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Archive for the ‘Depression’ Category

The NPR (10/5, Hamilton) “Shots” blog reports that “scientists say they have figured out how an experimental drug called ketamine is able to relieve major depression in hours instead of weeks.” Ketamine is an FDA-approved anesthetic. It’s also a popular club drug that can produce out-of-body experiences and hallucinations. Not exactly what you’d want from a depression drug.  “It’s exciting,” says Ron Duman, a a psychiatarist and neurobiologist at Yale University. “The hope is that this new information about ketamine is really going to provide a whole array of new targets that can be developed that ultimately provide a much better way of treating depression.”  In stressed mice, a dose of ketamine was able to “rapidly increase  connections and also to rapidly reverse the deficits that are caused by stress,” Duman says.   Research is intended to produce drugs that will work like ketamine, but without the hallucinations.  Several of these alternative drugs are already being tried in people.

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ImageAccording to a study in the August issue of the Journal of Clinical Psychiatry “A cohort study of 84 adults from Sweden showed that those who had been infected with T gondii were seven times more likely to participate in nonfatal, self-directed violence compared with their counterparts who had not been infected.”  T gondii has always been known to be dangerous espically in pregnant women.  It is the causative agent in Toxoplamosis.  It is frequently contracted through eating undercooked meat or comin into contact with cat feces.

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HealthDay (6/29, http://tinyurl.com/generic-eff-xr) reported the first generic version of Effexor extended release  (XR) capsules (venlafaxine hydrochloride) to treat major depressive disorder has been approved by the U.S. Food and Drug Administration.  Teva said it will start shipping its version of Effexor, or venlafaxine, on July 1st, 2020. The Israeli company originally sought approval for its generic in 2006, but as part of a patent settlement with Wyeth  it agreed not to sell its version until July 1, 2010. Pfizer acquired Wyeth last year.  As the first company to file an Abbreviated New Drug Application (ANDA) containing a paragraph IV certification for this product, Teva has been awarded a 180-day period of marketing exclusivity.  Teva said annual U.S. sales of Effexor XR are around $2.75 billion.

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HealthDay (5/27, Gardner, http://tinyurl.com/allergies-depression) reported that allergies may increase the risk for depression. “Depression is a very common disorder and allergies are even more common,” said study author Dr. Partam Manalai, in the department of psychiatry at the University of Maryland School of Medicine in Baltimore.  “Allergies make one more prone to worsening mood, cognition and quality of life.”  A large peak in pollen particles floating in the air occurs in the spring, with a smaller peak in the fall.  This coincides with a worldwide spike in suicides every spring and a lower peak in the fall.  Manalai and his colleagues recruited 100 volunteers from Baltimore and Washington, D.C., who had major depression, half were allergic and half were not allergic to trees and/or ragweed pollen.  Volunteers were evaluated during both high and low pollen seasons, and also had levels of their IgE antibodies (a measure of sensitivity to allergens) measured.  “Patients with mood disorders who were allergic to an aeroallergen experienced a worsening in mood when they were exposed to the allergen,” Manalai said. “Patients who have both of these disorders might be more vulnerable to depression in peak pollen season,” he suggested.  “Treating those conditions might prevent them from having a depressive episode during high-pollen season,” Manalai added.  The findings might also help determone how much of the depression associated with allergy is psychological and how much is biological.  With that knowledge in hand, researchers may be able to find new therapies.

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The St. Petersburg Times (3/3, Stein, http://tinyurl.com/TMS-depression) reports that for patients who don’t respond to drugs and counseling, TMS (transcranial magnetic stimulation) offers an alternative to electric shock therapy, still used to treat depression despite its reputation in popular culture as a barbaric treatment.  Many physicians consider ECT the gold standard treatment for severe depression that doesn’t respond to other remedies.  It is considered safe, but side effects can include short-term memory loss.  TMS involves using an electromagnetic coil to beam pulsations through the skull to stimulate a part of the brain thought to be involved in depression.  By contrast, the primary discomfort associated with TMS is a staccato tapping noise.  Another consideration is cost, which can reach $10,000 and isn’t routinely covered by insurance since it is relatively new and its availability limited. At USF, the treatment costs about $350 per session, and patients need about 10 to 20 procedures.  Clinical trials on TMS have yielded mixed results, and the U.S. Food and Drug Administration received some criticism when it approved the therapy for use in treatment-resistant depression over a year ago.  At least some questions may be settled in May, when the results of a five-year study sponsored by the NIH will be published in the Archives of General Psychiatry.

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The UK’s Daily Mail // (1/11, Ferrier http://tinyurl.com/adrenal-gland-fatigue) reports a  new syndrome coined Adrenal Fatigue is now so commonplace it has been recognized by the World Health Organization.  The umbrella term for a group of non-specific symptoms affects significantly more women than men.  Adrenal Fatigue occurs because the adrenals – walnut-sized glands that sit just above the kidneys – get overworked.  The adrenals are expected to churn out high levels of the hormone cortisol, traditionally during short-term periods of high stress. People suffering from adrenal fatigue often have to use coffee, colas and other stimulants to get going in the morning and to prop themselves up during the day.   When we are children, our cortisol levels fluctuate as we get excited and nervous, but as we get older, some of us live with permanently raised levels.  This wreaks havoc with our bodies and leaves many of us feeling deflated and anxious – and never more so than around the Christmas and New Year period, when we’re grappling with all manner of stress-inducing situations, from worrying about that upcoming credit card bill to dealing with in-laws.  The increasing prevalence of the syndrome presents one of the most interesting medical paradigms of our time.  First coined by Canadian alternative medicine specialist Dr James Wilson in 1998, the term Adrenal Fatigue is beginning to be recognized by mainstream health organizations.   The condition is difficult to diagnose because adrenal function is measured on a sliding scale, a bit like thyroid function. It’s only if a test shows you to have levels in the highest or lowest 2 per cent that you’ll be deemed ‘abnormal’.    So if your cortisol levels are in the lowest 5 per cent and you are suffering significant symptoms, it still wouldn’t be deemed a medical issue.   A good diet may be helpful in treating Adrenal Fatigue, including wholegrains, oily fish and fruit, supplemented by magnesium, B5 and vitamins C and B12. 

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According to a study done by Blier et al published in the American Journal of Psychiatry (http://tinyurl.com/mirtazapine-combo) “the use of antidepressant combinations from treatment initiation may double the likelihood of remission compared with use of a single medication”. Various classes of antidepressant medications generally induce remission of major depressive disorder in only about one-third of patients. In a previous study using  mirtazapine or paroxetine alone or in combination from treatment initiation, the rate of patients who remitted within a 6-week period was twice that of patients using either drug alone. In the current study “remission rates (defined as a HAM-D score of 7 or less) were 25% for fluoxetine, 52% for mirtazapine plus fluoxetine, 58% for mirtazapine plus venlafaxine, and 46% for mirtazapine plus bupropion”.  “The study results, which add to a growing body of evidence, suggest that use of antidepressant combinations from treatment initiation may double the likelihood of remission compared with use of a single medication”.

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