Neuroprotective Effect of Escitalopram Oxalate in Rats with Chronic Hypoperfusion

Summary： The neuroproteetive effects of escitalopram oxalate in rats with chronic hypoperfusion and the possible mechanism were explored. Chronic hypoperfusion （2-VO） model was prepared and given escitalopram oxalate （experimental group） or PBS （control group） after 6 weeks. Eight weeks after the operation, Morris water maze test was carried out to evaluate the learning and memory ability of the rats. The cell proliferation, three-dimensional vascular distribution, cell morphological changes in ischemic area and the plasma vascular endothelial growth factor （VEGF） were detected to explore the possible mechanisms. （1） Morris water maze test showed that the escape latency in the experimental group was significantly shorter than in the control group, while the first quadrant swimming time in the experi- mental group was significantly longer than the control group （both P〈0.01）. （2） Cerebrovascular confo- cal detection results showed that the inside diameter of capillaries was significantly less in the experi- mental group than in the control group; the vascular density was significantly increased in the experi- mental group and the total area of capillaries was also significantly increased in the experimental group as compared with the control group. （3） There was statistically significant difference in BrdU-positive cells in the ischemic brain tissue between the experimental group and the control group （P=0.003〈0.01）. （4） VEGF concentrations in the plasma and the ischemic area were higher in the experimental group than in the control group （P〈0.05）. It was concluded that escitalopram oxalate could significantly im- prove the learning and memory ability of the rats with chronic cerebral ischemia probably by the VEGF-mediated angiogenesis.

Clinical efficacy and safety of Guipi decoction combined with escitalopram oxalate tablets in patients with depression

BACKGROUND Depression is a widespread mental health condition that requires effective treatment.In the treatment of depression,traditional Chinese medicine(TCM)offers obvious advantages,fewer adverse reactions,and a lower recurrence rate.AIM To evaluate the clinical benefits of Guipi decoction combined with escitalopram oxalate tablets for individuals with depression.METHODS In total,80 patients diagnosed as having depression were enrolled in the study and divided into either an experimental group or a control group.All of the patients were orally administered escitalopram oxalate tablets.Additionally,the experimental group received Jiajian Guipi decoction and reduced Governor vessel fumigation over 4 wk.TCM syndrome scores,Hamilton depression rating scale(HAM-D)scores,self-rating depression scale(SDS)scores,and Pittsburgh sleep quality index scores were measured for the two groups and compared before and after the treatment.The two groups were monitored for any adverse reactions.RESULTS After 4 wk of treatment,both groups exhibited a significant reduction in TCM syndrome scores compared with their pre-treatment scores(P<0.05).However,the experimental group exhibited significantly lower TCM syndrome scores than the control group(P<0.05).Similarly,the post-treatment SDS and HAM-D-24 scores were significantly lower in both groups than the pre-treatment scores(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The total treatment efficiency was significantly better in the experimental group(97.14%)than in the control group(77.78%)(P<0.05).Furthermore,after 4 wk of treatment,the Pittsburgh sleep quality index scores for both groups were significantly lower than those before the treatment(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The incidence of adverse reactions was significantly lower in the experimental group than in the control group(P<0.05).CONCLUSION The combination of Guipi decoction and escitalopram oxalate tablets was found to be an effective and safe treatment for depression.This combination could reduce TCM syndrome scores,improve depressive symptoms,and enhance sleep quality.

Pumpkin seed ethanolic extract protects against escitalopram-induced reproductive toxicity in male mice

Objective:To investigate the protective role of pumpkin seed ethanolic extract against escitalopram-induced reproductive toxicity in male mice.Methods:Swiss albino male mice were randomly divided into five groups with six mice in each group.Group Ⅰreceived normal water orally,Group Ⅱ,Ⅲ,Ⅳand Ⅴreceived escitalopram oxalate(10 mg/kg),pumpkin seed extract(300 mg/kg)plus escitalopram oxalate(10 mg/kg),escitalopram oxalate(20 mg/kg),and pumpkin seed extract(300 mg/kg)plus escitalopram oxalate(20 mg/kg),respectively.All test doses were continuously administered orally once daily per animal body weight for 30 days and 60 days.Body weight and sexual organ weight were evaluated on day 31 and 61.Effects of pumpkin seed extract on sperm parameters,biochemical parameters and histology of testis were also investigated.Results:Escitalopram 10 or 20 mg/kg caused reproductive toxicity in male mice after 30 and 60 days of treatment.However,simultaneous administration of escitalopram oxalate(10 or 20 mg/kg)with pumpkin seed extract(300 mg/kg)attenuated escitalopram-induced testicular toxicity.Significant increase in the body weight and relative organ weight was observed.Sperm count,sperm motility and viability significantly increased(P<0.05).The histopathological alterations caused by escitalopram was also ameliorated.Conclusions:Ethanolic extract of pumpkin seeds(300 mg/kg body weight)protects again reproductive toxicity induced by escitalopram.Therefore,dietary intake of pumpkin seed extract might be useful for male patients who expose to antidepressant drug due to depression.

