Only people with severe depression benefit from antidepressants, says research published in the Journal of the American Medical Assn. Others do better with nonmedical approaches.
Antidepressant medications probably provide little or no benefit to people with mild or moderate depression, a new study has found. Rather, the mere act of seeing a doctor, discussing symptoms and learning about depression probably triggers the improvements many patients experience while on medication.
Only people with very severe depression receive additional benefits from drugs, said the senior author of the study, Robert J. DeRubeis, a University of Pennsylvania psychology professor. The research was released online Tuesday and will be published today in the Journal of the American Medical Assn.
Hundreds of studies have attested to the benefits of antidepressants over placebos, DeRubeis said. But many studies involve only participants with severe depression. Confusion arises, he said, "because there is a tendency to generalize the findings to mean that all depressed people benefit from medications."
The current analysis attempted to quantify how much of antidepressants' benefit is attributable to chemical effects on the brain and how much can be explained by other factors, such as visiting a doctor, taking action to feel better or merely the passage of time.
READ MORE @ LOS ANGELES TIMES
Showing posts with label antidepressants. Show all posts
Showing posts with label antidepressants. Show all posts
Wednesday, January 6, 2010
Thursday, November 26, 2009
'Doctors should stop pushing drugs at depressed people'
Despite a large increase in cognitive behaviour therapy (CBT) doctors are still pushing drugs at patients, according to Dr Jennifer Wild, a senior lecturer at the Institute of Psychiatry.
In this week's Scrubbing Up, she argues that GPs need to understand that psychological therapies like CBT work and should choose to offer them.
People with depression often get better when they change the way they think.
Since therapy is more likely to achieve this with longer-lasting results than drugs, doctors need to stop pushing pills and start pushing treatments that work.
Depressed people feel low, worthless, and often suicidal. They need treatment.
Six million people suffer from depression and anxiety in the UK, and surveys show that most do not want to take drugs.
They want a treatment with long-lasting results.
READ MORE @ BBC NEWS"
'Distorted thinking'
This treatment is cognitive behavioural therapy (CBT).
CBT is based on a well-supported theory of how depression starts and what keeps it going: distorted thinking patterns.
Change people's thoughts and recovery occurs.
In this week's Scrubbing Up, she argues that GPs need to understand that psychological therapies like CBT work and should choose to offer them.
People with depression often get better when they change the way they think.
Since therapy is more likely to achieve this with longer-lasting results than drugs, doctors need to stop pushing pills and start pushing treatments that work.
Depressed people feel low, worthless, and often suicidal. They need treatment.
Six million people suffer from depression and anxiety in the UK, and surveys show that most do not want to take drugs.
They want a treatment with long-lasting results.
READ MORE @ BBC NEWS"
'Distorted thinking'
This treatment is cognitive behavioural therapy (CBT).
CBT is based on a well-supported theory of how depression starts and what keeps it going: distorted thinking patterns.
Change people's thoughts and recovery occurs.
Monday, November 23, 2009
Psychotropic Drugs Boost Fall Risk in the Elderly
A new analysis of studies including nearly 80,000 people aged 60 and older confirms that certain types of widely prescribed drugs, such as antidepressants and sedatives, can increase their risk of falling.
Falls often have serious consequences for older people, such as injuries leading to disability and admission to a nursing home, or even death.
While prescription drugs are recognized as contributing to fall risk among older people --who are likely to be on lots of medications -- discovering just which drugs are the problem is still a "challenge," Dr. Carlo A. Marra of the University of British Columbia in Vancouver and colleagues note in the Archives of Internal Medicine.
To update a review of studies on this subject published in 1996, Marra and his team identified 22 studies published between 1996 and 2007 including 79,081 people 60 and older, some of whom lived independently, and some of whom were institutionalized. They analyzed the risk of falling associated with nine classes of drugs.
Three classes turned out to significantly boost fall risk: sedatives and hypnotics, typically prescribed as sleeping aids; antidepressants; and benzodiazepines, which include tranquilizers like Xanax and Valium.
READ MORE @ ABC NEWS
Falls often have serious consequences for older people, such as injuries leading to disability and admission to a nursing home, or even death.
While prescription drugs are recognized as contributing to fall risk among older people --who are likely to be on lots of medications -- discovering just which drugs are the problem is still a "challenge," Dr. Carlo A. Marra of the University of British Columbia in Vancouver and colleagues note in the Archives of Internal Medicine.
