2019年10月13日(日) 08:40 〜 10:20 第6会場 (401+402)

Organizer / Chair: Po-Hsiu KUO (Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taiwan), Co-chair: Osamu SHIRAKAWA (Department of Neuropsychiatry, Kindai University, Faculty of Medicine, Japan), Discussants: ‌Kristian LIAURY (Department of Psychiatry, Hasanuddin University, Indonesia), Takeshi INOUE (Department of Psychiatry, Tokyo Medical University, Japan)

Treatment-resistant depression, a complex clinical problem caused by multiple risk factors, is targeted by integrated therapeutic strategies. Augmentation strategies are commonly applied when an individual is unresponsive to antidepressant monotherapy. But the efficacy and safety of lamotrigine augmentation in patients with treatment-resistant MDD remain inconclusive. Prof. Lu will present “Lamotrigine augmentation in treatment-resistant depression: A comprehensive meta-analysis of efficacy and safety.” In this meta-analysis, the evidence for the therapeutic effects and safety profiles of lamotrigine augmentation in patients with treatment-resistant MDD are synthesized. Significant improvements in HAMD scores and response rate were shown in lamotrigine augmentation group compared with control group. Lamotrigine augmentation is well-tolerated in terms of all-cause discontinuation rate and reported adverse events.
Major depressive disorder (MDD) is heterogeneous in clinical presentation and etiology. To better subgrouping MDD patients may help the discovery of pathomechanism and enhance the practice of precision medicine. One way of assessing treatment response is to investigate the naturalistic pattern of psychotropic agents in the early phase of clinical course, and may intuitively reflect the underlying deficits of neurobiology and neurotransmitters in MDD patients. Dr. Chen will present “A Novel Approach to Subgroup First-Episode MDD by Dissecting Psychotropic Loads” to dissect empirical pattern of psychotropic agents use during the first 2 years of clinical course in drug-naïve MDD patients. In total, four groups of MDD patients were extracted, which were featured by short-term antidepressant use, long-term antidepressant use, long-term antidepressant and sedatives use and long-term antidepressant, sedative and antipsychotics use, respectively. The clinical implication of this novel approach will be discussed.
And we intend to study heterogeneous syndromal presentations of MDD patients during a common treatment regimen. Patients’ response to commonly prescribed selective serotonin reuptake inhibitors (SSRIs) varies across individuals and symptoms. Certain genetic variants may modify the effects of SSRIs treatment on different symptom profiles. Prof. Kuo will present “A pharmacogenetics study for treatment responses of SSRI by syndromal features.” We obtained six empirically derived syndromal factors, namely sleep, core, anxiety, somatization, psychomotor, and energy. The degree of syndromal improvement at week-4 was ranged from 33% (energy) to 70% (psychomotor). Using Genome-wide association study design, we found that several markers showed suggested signals with p-value<5×10-06. These loci are potentially involved in modifying treatment response for different empirically defined syndromal factors among SSRIs treated MDD patients.