Watch for depression in the elderly - Know the signs, step in if necessary

Experts are quick to say that depression isn't a normal part of aging, nor is it a sign of weakness.

But older family members who suffer from the condition may need your help to overcome those misconceptions and get treatment.

"In the elderly community, there is a lot of stigma still about depression and anxiety," said Dr. Greg Jicha, a neurologist at the University of Kentucky Sanders-Brown Center on Aging. "People are very hesitant to seek out any kind of help for these sorts of things."

Jicha believes it's important for relatives to be alert to signs of depression in older people to help restore joy in their lives and keep them from entering nursing homes too early. He recommends raising a red flag with primary care physicians, who may otherwise miss the signs.

READ MORE @ LOUISVILLE COURIER-JOURNAL

Large Pharma Cos Shift Focus To Research, From Cost Cuts

Pharmaceutical executives, faced with generic competition and other challenges, have shifted their primary focus from cost-cutting campaigns to reinvigorating research efforts, a new survey suggests.

Some 66% of industry executives said reinvigorating research-and-development was their top strategic initiative, while 40% said "optimizing costs" was the top priority, according to the survey released Wednesday.

That's a shift from last year, when a survey by E&Y together with The Economist found that 92% of executives ranked cost reduction as their number one initiative. "Large pharmaceutical companies have been intensely focused on costs for the last two years and are moving beyond short-term reductions to longer- term strategic cost management," the new report said.

READ MORE @ CNN MONEY

Drugged-out seniors a prescription for disaster

They are the drugged-out generation, and they're not who you think they are.

They're 80. And 85 and 90 and 95 – overmedicated seniors clogging emergency departments, blocking hospital beds and sicker than they have any reason to be.

The Number 1 drug users in North America, outside of patients in long-term care facilities, are women over the age of 65. Twelve per cent are on 10 or more meds, sometimes up to 20 or more drugs; 23 per cent take at least five drugs. In long-term care, seniors are on six to eight medications, on average. Fifteen per cent of seniors admitted to hospital are suffering drug side effects. It's not uncommon to find seniors dizzy and dotty from being prescribed so many drugs.

"You'd fall down, too, if you were on so many drugs," says Dr. William Dalziel, a prominent Ottawa geriatrician.

Typically, overmedicated seniors have been seen by numerous specialists who have prescribed various medications to treat a host of chronic ailments – high blood pressure, hypertension, diabetes, osteoporosis, arthritis, heart disease, cancer – but there hasn't been any oversight by a geriatrician skilled in looking at the big picture and assessing contra-indications and side effects. Ask any doctor with expertise in seniors what their top health concerns are and they all cite overmedication.

read more @ THE TORONTO STAR

Antipsychotics Aren't Anti-Depressants

I saw the Abilify for depression TV ad again over the weekend and I continue to be concerned about how Bristol-Myers Squibb is very craftily making the drug, an atypical antipsychotic, sound as if it's an anti-depressant. Nowhere in the TV is it mentioned that the drug is an antipsychotic, at least not in what I've caught on-air.

I've written about the ad previously here and have also written about how the drug's clinical trials for depression show a greater chance for a patient to experience akathisia than to have his or her depression improved.

READ MORE @ FURIOUS SEASONS

Antidepressant treatment may reduce male fertility

Treatment with paroxetine (Paxil), which belongs to the selective serotonin reuptake inhibitor (SSRI) class of antidepressant drugs, increases DNA fragmentation in sperm, according to research presented today at the 64th annual meeting of the American Society for Reproductive Medicine in San Francisco.

Although the study did not directly evaluate male fertility, the five-fold increase in the number of men who developed abnormal sperm DNA while being treated with paroxetine is "troubling" and "suggests an adverse effect on fertility," co-investigator Dr. Cigdem Tanrikut, from Harvard Medical School in Boston, told Reuters Health.

In a clinical trial she described as "the first study to assess the impact of an SSRI on semen parameters in healthy men," 35 men took paroxetine for 5 weeks. The drug was administered in once-daily doses of 10 mg the first week, 20 mg in the second week, 30 mg the third and fourth week, and 20 mg in the fifth week.