To update a review of studies on this subject published in 1996, Marra and his team identified 22 studies published between 1996 and 2007 including 79,081 people 60 and older, some of whom lived independently, and some of whom were institutionalized. They analyzed the risk of falling associated with nine classes of drugs.
Three classes turned out to significantly boost fall risk: sedatives and hypnotics, typically prescribed as sleeping aids; antidepressants; and benzodiazepines, which include tranquilizers like Xanax and Valium.
READ MORE @ ABC NEWS
Tuesday, November 10, 2009
Adjunctive Psychotherapy for Depression Studied Findings suggest addition of psychotherapy does not increase remission over medication alone
Adjunctive psychotherapy added to antidepressant medications for patients with chronic depression did not increase the proportion of patients achieving remission, according to a study in the November issue of the Archives of General Psychiatry.
James H. Kocsis, M.D., of Weill Cornell Medical College in New York City, and colleagues treated chronically depressed patients using a two-phase treatment protocol with phase one consisting of an antidepressant medication used in accordance with a pharmacotherapy algorithm. After phase one, patients not achieving remission were randomized to 12 weeks of either continued medication and the addition of the cognitive behavioral analysis system of psychotherapy, continued medication and the addition of brief supportive psychotherapy, or optimized medication alone.
READ MORE @ MODERN MEDICINE
James H. Kocsis, M.D., of Weill Cornell Medical College in New York City, and colleagues treated chronically depressed patients using a two-phase treatment protocol with phase one consisting of an antidepressant medication used in accordance with a pharmacotherapy algorithm. After phase one, patients not achieving remission were randomized to 12 weeks of either continued medication and the addition of the cognitive behavioral analysis system of psychotherapy, continued medication and the addition of brief supportive psychotherapy, or optimized medication alone.
READ MORE @ MODERN MEDICINE
Sunday, November 8, 2009
Chronically Depressed? What to Do When Antidepressants Don't Work
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
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
Wednesday, November 4, 2009
The Role of Antidepressants for the Treatment of Bipolar Depression
Although rapid-cycling bipolar disorder has been linked to the use of antidepressants, these treatments may still have a role in the management of patients with bipolar depression, said Stephen V. Sobel, MD, clinical instructor at the University of California, San Diego School of Medicine, in a presentation at the U.S. Psychiatric and Mental Health Congress is Las Vegas. Patients with bipolar disorder spend most of their time in depression, and antidepressants can alleviate these symptoms, said Sobel. “That’s why it’s so tempting to treat these patients with an antidepressant. But it’s important to be familiar with recent studies on the development of rapid-cycling bipolar disorder and to weigh the risks and benefits,” he said.
The use of antidepressants may increase a patient’s risk of rapid-cycling bipolar disorder. The Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) included 1742 patients treated with a variety of approved medications for bipolar I and bipolar II disorder, and 32% reported having rapid-cycling at baseline. After 2 years of treatment, 5% still had rapid-cycling bipolar disorder. Those who were treated with an antidepressant were 3.8 times more likely to have rapid-cycling bipolar disorder.1
READ MORE @ PSYCHIATRIC TIMES
The use of antidepressants may increase a patient’s risk of rapid-cycling bipolar disorder. The Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) included 1742 patients treated with a variety of approved medications for bipolar I and bipolar II disorder, and 32% reported having rapid-cycling at baseline. After 2 years of treatment, 5% still had rapid-cycling bipolar disorder. Those who were treated with an antidepressant were 3.8 times more likely to have rapid-cycling bipolar disorder.1
READ MORE @ PSYCHIATRIC TIMES
Friday, October 23, 2009
Why antidepressants don't work for so many Northwestern research finds drugs aim at wrong target
More than half the people who take antidepressants for depression never get relief.
Why? Because the cause of depression has been oversimplified and drugs designed to treat it aim at the wrong target, according to new research from the Northwestern University Feinberg School of Medicine. The medications are like arrows shot at the outer rings of a bull's eye instead of the center.
A study from the laboratory of long-time depression researcher Eva Redei, presented at the Neuroscience 2009 conference in Chicago this week, appears to topple two strongly held beliefs about depression. One is that stressful life events are a major cause of depression. The other is that an imbalance in neurotransmitters in the brain triggers depressive symptoms.
Both findings are significant because these beliefs were the basis for developing drugs currently used to treat depression.
