Using of rTMS and antidepressant drugs Simultaneously To increase the Essay

Using of rTMS and antidepressant drugs Simultaneously To increase the therapeutic efficacy for patients with psychotic printing - Essay ExamplePsychotic depression is a fairly common psychiatric condition that has been found to keep in nearly 20% of patients with major(ip) depression (Flores et al., 2006). The preferred treatment for psychotic depression so far has consisted of tricyclic antidepressants (TCAs) as also neuroleptic and electroconvulsive therapies (ONeal et al., 2000). Patients with psychotic depression have a more severely disordered hypothalamic-pituitary-adrenocortical (HPA) axis (Kathol et al., 1989). The psychotic features of psychotic depression have been attributed also to excessive glucocorticoid activity (Schatzberg et al., 1985). Interestingly, HPA axis activity is, to a astronomical extent, regulated by the combination of mineralocorticoid receptors (MR) and glucocorticoid receptors (GR) (Spencer et al., 1998 Young et al., 2003). Any mismatch between them could lead to inappropriate responses to stress, and incidence of major depression (Young et al., 2003). Decreases in MR sensitivity postulated to occur in major depression could result in elevated cortisol levels (Gesing et al., 2001 Young et al., 2003). In contrast, GR gives rise to feedback modifications in response to rising levels of cortisol as, for example, in response to stress or following the circadian rhythm. Hence, a GR antagonist e.g., the anti-progesterone steroid mifepristone (dimethylaminophenyl (17(-hydroxy-11(1(4-dimethylaminophenyl) 17(1- propynyl)estra-4,9-dien-3-one) exerts a powerful effect in the rising dent of the HPA axis (Flores et al., 2006). A major effect of mifepristone occurs through obstruction of GR in crucial regions of the brain and in monaminergic nuclei, thereby, directly leading to recovery of symptomatic and cognitive faculties.First observed by Bickford et al.(1987) to trigger transient mood elevation in normal subjects receiving single-pulse arousals to the motor cortex, the technique of non-invasive repetitive transcranial magnetic stimulation