Contrary to long-standing thinking, medications may offer comparable headache relief to those with and without mental disorders.
For an especially miserable time, mix recurring headaches with depression, anxiety or both. But people in such a fix have cause for optimism, courtesy of a team led by psychologist Bernadette Heckman of Ohio University in Athens.
Drug treatments for headaches work just as well for patients with these psychiatric disorders as for those with no such problems, Heckman and her colleagues report in the November Pain.
Researchers and clinicians generally assume that the presence of one or more psychiatric ailments worsens headache symptoms and thus the prospects for successful treatment. Heckman and her colleagues conducted one of the few prospective studies to test that conviction.
“Contrary to conventional clinical wisdom, many patients with psychiatric disorders responded favorably to headache treatment,” Heckman says.
The team found that, during six months of treatment at any of four outpatient headache clinics, rates of improvement in headache frequency and intensity were about the same for patients with depression, anxiety, a combination of the two or no psychiatric disorders.
In a comment published with the new study, psychologist Todd Smitherman of the University of Mississippi in Oxford and psychiatrist Donald Penzien of the University of Mississippi Medical Center in Jackson say that the new findings “give us pause to reconsider our earlier predictions” that people with mental disorders respond poorly to headache treatment.
READ MORE @ SCIENCE NEWS
Showing posts with label anxiety. Show all posts
Showing posts with label anxiety. Show all posts
Tuesday, October 20, 2009
Saturday, August 8, 2009
Antidepressants once seen as miracle drugs: now risks are becoming evident
Since the horror of the Thalidomide scandal in the 1960s, pharmaceutical companies and medicines regulators have been acutely aware of the dangers drugs may pose to the unborn child.
Establishing what the effect of a drug may be on a foetus, however, is no simple task. Companies must rely on animal studies in the early stages of research and hope that the drug will behave in humans in the same way. Trials on pregnant women are rarely carried out, for obvious reasons.
Depression and anxiety became big business for the pharmaceutical industry in the 1990s as doctors became better at diagnosing the problems, exposing a population of over-achieving, highly-stressed, worried-well.
Women, always more willing to see a doctor than men, were a large proportion of those diagnosed and put on SSRIs (selective serotonin reuptake inhibitors) such as Prozac and the British drug Seroxat, known as Paxil in the US. For a while, these seemed to be the new miracle drugs. They were safer than older antidepressants because the severely depressed could not overdose on them.
But in court cases about to begin in the US, it will be argued that insufficient attention was paid to the possible dangers for young women who were pregnant or might become pregnant and more particularly, for their babies.
READ MORE @ GUARDIAN
Establishing what the effect of a drug may be on a foetus, however, is no simple task. Companies must rely on animal studies in the early stages of research and hope that the drug will behave in humans in the same way. Trials on pregnant women are rarely carried out, for obvious reasons.
Depression and anxiety became big business for the pharmaceutical industry in the 1990s as doctors became better at diagnosing the problems, exposing a population of over-achieving, highly-stressed, worried-well.
Women, always more willing to see a doctor than men, were a large proportion of those diagnosed and put on SSRIs (selective serotonin reuptake inhibitors) such as Prozac and the British drug Seroxat, known as Paxil in the US. For a while, these seemed to be the new miracle drugs. They were safer than older antidepressants because the severely depressed could not overdose on them.
But in court cases about to begin in the US, it will be argued that insufficient attention was paid to the possible dangers for young women who were pregnant or might become pregnant and more particularly, for their babies.
READ MORE @ GUARDIAN
Wednesday, July 1, 2009
Depression, Anxiety Bad for the Heart
Two new studies show that problems with the mind can play a significant role in problems of the heart.
One study found that anxiety and depression can increase the incidence of angina, the chest pain that sends many people to the doctor, said Dr. Mark Sullivan, professor of psychiatry and behavioral sciences at the University of Washington, and senior author of one of the reports in the June 29 online issue of Circulation.
"The overwhelming focus in the United States has been on ischemia," the blockage of heart arteries, Sullivan said. "That is pretty unique in the world. The rest of the world takes a much more multi-modal approach to chest pain. Ischemia is not the only or most important cause of what patients are feeling."