Redei, the David Lawrence Stein Professor of Psychiatry at Northwestern's Feinberg School, found powerful molecular evidence that quashes the long-held dogma that stress is generally a major cause of depression. Her new research reveals that there is almost no overlap between stress-related genes and depression-related genes.
READ MORE @ EUREKALERT
Why? Because the cause of depression has been oversimplified and drugs designed to treat it aim at the wrong target, according to new research from the Northwestern University Feinberg School of Medicine. The medications are like arrows shot at the outer rings of a bull's eye instead of the center.
A study from the laboratory of long-time depression researcher Eva Redei, presented at the Neuroscience 2009 conference in Chicago this week, appears to topple two strongly held beliefs about depression. One is that stressful life events are a major cause of depression. The other is that an imbalance in neurotransmitters in the brain triggers depressive symptoms.
Both findings are significant because these beliefs were the basis for developing drugs currently used to treat depression.
Redei, the David Lawrence Stein Professor of Psychiatry at Northwestern's Feinberg School, found powerful molecular evidence that quashes the long-held dogma that stress is generally a major cause of depression. Her new research reveals that there is almost no overlap between stress-related genes and depression-related genes.
READ MORE @ EUREKALERT
Saturday, October 10, 2009
Antidepressant Use in Children With Cancer What We Now Know (and Need to Know) About the Use of Antidepressants
In 2007, cancer was diagnosed in 10,400 children and adolescents under the age of 15 years.1 While cancer remains the second leading cause of death in children, increasing numbers of children with cancer are surviving into adulthood.2 Over the past 30 years, 5-year survival rates for children with cancer have significantly improved, from 59% in 1975 to 1977 to 80% in 1996 to 2004.3 Pediatric cancer, increasingly considered a chronic rather than an acute condition, is an intense emotional and physical experience for patients and their families.4
Comprehensive psychiatric assessment of these children is complicated by symptoms of medical comorbidities that overlap mental health conditions. Few resources exist to guide clinicians in the psychiatric treatment of children with cancer. This article describes the sparse research from small clinical studies on the extent of psychiatric treatment in children with cancer and evidence from outcome studies of medication use in these children. Minimal knowledge on the role of antidepressants in such children motivated us to examine the question in a broad population-based approach.
Psychopathology
One area of interest in caring for children with cancer is the prevalence of psychiatric diagnoses. Assessment of psychiatric disorders in these children from either research or community settings is difficult because of the complex medical and emotional presentation of illness.5,6 DSM-IV criteria for mood disorders, for example, include both somatic and cognitive symptom criteria, and clinicians must decide which symptoms are caused by the illness and treatment and which are related to a separate psychiatric diagnosis.7
In addition, doctors and nurses may overestimate psychosocial distress and symptoms in children and adolescents with cancer.6 Assessment tools for psychiatric disorders are not often validated in children with medical illnesses, which may lead in part to the varying research prevalence of psychiatric disorders in this population.8
Reports of psychiatric illness in children with cancer range from a high of 17% to rates that do not differ significantly from those for the general population.9 Specific cancers and their treatments may also contribute to the variable rates of depression. Without more precise estimates that generalize to large youth populations, it is unclear whether children with cancer are at higher risk for a psychiatric disorder than children who are not medically ill.
READ MORE @ PSYCHIATRIC TIMES
Comprehensive psychiatric assessment of these children is complicated by symptoms of medical comorbidities that overlap mental health conditions. Few resources exist to guide clinicians in the psychiatric treatment of children with cancer. This article describes the sparse research from small clinical studies on the extent of psychiatric treatment in children with cancer and evidence from outcome studies of medication use in these children. Minimal knowledge on the role of antidepressants in such children motivated us to examine the question in a broad population-based approach.
Psychopathology
One area of interest in caring for children with cancer is the prevalence of psychiatric diagnoses. Assessment of psychiatric disorders in these children from either research or community settings is difficult because of the complex medical and emotional presentation of illness.5,6 DSM-IV criteria for mood disorders, for example, include both somatic and cognitive symptom criteria, and clinicians must decide which symptoms are caused by the illness and treatment and which are related to a separate psychiatric diagnosis.7
In addition, doctors and nurses may overestimate psychosocial distress and symptoms in children and adolescents with cancer.6 Assessment tools for psychiatric disorders are not often validated in children with medical illnesses, which may lead in part to the varying research prevalence of psychiatric disorders in this population.8
Reports of psychiatric illness in children with cancer range from a high of 17% to rates that do not differ significantly from those for the general population.9 Specific cancers and their treatments may also contribute to the variable rates of depression. Without more precise estimates that generalize to large youth populations, it is unclear whether children with cancer are at higher risk for a psychiatric disorder than children who are not medically ill.
