The range of options includes cognitive behavioral therapy and brain stimulation techniques like ECT.
Last winter, confined to bed by intense sadness, exhaustion, and headaches, the University of Kansas student found herself considering suicide. Desperate after a years-long struggle with depression, she sought a treatment she had once viewed as extreme: electroconvulsive therapy. After a few sessions, "I literally went from almost unable to function—feeling suicidal—to a 180-degree change," she says.
The student, who still contends with depression, is one of the many people chronically in its grip who, disappointed by antidepressants, are finding some relief in therapies ranging from exercise to various forms of high-tech brain stimulation. Some 27 million Americans were taking an antidepressant in 2005, more than twice the number almost 10 years earlier, thanks largely to the arrival of Prozac and other effective antidepressants with fewer side effects. But a groundbreaking 2006 trial known as STAR*D revealed that about one third of people found total relief with their first drug, and around a third were not helped even after trying several drugs and combinations. ECT, which has been controversial since the days when it was performed without anesthesia and sometimes without proper consent, has evolved considerably in recent years; by inducing a seizure, it is thought to reset dysfunctional brain circuitry. It "is the most effective and rapidly acting treatment for severe depression," says Sarah Lisanby, a professor of clinical psychiatry at Columbia University Medical Center who is a leading brain stimulation researcher.
READ MORE @ U.S. NEWS & WORLD REPORT
Showing posts with label Depression Treatment. Show all posts
Showing posts with label Depression Treatment. Show all posts
Sunday, November 8, 2009
Friday, October 16, 2009
Response to Nortriptyline and Paroxetine Linked to Level of Neuropsychological Impairment in Patients With Parkinson's Disease: Presented at ANA
The use of nortriptyline and paroxetine in the treatment of depression does not affect cognitive functioning in patients with Parkinson's disease (PD); however, the higher the baseline performance on measures of executive functioning, speed of processing, and verbal memory, the better the response to antidepressant treatment, according to results presented here at the American Neurological Association (ANA) 134th Annual Meeting.
"This is one of the few studies to examine the impact of antidepressant treatment on cognition in PD patients with depression," said Roseanne D. Dobkin, PhD, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway, New Jersey.
More than 1 million people are affected by PD in the United States alone. It is the second most common neurodegenerative disease in the country, said Dr. Dobkin on October 10.
"Depression is one of the most common nonmotor symptoms of PD, affecting as many as half of these patients," she added.
READ MORE @ DOCTOR'S GUIDE"
"This is one of the few studies to examine the impact of antidepressant treatment on cognition in PD patients with depression," said Roseanne D. Dobkin, PhD, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway, New Jersey.
More than 1 million people are affected by PD in the United States alone. It is the second most common neurodegenerative disease in the country, said Dr. Dobkin on October 10.
"Depression is one of the most common nonmotor symptoms of PD, affecting as many as half of these patients," she added.
READ MORE @ DOCTOR'S GUIDE"
Sunday, August 9, 2009
Psychosocial Therapy With Antidepressants More Effective In Helping Depressed Stroke Patients
Psychosocial therapy combined with medication can effectively improve depression and recovery in stroke patients, according to a new study reported in Stroke: Journal of the American Heart Association.
In the first long-term study of psychosocial/behavioral therapy in combination with antidepressants, researchers found that adding psychosocial therapy improved depression scores short term and those improvements were sustained long term. At one year:
* Depression scores dropped 47 percent in patients treated with eight weeks of psychosocial/behavioral therapy and antidepressants.
* Scores dropped 32 percent among those having usual care, which included taking antidepressants.
The results are clinically and statistically significant, researchers said. Patients with improved depression perceived their recovery as significantly greater and also felt their physical condition and social participation were better than those with lesser improvement in depression.
<READ MORE @ SCIENCE DAILY
In the first long-term study of psychosocial/behavioral therapy in combination with antidepressants, researchers found that adding psychosocial therapy improved depression scores short term and those improvements were sustained long term. At one year:
* Depression scores dropped 47 percent in patients treated with eight weeks of psychosocial/behavioral therapy and antidepressants.
* Scores dropped 32 percent among those having usual care, which included taking antidepressants.
The results are clinically and statistically significant, researchers said. Patients with improved depression perceived their recovery as significantly greater and also felt their physical condition and social participation were better than those with lesser improvement in depression.
