PMID- 37829759 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231020 IS - 1664-0640 (Print) IS - 1664-0640 (Electronic) IS - 1664-0640 (Linking) VI - 14 DP - 2023 TI - Potential efficacy of dopaminergic antidepressants in treatment resistant anergic-anhedonic depression results of the chronic anergic-anhedonic depression open trial - CADOT. PG - 1194090 LID - 10.3389/fpsyt.2023.1194090 [doi] LID - 1194090 AB - INTRODUCTION: Among treatment-resistant depression (TRD), we identified anergic-anhedonic clinical presentations (TRAD) as putatively responsive to pro-dopaminergic strategies. Based on the literature, non-selective monoamine oxidase inhibitors (MAOI) and dopamine D2 receptor agonists (D2RAG) were sequentially introduced, frequently under the coverage of a mood stabilizer. This two-step therapeutic strategy will be referred to as the Dopaminergic Antidepressant Therapy Algorithm (DATA). We describe the short and long-term outcomes of TRAD managed according to DATA guidelines. METHOD: Out of 52 outpatients with TRAD treated with DATA in a single expert center, 48 were included in the analysis [severity - QIDS (Quick Inventory of Depressive Symptomatology) = 16 +/- 3; episode duration = 4.1 +/- 2.7 years; Thase and Rush resistance stage = 2.9 +/- 0.6; functioning - GAF (Global Assessment of Functioning) = 41 +/- 8]. These were followed-up for a median (1st - 3rd quartile) of 4 (1-9) months before being prescribed the first dopaminergic treatment and remitters were followed up 21 (11-33) months after remission. RESULTS: At the end of DATA step 1, 25 patients were in remission (QIDS <6; 52% [38-66%]). After DATA step 2, 37 patients were in remission (77% [65-89%]) to whom 5 patients with a QIDS score = 6 could be added (88% [78-97%]). Many of these patients felt subjectively remitted (GAF = 74 +/- 10). There was a significant benefit to combining MAOI with D2RAG which was maintained for at least 18 months in 30 patients (79% [62-95%]). CONCLUSION: These results support TRAD sensitivity to pro-dopaminergic interventions. However, some clinical heterogeneities remain in our sample and suggest some improvement in the description of dopamine-sensitive form(s). CI - Copyright (c) 2023 Dormegny-Jeanjean, de Billy, Mainberger, Weibel, Schorr, Obrecht, Landre, Berna, Causin, Blanc, Danila, Tomsa, Pfleger, Meyer, Humbert, Javelot, Meyer, Bertschy and Foucher. FAU - Dormegny-Jeanjean, Ludovic Christophe AU - Dormegny-Jeanjean LC AD - Treatment resistant depression expert center of Alsace (CEDRA), Strasbourg-Rouffach-Erstein-Brumath, Rouffach, France. AD - Non-Invasive neuroModulation Center of Strasbourg (CEMNIS), University Hospital of Strasbourg, Strasbourg, France. AD - CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, Strasbourg, France. FAU - de Billy, Clement AU - de Billy C AD - Treatment resistant depression expert center of Alsace (CEDRA), Strasbourg-Rouffach-Erstein-Brumath, Rouffach, France. AD - Non-Invasive neuroModulation Center of Strasbourg (CEMNIS), University Hospital of Strasbourg, Strasbourg, France. AD - CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, Strasbourg, France. FAU - Mainberger, Olivier AU - Mainberger O AD - Treatment resistant depression expert center of Alsace (CEDRA), Strasbourg-Rouffach-Erstein-Brumath, Rouffach, France. AD - Non-Invasive neuroModulation Center of Strasbourg (CEMNIS), University Hospital of Strasbourg, Strasbourg, France. AD - CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, Strasbourg, France. FAU - Weibel, Sebastien AU - Weibel S AD - Treatment resistant depression expert center of Alsace (CEDRA), Strasbourg-Rouffach-Erstein-Brumath, Rouffach, France. AD - Department of Psychiatry and Mental Health - University Hospital of Strasbourg, University of Strasbourg, Strasbourg, France. AD - INSERM UMR 1114, Physiopathology and Cognitive Psychopathology of Schizophrenia, University of Strasbourg, Strasbourg, France. FAU - Schorr, Benoit AU - Schorr B AD - Department of Psychiatry and Mental Health - University Hospital of Strasbourg, University of Strasbourg, Strasbourg, France. AD - INSERM UMR 1114, Physiopathology and Cognitive Psychopathology of Schizophrenia, University of Strasbourg, Strasbourg, France. AD - Geriatrics Department and Expert Center for Neurocognitive Disorders, University Hospital of Strasbourg, Strasbourg, France. FAU - Obrecht, Alexandre AU - Obrecht A AD - Treatment resistant depression expert center of Alsace (CEDRA), Strasbourg-Rouffach-Erstein-Brumath, Rouffach, France. AD - Non-Invasive neuroModulation Center of Strasbourg (CEMNIS), University Hospital of Strasbourg, Strasbourg, France. FAU - Landre, Lionel AU - Landre L AD - CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, Strasbourg, France. FAU - Berna, Fabrice AU - Berna F