READ MORE @ PSYCHIATRIC TIMES
Tuesday, October 6, 2009
Depression Is a Dilemma for Women in Pregnancy
When Sherean Malekzadeh Allen of Marietta, Ga., learned she was pregnant, she was 43, had been married for two years, had gone through two miscarriages and had all but given up hope of having a baby.
But instead of being overjoyed, Ms. Allen was immobilized: panic-ridden, nauseated, listless and thoroughly depressed. She could not rouse herself to go to work in the marketing business she founded and ran, or even get through the newspaper.
And she faced the pregnant woman’s quintessential dilemma: take drugs that might pose a risk to the developing baby, or struggle through an anguishing pregnancy that could harm the baby in other ways?
“Every single thing you put in your body when you’re pregnant, you wonder, ‘Oh, my God, am I growing my baby an extra finger?’ ” Ms. Allen said. “I was worried that I would hurt the baby if I took the pills, and I was worried I would hurt the baby if I didn’t.”
READ MORE @ NY TIMES
But instead of being overjoyed, Ms. Allen was immobilized: panic-ridden, nauseated, listless and thoroughly depressed. She could not rouse herself to go to work in the marketing business she founded and ran, or even get through the newspaper.
And she faced the pregnant woman’s quintessential dilemma: take drugs that might pose a risk to the developing baby, or struggle through an anguishing pregnancy that could harm the baby in other ways?
“Every single thing you put in your body when you’re pregnant, you wonder, ‘Oh, my God, am I growing my baby an extra finger?’ ” Ms. Allen said. “I was worried that I would hurt the baby if I took the pills, and I was worried I would hurt the baby if I didn’t.”
READ MORE @ NY TIMES
Sunday, August 30, 2009
Antidepressants Vary More in Side Effects, Not Efficacy
Summary
[SIDE EFFECTS] The main differences among the newer antidepressants are side effects and drug interactions. See the Commentary for a drug-by-drug list of these key differences. [PCP's] This review comes from a group of primary care docs, which is important because most depression is treated by PCPs. [FOLLOW-UP] It emphasizes the need for follow-up 1-2 weeks after initial prescription, which is KEY to improving adherence and addressing new side effects.
READ MORE @ GERSON LEHMAN GROUP
[SIDE EFFECTS] The main differences among the newer antidepressants are side effects and drug interactions. See the Commentary for a drug-by-drug list of these key differences. [PCP's] This review comes from a group of primary care docs, which is important because most depression is treated by PCPs. [FOLLOW-UP] It emphasizes the need for follow-up 1-2 weeks after initial prescription, which is KEY to improving adherence and addressing new side effects.
READ MORE @ GERSON LEHMAN GROUP
Thursday, August 27, 2009
Antidepressants: Selective Serotonin And Norepinephrine Reuptake Inhibitor Drugs Show Benefits In German Study
The Institute for Quality and Efficiency in Health Care (IQWiG) was commissioned by the Federal Joint Committee (G-BA) to investigate whether patients with depression benefit from taking drugs belonging to the selective serotonin and norepinephrine reuptake inhibitor (SNRI) drug class. Up till now, 2 of these drugs have been approved as antidepressants in Germany: venlafaxine and duloxetine. The Institute published its final report on 18 August. According to this report, the benefit of both drugs has been proven compared to a sham drug (placebo): patients respond better to the therapy and suffer less from the symptoms of depression. Moreover, there are indications that both drugs protect against relapse in addition to alleviating symptoms.
Interplay of biological and psycho-social factors
There are various assumptions about when and how depression occurs. The possible causes and influencing factors are manifold. What is not disputed is that the complete clinical picture of depression is the result of a complex interplay of biological and psycho-social factors. There are indications that a modification or reduction in the transfer of certain messenger substances in the central nervous system plays a part. This is where most drug therapies start their effect. The comparatively new SNRI drug class is intended to influence two of these messenger substances (neurotransmitters) by inhibiting the reuptake of serotonin and norepinephrine.