<READ MORE @ SCIENCE DAILY
Wednesday, May 13, 2009
Role of Acupuncture in the Treatment of Depression Benefits and Limitations of Adjunctive Treatment and Monotherapy
Acupuncture is being integrated into Western medicine, particularly for treatment of pain, nausea, asthma, and neurological conditions.1 Although the exact mechanism of action for acupuncture is unknown, it is associated with an increase in the level of neurobiologically active substances, such as endorphins and enkephalins.2 There are also data indicating that acupuncture induces the release of norepinephrine, serotonin, and dopamine.3-5
ADVERSE EFFECTS
Acupuncture is well tolerated compared with tricyclic antidepressant medications.6-9 Adverse effects are mild and transient and include tiredness, drowsiness, exacerbation of primary symptoms, and itching in the area of acupuncture.10 Complications such as pneumothorax, infection, cardiac conditions, and spinal cord injury are extremely rare.10
AVAILABLE DATA
The number of studies of Western acupuncture in the treatment of depression and conditions associated with depression is limited.10 Even fewer reports provide objective data to support efficacy (eg, neurotransmitter) level change, imaging studies, and electroencephalographic alterations. Only 7 randomized comparative studies have been published, even though the first attempts to compare acupuncture with conventional treatments for depression began in the 1970s.
READ MORE @ PSYCHIATRIC TIMES
ADVERSE EFFECTS
Acupuncture is well tolerated compared with tricyclic antidepressant medications.6-9 Adverse effects are mild and transient and include tiredness, drowsiness, exacerbation of primary symptoms, and itching in the area of acupuncture.10 Complications such as pneumothorax, infection, cardiac conditions, and spinal cord injury are extremely rare.10
AVAILABLE DATA
The number of studies of Western acupuncture in the treatment of depression and conditions associated with depression is limited.10 Even fewer reports provide objective data to support efficacy (eg, neurotransmitter) level change, imaging studies, and electroencephalographic alterations. Only 7 randomized comparative studies have been published, even though the first attempts to compare acupuncture with conventional treatments for depression began in the 1970s.
READ MORE @ PSYCHIATRIC TIMES
Monday, May 11, 2009
Antidepressants: The right people aren't always getting them
The medications are widely used to treat complaints such as loneliness or low energy. Meanwhile, studies say many with depression go untreated.
It was just over 20 years ago that the antidepressant Prozac was first approved by the U.S. Food and Drug Administration. The medication was touted as nothing short of a miracle: Not only was it was highly effective in treating depression, it also caused very few side effects.
The drug's popularity grew rapidly, and pharmaceutical companies got busy developing a variety of other, chemically similar antidepressants, collectively referred to as selective serotonin reuptake inhibitors (or SSRIs). There are at least half a dozen SSRIs on the market, including Lexapro, Paxil, Zoloft, Celexa and Luvox.
Since the introduction of these drugs, the number of Americans being treated for depression has increased dramatically; the Centers for Disease Control and Prevention says antidepressants are the most commonly prescribed medication in the country. But it's not always the right people taking them. Some who probably have very little to gain from their use are on SSRIs; others who stand to benefit are not.
READ MORE @ LOS ANGELES TIMES
It was just over 20 years ago that the antidepressant Prozac was first approved by the U.S. Food and Drug Administration. The medication was touted as nothing short of a miracle: Not only was it was highly effective in treating depression, it also caused very few side effects.
The drug's popularity grew rapidly, and pharmaceutical companies got busy developing a variety of other, chemically similar antidepressants, collectively referred to as selective serotonin reuptake inhibitors (or SSRIs). There are at least half a dozen SSRIs on the market, including Lexapro, Paxil, Zoloft, Celexa and Luvox.
Since the introduction of these drugs, the number of Americans being treated for depression has increased dramatically; the Centers for Disease Control and Prevention says antidepressants are the most commonly prescribed medication in the country. But it's not always the right people taking them. Some who probably have very little to gain from their use are on SSRIs; others who stand to benefit are not.
READ MORE @ LOS ANGELES TIMES
Wednesday, May 6, 2009
Why Antidepressants Don't Live Up to the Hype
In the '90s, Americans grew fond of the idea that you can fix depression simply by taking a pill — most famously fluoxetine (better known as Prozac), though fluoxetine is just one of at least seven selective serotonin reuptake inhibitors (SSRIs) that have been prescribed to treat hundreds of millions of people around the world.
But in the past few years, researchers have challenged the effectiveness of Prozac and other SSRIs in several studies. For instance, a review published in the Journal of Affective Disorders in February attributed 68% of the benefit from antidepressants to the placebo effect. Likewise, a paper published in PLoS Medicine a year earlier suggested that widely used SSRIs, including Prozac, Effexor and Paxil, offer no clinically significant benefit over placebos for patients with moderate or severe depression. Meanwhile, pharmaceutical companies maintain that their research shows that SSRIs are powerful weapons against depression. (Here's a helpful blog post that summarizes the debate.)
