Clinical Research

The DCRP is currently conducting cutting edge research in the area of depression, with a focus on testing novel antidepressant treatments and on developing new tools to understand the biological changes that occur in this condition.

Publications of Recent Research including DCRP clinicians.

Alternatives |  Treatment Resistant depression |  Major Depression |  Medication Side Effects |  Treatments |  Hormone/Biological/Genetic Research |  Books


 

Alternative Treatments for Depression

Murck H, Fava M, Alpert J, Nierenberg AA, Mischoulon D, Otto MW, Zajecka J, Mannel M, Rosenbaum JF.
Hypericum extract in patients with MDD and reversed vegetative signs: re-analysis from data of a double-blind, randomized trial of hypericum extract, fluoxetine, and placebo. Int J Neuropsychopharmacol. 2004 Sep 30:1-7.

 

 

Alpert JE, Papakostas G, Mischoulon D, Worthington JJ 3rd, Petersen T, Mahal Y, Burns A, Bottiglieri T, Nierenberg AA, Fava M.
S-Adenosyl-L-methionine (SAMe) as an adjunct for resistant major depressive disorder: an open trial following partial or nonresponse to selective serotonin reuptake inhibitors or venlafaxine. J Clin Psychopharmacol. 2004 Dec;24(6):661-4.

Fava M, Alpert J, Nierenberg AA, Mischoulon D, Otto MW, Zajecka J, Murck H, Rosenbaum JF.
A double-blind, randomized trial of St. John’s wort, fluoxetine, and placebo in major depressive disorder. Journal of Clinical Psychopharmacology 2005 Oct;25(5):441-7.

Mischoulon D, Best-Popescu C, Laposata M, Merens W, Murakami JL, Wu S, Papakostas GI, Dording CM, Sonawalla SB, Nierenberg AA, Alpert JE, Fava M.
A double-blind dose-finding pilot study of docosahexaenoic acid (DHA) for major depressive disorder. Eur Neuropsychopharm 2008; 18:639-645.

Nierenberg AA, Alpert JE, Gardner-Schuster EE, Seay S, Mischoulon D.
Vagus nerve stimulation: 2-year outcomes for bipolar versus unipolar treatment-resistant depression. Biol Psychiatry. 2008 Sep 15;64(6):455-60.

Dording CM, Fisher L, Papakostas G, Farabaugh A, Sonawalla S, Fava M, Mischoulon D.
A double blind, randomized dose finding pilot study of maca root (l. meyenii) for the management of SSRI-induced sexual dysfunction. CNS Neuroscience and Therapeutics 2008;14(3):182-191

Mischoulon D, Papakostas GI, Dording CM, Farabaugh AH, Sonawalla SB, Agoston M, Smith J, Beaumont E, Dahan L, Alpert JE, Nierenberg AA, Fava M.
A double-blind, randomized controlled trial of ethyl-eicosapentaenoate for major depressive disorder. J Clin Psychiatry 2009; 70:1634-1644.

Mischoulon D, Pedrelli P, Wurtman J, Vangel M, Wurtman R.
Report of two double-blind randomized placebo-controlled pilot studies of a carbohydrate-rich nutrient mixture for treatment of seasonal affective disorder (SAD). CNS Neuroscience and Therapeutics 2010; 16:13-24.

Miller KK, Perlis RH, Papakostas GI, Mischoulon D, Iosifescu DV, Brick DJ, Fava M.
Low-dose transdermal testosterone augmentation therapy improves depression severity in women. CNS Spectr. 2009 Dec;14(12):688-94.

Freeman MP, Mischoulon D, Tedeschini E, Goodness T, Cohen LS, Fava M, Papakostas G.
Complementary and alternative medicine for major depressive disorder: a meta-analysis of patient characteristics, placebo response rates, and treatment outcomes relative to standard antidepressants. J Clin Psych 2010; 71(6):682-688.

Papakostas GI, Mischoulon D, Shyu I, Alpert, JE, Fava M.
S-adenosyl Methionine (SAMe) Augmentation of Serotonin Reuptake Inhibitors (SRIs) for SRI- Non-responders with Major Depressive Disorder: A Double-blind, Randomized Clinical Trial. American J Psychiatry 2010; 167:942-948.

Yeung AS, Ameral BE, Chuzi SE, Fava M, Mischoulon D.
A Pilot Study of Acupuncture Augmentation Therapy in Antidepressant Partial and Non-Responders with Major Depressive Disorder. J Affective Disorders (in press).

Folinic acid (Leucovorin) as an adjunctive treatment for SSRI-refractory depression.
Alpert JE, Mischoulon D, Rubenstein GE, Bottonari K, Nierenberg AA, Fava M.

Screening for major depression in Asian-Americans: a comparison of the Beck and the Chinese Depression Inventory.
Yeung A, Neault N, Sonawalla S, Howarth S, Fava M, Nierenberg AA.

Use of the Chinese version of the Beck Depression Inventory for screening depression in primary care.
Yeung A, Howarth S, Chan R, Sonawalla S, Nierenberg AA, Fava M.