Stress tests and similar measures are properly used to assess ischemia in people with angina, Sullivan said. "But in addition to the kind of diagnostic studies done with stress tests, patients who have a lot of angina should be screened for anxiety and depression, because they could be very cost-effective targets for intervention," he said.
To prove that point, Sullivan and his colleagues studied 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 30 percent 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.
READ MORE @ ATLANTA JOURNAL CONSTITUTION
One study found that anxiety and depression can increase the incidence of angina, the chest pain that sends many people to the doctor, said Dr. Mark Sullivan, professor of psychiatry and behavioral sciences at the University of Washington, and senior author of one of the reports in the June 29 online issue of Circulation.
"The overwhelming focus in the United States has been on ischemia," the blockage of heart arteries, Sullivan said. "That is pretty unique in the world. The rest of the world takes a much more multi-modal approach to chest pain. Ischemia is not the only or most important cause of what patients are feeling."
Stress tests and similar measures are properly used to assess ischemia in people with angina, Sullivan said. "But in addition to the kind of diagnostic studies done with stress tests, patients who have a lot of angina should be screened for anxiety and depression, because they could be very cost-effective targets for intervention," he said.
To prove that point, Sullivan and his colleagues studied 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 30 percent 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.
READ MORE @ ATLANTA JOURNAL CONSTITUTION
Thursday, February 12, 2009
Economy triggering depression, anxiety
n his stirring inauguration speech, President Barack Obama urged Americans to choose hope over fear.
While Obama's election clearly has given some people a lift, rhetoric alone isn't comforting those hit hardest by the country's economic downturn.
As people lose jobs or watch their retirement savings dry up, some local psychiatrists say they are seeing an increasing number of new patients with depression or anxiety, and that the symptoms of some current patients have worsened.
Beyond that, these doctors say, many who need treatment aren't receiving it because they cannot pay, having lost their jobs or their insurance.
Psychiatrist Bhawani Ballamudi, who practices at Dean Clinic East, said she is seeing a lot of depression.
"They just lost their job and have a family to feed, and they are trying to figure out how to do that, and that has caused a lot of stress," she said.
According to a Jan. 31 story in the New York Times, cries for help have increased nationwide. The National Suicide Prevention Lifeline reported a 36 percent jump in calls over the last year, to 545,851 from 402,167. Richard McKeon, a psychologist and federal public health expert, said crisis centers were reporting "a significant increase in the number of people who are giving economic reasons" for calling, whether it is "the loss of a job, loss of a home, or fear of that."
READ MORE @ THE CAPITAL TIMES
While Obama's election clearly has given some people a lift, rhetoric alone isn't comforting those hit hardest by the country's economic downturn.
As people lose jobs or watch their retirement savings dry up, some local psychiatrists say they are seeing an increasing number of new patients with depression or anxiety, and that the symptoms of some current patients have worsened.
Beyond that, these doctors say, many who need treatment aren't receiving it because they cannot pay, having lost their jobs or their insurance.
Psychiatrist Bhawani Ballamudi, who practices at Dean Clinic East, said she is seeing a lot of depression.
"They just lost their job and have a family to feed, and they are trying to figure out how to do that, and that has caused a lot of stress," she said.
According to a Jan. 31 story in the New York Times, cries for help have increased nationwide. The National Suicide Prevention Lifeline reported a 36 percent jump in calls over the last year, to 545,851 from 402,167. Richard McKeon, a psychologist and federal public health expert, said crisis centers were reporting "a significant increase in the number of people who are giving economic reasons" for calling, whether it is "the loss of a job, loss of a home, or fear of that."
READ MORE @ THE CAPITAL TIMES
Saturday, February 7, 2009
SSRIs as Antihypertensives in Patients With Autonomic Panic Disorder Is There a Link Between Panic Disorder and Hypertension?
We would like provisionally to name it serotonin, which indicates that its source is serum and its activity is one of causing constriction.
Rapport M, et al
The cardiovascular properties of serotonin (5-HT) have been known for some time—its name reflects its presence in serum and its action in increasing vascular tone. Serotonergic medications are routinely used to treat depressive and anxiety disorders, and the association of depression with cardiovascular disease has become well established.2 Recent studies have confirmed the colloquial wisdom that anxiety (especially panic) and hypertension are linked.
