Study suggests combining antidepressants, ECT may be more effective for reducing symptoms of severe depression.

Medscape (7/10, Kelly) reported that, according to a study published in the July issue of Archives of General Psychiatry, “combining antidepressant” medications “with electroconvulsive therapy (ECT) does a better job of reducing symptoms of severe depression and causes less memory loss than using ECT alone.” For the study, researchers from Columbia University “randomized 319 patients who had major depression to receive either a placebo or one of two antidepressants: nortriptyline or venlafaxine, starting the afternoon following the first ECT treatment.” Electroconvulsive therapy “was given three times per week.” Meanwhile “a battery of cognitive tests was administered before ECT and one to four days following all ECT.” The team found that “using either antidepressant during ECT improved depression more than ECT alone and that adding nortriptyline to ECT increased remission rates by about 15 percent.” In addition, “patients who received nortriptyline during ECT had fewer memory problems than those in the venlafaxine group.”

Senate approves measure allowing reimportation of medications from Canada.

The AP (7/10, Taylor) reports that, with a 55 to 36 vote, the Senate approved a measure which could allow US citizens to “get lower-cost” medications “from Canada over the Internet.” The measure is portrayed as “a defeat to the powerful” pharmaceutical industry. It was “attached to a bill funding the Customs Department and other homeland security agencies.” Critics argue that the amendment “would open a gaping loophole that would expose people to Internet scams and unsafe” medicines, “but the allure of importing US-made” medications “from other countries where government policies have driven prices lower has long had a pull on lawmakers.” Detractors included Senate Majority Leader Harry Reid (D-NV) and Sen. Dick Durbin (D-IL), who “only [switched] their votes after it became clear the popular idea would pass.” Still, “their doubts about the idea may ensure” that the medication “importation rule gets dropped during House-Senate negotiations on a final bill.”

Researchers associate postpartum depression with poor sleep.

Medscape (7/8) reported that, according to a study published in the July issue of Sleep, “poor sleep is linked to postpartum depression independently of other risk factors.” For the study, researchers from Norway’s Stavanger University Hospital sought to “assess the prevalence of and risk factors for concurrent postpartum maternal sleep problems and depressive symptoms, to identify factors independently associated with either condition, and to examine associations between specific components of postpartum sleep and depression.” They did so by mailing “a questionnaire seven weeks after delivery” to “a total of 4,191 women” who “delivered at Stavanger University Hospital” from Oct. 2005 to Sept. 2006. The investigators found that “the prevalence of sleep problems was 57.7 percent, and the prevalence of depression was 16.5 percent.” Specific “factors associated with poor postpartum sleep quality were depression, history of sleep problems, primiparity, not exclusively breast-feeding, or having a younger or male infant.” Overall, “the aspects of sleep most strongly associated with depression were sleep disturbances and subjective sleep quality.”

Small study indicates amino acid N-acetylcysteine may help treat people with trichotillomania.

The BBC News (7/7) reports that, according to a study published in the July issue of the Archives of General Psychiatry, “a simple supplement” containing the amino acid N-acetylcysteine “could help treat people with” trichotillomania, “an impulse disorder that manifests in hair-tearing.” People who suffer from trichotillomania have “uncontrollable urges to pluck the hair of the scalp and even eyebrows and lashes, often to the point of baldness.” For the study, researchers from the University of Minnesota School of Medicine asked a “group of 50 people with trichotillomania…to take part in a 12-week trial of the pill containing the amino acid N-acetylcysteine.” Half of the participants “were given the treatment, and the other half a dummy pill.” At study end, the team found that “patients taking the active medication had significantly greater reductions in hair-pulling symptoms than those taking placebo.  Reuters (7/7, Stern) explains that study participants received a starting dose of 1,200 milligrams of N-acetylcysteine daily, which was doubled after a period of six weeks if no improvement took place. At the end of the study, 56 percent of the participants were considered to have had improvement in their condition, compared to the 16 percent of participants taking placebo. Forty-four percent of the participants did not respond to N-acetylcysteine, however.  Minnesota’s Pioneer Press (7/7, Olson) points out that N-acetylcysteine “can be found at nutrition and health food stores. Recent mouse studies revealed that the supplement affects” glutamate, “a brain chemical that has been linked to compulsive behaviors.” Study author Jon E. Grant, JD, MD, MPH, “cautioned against overuse of the supplement, which appeared affective in the study at 2,400 milligrams per day.” It also “remains unclear whether short-term consumption would result in permanent improvements, or whether people would need to take the supplement indefinitely. Taking the supplement in combination with therapy would probably work best,” Dr. Grant theorized. The Pioneer Press also noted that trichotillomania “appears more common in women and is often linked to anxiety disorders and social phobias.” It responds somewhat to counseling, but “antidepressants have been largely unsuccessful in treating the disorder.”

Mouse study suggests caffeine may reverse Alzheimer’s-related memory problems.