Treatment Resistant Depression

Papakostas GI, Fava M.
Pharmacotherapy for Depression and Treatment-Resistant Depression. 1st Edition. Singapore: World Scientific Publishing; 2010.

Melancholia and axis II comorbidity.
Tedlow J. Smith M. Neault N. Polania L. Alpert J. Nierenberg A. Fava M.

Lithium Augmentation of Nortriptyline for Subjects Resistant to Multiple Antidepressants.
Nierenberg A, Papakostas GI, Petersen T, Worthington JJ III, Tedlow J, Alpert JE, Fava M.

Nortriptyline for Treatment Resistant Depression.
Nierenberg A, Papakostas GI, Petersen T, Worthington JJ III, Tedlow J, Alpert JE, Fava M.

 

 

Major Depression and Other Disorders

Body dysmorphic disorder in outpatients with major depression.
Nierenberg AA, Phillips KA, Petersen TJ, Kelly KE, Alpert JE, Worthington JJ, Tedlow JR, Rosenbaum JF, Fava M.

 

Predictors of stable personality disorder diagnoses in outpatients with remitted depression.
Farabaugh A, Mischoulon D, Yeung A, Alpert J, Matthews J, Pava J, Fava M. J.

Fluoxetine treatment of depressed patients with comorbid anxiety disorders.
Sonawalla SB. Farabaugh A. Johnson MW. Morray M. Delgado ML. Pingol MG. Rosenbaum JF. Fava M.

Melancholia and axis II comorbidity.
Tedlow J. Smith M. Neault N. Polania L. Alpert J. Nierenberg A. Fava M.

Personality disorders and depression.
Fava M. Farabaugh AH. Sickinger AH. Wright E. Alpert JE.

Eating disorder symptomatology in major depression.
Fava, M., Abraham, M.E., Clancy-Colecchi, K., Pava, J.A., Matthews, J., & Rosenbaum, J.F.

Gender differences in Axis I comorbidity among depressed outpatients.
Fava, M., Abraham, M.E., Alpert, J.E., Pava, J.A., & Rosenbaum, J.F.

The Impact of Medical Comorbidity on Acute Treatment in Major Depressive Disorder.
Iosifescu DV, Nierenberg AA, Alpert JE, Smith M, Bitran S, Dording C, Fava M.

Medication Side Effects

 

Treatments for Depression

Double-blind study of high-dose fluoxetine versus lithium or desipramine augmentation of fluoxetine in partial responders and nonresponders to fluoxetine.
Fava M, Alpert J, Nierenberg A, Lagomasino I, Sonawalla S, Tedlow J, Worthington J, Baer L, Rosenbaum JF.

 

Treatment Approaches to Major Depressive Disorder Relapse. part 2: reinitiation of antidepressant treatment.
Fava M, Schmidt ME, Zhang S, Gonzales J, Raute NJ, Judge R.

Treatment Approaches to Major Depressive Disorder Relapse. part 1: dose increase.
Schmidt ME, Fava M, Zhang S, Gonzales J, Raute NJ, Judge R.

Early drop-outs, late drop-outs and completers: differences in the continuation phase of a clinical trial.
Sonawalla SB, Farabaugh AH, Leslie VM, Pava JA, Matthews JD, Fava M.

 

Early drop-outs, late drop-outs and completers: differences in the continuation phase of a clinical trial.
Sonawalla SB, Farabaugh AH, Leslie VM, Pava JA, Matthews JD, Fava M.

Acute efficacy of fluoxetine versus sertraline and paroxetine in major depressive disorder including effects of baseline insomnia.
Fava M, Hoog SL, Judge RA, Kopp JB, Nilsson ME, Gonzales JS.

Use of the Chinese version of the Beck Depression Inventory for screening depression in primary care.
Yeung A, Howarth S, Chan R, Sonawalla S, Nierenberg AA, Fava M.

A survey of prescribing practices in the treatment of depression.
Petersen T, Dording C, Neault NB, Kornbluh R, Alpert JE, Nierenberg AA, Rosenbaum JF, Fava M.

NEO-FFI factor scores as predictors of clinical response to fluoxetine in depressed outpatients.
Petersen T, Papakostas GI, Bottonari K, Iacoviello B, Alpert JE, Fava M, Nierenberg AA.

Switching to bupropion in fluoxetine-refractory depression.
Fava M, Papakostas GI, Petersen T, Mahal Y, Quitkin F, Stewart J, McGrath P.

Management of major depression in the primary care setting.
Mischoulon D, McColl R, Howarth S, Lagomasino IT, Alpert JE, Nierenberg AA, Fava M.

An open pilot study of nefazodone in depression with anger attacks: relationship between clinical response and receptor binding.
Mischoulon D, Dougherty DD, Bottonari KA, Gresham RL, Sonawalla SB, Fischman AJ, Fava M.

