| 1989 — 1993 |
Parry, Barbara L |
R29Activity Code Description:
Undocumented code - click on the grant title for more information. |
Chronobiology of Premenstrual Syndrome @ University of California San Diego
Premenstrual Syndrome (PMS) may have unique physiological underpinnings which make it of considerable interest to biological psychiatry. In pilot studies, we have found that phototherapy and sleep deprivation have marked therapeutic effects in PMS patients. The aims of this proposal are first, to validate the clinical efficacy of these treatments and second, to test hypotheses about their possible mechanisms of action. One hypothesis that we will test is that certain circadian rhythms may be phase-advanced relative to the sleep-wake cycle in some patients with PMS, and that phototherapy and sleep deprivation, by correcting this disturbance, produce clinical remission. We propose 3 studies: In Study I, we will contrast circadian hormones in PMS patients and control subjects. In Study II we will treat PMS patients with either morning bright light (which advances circadian rhythms), evening bright light (which delays circadian rhythms), or with evening dim light (which serves as a placebo control). In Study III, we will contrast late-night partial sleep deprivation (phase delay of sleep) in PMS patients. Our pilot data suggest that PMS patients respond preferentially to evening bright light and to late-night partial sleep deprivation, which is consistent with a phase-advance hypothesis. Since these interventions may be acting through mechanisms other than shifting circadian phase, we will examine alternative theories that might explain the beneficial effects of these treatments. Both phototherapy and sleep deprivation alter TSH and prolactin, hormones implication in the pathogenesis of PMS. Therefore, we will investigate effects of these treatments on circadian and endocrine systems. Thus phototherapy and sleep deprivation may serve not only as clinical probes to test our experimental hypotheses but also as potential alternatives to the pharmacologic management of PMS.
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1 |
| 1995 — 2002 |
Parry, Barbara L |
M01Activity Code Description:
An award made to an institution solely for the support of a General Clinical Research Center where scientists conduct studies on a wide range of human diseases using the full spectrum of the biomedical sciences. Costs underwritten by these grants include those for renovation, for operational expenses such as staff salaries, equipment, and supplies, and for hospitalization. A General Clinical Research Center is a discrete unit of research beds separated from the general care wards. |
Chronobiology of Pms and Seasonal Depression @ University of California San Diego
The purpose of this proposal is to test the hypothesis that disturbances in the timing of certain circadian rhythms may contribute to the pathophysiology of premenstrual and seasonal depressions and that correcting these disturbances using chronobiological interventions may result in clinical remission.
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1 |
| 1995 — 2007 |
Parry, Barbara L |
M01Activity Code Description:
An award made to an institution solely for the support of a General Clinical Research Center where scientists conduct studies on a wide range of human diseases using the full spectrum of the biomedical sciences. Costs underwritten by these grants include those for renovation, for operational expenses such as staff salaries, equipment, and supplies, and for hospitalization. A General Clinical Research Center is a discrete unit of research beds separated from the general care wards. |
Chronobiology of Postpartum Depression @ University of California San Diego
To determine if circadian rhythm disturbances, as measured by melatonin, contribute to the pathogenesis of postpartum depression and if these chronobiological disturbances can be treated by shifting the sleep-wake cycle and with phototherapy.
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1 |
| 1995 — 1999 |
Parry, Barbara L |
M01Activity Code Description:
An award made to an institution solely for the support of a General Clinical Research Center where scientists conduct studies on a wide range of human diseases using the full spectrum of the biomedical sciences. Costs underwritten by these grants include those for renovation, for operational expenses such as staff salaries, equipment, and supplies, and for hospitalization. A General Clinical Research Center is a discrete unit of research beds separated from the general care wards. |
Paroxetine in Postmenopausal Women--Effects of Estrogen @ University of California San Diego
To test the hypothesis that estrogen replacement enhances the antidepressant efficacy of paroxetine in postmenopausal depressed female subjects compared to paroxetine or estrogen alone.