READ MORE @ SCIENCE DAILY
Interplay of biological and psycho-social factors
There are various assumptions about when and how depression occurs. The possible causes and influencing factors are manifold. What is not disputed is that the complete clinical picture of depression is the result of a complex interplay of biological and psycho-social factors. There are indications that a modification or reduction in the transfer of certain messenger substances in the central nervous system plays a part. This is where most drug therapies start their effect. The comparatively new SNRI drug class is intended to influence two of these messenger substances (neurotransmitters) by inhibiting the reuptake of serotonin and norepinephrine.
READ MORE @ SCIENCE DAILY
Sunday, August 23, 2009
Cymbalta's waning patent and generic rivals soon could threaten Lilly's sales
Eli Lilly has enjoyed a wave of success with antidepressants, but analysts say such expertise must now bring new revenue growth.
Eli Lilly and Co. built a large part of its fortune selling medications for gloom, anxiety and withdrawal.
Now the question is: Can the Indianapolis drug maker keep riding the antidepressant wave? Can it find its next Prozac, its next Cymbalta?
Use of antidepressants in the U.S. doubled from 1996 to 2005, as more people sought out treatment and the stigma of depression has fallen, according to a study published in the August issue of the Archives of General Psychiatry. All told, about 10 percent of Americans, or 27 million people, were prescribed an antidepressant in 2005, up sharply from 13 million people a decade earlier.
"There's a huge increase in the recognition of depression and its symptoms," said Dr. Jim Martinez, an Indianapolis psychiatrist and adviser to Lilly. "And I think we've seen a growing improvement in public attitudes around seeking care for this disease."
But in recent years, the market has faced growing headwinds. Industry sales from antidepressants dipped nearly 14 percent in the past four years, even as the number of prescriptions dispensed for the pills has continued to climb. Medco Health Solutions, a huge pharmacy company that studies drug trends, is forecasting that use of antidepressants is likely to grow slowly over the next three years.
READ MORE @ INDIANAPOLIS STAR
Eli Lilly and Co. built a large part of its fortune selling medications for gloom, anxiety and withdrawal.
Now the question is: Can the Indianapolis drug maker keep riding the antidepressant wave? Can it find its next Prozac, its next Cymbalta?
Use of antidepressants in the U.S. doubled from 1996 to 2005, as more people sought out treatment and the stigma of depression has fallen, according to a study published in the August issue of the Archives of General Psychiatry. All told, about 10 percent of Americans, or 27 million people, were prescribed an antidepressant in 2005, up sharply from 13 million people a decade earlier.
"There's a huge increase in the recognition of depression and its symptoms," said Dr. Jim Martinez, an Indianapolis psychiatrist and adviser to Lilly. "And I think we've seen a growing improvement in public attitudes around seeking care for this disease."
But in recent years, the market has faced growing headwinds. Industry sales from antidepressants dipped nearly 14 percent in the past four years, even as the number of prescriptions dispensed for the pills has continued to climb. Medco Health Solutions, a huge pharmacy company that studies drug trends, is forecasting that use of antidepressants is likely to grow slowly over the next three years.
READ MORE @ INDIANAPOLIS STAR
Tuesday, August 11, 2009
Antidepressant suicide risk varies by age: FDA
People under age 25 who take antidepressants have a higher risk of suicide, but adults older than that do not, an analysis by U.S. Food and Drug Administration researchers released on Tuesday showed.
The report by the FDA scientists confirms earlier studies and supports the agency's age-related warnings on the drugs' labeling.
U.S. and European regulators have been sounding alarms on the use of antidepressant drugs since 2003 after clinical trials showed they increased the risk of suicidal thoughts and behaviors in those under age 18.
In February 2005, the FDA added a so-called black box warning -- the agency's strongest warning -- on the use of all antidepressants in young children and teens to draw attention to the possible risks of these medications. In May 2007, it extended the warnings to young adults aged 18 to 24.
Many psychiatrists have criticized the warnings, saying they scare people away from effective treatment for depression, the leading cause of suicide. In fact, recent studies have suggested the warnings triggered an 8 percent rise in suicide among youth and teens in 2004, the biggest one-year gain in 15 years.
READ MORE @ REUTERS
The report by the FDA scientists confirms earlier studies and supports the agency's age-related warnings on the drugs' labeling.