Now a major new study suggests that both critics and proponents might be right about SSRIs: the drugs can work, but they appear to work best for only a subset of depressed patients — those with a limited range of psychological problems. People whose depression is compounded with, say, substance abuse or a personality disorder may not get much help from SSRIs — which is unfortunate for the 45% to 60% of patients in the U.S. who have been diagnosed with a common mental disorder like depression and also meet the criteria for at least one other disorder, like substance abuse. (Multiple diagnoses are known in medical parlance as comorbidities.)
READ MORE @ TIME
But in the past few years, researchers have challenged the effectiveness of Prozac and other SSRIs in several studies. For instance, a review published in the Journal of Affective Disorders in February attributed 68% of the benefit from antidepressants to the placebo effect. Likewise, a paper published in PLoS Medicine a year earlier suggested that widely used SSRIs, including Prozac, Effexor and Paxil, offer no clinically significant benefit over placebos for patients with moderate or severe depression. Meanwhile, pharmaceutical companies maintain that their research shows that SSRIs are powerful weapons against depression. (Here's a helpful blog post that summarizes the debate.)
Now a major new study suggests that both critics and proponents might be right about SSRIs: the drugs can work, but they appear to work best for only a subset of depressed patients — those with a limited range of psychological problems. People whose depression is compounded with, say, substance abuse or a personality disorder may not get much help from SSRIs — which is unfortunate for the 45% to 60% of patients in the U.S. who have been diagnosed with a common mental disorder like depression and also meet the criteria for at least one other disorder, like substance abuse. (Multiple diagnoses are known in medical parlance as comorbidities.)
READ MORE @ TIME
Tuesday, May 5, 2009
New Route To Treat Depression - Finding could help people failed by current antidepressants
A NEW TARGET for treating depression, discovered by researchers in Iowa, may offer an alternative to current antidepressants, which target other mechanisms to treat the condition.
"The mechanism issue is important because if a patient doesn't respond to one drug, the chances of them responding to another drug that works through the same mechanism are low," says John A. Wemmie, who led the research team. Wemmie is an associate professor of psychiatry and neurosurgery at the University of Iowa and a staff physician and researcher at the Iowa City Veterans Affairs Medical Center.
Wemmie's team focused on a biochemical pathway involving acid-sensing ion channel (ASIC) proteins expressed by neurons. ASICs are activated by protons that are believed to act as neurotransmitters (C&EN, Jan. 14, 2008, page 10). Wemmie and his colleagues concentrated on the ASIC1a class of these ion channels, which are abundant in regions of the brain associated with mood.
The research group had previously shown in mice that ASIC1a activity is associated with anxiety, which often accompanies depression. In the new work, the researchers showed that mice lacking the gene for ASIC1a were less susceptible than normal mice to depression caused by stress. In a second experiment, the researchers treated normal mice with A-317567, an experimental ASIC inhibitor that Abbott Laboratories has been studying for pain treatment. Wemmie's team reports that blocking ASIC1a in this way produced antidepressant effects in the animals (J. Neurosci. 2009, 29, 5381).
READ MORE @ CHEMICAL & ENGINEERING NEWS
"The mechanism issue is important because if a patient doesn't respond to one drug, the chances of them responding to another drug that works through the same mechanism are low," says John A. Wemmie, who led the research team. Wemmie is an associate professor of psychiatry and neurosurgery at the University of Iowa and a staff physician and researcher at the Iowa City Veterans Affairs Medical Center.
Wemmie's team focused on a biochemical pathway involving acid-sensing ion channel (ASIC) proteins expressed by neurons. ASICs are activated by protons that are believed to act as neurotransmitters (C&EN, Jan. 14, 2008, page 10). Wemmie and his colleagues concentrated on the ASIC1a class of these ion channels, which are abundant in regions of the brain associated with mood.
The research group had previously shown in mice that ASIC1a activity is associated with anxiety, which often accompanies depression. In the new work, the researchers showed that mice lacking the gene for ASIC1a were less susceptible than normal mice to depression caused by stress. In a second experiment, the researchers treated normal mice with A-317567, an experimental ASIC inhibitor that Abbott Laboratories has been studying for pain treatment. Wemmie's team reports that blocking ASIC1a in this way produced antidepressant effects in the animals (J. Neurosci. 2009, 29, 5381).
READ MORE @ CHEMICAL & ENGINEERING NEWS
Sunday, April 12, 2009
Atypical antipsychotics: too hard a sell?