Hormone/Biological/Genetic Research on Depression

Recent Research including DCRP clinicians. Click on study title link to view abstract (appears in new window)

 

T3 blood levels and treatment outcome in depression. Iosifescu DV, Howarth S, Alpert JE, Nierenberg AA, Worthington JJ, Fava M.

Elevated cholesterol levels associated with nonresponse to fluoxetine treatment in major depressive disorder. Sonawalla SB. Papakostas GI. Petersen TJ. Yeung AS. Smith MM. Sickinger AH. Gordon J. Israel JA. Tedlow JR. Lamon Fava S. Fava M.

Anemia and macrocytosis in the prediction of serum folate and B12, and outcome in major depression. Mischoulon D, Burger JK, Spillmann MK, Worthington JJ, Fava M, Alpert JE.

Serum cholesterol in the continuation phase of pharmacotherapy with fluoxetine in remitted major depressive disorder. Papakostas GI, Iosifescu DV, Petersen T, Hamill SK, Alpert JE, Nierenberg AA, Rosenbaum JF, Fava M.

An Automated Registration Algorithm for Measuring MRI Subcortical Brain Structures. Iosifescu DV, Shenton ME, Warfield SK, Kikinis R, Dengler J, Jolesz FA and McCarley.

Books

Mischoulon D, Rosenbaum J, editors. Natural medications for psychiatric disorders: considering the alternatives. Philadelphia: Lippincott Williams & Wilkins, 2002. Second edition published in September 2008.

 

Natural and alternative therapies have been gaining popularity in the US and worldwide. However, most clinicians and consumers are not well informed about the pros and cons of these therapies. In this book, Drs. Mischoulon and Rosenbaum have assembled a team of distinguished clinician-investigators to write the chapters on various alternative therapies such as St John’s Wort, omega-3 fatty acids, SAMe, valerian, melatonin, and acupuncture, to name a few. The book presents a balanced, scientific perspective on the knowledge about the efficacy and safety of each of these therapies, and provides guidelines for their proper use.

A new book on Self Management of Depression: A Manual for Mental Health and Primary Care Professionals coauthored by Albert Yeung, M.D., ScD; Greg Feldman, Ph.D., Maurizio Fava, M.D.

 

 

In our clinic, patients frequently ask, "Is there anything more I can do to control my depression?" In this book, we discuss effective self-management measures for depression that are supported by scientific evidence and informed by successful approaches to manage other chronic medical illnesses. For example, many clinicians advise depressed patients to exercise. This book presents the evidence for exercise as a treatment for depression, the type and dosage of exercises shown to be useful, and whether exercise can be used to prevent future relapse of depression. In addition, we present strategies for helping patients overcome motivational barriers to regular exercise. We provide a similarly detailed discussion of the efficacy of other self-management approaches including psychoeducational resources, peer support groups, mind-body interventions such as relaxation response and mindfulness meditation, and computerized self-administered CBT programs. Clinicians who read this book will be equipped with a broad knowledge base and specific strategies to advise their depressed patients and empower them to become active partners in the management of their depression symptoms.

A work in progress: A call for entries on your experiences with depression.

Dr. Farabaugh and Dr. Witte respectfully invite you to submit a 1 to 5 page personal narrative, to be considered for inclusion in a forthcoming book. The purpose of the book is to relate experiences that individuals, and those close to them, have had with depression. A major focus of the book is to expand public awareness of this highly prevalent, yet somehow still stigmatized illness; to educate people about common as well as surprising or under-appreciated symptoms of the disease; and to provide specific, real-world examples and suggestions about things that help, and things that don't, from people with first-hand experience.

Your participation in this project is voluntary. If you currently receive treatment at the DCRP/MGH, you do not have to participate in the project in order to continue your treatment, and your participation will have no bearing on your treatment. Should you choose to participate, you maintain the option to retract your narrative at a later date.

We are planning to collect a series of personal reflections, by people who have had depression, that touch in some way on their own experiences. You can write about absolutely anything that you find especially meaningful. You might want to consider things that you really wish other people knew about the disease. We also seek reflections by people with a loved one who has suffered from depression.

To start, you could think about the single most important piece of advice you would want to give (or that you wish you had known) when you first developed depression, and make that statement, specifically, at the beginning of the narrative. Then, go on to tell your own story, including whatever you feel needs to be told, and illuminating the relevance of the advice.

Please don't feel limited in scope. Topics might include the challenge of finding the right diagnosis and treatment, the ways you learned what helped and hurt, challenges of implementing behavioral changes when motivation escapes you, what therapy was like, or any of hundreds of other ideas.

We would like to collect a diversity of personal accounts. Unfortunately, because of space limitations and other constraints, itÂ’s possible that your narrative would not be included in the book.

Your participation will not be compensated. You will not receive, and are giving up any claim to receive, any payment or royalties in connection with any publication, exhibition, televising or other showing of these narratives.

If you have any questions about this project, please contact
Dr. Janet Witte at 617-726-5104 or Dr. Amy Farabaugh at 617-726-1629.