U.S. and European regulators have been sounding alarms on the use of antidepressant drugs since 2003 after clinical trials showed they increased the risk of suicidal thoughts and behaviors in those under age 18.
In February 2005, the FDA added a so-called black box warning -- the agency's strongest warning -- on the use of all antidepressants in young children and teens to draw attention to the possible risks of these medications. In May 2007, it extended the warnings to young adults aged 18 to 24.
Many psychiatrists have criticized the warnings, saying they scare people away from effective treatment for depression, the leading cause of suicide. In fact, recent studies have suggested the warnings triggered an 8 percent rise in suicide among youth and teens in 2004, the biggest one-year gain in 15 years.
READ MORE @ REUTERS
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
Friday, July 31, 2009
Stopping antidepressants can cause side effects - Recognizing withdrawal symptoms and working with your doctor are key.
Ryan Yorke, now 21, started taking Paxil after an out-of-the-blue panic attack his freshman year of high school. At first it worked great. But he gained weight and had other problems -- he started acting up in school and failing classes, for example. So after a year, he -- along with his mother and his psychologist -- decided it was time to stop.
Every time he reduced his dose, things got out of control, says his mother, Laurie Yorke, a registered nurse and now an administrator of paxilprogress.org, an antidepressant-withdrawal support site.
After the first big dose drop, Ryan slashed his wrists in front of his mother in the living room. "It was a six-hour psychotic episode. He was quoting Shakespeare and saying he wanted to die," she recalls.
A few weeks later, after more gradual dose changes, Ryan was still so sensitive to light and sound that he taped shut the window shades in his bedroom. His memory and concentration were poor. He dropped out of school and got his GED later, after the withdrawal process was over.
Mental health professionals aren't sure how many people have problems when stopping antidepressant medication. It's not even clear how to define the cluster of withdrawal symptoms people report, or even what causes the effects. "It's a difficult corner of the field," says Dr. Kenneth Duckworth, medical director of the National Alliance on Mental Illness and psychiatry professor at Harvard Medical School. "It's hard to know whether the person's depression is worsening or if they're having a variation on a discontinuation syndrome.
READ MORE @ LOS ANGELES TIMES
Every time he reduced his dose, things got out of control, says his mother, Laurie Yorke, a registered nurse and now an administrator of paxilprogress.org, an antidepressant-withdrawal support site.
After the first big dose drop, Ryan slashed his wrists in front of his mother in the living room. "It was a six-hour psychotic episode. He was quoting Shakespeare and saying he wanted to die," she recalls.
A few weeks later, after more gradual dose changes, Ryan was still so sensitive to light and sound that he taped shut the window shades in his bedroom. His memory and concentration were poor. He dropped out of school and got his GED later, after the withdrawal process was over.
Mental health professionals aren't sure how many people have problems when stopping antidepressant medication. It's not even clear how to define the cluster of withdrawal symptoms people report, or even what causes the effects. "It's a difficult corner of the field," says Dr. Kenneth Duckworth, medical director of the National Alliance on Mental Illness and psychiatry professor at Harvard Medical School. "It's hard to know whether the person's depression is worsening or if they're having a variation on a discontinuation syndrome.
READ MORE @ LOS ANGELES TIMES
Saturday, July 25, 2009
Antidepressants, not sleep drugs, often prescribed for insomnia * Story Highlights * Doctors prescribed more antidepressants for insomnia
Insomnia, the inability to fall or stay asleep, can make the days feel fuzzy and the nights never-ending.
The disorder can increase the risk for depression and suicidal thoughts, lower work productivity and even raise blood pressure, studies have shown.
About 40 million Americans have chronic sleep disorders that prevent them from getting good rest. Singer Michael Jackson struggled with insomnia, a nutritionist who worked for him told CNN. Sources close to Jackson told CNN that during a world tour in the mid-'90s, the pop star traveled with an anesthesiologist who would "take him down" at night, then "bring him back up."
Stress or traumatic events can trigger the sleeping disorder. Insomnia drugs help the patient sleep, but they do not treat the underlying cause, which could be a result of another illness, life changes or shifting work schedules. And patients who seek relief for insomnia may not receive the most effective prescription.
Over the last two decades, doctors treating sleep disorders have prescribed more antidepressants than insomnia drugs, according to several published analyses. And there is insufficient evidence that most antidepressants are effective in treating insomnia, concluded a National Institutes of Health panel that convened on the topic in 2005.