Use of drugs such as Abilify, Seroquel and Zyprexa for treatment-resistant depression is gaining ground. Some see an 'unmet need' for medication. Others worry about side effects.
About a year ago, patients began trooping into the office of UCLA psychiatrist Andrew Leuchter, asking whether an antipsychotic drug called Abilify "might be right for them." Few appeared to be delusional, plagued by hallucinations or suffering fearsome mood swings. Mostly, they were depressed or anxious, and frustrated by the pace of their recovery.
Leuchter wondered what was up: Depressed patients didn't usually seek out drugs used to quell psychiatry's most disturbing symptoms.
What was up, he soon discovered, was spending on a new advertising campaign touting Abilify as an "add-on" treatment for depression. For the first time since the arrival of a new generation of antipsychotic medications -- six drugs called the "atypicals" because they work differently from the earlier generation of antipsychotic drugs -- the makers of one, Abilify, had been granted the legal right to market to a vast new population of patients beyond those with schizophrenia or bipolar disorder.
This week, a Food and Drug Administration advisory panel recommended that the agency should grant the makers of a second atypical antipsychotic drug -- Seroquel XR -- similar latitude. The drug giant AstraZeneca wants permission to market the drug as a treatment for depression or anxiety that has not yielded to antidepressants alone.
READ MORE @ LOS ANGELES TIMES
About a year ago, patients began trooping into the office of UCLA psychiatrist Andrew Leuchter, asking whether an antipsychotic drug called Abilify "might be right for them." Few appeared to be delusional, plagued by hallucinations or suffering fearsome mood swings. Mostly, they were depressed or anxious, and frustrated by the pace of their recovery.
Leuchter wondered what was up: Depressed patients didn't usually seek out drugs used to quell psychiatry's most disturbing symptoms.
What was up, he soon discovered, was spending on a new advertising campaign touting Abilify as an "add-on" treatment for depression. For the first time since the arrival of a new generation of antipsychotic medications -- six drugs called the "atypicals" because they work differently from the earlier generation of antipsychotic drugs -- the makers of one, Abilify, had been granted the legal right to market to a vast new population of patients beyond those with schizophrenia or bipolar disorder.
This week, a Food and Drug Administration advisory panel recommended that the agency should grant the makers of a second atypical antipsychotic drug -- Seroquel XR -- similar latitude. The drug giant AstraZeneca wants permission to market the drug as a treatment for depression or anxiety that has not yielded to antidepressants alone.
READ MORE @ LOS ANGELES TIMES
Saturday, January 10, 2009
One flew into the cuckoo's nest
First she posed as a man. Now Norah Vincent has gone under cover as a 'loony'. Alexander Linklater is intrigued by the result
To produce her first book, Self-Made Man, lesbian author Norah Vincent embarked on an adventure in "immersion journalism", spending a year disguised as a man. She emerged with a bestselling account of American masculinity and some unresolved mental-health issues. Though she does not clarify whether the strain of adopting a fake identity was a trigger, she suffered a depressive collapse towards the end of her research and wound up in a locked psychiatric ward.
Where Self-Made Man ended, her new book, Voluntary Madness, begins. After her breakdown, Vincent decided to re-enter the psychiatric system as a journalist, posing as a patient with a serious mental disorder. Unsurprisingly, as her immersion-narrative deepens, the distinction between Vincent as journalist and Vincent as patient dissolves. It turns out she has long suffered from depressive episodes that date back to a childhood trauma, the precise nature of which is revealed towards the end of her story.
READ MORE @ THE GUARDIAN
To produce her first book, Self-Made Man, lesbian author Norah Vincent embarked on an adventure in "immersion journalism", spending a year disguised as a man. She emerged with a bestselling account of American masculinity and some unresolved mental-health issues. Though she does not clarify whether the strain of adopting a fake identity was a trigger, she suffered a depressive collapse towards the end of her research and wound up in a locked psychiatric ward.
Where Self-Made Man ended, her new book, Voluntary Madness, begins. After her breakdown, Vincent decided to re-enter the psychiatric system as a journalist, posing as a patient with a serious mental disorder. Unsurprisingly, as her immersion-narrative deepens, the distinction between Vincent as journalist and Vincent as patient dissolves. It turns out she has long suffered from depressive episodes that date back to a childhood trauma, the precise nature of which is revealed towards the end of her story.
READ MORE @ THE GUARDIAN
Friday, December 19, 2008
Older Antidepressants May Be Better for Parkinson's Patients
For Parkinson's disease patients with depression, an older tricyclic antidepressant outperformed a newer selective serotonin reuptake inhibitor, one of a class that is commonly prescribed, according to researchers here.