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1 |
| 1995 — 2002 |
Parry, Barbara L |
M01Activity Code Description:
An award made to an institution solely for the support of a General Clinical Research Center where scientists conduct studies on a wide range of human diseases using the full spectrum of the biomedical sciences. Costs underwritten by these grants include those for renovation, for operational expenses such as staff salaries, equipment, and supplies, and for hospitalization. A General Clinical Research Center is a discrete unit of research beds separated from the general care wards. |
Melatonin Sensitivity to Light in Women With Pms and Mood Disorders @ University of California San Diego
To study light pulses on circadian rhythms and to determine the role of altered human circadian pacemaker dynamics in female depressed and control populations.
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1 |
| 1995 — 2007 |
Parry, Barbara L |
M01Activity Code Description:
An award made to an institution solely for the support of a General Clinical Research Center where scientists conduct studies on a wide range of human diseases using the full spectrum of the biomedical sciences. Costs underwritten by these grants include those for renovation, for operational expenses such as staff salaries, equipment, and supplies, and for hospitalization. A General Clinical Research Center is a discrete unit of research beds separated from the general care wards. |
Estradiol and Progesterone Circadian Rhythms in Postmenopause @ University of California San Diego
To determine if estrogen advances and enhances the amplitude and synchrony of components of the circadian system whereas progesterone antagonizes these effects. To investigate whether the effect of estrogen and progesterone on mood sleep and behavior in postmenopausal women may be mediated by effects of the circadian system.
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1 |
| 1996 — 1998 |
Parry, Barbara L |
R01Activity Code Description:
To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Chronobiologic Basis of Mood Disorders in Women @ University of California San Diego |
1 |
| 1997 |
Parry, Barbara L |
M01Activity Code Description:
An award made to an institution solely for the support of a General Clinical Research Center where scientists conduct studies on a wide range of human diseases using the full spectrum of the biomedical sciences. Costs underwritten by these grants include those for renovation, for operational expenses such as staff salaries, equipment, and supplies, and for hospitalization. A General Clinical Research Center is a discrete unit of research beds separated from the general care wards. |
Malatonin in Premenstrual Dysphoric Disorder @ University of California San Diego
clinical depression; melatonin; hormone therapy; premenstrual syndrome; human therapy evaluation; sign /symptom; clinical research; female; human subject;
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1 |
| 1998 — 1999 |
Parry, Barbara L |
M01Activity Code Description:
An award made to an institution solely for the support of a General Clinical Research Center where scientists conduct studies on a wide range of human diseases using the full spectrum of the biomedical sciences. Costs underwritten by these grants include those for renovation, for operational expenses such as staff salaries, equipment, and supplies, and for hospitalization. A General Clinical Research Center is a discrete unit of research beds separated from the general care wards. |
Sertraline and Placebo in Premenstrual Dysphoric Disorder @ University of California San Diego
Evaluate the comparative safety and efficacy of luteal phase dosing of sertraline and placebo in outpatients with DSM-IV diagnoses of premenstrual dysphoric disorder.