Doctors may be factoring in cost considerations and their own familiarity with prescribing antidepressants relative to newer sleep medications, experts said.
READ MORE @ CNN
The disorder can increase the risk for depression and suicidal thoughts, lower work productivity and even raise blood pressure, studies have shown.
About 40 million Americans have chronic sleep disorders that prevent them from getting good rest. Singer Michael Jackson struggled with insomnia, a nutritionist who worked for him told CNN. Sources close to Jackson told CNN that during a world tour in the mid-'90s, the pop star traveled with an anesthesiologist who would "take him down" at night, then "bring him back up."
Stress or traumatic events can trigger the sleeping disorder. Insomnia drugs help the patient sleep, but they do not treat the underlying cause, which could be a result of another illness, life changes or shifting work schedules. And patients who seek relief for insomnia may not receive the most effective prescription.
Over the last two decades, doctors treating sleep disorders have prescribed more antidepressants than insomnia drugs, according to several published analyses. And there is insufficient evidence that most antidepressants are effective in treating insomnia, concluded a National Institutes of Health panel that convened on the topic in 2005.
Doctors may be factoring in cost considerations and their own familiarity with prescribing antidepressants relative to newer sleep medications, experts said.
READ MORE @ CNN
Friday, July 24, 2009
Study shows schools could help in reducing depression
Research by the University of Queensland has shown school intervention programs could help radically reduce the amount ofhttp://www.thetechherald.com/article.php/200930/4122/Study-shows-schools-could-help-in-reducing-depression being prescribed to adolescent boys.
School Counsellor Mark Taylor, who led the research, said that schools could help students deal with depression by teaching more conflict resolution and positive thinking, as well as encouraging more outdoor activities.
Dr Taylor said he was concerned not enough was being done to look at underlying conditions of adolescents' depression.
“Working in a school setting as a counsellor I became concerned about the numbers of students who were being prescribed antidepressants, without what I considered to be enough effort to find out what was going on in the lives of these students,” Dr Taylor said in a University of Queensland (UQ) news release.
“I wanted to substantiate that there are viable alternatives to antidepressants which can significantly reduce depressive symptoms.”
READ MORE @ THE TECH HERALD
School Counsellor Mark Taylor, who led the research, said that schools could help students deal with depression by teaching more conflict resolution and positive thinking, as well as encouraging more outdoor activities.
Dr Taylor said he was concerned not enough was being done to look at underlying conditions of adolescents' depression.
“Working in a school setting as a counsellor I became concerned about the numbers of students who were being prescribed antidepressants, without what I considered to be enough effort to find out what was going on in the lives of these students,” Dr Taylor said in a University of Queensland (UQ) news release.
“I wanted to substantiate that there are viable alternatives to antidepressants which can significantly reduce depressive symptoms.”
READ MORE @ THE TECH HERALD
Wednesday, July 8, 2009
Antidepressants aid electroconvulsive therapy in treating severe depression
Combining antidepressant drugs with electroconvulsive therapy (ECT) does a better job of reducing symptoms of severe depression and causes less memory loss than using ECT alone, according to a new study by researchers at Wake Forest University School of Medicine and colleagues.
This finding could alleviate one of the primary concerns about ECT – that it causes memory loss, said W. Vaughn McCall, M.D., M.S, professor and chairman of the Department of Psychiatry and Behavioral Medicine and the principal investigator for the study's Wake Forest Baptist site.
The full study appears in the current issue of the Archives of General Psychiatry, published today.
ECT uses an electrical stimulus to the brain to induce seizures. It is prescribed for patients with crisis-level severe depression – who are catatonic (people who are so slowed down that they stop moving, talking and eating) or suicidal – or for patients with major depression who have not responded to medication. Electrodes attached to the head deliver the stimulus and patients are anesthetized and receive muscle relaxants during the procedure.
Patients receiving ECT often experience some memory loss that usually improves within days of treatment.
Researchers wanted to find a way to increase the effectiveness of ECT while reducing the side effects of memory loss.
READ MORE @ EUREKALERT
This finding could alleviate one of the primary concerns about ECT – that it causes memory loss, said W. Vaughn McCall, M.D., M.S, professor and chairman of the Department of Psychiatry and Behavioral Medicine and the principal investigator for the study's Wake Forest Baptist site.
The full study appears in the current issue of the Archives of General Psychiatry, published today.