In this article, we examine the trinity of serotonin—serotonergic dysfunction, autonomic panic, and normal-weight essential hypertension— and the evidence that hypertensive individuals who experience panic with autonomic symptoms may be a group of patients in whom serotonergic dysfunction plays a key role. We discuss implications of this model, including the potential utility of SSRIs as antihypertensives in this cohort.
READ MORE @ PSYCHIATRIC TIMES
Rapport M, et al
The cardiovascular properties of serotonin (5-HT) have been known for some time—its name reflects its presence in serum and its action in increasing vascular tone. Serotonergic medications are routinely used to treat depressive and anxiety disorders, and the association of depression with cardiovascular disease has become well established.2 Recent studies have confirmed the colloquial wisdom that anxiety (especially panic) and hypertension are linked.
In this article, we examine the trinity of serotonin—serotonergic dysfunction, autonomic panic, and normal-weight essential hypertension— and the evidence that hypertensive individuals who experience panic with autonomic symptoms may be a group of patients in whom serotonergic dysfunction plays a key role. We discuss implications of this model, including the potential utility of SSRIs as antihypertensives in this cohort.
READ MORE @ PSYCHIATRIC TIMES
Tuesday, September 2, 2008
Long-Term Antidepressant Treatment Without Active Management Hardly Induces Remission: Presented at ECNP
A Scottish study identified a group of patients in primary care who are on long-term and stable treatment with selective serotonin reuptake inhibitors (SSRIs). A substantial proportion of patients displayed prevailing residual depressive and anxiety symptoms as well as sleep problems in spite of their treatment.
Alan Wade, MD, CPS Clinical Research Centre, Glasgow, Scotland, presented the study at a poster session on September 1 here at the 21st European College of Neuropsychopharmacology (ECNP) Congress.
Patients who were prescribed standard doses of antidepressants by their general practitioners without active management due to repeat prescriptions were identified from prescribing records in the West of Scotland.
READ MORE @ DOCTOR'S GUIDE
Alan Wade, MD, CPS Clinical Research Centre, Glasgow, Scotland, presented the study at a poster session on September 1 here at the 21st European College of Neuropsychopharmacology (ECNP) Congress.
Patients who were prescribed standard doses of antidepressants by their general practitioners without active management due to repeat prescriptions were identified from prescribing records in the West of Scotland.
READ MORE @ DOCTOR'S GUIDE
Monday, June 16, 2008
Hunger hormone increases during stress, may have antidepressant effect
New research at UT Southwestern Medical Center may explain why some people who are stressed or depressed overeat.
While levels of the so-called "hunger hormone" ghrelin are known to increase when a person doesn't eat, findings by UT Southwestern scientists suggest that the hormone might also help defend against symptoms of stress-induced depression and anxiety.
"Our findings in mice suggest that chronic stress causes ghrelin levels to go up and that behaviors associated with depression and anxiety decrease when ghrelin levels rise. An unfortunate side effect, however, is increased food intake and body weight," said Dr. Jeffrey Zigman, assistant professor of internal medicine and psychiatry at UT Southwestern and senior author of a study appearing online today and in a future print edition of Nature Neuroscience.
Dr. Michael Lutter, instructor of psychiatry at UT Southwestern and lead author of the study, said, "Our findings support the idea that these hunger hormones don't do just one thing; rather, they coordinate an entire behavioral response to stress and probably affect mood, stress and energy levels."
READ MORE @ EUREKALERT
While levels of the so-called "hunger hormone" ghrelin are known to increase when a person doesn't eat, findings by UT Southwestern scientists suggest that the hormone might also help defend against symptoms of stress-induced depression and anxiety.
"Our findings in mice suggest that chronic stress causes ghrelin levels to go up and that behaviors associated with depression and anxiety decrease when ghrelin levels rise. An unfortunate side effect, however, is increased food intake and body weight," said Dr. Jeffrey Zigman, assistant professor of internal medicine and psychiatry at UT Southwestern and senior author of a study appearing online today and in a future print edition of Nature Neuroscience.
Dr. Michael Lutter, instructor of psychiatry at UT Southwestern and lead author of the study, said, "Our findings support the idea that these hunger hormones don't do just one thing; rather, they coordinate an entire behavioral response to stress and probably affect mood, stress and energy levels."