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1 |
| 2000 — 2004 |
Parry, Barbara L |
R01Activity Code Description:
To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Menopausal Depression: Chronobiologic Basis @ University of California San Diego
progesterone; postmenopause; estradiol; hormone regulation /control mechanism; circadian rhythms; hormone therapy; depression; melatonin; sleep; clinical research; women's health; human subject; female;
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1 |
| 2002 — 2007 |
Parry, Barbara L |
R01Activity Code Description:
To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Probing Premenstrual Dysphoric Disorder With Light @ University of California San Diego
DESCRIPTION (provided by applicant): Depression is a major health problem, on a par with heart disease in its annual cost of $43.7 billion. Women, compared with men, have a 2 to 1 incidence of major depression and are prone to develop episodes at times of reproductive hormonal change. The focus of this revised application is premenstrual dysphoric disorder (PMDD), a depressive disorder in the DSM-1V. In a pilot study, we observed in PMDD, but not in normal control (NC) subjects, an abnormal direction and a decreased magnitude of phase-shift responses in melatonin offset time alter a morning bright light pulse. The abnormality occurred in the symptomatic luteal, but not the asymptomatic follicular, menstrual cycle phase. In this proposal, we aim to replicate and extend these findings to determine whether abnormal phase-shifts to light occur in PMDD at other times of day. We will test the hypothesis that abnormal phase-shift responses to light also occur in the late subjective evening (during a delay portion of the phase-response curve, PRC), and during the early subjective morning (during an advance portion of the PRC). To assess phase-shift responses, we will measure the effects of bright (about 6,000 lux), 3-hour (h) light pulses on the critical circadian parameters of rhythmic plasma melatonin secretion, sleep electroencephalogram (EEG), and core body temperature. Responses to light at 2 different times of day will be compared between the follicular and luteal phases in women with PMDD and in normal control subjects. Altered phase-shift responses may contribute to disturbances in internal temporal order, and thereby result in mood disorders in predisposed individuals. These investigations will provide further insight into the pathophysiology of PMDD and other depressive disorders in women, and serve as a basis for refining light treatment interventions in the future.
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1 |
| 2004 |
Parry, Barbara L |
M01Activity Code Description:
An award made to an institution solely for the support of a General Clinical Research Center where scientists conduct studies on a wide range of human diseases using the full spectrum of the biomedical sciences. Costs underwritten by these grants include those for renovation, for operational expenses such as staff salaries, equipment, and supplies, and for hospitalization. A General Clinical Research Center is a discrete unit of research beds separated from the general care wards. |
Antidepressants in Menopausal Depressed Women--Estrogen @ University of California San Diego
paroxetine; chemosensitizing agent; depression; postmenopause; human therapy evaluation; estrogens; hormone therapy; combination chemotherapy; women's health; drug screening /evaluation; clinical research; human subject; female;
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1 |
| 2004 — 2009 |
Parry, Barbara L |
M01Activity Code Description:
An award made to an institution solely for the support of a General Clinical Research Center where scientists conduct studies on a wide range of human diseases using the full spectrum of the biomedical sciences. Costs underwritten by these grants include those for renovation, for operational expenses such as staff salaries, equipment, and supplies, and for hospitalization. A General Clinical Research Center is a discrete unit of research beds separated from the general care wards. |
Melatonin Sensitivity to Light in Premenstrual Mood Disorder Patients @ University of California San Diego
human therapy evaluation; clinical depression; melatonin; premenstrual syndrome; mood disorders; phototherapy; circadian rhythms; women's health; photostimulus; clinical research; human subject; female;
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1 |
| 2004 |
Parry, Barbara L |
M01Activity Code Description:
An award made to an institution solely for the support of a General Clinical Research Center where scientists conduct studies on a wide range of human diseases using the full spectrum of the biomedical sciences. Costs underwritten by these grants include those for renovation, for operational expenses such as staff salaries, equipment, and supplies, and for hospitalization. A General Clinical Research Center is a discrete unit of research beds separated from the general care wards. |
Estradiol/Progesterone Circadian Rhythm in Postmenopause @ University of California San Diego
progesterone; postmenopause; hormone regulation /control mechanism; women's health; mood disorders; sleep; circadian rhythms; estradiol; clinical research; female; human subject;
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1 |
| 2005 — 2007 |
Parry, Barbara L |
M01Activity Code Description:
An award made to an institution solely for the support of a General Clinical Research Center where scientists conduct studies on a wide range of human diseases using the full spectrum of the biomedical sciences. Costs underwritten by these grants include those for renovation, for operational expenses such as staff salaries, equipment, and supplies, and for hospitalization. A General Clinical Research Center is a discrete unit of research beds separated from the general care wards. |
Antidepressants in Menopausal Depressed Women -Effects of Estrogen @ University of California San Diego |
1 |
| 2005 — 2010 |
Parry, Barbara L |
M01Activity Code Description:
An award made to an institution solely for the support of a General Clinical Research Center where scientists conduct studies on a wide range of human diseases using the full spectrum of the biomedical sciences. Costs underwritten by these grants include those for renovation, for operational expenses such as staff salaries, equipment, and supplies, and for hospitalization. A General Clinical Research Center is a discrete unit of research beds separated from the general care wards. |
Chronobiology of Premenstrual and Seasonal Depression @ University of California San Diego |
1 |
| 2005 — 2009 |
Parry, Barbara L |
R01Activity Code Description:
To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Biological Rhythms in Postpartum Depression @ University of California San Diego
[unreadable] DESCRIPTION (provided by applicant): Our hypothesis is that altered circadian rhythms (melatonin, sleep/activity/illumination, prolactin, cortisol, thyroid stimulating hormone-TSH) characterize women with postpartum depression. This hypothesis is based on the testable theory that rapidly changing reproductive hormones (estradiol, progesterone, follicle stimulating hormone-FSH, luteinizing hormone-LH') during the postpartum period precipitate disturbances in the amplitude, phase (timing') or temporal organization of circadian rhythms that contribute to depressed mood in predisposed women. In particular, melatonin and prolactin amplitude and phase, and their temporal relationship, are altered. Identifying abnormalities in the regulation of circadian rhythms can serve as a basis for developing specific chronobiological or other treatment modalities in future studies. Postpartum major depression can have disabling effects on the mother and family and impair the growth and neurocognitive development of the child. Investigation into its pathogenesis, with the ultimate aim of developing new treatment strategies, is needed urgently, particularly given limitations on the safe and effective treatment options documented in lactating women. To assess whether alterations in amplitude, phase or temporal organization of circadian rhythms distinguish postpartum depressed patients (DP) from postpartum normal control (NC) women, we will examine plasma melatonin, the sleep/wake and illumination cycle, and prolactin, cortisol, and TSH in relationship to mood and reproductive hormones in 100 unmedicated postpartum women, 50 non-psychotic, unipolar women, whose onset of a major depressive episode (MDE) by DSM-IV criteria occurs during the first 3 months postpartum, and 50 healthy NC subjects, matched for age, postpartum week, and breast-feeding status. We hypothesize that the circadian rhythms of postpartum DP, compared with NC women, will exhibit abnormal amplitude, phase or temporal relationships. This study would serve as the basis of future studies in which treatments designed to correct these underlying abnormalities in circadian rhythms, and restore them to those of NC women, thereby would improve mood in DP. [unreadable] [unreadable]
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1 |
| 2008 — 2009 |
Parry, Barbara L |
M01Activity Code Description:
An award made to an institution solely for the support of a General Clinical Research Center where scientists conduct studies on a wide range of human diseases using the full spectrum of the biomedical sciences. Costs underwritten by these grants include those for renovation, for operational expenses such as staff salaries, equipment, and supplies, and for hospitalization. A General Clinical Research Center is a discrete unit of research beds separated from the general care wards. |
Effect of Estradiol and Progesterone Circadian Rhythms in Postmenopause @ University of California San Diego
Aquadiol; Behavior; CRISP; Circadian Rhythms; Computer Retrieval of Information on Scientific Projects Database; Corpus Luteum Hormone; Delta4-pregnene-3,20-dione; Dimenformon; Diogyn; Diogynets; Diurnal Rhythm; Estra-1,3,5(10)-triene-3,17-diol (17beta)-; Estrace; Estradiol; Estradiol-17 beta; Estradiol-17beta; Estraldine; Estrogenic Agents; Estrogenic Compounds; Estrogens; Funding; Grant; Institution; Investigators; Mediating; Moods; NIH; National Institutes of Health; National Institutes of Health (U.S.); Nyctohemeral Rhythm; Ovocyclin; Ovocylin; Post-Menopause; Post-menopausal Period; Postmenopausal Period; Postmenopause; Pregn-4-ene-3,20-dione; Pregnenedione; Progesterone; Progynon; Research; Research Personnel; Research Resources; Researchers; Resources; Sleep; Source; System; System, LOINC Axis 4; Therapeutic Estradiol; Therapeutic Estrogen; Therapeutic Progesterone; Twenty-Four Hour Rhythm; United States National Institutes of Health; Woman; circadian; circadian process; daily biorhythm; diurnal variation; post-menopausal; postmenopausal
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1 |
| 2008 — 2012 |
Parry, Barbara L |
R01Activity Code Description:
To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Melatonin in Menopausal Depression @ University of California San Diego
[unreadable] DESCRIPTION (provided by applicant): Now a clearly identified phenomenon, a major depressive episode at menopause can cause extensive morbidity and mortality. Its pathogenesis and treatment, however, have not been systematically investigated. Medical studies have focused on the cardiovascular and reproductive systems, with relatively little attention being paid to the central nervous system. We have observed increased melatonin secretion and delayed morning offset in menopausal depressed patients (DP) compared with normal control (NC) women. The aim of this revised application is to test the hypothesis that compared with NC women, menopausal DP have increased melatonin amplitude and delayed morning offset, attributable primarily to alterations in a) light/dark and sleep/wake cycles and b) reproductive and other endocrine functions. According to our conceptual model, menopausal DP have a decreased hypothalamic sensitivity to gonadal steroids, which disrupts the normal regulation of circadian rhythms, and is manifested in increased melatonin secretion with delayed morning offset. Increased arousals in dim light at night, resulting in delayed wake time with decreased and delayed exposure to morning bright light, increased daytime sleep or insufficient or decreased sensitivity to light exposure, exacerbate the problem. Reminiscent of the findings in hamsters during extended dark periods at night in winter, menopausal DP have increased melatonin duration, extended sleep time, recent hypogonadism, higher Follicle Stimulating Hormone (FSH) levels and Body Mass Index (BMI) that correlate with depression ratings. Our aim in this proposal is to extend and replicate our preliminary findings of abnormal melatonin secretion in menopausal DP and investigate the likely contributing factors of light, sleep, activity and reproductive endocrine function, as a basis for developing treatments targeted to specific pathogenic factors in future studies. In 50 peri- or post-menopausal DP by DSM-IV criteria, and in 50 NC women, matched for age and menopausal status, we will measure the phase, amplitude, waveform and temporal relations among 24-hour cycles of plasma melatonin (30 minute sampling in dim light), illumination, sleep and activity (by polysomnography and Actillume), as well as reproductive endocrine function (by gonadotropin and steroid levels) and BMI, in relation to mood. As an extension of our ongoing investigation of the chronobiology of premenstrual, pregnancy and postpartum depression, this study has the potential to lead to the development of new hypotheses and treatment strategies. The findings may impact the understanding of other depressive disorders related to the reproductive cycle in women. It also will confirm and extend our understanding of chronobiological abnormalities in depressed women as the basis for developing innovative treatments.Project Narrative [unreadable] [unreadable] Depression that occurs at menopause is a poorly understood condition, which impairs the ability to develop effective treatments. In this proposal we plan to investigate the role of melatonin circadian rhythms in this disorder and the disruptions in the sleep, light and endocrine cycle that may contribute to it as a basis for developing better treatments in future studies. [unreadable] [unreadable] [unreadable]
