmacotherapy in elderly adults with major depressive disorder (MDD). Addressing this gap, we report acute neurocognitive outcomes from Phase 1 of the Prolonging Remission in Depressed Elderly (PRIDE) study. METHODS:Elderly adults (age ≥60) with MDD received an acute course of 6 times seizure threshold right unilateral ultrabrief pulse (RUL-UB) ECT. Venlafaxine was initiated during the first treatment week and continued throughout the study. A comprehensive neurocognitive battery was administered at baseline and 72 hours following the last ECT session. Statistical significance was defined as a two-sided p-value of less than 0.05. RESULTS:A total of 240 elderly adults were enrolled. Neurocognitive performance acutely declined post ECT on measures of psychomotor and verbal processing speed, autobiographical memory consistency, short-term verbal recall and recognition of learned words, phonemic fluency, and complex visual scanning/cognitive flexibility. The magnitude of change from baseline to end for most neurocognitive measures was modest. CONCLUSION:This is the first study to characterize the neurocognitive effects of combined RUL-UB ECT and venlafaxine in elderly adults with MDD and provides new evidence for the tolerability of RUL-UB ECT in an elderly sample. Of the cognitive domains assessed, only phonemic fluency, complex visual scanning, and cognitive flexibility qualitatively declined from low average to mildly impaired. While some acute changes in neurocognitive performance were statistically significant, the majority of the indices as based on the effect sizes remained relatively stable.
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    The assessment of resistance to antidepressant treatment: Rationale for the Antidepressant Treatment History Form: Short Form (ATHF-SF).
    (Journal of psychiatric research, 2019-06) Sackeim, Harold A; Aaronson, Scott T; Bunker, Mark T; Conway, Charles R; Demitrack, Mark A; George, Mark S; Prudic, Joan; Thase, Michael E; Rush, A John
    There is considerable diversity in how treatment-resistant depression (TRD) is defined. However, every definition incorporates the concept that patients with TRD have not benefited sufficiently from one or more adequate trials of antidepressant treatment. This review examines the issues fundamental to the systematic evaluation of antidepressant treatment adequacy and resistance. These issues include the domains of interventions deemed effective in treatment of major depressive episodes (e.g., pharmacotherapy, brain stimulation, and psychotherapy), the subgroups of patients for whom distinct adequacy criteria are needed (e.g., bipolar vs. unipolar depression, psychotic vs. nonpsychotic depression), whether trials should be rated dichotomously as adequate or inadequate or on a potency continuum, whether combination and augmentation strategies require specific consideration, and the criteria used to evaluate the adequacy of treatment delivery (e.g., dose, duration), trial adherence, and clinical outcome. This review also presents the Antidepressant Treatment History Form: Short-Form (ATHF-SF), a completely revised version of an earlier instrument, and details how these fundamental issues were addressed in the ATHF-SF.