Shugan Jieyu capsule effects on peripheral blood micro-124, micro- 132, and brain-derived neurotrophic factor in patients with mild to moderate depression

BACKGROUND To assess the effectiveness of Shugan Jieyu capsules on peripheral blood miR-124,miR-132,and brain-derived neurotrophic factor(BDNF)levels in patients with mild to moderate depression following coronary artery intervention[percuta-neous coronary intervention(PCI)]for coronary heart disease.Patients with mild-to-moderate depression of the liver-qi stagnation type after PCI for coronary heart disease at the 305th Hospital of the People’s Liberation Army were enrolled from June 2022 to November 2023 and randomly assigned to two groups:Experimental(treated with Shugan Jieyu capsules)and control(tr-eated with escitalopram oxalate tablets).This study compared the antidepressant effects of these treatments using 17-item Hamilton Rating Scale for Depression(HAMD-17)scores,metabolic equivalents,low-density lipoprotein cholesterol,BDNF,high-sensitivity C-reactive protein levels,miR-124 and miR-132 levels,distribution of immune-related lymphocyte subsets,and traditional Chinese me-dicine syndrome scores before and after 6 weeks of treatment.RESULTS No significant difference was observed in any index between the two groups before treatment(P>0.05).After treatment,the total efficacy rates were 93.33%and 90.00%in the experimental and control groups,respectively.Experimental group had significantly lower scores for the main and secondary syndromes compared to the control group(P<0.05).No significant difference was observed in the metabolic equivalents between the two groups be-fore and after treatment(P>0.05).The levels of low-density lipoprotein cholesterol,high-sensitivity C-reactive pro-tein,and miR-132 were significantly lower,whereas those of miR-124,BDNF,CD3+T lymphocytes,CD3+CD4+T helper lymphocytes,and CD3+CD4+/CD3+CD8+cells were significantly higher in the experimental group com-pared to the control group(P<0.05).The incidence of adverse reactions during experimental group was signi-ficantly lower than that in control group(P<0.05).CONCLUSION Shugan Jieyu capsules have good efficacy in patients with mild-to-moderate depression after PCI,and its me-chanism may contribute to the regulation of miR-124,miR-132,BDNF levels,and lymphoid immune cells.

Subclinical Hypothyroidism, Its Manifestations and Management a Case Report

Introduction: Thyroid states can be associated with psychiatric manifestations, be it hypothyroid, hyperthyroid or even euthyroid. The effect of depression is significant in subclinical hypothyroidism. Sometimes, its signs and symptoms are indistinguishable from Major Depressive Disorder. Our immunological system and early embryologic origins also play a role in the coexistence of other comorbidities like Pernicious Anemia. Case: A 35-year-old Hispanic female presented with significant low mood, somnolence, weight gain, increased hunger, cold intolerance and epigastric pain. It is important to note the variety of clinical manifestations of our hypothyroidism patient to understand its associations and help us with a better approach to treatment. Discussion: Standard approaches to treatment of Subclinical Hypothyroidism will depend mostly on laboratory findings such as TSH levels and free T4. Individualized therapy chosen for our patient was based on his mood symptoms, laboratory findings and coexistence of Pernicious Anemia. The use of daily 0.025 mg of levothyroxine, 10 mg of escitalopram oxalate and weekly injections of cyanocobalamin were treatments of choice. Conclusion: During follow up of our patient, we can conclude that Levothyroxine and Escitalopram Oxalate were able to improve hypothyroidism symptoms, reduce thyroglobulin and peroxidase antibodies and improve mood symptoms including cognitive functions. In addition to this, weekly cyanocobalamin injections were integrated into the management. As parietal cell antibodies decreased, gastrointestinal symptoms also disappeared. By addressing the concerns of our patient, we improved quality of care, and this is reflected in the patient’s wellbeing in physical and psychological.

Evaluation of the curative effect of acupuncture manipulation of regulating governor vessel and unblocking brain on the patients with post stroke depression associated with anxiety

Objective： To observe the comprehensive curative effect of acupuncture manipulation of regulating governor vessel and unblocking brain for post stroke depression associated with anxiety.Methods： Sixty-four patients with post stroke depression associated with anxiety were randomly divided into 2 groups according to the random numbers generated by spss16.0 software, the group of acupuncture manipulation of regulating governor vessel and unblocking brain（group A） and medication group（group B）, with 32 patients in each group. Acupuncture manipulation of regulating governor vessel and unblocking brain was performed in group A.Bǎihuì（百会GV 20）, Shéntíng（神庭GV 24）, Yǎmén（哑门GV 15） and Dànzhōng（膻中CV 17）, Gānshū（肝俞BL 18）. Xīnshū（心俞BL 15）. Shènshū（肾俞BL 23）,Tàichōng（太冲LR 3）, Tàixī（太溪KI 3）, Shénmén（神门HT 7） and Nèiguān（内关PC 6） were selected. The treatment was conducted for once a day, and 5 times a week. Escitalopram oxalate tablets were given orally to the patients in group B for once a day. The treatment was conducted for 8 consecutive weeks in each group. The scores of Hamilton depression scale（HAMD）, Hamilton anxiety scale（HAMA）, Barthel index（BI） and Fugl-Meyer assessment（FMA） in the two groups before and after treatment were compared.Results： Comparison with the same group before treatment, HAMD score and HAMA sore in the two groups after treatment for 4 weeks and 8 weeks were all obviously lower than that in the same group before treatment（all P〈0.01）; after treatment for 8 weeks, B1 score and FMA score in the two groups were all significantly higher than that in the same group before treatment（all P〈0.01）. Comparison between two groups after treatment. HAMD score and HAMA sore in group A after treatment for 4 weeks were significantly lower than that in group B（both P〈0.05）; only the HAMA sore in group A after treatment for 8 weeks was lower than that in group B（P〈0.05）, and there was no significant difference in HAMD score in the two groups（P〉0.05）; after treatment for 8 weeks, FMA score in group A was obviously higher than that in group B（P〈0.05）, and there was no significant difference in BI score in the two groups（P〉 0.05）.Conclusion： The curative effect of acupuncture manipulation of regulating governor vessel and unblocking brain on the anxiety state and motor function of the patients with post stroke depression is superior to that of escitalopram. With regard to the improvement of depression, this acupuncture manipulation was provided with the characteristic of rapid onset, and its long-term efficacy is equivalent to that of escitalopram. In terms of the improvement of activities of daily living, the curative effect of the two methods is equally well.