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1 |
| 2008 — 2010 |
Parry, Barbara L |
M01Activity Code Description:
An award made to an institution solely for the support of a General Clinical Research Center where scientists conduct studies on a wide range of human diseases using the full spectrum of the biomedical sciences. Costs underwritten by these grants include those for renovation, for operational expenses such as staff salaries, equipment, and supplies, and for hospitalization. A General Clinical Research Center is a discrete unit of research beds separated from the general care wards. |
Chronobiology of Pregnancy and Postpartum Depression @ University of California San Diego
Acetamide, N-(2-(5-methoxy-1H-indol-3-yl)ethyl)-; Actinotherapy; CRISP; Chronobiology; Circadian Rhythms; Computer Retrieval of Information on Scientific Projects Database; Depression, Postpartum; Diurnal Rhythm; Funding; Gestation; Grant; Institution; Investigators; Light Therapy; Measures; Melatonin; NIH; National Institutes of Health; National Institutes of Health (U.S.); Nyctohemeral Rhythm; Pathogenesis; Photoradiation Therapy; Phototherapy; Post-Natal Depression; Post-Partum Depression; Postnatal Depression; Postpartum Depression; Pregnancy; Research; Research Personnel; Research Resources; Researchers; Resources; Sleep Wake Cycle; Source; Twenty-Four Hour Rhythm; United States National Institutes of Health; circadian; circadian process; daily biorhythm; diurnal variation
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1 |
| 2013 — 2016 |
Parry, Barbara L |
R01Activity Code Description:
To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Complementary Chronotherapeutics For Pregnancy and Postpartum Depression @ University of California San Diego
DESCRIPTION (provided by applicant): Pregnant and postpartum major depression (MD) has disabling effects on the mother and her family, and impairs growth and neurocognitive development of the child. Investigation into its pathogenesis, with the ultimate aim of developing new treatment strategies, is needed urgently, particularly given the limited safety and efficacy of treatment options documented in pregnant and in lactating women. In previous work, we demonstrated that pregnant depressed patients (DP) had phase-advanced (shifted-earlier), whereas postpartum DP had phase-delayed (shifted-later) melatonin rhythms compared with normal control (NC) pregnant or postpartum women. In this new application we will test the hypothesis that correcting these underlying circadian rhythm disturbances with a combination of appropriately-timed wake therapy and light treatment achieves antidepressant effects. We expect treatments to act selectively: In pregnant DP with phase- advanced rhythms, we hypothesize that early wake therapy (EWT: wake until 03:00 h, followed by sleep until 07:00 h) plus evening (PM) bright white light (BWL), which phase-delay melatonin rhythms, will improve mood more than late wake therapy (LWT: sleep from 21:00-01:00 h, followed by wake) plus morning (AM) BWL, which phase-advance melatonin rhythms. In contrast, in postpartum DP with phase-delayed rhythms, we hypothesize that LWT plus AM BWL, which phase-advance melatonin rhythms, will improve mood more than EWT plus PM BWL, which phase-delay them. These combined chronobiological treatments are complementary in that wake therapy can hasten and potentiate the antidepressant effects of light treatment that may take up to 10 weeks to show efficacy in pregnant DP, while light treatment can sustain the antidepressant effects of wake therapy that often are lost after subsequent sleep. Although these combined treatments have demonstrated safety and efficacy in other mood disorders, they have not been applied to pregnant and postpartum MD. We will examine the effects of EWT plus PM BWL vs. LWT plus AM BWL on mood, urinary melatonin and the sleep/wake cycle in pregnant and postpartum DP at home. By this translational approach targeted to underlying chronobiological abnormalities, we aim to develop innovative alternative interventions for puerperal MD, potentially transforming treatment approaches for women's mood and other disorders with circadian rhythm disturbances.