READ MORE @ EUREKALERT
Sunday, October 14, 2007
A dark age for mental health - A therapy last used on a mass scale in China's cultural revolution is to be unleashed on the NHS
It looks like good news. In an era where psychological problems are increasingly explained in terms of biological deficits, the government has announced that it will spend £170m by 2010 on talking therapies for depression and anxiety. The scheme should pay for itself as better mental health will mean fewer sick days and benefits - £170m isn't much compared with an annual £12bn cost to the economy. But will it really help?
The answer, sadly, is negative. Talking therapy means not psychotherapy, but cognitive behavioural therapies (CBTs). These aim at the removal of symptoms and the return to work of sufferers, who will have learned to identify and manage patterns of undesirable behaviour. However, clinicians know that patients are likely to be back on a waiting list within a year to 18 months. Their underlying problems will not have been resolved, resulting in new symptoms or the return of old ones.
READ MORE @ THE GUARDIAN
The answer, sadly, is negative. Talking therapy means not psychotherapy, but cognitive behavioural therapies (CBTs). These aim at the removal of symptoms and the return to work of sufferers, who will have learned to identify and manage patterns of undesirable behaviour. However, clinicians know that patients are likely to be back on a waiting list within a year to 18 months. Their underlying problems will not have been resolved, resulting in new symptoms or the return of old ones.
READ MORE @ THE GUARDIAN
Saturday, August 25, 2007
Happy Days: Unraveling the Mystery of How Antidepressants Work
The mechanism behind antidepressant drugs is unveiled, which could lead to better treatments for depression and anxiety disorders.
New research shows how certain antidepressants work, paving the way to new, improved versions of the drugs used to treat depression, anxiety and attention deficit disorder.
Two separate studies—published this week in Science and Nature—provide a window into the way tricyclic antidepressants, such as clomipramine and desipramine, provide therapeutic relief by adhering to proteins on the part of a nerve cell's outer membrane that extends into the brain's synapses (spaces between the cells). These so-called transporter proteins, so-named because they carry molecules inside the nerve cell, gobble up neurotransmitters (chemical messengers such as norepinephrine, serotonin and dopamine) sent by neighboring cells. The drainage of these neurotransmitters from synapses—resulting, ironically, from the reimportation of the chemical just secreted by the sending neuron—has been linked to anxiety disorders; tricyclic antidepressants boost the activity of these neurotransmitters in synapses. But scientists have never been sure how this was accomplished.
READ MORE @ SCIENTIFIC AMERICAN
New research shows how certain antidepressants work, paving the way to new, improved versions of the drugs used to treat depression, anxiety and attention deficit disorder.
Two separate studies—published this week in Science and Nature—provide a window into the way tricyclic antidepressants, such as clomipramine and desipramine, provide therapeutic relief by adhering to proteins on the part of a nerve cell's outer membrane that extends into the brain's synapses (spaces between the cells). These so-called transporter proteins, so-named because they carry molecules inside the nerve cell, gobble up neurotransmitters (chemical messengers such as norepinephrine, serotonin and dopamine) sent by neighboring cells. The drainage of these neurotransmitters from synapses—resulting, ironically, from the reimportation of the chemical just secreted by the sending neuron—has been linked to anxiety disorders; tricyclic antidepressants boost the activity of these neurotransmitters in synapses. But scientists have never been sure how this was accomplished.
READ MORE @ SCIENTIFIC AMERICAN
Saturday, June 30, 2007
Dosage Adjustment in Special Populations
Special consideration may be necessary when prescribing pharmacologic therapy for depression and anxiety disorders in certain populations of patients. These populations are diverse in demographics and symptomatology. As a result, discussions of the special considerations their comorbid conditions require tend to be outside of the mainstream literature. This article discusses 3 special populations: patients with traumatic brain injury (TBI), patients with HIV or AIDS, and Asian Americans. When prescribing pharmacologic therapy for depression to patients in these special populations, clinicians must perform thorough patient assessments, maintain a high index of suspicion for comorbidities, and proceed with slow and gentle titration of medications.
READ MORE @ ABKHAZIA
READ MORE @ ABKHAZIA
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