In a randomized trial, the older tricyclic antidepressant, nortriptyline, significantly improved symptoms of depression after eight weeks compared with placebo (P<0.002) Matthew Menza, M.D., of Robert Wood Johnson Medical School here, and colleagues reported online in Neurology. A newer SSRI, paroxetine CR, did not (P=0.165) help.
The percentage of patients who had at least a 50% reduction in their depression symptoms was significantly higher in those taking nortriptyline than in those taking paroxetine CR (53% versus 11%, P=0.034).
READ MORE @ MEDPAGE TODAY
In a randomized trial, the older tricyclic antidepressant, nortriptyline, significantly improved symptoms of depression after eight weeks compared with placebo (P<0.002) Matthew Menza, M.D., of Robert Wood Johnson Medical School here, and colleagues reported online in Neurology. A newer SSRI, paroxetine CR, did not (P=0.165) help.
The percentage of patients who had at least a 50% reduction in their depression symptoms was significantly higher in those taking nortriptyline than in those taking paroxetine CR (53% versus 11%, P=0.034).
READ MORE @ MEDPAGE TODAY
Wednesday, December 3, 2008
Zapping depression - Approval of a new kind of treatment reflects advances in fields that involve electrical stimulation of the brain.
In the late 1700s, Italian anatomist Luigi Galvani made a dead frog's muscles twitch when struck by a spark, a discovery that paved the way for the modern understanding of electricity's role in living things. It is the basis for countless medical technologies like the pacemaker.
But electricity does not travel easily through the skull to the brain, the organ responsible for every purposeful twitch and altered mood. So when a group of British scientists in 1985 used magnetic pulses from outside the head to induce an electrical field inside the brain - and got a subject's hands to move - their colleagues clamored for a chance to zap themselves.
That breakthrough, known as transcranial magnetic stimulation (TMS), led to the Food and Drug Administration's approval last month of the first noninvasive, non-pharmacological treatment for depression.
As a practical matter, approval of the device made by Neuronetics Inc., a five-year-old Malvern company, is intended for patients with major treatment-resistant depression who do not respond to any one medication. Millions of Americans fail to benefit from antidepressants, and millions more quit because of side effects.
READ MORE @ PHILADELPHIA INQUIRER
But electricity does not travel easily through the skull to the brain, the organ responsible for every purposeful twitch and altered mood. So when a group of British scientists in 1985 used magnetic pulses from outside the head to induce an electrical field inside the brain - and got a subject's hands to move - their colleagues clamored for a chance to zap themselves.
That breakthrough, known as transcranial magnetic stimulation (TMS), led to the Food and Drug Administration's approval last month of the first noninvasive, non-pharmacological treatment for depression.
As a practical matter, approval of the device made by Neuronetics Inc., a five-year-old Malvern company, is intended for patients with major treatment-resistant depression who do not respond to any one medication. Millions of Americans fail to benefit from antidepressants, and millions more quit because of side effects.
READ MORE @ PHILADELPHIA INQUIRER
Monday, December 1, 2008
Depression Treatment: Mindfulness-based Cognitive Therapy As Effective As Anti-depressant Medication, Study Suggests
Research shows for the first time that a group-based psychological treatment, Mindfulness Based Cognitive Therapy (MBCT), could be a viable alternative to prescription drugs for people suffering from long-term depression.
In a study, published December 1, 2008 in the Journal of Consulting and Clinical Psychology, MBCT proved as effective as maintenance anti-depressants in preventing a relapse and more effective in enhancing peoples' quality of life. The study also showed MBCT to be as cost-effective as prescription drugs in helping people with a history of depression stay well in the longer-term.
The randomised control trial involved 123 people from urban and rural locations who had suffered repeat depressions and were referred to the trial by their GPs. The participants were split randomly into two groups. Half continued their on-going anti-depressant drug treatment and the rest participated in an MBCT course and were given the option of coming off anti-depressants.
READ MORE @ SCIENCE DAILY
In a study, published December 1, 2008 in the Journal of Consulting and Clinical Psychology, MBCT proved as effective as maintenance anti-depressants in preventing a relapse and more effective in enhancing peoples' quality of life. The study also showed MBCT to be as cost-effective as prescription drugs in helping people with a history of depression stay well in the longer-term.
The randomised control trial involved 123 people from urban and rural locations who had suffered repeat depressions and were referred to the trial by their GPs. The participants were split randomly into two groups. Half continued their on-going anti-depressant drug treatment and the rest participated in an MBCT course and were given the option of coming off anti-depressants.
READ MORE @ SCIENCE DAILY
Subscribe to:
Posts (Atom)
