The Right Rx for Sadness

In the 19th-century novel Hyperion, Henry Wadsworth Longfellow admonished his hero, unlucky in love, to "take this sorrow to thy heart, and make it a part of thee, and it shall nourish thee till thou art strong again." Had Paul Flemming been real and alive today, chances are he would have taken Prozac or Paxil instead. Last month, the Centers for Disease Control and Prevention announced that antidepressants are the country's most commonly prescribed medication, accounting for 118 million prescriptions in 2005. A sign, some experts are wondering, that it's time to reassess?

Although many psychiatrists worry more about desperate souls not getting help, there's a growing concern that medicine often goes to people who shouldn't be taking it. And a consensus has formed that the estimate of how many people will develop depression at some point—1 in 6—might be greatly inflated. "There's no question that the availability of these drugs has increased the diagnosis of depression," says Jerome Wakefield, a professor of social work at New York University. Wakefield is coauthor of the new book The Loss of Sadness, which argues that selective serotonin reuptake inhibitors—Prozac, Paxil, Zoloft—are commonly overused to treat sadness, a normal and healthy response to divorce, sudden unemployment, the end of a friendship, a house foreclosure.

READ MORE @ US NEWS & WORLD REPORT

Antidepressants and alcohol: Why can't they be taken together?

If you are taking antidepressants, you should talk to your doctor before drinking alcohol. The drug you are taking and your current emotional and physical state should be considered in deciding if you can safely drink alcohol while taking your medication. But generally, mixing antidepressants and alcohol is discouraged.

READ MORE @ MAYOCLINIC.COM

Experimental Medication Ketamine Relieves Depression In Just Hours: Points To Targets For New Medications

A new study has revealed more about how the medication ketamine, when used experimentally for depression, relieves symptoms of the disorder in hours instead of the weeks or months it takes for current antidepressants to work. While ketamine itself probably won't come into use as an antidepressant because of its side effects, the new finding moves scientists considerably closer to understanding how to develop faster-acting antidepressant medications -- among the priorities of the National Institute of Mental Health (NIMH), part of the National Institutes of Health.

READ MORE @ SCIENCE DAILY

Child use of antidepressants up four-fold

The use of antidepressants and other mind-altering drugs among schoolchildren has more than quadrupled in the last decade, it is revealed today.

New figures show that GPs are prescribing pills in record numbers to combat stress, violent behaviour and even tiredness.

Under-16s were given drugs for mental health problems more than 631,000 times last year, compared to just 146,000 in the mid-Nineties.

The huge increase has been blamed on a rise in childhood mental illness sparked by family breakdown and high-stakes school exams.

But there are fears that family doctors are coming under pressure to prescribe drugs such as Prozac as a "quick fix" solution, when counselling would be better.

READ MORE @ TELEGRAPH

Should Adolescent Patients With Depression Be Given Antidepressants?

The National Institute for Health and Clinical Excellence (NICE), UK, advocates antidepressants should only be given to adolescent patients with depression if accompanied with psychological therapy. A new study published in the British Medical Journal suggests SSRI treatment with cognitive behavioral therapy will most probably not improve outcomes for adolescent patients with moderate to severe depression.

The study contradicts what NICE has in its guidelines.

A BMJ editorial this week examines the evidence and explains what the implications might be for health care professionals treating adolescents with depression.

READ MORE @ MEDICAL NEWS TODAY

Improvement Following ADHD Treatment Sustained In Most Children

Most children treated in a variety of ways for attention deficit hyperactivity disorder (ADHD) showed sustained improvement after three years in a major follow-up study funded by the National Institutes of Health's (NIH) National Institute of Mental Health (NIMH). Yet increased risk for behavioral problems, including delinquency and substance use, remained higher than normal.

The study followed-up children who had participated in the Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (MTA).

Initial advantages of medication management alone or in combination with behavioral treatment over purely behavioral or routine community care waned in the years after 14 months of controlled treatment ended. However, Peter Jensen, M.D., Columbia University, and colleagues emphasized that "it would be incorrect to conclude from these results that treatment makes no difference or is not worth pursuing."

READ MORE @ SCIENCE DAILY

Bipolar Disorder: Psychiatrists Are Taking A New Approach That Aims To Treat Not Just Symptoms But The Whole Person

Bipolar disorder is the name now used to describe Manic Depression - the condition where mood veers between two poles or extremes - one of euphoria (mania) and the other of despair (depression). Most of us know of it - if only because of famous sufferers such as Vincent van Gogh - but although bipolar disorder is as common as diabetes, much of it goes unrecognised and inadequately treated. This is a pity because there are now good treatments available that can help keep the condition under control and, to a large extent, allow individuals to carry on normally.

Official estimates say bipolar illness affects 1 to 4 per cent of the population but some researchers believe the real figure is closer to 10 per cent (1). The World Health Organization says it is already the sixth leading cause of disability (2).