BBC News (7/5) reported that, according to a mouse study published in the July 5 online edition of the Journal of Alzheimer’s Disease, “drinking five cups of coffee a day could reverse memory problems seen in Alzheimer’s disease.” For the study, researchers from the University of Florida studied “55 mice…bred to develop symptoms of Alzheimer’s disease (AD)” and found that “caffeine hampered the production of the” beta-amyloid “protein plaques which are the hallmark of” AD. The team used “behavioral tests to confirm the mice were exhibiting signs of memory impairment when they were aged 18 to 19 months, the equivalent to humans being about 70,” then “gave half the mice caffeine in their drinking water. The rest were given plain water.” The animals received “the equivalent of five 8 oz. (227 grams) cups of coffee a day — about 500 milligrams of caffeine.”
        The UK’s Telegraph (7/5) explained that “at the end of the two-month study, the caffeine-drinking mice performed far better on tests of memory and thinking than mice given only water.” In fact, “their memories were as sharp as those of healthy older mice without dementia.” For humans, the “equivalent dose for their body weight would be consuming 500 milligrams of caffeine a day, equivalent to five cups of ordinary coffee,” which is “the same amount of caffeine can be obtained by drinking two cups of strong coffee, 14 cups of tea, or 20 cola drinks.”
        HealthDay (7/5, McKeever) pointed out that, according to the study’s authors, “consuming 500 milligrams of caffeine a day would not cause ill effects for most people,” but “people with high blood pressure or who are pregnant need to limit their caffeine intake.” Notably, the study authors “also found that caffeine did not improve the memory of normal mice as it did for the Alzheimer’s mice.” They concluded, “This suggests that caffeine will not increase memory performance above normal levels. Rather, it appears to benefit those destined to develop Alzheimer’s disease.” The St. Petersburg Times (7/6, Nohlgren) also covers the story.

Study indicates anxiety, depression may increase incidence of angina.

HealthDay (6/29, Edelson) reported that, according to a study published online June 29 in the journal Circulation, “anxiety and depression can increase the incidence of angina.” For the study, a team led by Mark Sullivan, MD, PhD, of the University of Washington, followed “191 people with known ischemia who underwent stress testing and heart imaging. They found that 36 percent reported no angina in the previous month, with 35 percent reporting monthly incidents.” Of the group “who had daily or weekly angina, psychological assessments, including a self-reporting anxiety and depression questionnaire, showed that 44 percent had significant anxiety and two-thirds had significant depression.” It remained unclear “whether the psychological problems were heightening the effect of angina or vice versa,” but Dr. Sullivan said that “physicians treating people with angina can use ‘fairly simple screening tests’ to determine the presence of anxiety or depression and treat those conditions, if necessary.”

Animal experiments indicate lovastatin may protect against Alzheimer’s.

HealthDay (6/30, West) reported that, according to a study published in the June issue of the Journal of Alzheimer’s Disease, “treatment with a cholesterol-lowering” medication “might protect against Alzheimer’s disease.” For the study, researchers from the University of Groningen, the Netherlands, “conducted animal experiments in which they administered lovastatin (Altoprev, Mevacor) to overstimulated nerve cells.” The team found that “lovastatin did indeed prevent cell death and, just as important, blocked the loss of memory that accompanies excitotoxicity.” Previous research has demonstrated that “statins seem to stimulate the protective capacity of tumor necrosis factor, a key player in the brain’s immune response.” Furthermore, “some researchers have speculated that high cholesterol might be a risk factor for Alzheimer’s, suggesting that lowering cholesterol could be beneficial.”

Study indicates biomarkers for Alzheimer’s may be detected in cerebrospinal fluid in earliest stages of disease.

HealthDay (6/24, Preidt) reported that, according to a study published in the July issue of The Lancet Neurology, “biomarkers for Alzheimer’s disease can be detected in the cerebrospinal fluid in the very early stages of the disease.” For the study, researchers from Sweden’s University of Gothenburg “analyzed cerebrospinal fluid (CSF) samples from 168 patients and found the typical pattern of biomarkers known as the ‘CSF AD profile’ present in patients with mild memory problems, which is earlier than the illness could be detected by current tests.” In fact, “patients who had the typical changes in biomarker profile of the cerebrospinal fluid had a risk of deterioration that was 27 times higher than the control group,” the investigators found. In addition, the authors “found a relationship between the CFS AD profile and other typical signs of Alzheimer’s, including the presence of the gene APOE e4 and deterioration of the area of the brain that controls memory.”

Researchers may have identified hundreds of genetic variations associated with AD/HD.

HealthDay (6/25, Preidt) reported that, according to a study published online June 23 in Molecular Psychiatry, researchers from the Children’s Hospital of Philadelphia, PA, have identified “hundreds of gene variations that may be associated with attention-deficit/hyperactivity disorder (AD/HD).” For the study, the team “analyzed genomes from 335 AD/HD patients and their families, and compared them to more than 2,000 children without AD/HD. The hundreds of gene variations were found to occur more often in children with AD/HD than in normal children.” In a news release, psychiatrist and AD/HD expert Josephine Elia, MD, stated, “Because the gene alterations we found are involved in the development of the nervous system, they may eventually guide researchers to better targets in designing early intervention for children with AD/HD.” HealthDay noted, “The cause of AD/HD isn’t known, but studies have shown that it’s strongly influenced by genetics.”

Research suggests REM sleep may facilitate problem solving.

The New York Times (6/23, D6, Bakalar) reports in Vital Signs that, according to a study published June 8 in the Proceedings of the National Academy of Sciences, rapid eye movement sleep (REM), “the kind that includes dreams,” may facilitate problem solving. For the study, researchers from the University of California-San Diego “gave 77 volunteers word-association tests under three before-and-after conditions: spending a day without a nap, napping without REM sleep, and napping with REM sleep.” They found that “a nap that included REM sleep resulted in nearly a 40 percent improvement over the pre-nap performance.” Study author Sara C. Mednick, PhD, stated that dreams “incorporate strange ideas that you would never have put together in waking life. In REM sleep, it becomes more likely that ideas might come together in a solution.”