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1 |
| 2013 — 2017 |
Parry, Barbara L |
R01Activity Code Description:
To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Alternative Treatments For Premenstrual Dysphoric Disorder @ University of California San Diego
Innovative, alternative treatments are needed for Premenstrual Dysphoric Disorder (PMDD), a disabling depressive disorder listed in DSM-IV, affecting 5-8% of menstruating women. Left untreated, PMDD can progress to major depression. Offered medication, at least 40% of women do not respond, develop problematic side-effects or seek options other than chronic pharmacological treatment for this periodic illness. Previously we independently administered sleep and light behavioral therapies, translating discoveries from basic circadian biology to improve the health of women with PMDD. In response to a call for the development of novel combination therapies, in this proposal we plan to co-administer wake therapy followed by light treatment, a novel alternative approach, never before tried in PMDD, despite its demonstrated efficacy in other mood disorders. These potentially complementary treatments have the advantage of wake therapy hastening the onset of the antidepressant effects of light treatment, a crucial benefit during the relatively short-lived symptoms of the 2-week luteal phase, whereas light treatment maintains the benefit of the otherwise transitory effects of wake therapy often lost after subsequent sleep. Our primary aim is to examine the effects of these interventions on mood, and secondarily on circadian rhythms, to test the hypothesis that critically-timed chronotherapy improves mood by correcting phase disturbances in melatonin and sleep. As we found that in PMDD melatonin rhythms were phase-delayed (shifted-later) in the symptomatic luteal compared with the asymptomatic follicular, menstrual cycle phase, we hypothesize that advancing melatonin rhythms with late wake therapy (LWT: sleep 21:00-01:00 h, followed by wake) plus morning bright white light (BWL) will improve mood in PMDD patients more than delaying them with early wake therapy (EWT: wake, then sleep 03:00-07:00 h) plus evening BWL. Outcome measures are mood, urinary melatonin, sleep/activity in PMDD subjects. These studies will determine whether innovative, alternative, combined chronobiological interventions, targeted to specific underlying circadian rhythm abnormalities, can benefit mood in PMDD. The results may impact other depressive disorders with chronobiological disturbances and other women¿s mood disorders.
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1 |
| 2017 |
Parry, Barbara L |
R01Activity Code Description:
To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Complementary Chronotherapeutics For Pregcy and Postpartum Depression @ University of California San Diego
DESCRIPTION (provided by applicant): Pregnant and postpartum major depression (MD) has disabling effects on the mother and her family, and impairs growth and neurocognitive development of the child. Investigation into its pathogenesis, with the ultimate aim of developing new treatment strategies, is needed urgently, particularly given the limited safety and efficacy of treatment options documented in pregnant and in lactating women. In previous work, we demonstrated that pregnant depressed patients (DP) had phase-advanced (shifted-earlier), whereas postpartum DP had phase-delayed (shifted-later) melatonin rhythms compared with normal control (NC) pregnant or postpartum women. In this new application we will test the hypothesis that correcting these underlying circadian rhythm disturbances with a combination of appropriately-timed wake therapy and light treatment achieves antidepressant effects. We expect treatments to act selectively: In pregnant DP with phase- advanced rhythms, we hypothesize that early wake therapy (EWT: wake until 03:00 h, followed by sleep until 07:00 h) plus evening (PM) bright white light (BWL), which phase-delay melatonin rhythms, will improve mood more than late wake therapy (LWT: sleep from 21:00-01:00 h, followed by wake) plus morning (AM) BWL, which phase-advance melatonin rhythms. In contrast, in postpartum DP with phase-delayed rhythms, we hypothesize that LWT plus AM BWL, which phase-advance melatonin rhythms, will improve mood more than EWT plus PM BWL, which phase-delay them. These combined chronobiological treatments are complementary in that wake therapy can hasten and potentiate the antidepressant effects of light treatment that may take up to 10 weeks to show efficacy in pregnant DP, while light treatment can sustain the antidepressant effects of wake therapy that often are lost after subsequent sleep. Although these combined treatments have demonstrated safety and efficacy in other mood disorders, they have not been applied to pregnant and postpartum MD. We will examine the effects of EWT plus PM BWL vs. LWT plus AM BWL on mood, urinary melatonin and the sleep/wake cycle in pregnant and postpartum DP at home. By this translational approach targeted to underlying chronobiological abnormalities, we aim to develop innovative alternative interventions for puerperal MD, potentially transforming treatment approaches for women's mood and other disorders with circadian rhythm disturbances.
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1 |