READ MORE @ MEDICAL NEWS TODAY

Risperdal Gave Kids Tooth Decay, Depression and Drowsiness

As drugmakers seek wider approval for their antipsychotics to be prescribed for youngsters, a new study finds some docs prescribed Risperdal for children 15 years old or younger who suffered insomnia or anxiety. Meanwhile, the med caused some kids to experience drowsiness, depression, tooth decay and weight gain. The findings were part of a national study in New Zealand and published in the latest edition of Drug Safety.

More than 90 per cent of prescriptions for the 420 children involved in the study were for Risperdal, where about 600 children are regularly prescribed the drug. The study by the Intensive Medicines Monitoring Programme found harmful side effects in 30 per cent of the children on the drugs classed as “atypical antipsychotics.” A third of these were linked to the drugs, say the researchers.

Read more @ PHARMALOT

Sertraline May Improve Function in Dementia

High-dose therapy with the selective serotonin reuptake inhibitor (SSRI) Sertraline resulted in statistically and clinically significant improvement in isolated impaired executive function in older patients.

Among 37 patients treated, 23 (62.1%) had clinically meaningful improvement, defined as a decrease of more than three points on the EXIT25 measure of executive function. Thirteen patients met EXIT25 criteria for clinical remission, according to results of a small retrospective study.

"Our mean improvement [on the EXIT25] is almost six points, which is the difference between two levels of care in a retirement community," said Donald R. Royall, M.D., of the University of Texas Health Science Center at San Antonio.

READ MORE @ MEDPAGE TODAY

The Drug Advertising Debate

Some members of Congress want to limit Big Pharma's ability to promote products directly to consumers. But the roadblocks are high.

If Representative Henry Waxman (D-Calif.) had his way, the little butterfly used to advertise the insomnia remedy Lunesta might not be allowed to flutter all over our TV screens, as it has incessantly since the drug was approved in late 2004. Waxman believes the U.S. Food & Drug Administration should be able to forbid companies from advertising directly to consumers until new drugs have been on the market for at least three years. He tried to mandate such a restriction by attaching it to a drug-safety bill. But on July 11 he came up short. After a debate centered on drug companies' right to free speech, the bill passed with virtually all restrictions on drug advertising stripped out.

READ MORE @ BUSINESS WEEK

Gov. seeks to cut mental services for homeless

Schwarzenegger says ending the acclaimed program would save $55 million annually toward $3-billion budget gap.

A nationally lauded program that has helped thousands of mentally ill homeless men and women break the cycle of psychiatric hospitalization, jail time and street life is now on Gov. Arnold Schwarzenegger's list of budget cuts.

The governor has proposed eliminating Integrated Services for Homeless Adults With Serious Mental Illness, which receives $55 million annually, as part of his attempt to close a budget gap estimated at more than $3 billion.

Mental health advocates, clients and concerned legislators are lobbying fiercely to save the program, which served as the blueprint for California's ongoing efforts to radically retool the state's mental health system.

READ MORE @ LOS ANGELES TIMES

Requiem for the Paxilated

Prozac was introduced by Eli Lilly to the US market in January 1988. Zoloft and Paxil followed in 1991 and 1992, respectively. Some 45,000 reports of adverse reactions to Prozac have been filed with the FDA. These include reports of about 2500 deaths, with the large majority linked to suicide or violence.

READ MORE @ COUNTERPUNCH

Backlash against antidepressants fuels alternative treatments.

From lobotomies with ice picks to early antidepressants that caused brain hemorrhaging, Americans have a complicated and ever-changing approach to treating mental illness. Now, spurred by the growing disenchantment with antidepressants, an increasing number of people are seeking treatment for depression, anxiety and eating disorders from naturopaths, acupuncturists and even chiropractors. At the same time, more traditional psychiatrists are incorporating massage and meditation in their practices.

The treatments go beyond needles and spinal manipulation. They include Emotional Freedom Techniques -- tapping on the body's "energy meridians" as the patient thinks about upsetting incidents -- and craniosacral therapy, which involves a gentle rocking of the head, neck, spine and pelvis. In cranial electrotherapy stimulation, a AA-battery-powered device sends mild electrical currents to the brain. (The procedure has its roots in ancient Greek medicine, when electric eels were used.) Clinicians are also prescribing supplements like omega-3 fatty acids, found in fish oil, or amino acids like L-theanine, found in green tea.

READ MORE @ WALL STREET JOURNAL

Use of Antipsychotics by the Young Rose Fivefold

The use of potent antipsychotic drugs to treat children and adolescents for problems like aggression and mood swings increased more than fivefold from 1993 to 2002, researchers reported yesterday.