AD - Department of Psychiatry and Mental Health - University Hospital of Strasbourg, University of Strasbourg, Strasbourg, France. AD - INSERM UMR 1114, Physiopathology and Cognitive Psychopathology of Schizophrenia, University of Strasbourg, Strasbourg, France. FAU - Causin, Jean-Baptiste AU - Causin JB AD - Treatment resistant depression expert center of Alsace (CEDRA), Strasbourg-Rouffach-Erstein-Brumath, Rouffach, France. AD - Department of Psychiatry and Mental Health - University Hospital of Strasbourg, University of Strasbourg, Strasbourg, France. AD - INSERM UMR 1114, Physiopathology and Cognitive Psychopathology of Schizophrenia, University of Strasbourg, Strasbourg, France. FAU - Blanc, Frederic AU - Blanc F AD - CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, Strasbourg, France. AD - Geriatrics Department and Expert Center for Neurocognitive Disorders, University Hospital of Strasbourg, Strasbourg, France. FAU - Danila, Vlad AU - Danila V AD - Treatment resistant depression expert center of Alsace (CEDRA), Strasbourg-Rouffach-Erstein-Brumath, Rouffach, France. AD - Department of Psychiatry "Pole 8/9", Rouffach Psychiatric Hospital, Rouffach, France. FAU - Tomsa, Mihaela AU - Tomsa M AD - Treatment resistant depression expert center of Alsace (CEDRA), Strasbourg-Rouffach-Erstein-Brumath, Rouffach, France. AD - Department of Psychiatry "Pole 8/9", Rouffach Psychiatric Hospital, Rouffach, France. FAU - Pfleger, Geraldine AU - Pfleger G AD - Treatment resistant depression expert center of Alsace (CEDRA), Strasbourg-Rouffach-Erstein-Brumath, Rouffach, France. AD - Department of Integrated Psychiatric Care, Centre Hospitalier d'Erstein, Erstein, France. FAU - Meyer, Camille AU - Meyer C AD - Treatment resistant depression expert center of Alsace (CEDRA), Strasbourg-Rouffach-Erstein-Brumath, Rouffach, France. AD - Non-Invasive neuroModulation Center of Strasbourg (CEMNIS), University Hospital of Strasbourg, Strasbourg, France. AD - Department of Psychiatry and Mental Health - University Hospital of Strasbourg, University of Strasbourg, Strasbourg, France. FAU - Humbert, Ilia AU - Humbert I AD - Treatment resistant depression expert center of Alsace (CEDRA), Strasbourg-Rouffach-Erstein-Brumath, Rouffach, France. AD - Non-Invasive neuroModulation Center of Strasbourg (CEMNIS), University Hospital of Strasbourg, Strasbourg, France. AD - Department of Psychiatry and Mental Health - University Hospital of Strasbourg, University of Strasbourg, Strasbourg, France. FAU - Javelot, Herve AU - Javelot H AD - Treatment resistant depression expert center of Alsace (CEDRA), Strasbourg-Rouffach-Erstein-Brumath, Rouffach, France. AD - Expert center in Psychopharmacology, Etablissement public de sante Alsace nord (EPSAN), Bischwiller, France. FAU - Meyer, Guillaume AU - Meyer G AD - Treatment resistant depression expert center of Alsace (CEDRA), Strasbourg-Rouffach-Erstein-Brumath, Rouffach, France. AD - Department of Psychopharmacology, Centre Hospitalier d'Erstein, Lingolsheim, France. FAU - Bertschy, Gilles AU - Bertschy G AD - Treatment resistant depression expert center of Alsace (CEDRA), Strasbourg-Rouffach-Erstein-Brumath, Rouffach, France. AD - Department of Psychiatry and Mental Health - University Hospital of Strasbourg, University of Strasbourg, Strasbourg, France. AD - INSERM UMR 1114, Physiopathology and Cognitive Psychopathology of Schizophrenia, University of Strasbourg, Strasbourg, France. FAU - Foucher, Jack Rene AU - Foucher JR AD - Treatment resistant depression expert center of Alsace (CEDRA), Strasbourg-Rouffach-Erstein-Brumath, Rouffach, France. AD - Non-Invasive neuroModulation Center of Strasbourg (CEMNIS), University Hospital of Strasbourg, Strasbourg, France. AD - CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, Strasbourg, France. AD - Department of Psychiatry and Mental Health - University Hospital of Strasbourg, University of Strasbourg, Strasbourg, France. LA - eng PT - Journal Article DEP - 20230927 PL - Switzerland TA - Front Psychiatry JT - Frontiers in psychiatry JID - 101545006 PMC - PMC10565009 OTO - NOTNLM OT - anergia OT - anhedonia OT - apathy OT - atypical depression OT - dopamine D2 receptor agonists OT - hypodopaminergic mesencephalic syndrome OT - monoamine oxidase inhibitors OT - treatment resistant depression COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/10/13 06:45 MHDA- 2023/10/13 06:46 PMCR- 2023/09/27 CRDT- 2023/10/13 04:11 PHST- 2023/03/26 00:00 [received] PHST- 2023/08/02 00:00 [accepted] PHST- 2023/10/13 06:46 [medline] PHST- 2023/10/13 06:45 [pubmed] PHST- 2023/10/13 04:11 [entrez] PHST- 2023/09/27 00:00 [pmc-release] AID - 10.3389/fpsyt.2023.1194090 [doi] PST - epublish SO - Front Psychiatry. 2023 Sep 27;14:1194090. doi: 10.3389/fpsyt.2023.1194090. eCollection 2023.