Major depressive disorder (MDD) is a common health disorders characterized by anhedonia along with physical changes. MDD is a leading cause of disability worldwide. MDD treatment mainly focuses on improving the quality of life of the patients suffering from this disorder. Various modalities of treatment include initiating pharmacotherapy, focussed psychotherapy, or electroconvulsive therapies. The current treatment modalities focus on the monoamine hypothesis with a wide range of drugs available from tricyclic antidepressants (TCAs) to selective serotonin reuptake inhibitors (SSRIs). Despite therapy with the currently available drugs a substantial proportion of patients do not achieve full remission with full-dose titration and there is still persistence of treatment-resistant depression (TRD). The currently available antidepressants drugs are associated with frequent adverse effects with tolerance limiting their long-term adherence. Delivery of psychotherapy has its own set of limitation and one of them is in form of delivery of psychotherapy. As many patients despite optimal therapy of currently available antidepressant drugs one-third of the patients do not respond to the currently available forms of therapy. The understanding of the pathophysiology has increased our knowledge with role of neuroplasticity, disrupted signalling pathway, decreased neurotropic factor expressions and altered functional connectivity of neurocircuitry also playing its role apart from the neurotransmission theory of depression. Opening up avenues for treatment of currently unanswered area for depression which include lag in onset of effect, tolerance to therapy, treatment resistant depression and delay in achieving remission. The current review tries to highlight the various options for treatment of depression for effective treatment of depression.
International Journal of Human and Health Sciences Vol. 10 No. 04 Oct’26 Page: 217-226
Jaspreet Kaur, Deepika Puri, K. Sachdeva et al.· International Journal of Hum...· 0 citations
Esophageal Cancer: Barrett‘s Esophagus: High-Grade Dysplasia and Early Invasive Cancer
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) delay gastric emptying and are linked to increased gastroesophageal reflux, a recognized risk factor for Barrett’s esophagus (BE) progression to esophageal cancer (EC). Extended use of GLP-1 RAs facilitates weight loss, mitigating reflux, possibly offering a protective effect against EC. This large retrospective study aimed to assess the association between GLP-1 use with the development of dysplastic Barrett’s esophagus (BE) and EC in patients with non-dysplastic BE (NDBE).
We used ICD and CPT codes within the TriNetX (a large multicenter claims based) database to identify NDBE patients. The cohort was then categorized as GLP-1 users vs. non-users based on ATC code A10BJ. A 1:1 propensity matched analysis was performed with balancing of confounders (Table 1). Primary outcomes included incidence of dysplastic BE and EC. Time to event analyses were performed.
A total of 4,534 patients were identified in the GLP-1 cohort and 55,621 in the non-GLP-1 cohort. After 1:1 matching, 4,530 patients were included in each cohort. Mean follow-up was 3.57 years in GLP-1 cohort and 3.30 years in non-GLP-1 cohort. Incidence of dysplastic BE/EC in the GLP 1 cohort was 1.24% (N=56) compared to 0.54% (N=24) in non-GLP 1 cohort. GLP-1 users demonstrated significantly higher risk of developing dysplastic BE/EC compared to non-users (RR: 2.30; 95% CI: 1.47–3.70, P = 0.0004. The cumulative incidence of dysplastic BE/EC was higher among GLP-1 cohort at 3 and 5 years—0.90 %, and 1.11%, respectively—compared to 0.47%, and 0.49 % in the non-GLP-1 group.
Our findings indicate that GLP-1 therapy was associated with an increased risk of progression to dysplastic BE/EC in patients with non-dysplastic BE. Further prospective studies are warranted to validate these results.
Russaal S Mann, K. Sachdeva, L. Dhaliwal et al.· Diseases of the esophagus· 0 citations
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