The researchers, who analyzed data from a national survey of doctors' office visits, found that antipsychotic medications were prescribed to 1,438 per 100,000 children and adolescents in 2002, up from 275 per 100,000 in the two-year period from 1993 to 1995.

The findings augment earlier studies that have documented a sharp rise over the last decade in the prescription of psychiatric drugs for children, including antipsychotics, stimulants like Ritalin and antidepressants, whose sales have slipped only recently. But the new study is the most comprehensive to examine the increase in prescriptions for antipsychotics.

READ MORE @ NY TIMES

Mental Health Suffers in COPD Patients

Chronic obstructive pulmonary disease (COPD) patients, particularly women, may be significantly more likely to suffer psychiatric disorders than the general population, researchers found.

Nearly half (49%) of the patients with COPD in a cross-sectional study had at least one psychiatric disorder. There's a 31% rate in the general population.

Nearly twice as many women in the study as men were diagnosed with a psychiatric problem despite similar COPD duration and severity (60% versus 38%, P=0.03), they reported in the July issue of the journal CHEST.

READ MORE @ MEDPAGE TODAY

Plagued by midsummer SADness

Seasonal Affective Disorder is normally banished by the sunshine, but this year it is lingering on, reports Chloe Rhodes

Now is the winter of our discontent. The fact that it's July is irrelevant.

Flooding, freak hail and attempted terrorist attacks have blighted what is usually our sunniest and most carefree time of year, while grey skies and incessant showers have turned midsummer into one long, gloomy February afternoon.

Everyone gets fed up when bad weather drags on, but for some people, including me, the lack of sunshine has a bigger impact.

One in 50 of us is thought to suffer from Seasonal Affective Disorder (SAD), the symptoms of which include lethargy, anxiety, irritability, loss of libido and depression. One in eight experiences a milder version known as winter blues, and both usually occur in the months between October and March, when daylight hours are reduced.

READ MORE @ TELEGRAPH

Antidepressants most prescribed drugs in U.S.

Dr. Ronald Dworkin tells the story of a woman who didn't like the way her husband was handling the family finances. She wanted to start keeping the books herself but didn't want to insult her husband.

Antidepressants such as Paxil, Prozac and Lexapro are among America's most-prescribed drugs.

The doctor suggested she try an antidepressant to make herself feel better.

She got the antidepressant, and she did feel better, said Dr. Dworkin, who told the story in his book "Artificial Unhappiness: The Dark Side of the New Happy Class." But in the meantime, Dworkin says, the woman's husband led the family into financial ruin.

"Doctors are now medicating unhappiness," said Dworkin. "Too many people take drugs when they really need to be making changes in their lives."

READ MORE @ CNN

Pharma ads could come to Canada

Now the Supreme Court of Canada has upheld tobacco advertising restrictions, the next giant court battle -- over prescription drug marketing -- is around the corner.

Cross-examination of expert witnesses is set to begin this fall in a constitutional challenge that pits CanWest MediaWorks Inc. against a coalition of health, consumer and union groups.

CanWest, which owns a string of newspapers, as well as Global Television, wants the ban on so-called direct-to-consumer advertising of prescription drugs removed, arguing it's a violation of freedom of expression.

READ MORE @ EDMONTON SUN

Medicaid Recipients Have Trouble Finding Mental Health Care

Medicaid beneficiaries with substance abuse and mental disorders are less likely to use community services, even though most of the medical help for these disorders is community-based, a new study finds.

The study, which is published in the July issue of Psychiatric Services, examined where integrated treatments for co-occurring psychiatric and substance abuse disorders would be most needed for Medicaid recipients.

Psychiatric and substance abuse disorders are a major problem among the Medicaid population, which has 50 percent to 100 percent more cases than the general population.

Previous research has suggested that community-based treatment for these disorders is superior to treatment in hospitals, with the continuity of treatment being weaker and costs being higher in hospital settings. Because of this, care providers have focused on providing intervention programs in community settings, such as clinics and therapists' offices.

READ MORE @ FORBES

Lilly May Face More Zyprexa Lawsuits After FDA Letter (Update2)

Eli Lilly & Co. may attract more lawsuits alleging it failed to warn users that a psychiatric drug was linked to diabetes after the pharmaceutical company received a letter from U.S. regulators.

The U.S. Food and Drug Administration told Lilly in March it would delay the approval of Symbyax for hard-to-treat depression because the agency wanted more information about the risk of diabetes in the medicine's prescribing label. Symbyax combines Lilly's antipsychotic pill Zyprexa and the antidepressant Prozac.

The FDA's request, in a letter to Lilly obtained by Bloomberg, may bolster plaintiffs' suits against the Indianapolis company over side effects tied to Zyprexa, lawyers said. Lilly has paid more than $1.2 billion to settle 29,000 claims that patients weren't adequately warned that Zyprexa can cause diabetes, weight gain and pancreas infections.

READ MORE @ BLOOMBERG