ECT uses an electrical stimulus to the brain to induce seizures. It is prescribed for patients with crisis-level severe depression – who are catatonic (people who are so slowed down that they stop moving, talking and eating) or suicidal – or for patients with major depression who have not responded to medication. Electrodes attached to the head deliver the stimulus and patients are anesthetized and receive muscle relaxants during the procedure.
Patients receiving ECT often experience some memory loss that usually improves within days of treatment.
Researchers wanted to find a way to increase the effectiveness of ECT while reducing the side effects of memory loss.
READ MORE @ EUREKALERT
Sunday, May 31, 2009
Antidepressants Cut Effectiveness of Tamoxifen in Breast Cancer
Tamoxifen, a breast cancer medicine used by millions of women, doesn’t work when taken with antidepressants like Eli Lilly & Co.’s Prozac, Pfizer Inc.’s Zoloft and GlaxoSmithKline Plc’s Paxil, a study says.
Tumors were more than twice as likely to return after two years in women taking the antidepressants while on the cancer drug, compared with those taking tamoxifen alone, the study showed. The research, by Medco Health Solutions Inc., was presented today at a meeting of the American Society of Clinical Oncology in Orlando.
Doctors began treating hot flashes with antidepressants, an unapproved use, after a U.S. study seven years ago linked the former standard remedy, hormone replacement therapy, to an increased risk of breast cancer and heart attacks. Other types of antidepressants, such as Wyeth’s Effexor, may be safer for women on tamoxifen than Paxil or Prozac, said Powel Brown, director of cancer prevention at the Lester and Sue Smith Breast Cancer Center at Baylor College of Medicine in Houston.
“Effexor doesn’t interfere with tamoxifen so that is the preferred drug for oncologists to treat hot flashes,” said Brown, who wasn’t involved in the study. “We need to get that message out to primary care doctors and psychiatrists and gynecologists so they will be aware that antidepressants like Paxil have a risk of inhibiting tamoxifen.”
READ MORE @ BLOOMBERG
Tumors were more than twice as likely to return after two years in women taking the antidepressants while on the cancer drug, compared with those taking tamoxifen alone, the study showed. The research, by Medco Health Solutions Inc., was presented today at a meeting of the American Society of Clinical Oncology in Orlando.
Doctors began treating hot flashes with antidepressants, an unapproved use, after a U.S. study seven years ago linked the former standard remedy, hormone replacement therapy, to an increased risk of breast cancer and heart attacks. Other types of antidepressants, such as Wyeth’s Effexor, may be safer for women on tamoxifen than Paxil or Prozac, said Powel Brown, director of cancer prevention at the Lester and Sue Smith Breast Cancer Center at Baylor College of Medicine in Houston.
“Effexor doesn’t interfere with tamoxifen so that is the preferred drug for oncologists to treat hot flashes,” said Brown, who wasn’t involved in the study. “We need to get that message out to primary care doctors and psychiatrists and gynecologists so they will be aware that antidepressants like Paxil have a risk of inhibiting tamoxifen.”
READ MORE @ BLOOMBERG
Friday, May 22, 2009
APA: Heart Risks May Impair Depression Treatment
Cardiovascular risk factors may be linked to lack of response to antidepressant treatment, researchers found.
Patients with diabetes, dyslipidemia, hypertension, and obesity were twice as likely to be unresponsive to antidepressant medication as other patients (P<0.05 to 0.01), Dale D'Mello, M.D., and Alric Hawkins, M.D., both of Michigan State University in East Lansing, reported at the American Psychiatric Association meeting.
The lack of response was not significantly more common among smokers, though.
The researchers' preliminary cohort study also revealed that those with comorbid cardiovascular risk factors were older at onset of depression and had tried -- unsuccessfully -- a greater number of antidepressant drugs.
READ MORE @ MEDPAGE TODAY
Patients with diabetes, dyslipidemia, hypertension, and obesity were twice as likely to be unresponsive to antidepressant medication as other patients (P<0.05 to 0.01), Dale D'Mello, M.D., and Alric Hawkins, M.D., both of Michigan State University in East Lansing, reported at the American Psychiatric Association meeting.
The lack of response was not significantly more common among smokers, though.
The researchers' preliminary cohort study also revealed that those with comorbid cardiovascular risk factors were older at onset of depression and had tried -- unsuccessfully -- a greater number of antidepressant drugs.
READ MORE @ MEDPAGE TODAY
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