READ MORE @ REUTERS UK

Increased Bipolar Risk Linked to Father's Age

Older men are more likely than younger men to father children with autism, schizophrenia, or early-onset bipolar disorder.

Fathering a child later in life seems to increase its risk of having autism or schizophrenia, research has shown. And now it seems to increase a child's risk of having bipolar disorder as well, a new study suggests.

The study was headed by Emma Frans, a doctoral student in epidemiology at the Karolinska Institute in Stockholm. Results were published in the September Archives of General Psychiatry.

Sweden's Multigeneration Register, as well as Sweden's National Hospital Discharge Register, made this new investigation possible. The former, which has been in existence since 1947, gives demographic information about all people living in Sweden as well as about their parents. The latter, which has been in existence since 1973, lists all people living in Sweden who have been hospitalized for various conditions.

READ MORE @ PSYCHIATRIC NEWS

US general bucks military silence on mental health

It takes a brave soldier to do what Army Maj. Gen. David Blackledge did in Iraq.

It takes as much bravery to do what he did when he got home.

Blackledge got psychiatric counseling to deal with wartime trauma, and now is defying the military's culture of silence on the subject of mental health problems and treatment.

"It's part of our profession. ... Nobody wants to admit that they've got a weakness in this area," Blackledge said about mental health problems among troops who return from America's two wars.

"I have dealt with it. I'm dealing with it now," said Blackledge, who came home with post-traumatic stress. "We need to be able to talk about it."

As the United States marks another Veterans Day on Tuesday, thousands of troops continue coming home with anxiety, depression and other emotional problems.

Up to 20 percent of the more than 1.7 million who have served in Iraq and Afghanistan are estimated to have symptoms. In a sign of how tough it may be to change attitudes, roughly half those who need help are not seeking it, studies have found.

READ MORE @ INTERNATIONAL HERALD TRIBUNE

Many more children on medication, study says - 'Surprising' rise targets diabetes, other obesity-related diseases

Hundreds of thousands more children are taking medications for chronic diseases, with a huge spike over a four-year period in the number given drugs to treat conditions once seen primarily in adults and now linked to what has become an epidemic of childhood obesity.

In a study appearing today in the journal Pediatrics, researchers saw surges in the number of U.S. children taking prescription medicines for diabetes and asthma, with smaller increases in those taking drugs for high blood pressure or high cholesterol. All of those conditions, to varying degrees, have been associated with obesity.

Though doctors have been seeing the trend in their practices, "the rate of rise is what's surprising," said Dr. Donna R. Halloran, a pediatrician at St. Louis University in Missouri and one of the study's authors.

The study found a doubling in the number of children taking medication for type 2 diabetes, with the largest increases seen among pre-teen and teenage girls. The number of asthma prescriptions was up nearly 47 percent.

READ MORE @ BALTIMORE SUN

Kidney Transplantation Can Improve Mental Performance, Study Finds

Individuals with kidney disease often suffer from cognitive impairment, but kidney transplantation can improve their mental performance, according to a paper being presented at the American Society of Nephrology's 41st Annual Meeting and Scientific Exposition in Philadelphia, Pennsylvania.

While researchers and clinicians consider cognitive decline to be a common occurrence in patients with chronic kidney disease, it is unclear if this impairment is due to patients' advanced age, their chronic health conditions, or potential treatment-related factors. In addition, the effects of surgery and immunosuppressant medications on memory and overall cognitive performance have been poorly studied, but previous research suggests that kidney transplantation may have a beneficial effect on patients' mental function.

READ MORE @ SCIENCE DAILY

Most kids get no therapy with antidepressants

At least half of U.S. children taking antidepressants aren't in therapy, suggests a large study, and that delays recovery while greatly increasing the number of kids on the medication who are suicidal.


"Therapy with antidepressants is the standard of care. But is it what's going on in the real world? No," says Sheila Marcus, child and adolescent psychiatry chief at the University of Michigan Medical School.

The report tracks insurance claims for antidepressants from a database of 6.8 million children and teens from 2002 to 2006. The analysis was done by Thomson Reuters, a research firm that helps companies evaluate health care.

READ MORE @ ELMIRA STAR GAZETTE

Johnson & Johnson Psychiatric Gifts Probed by Senate (Update2)

Johnson & Johnson, the world's largest health-care company, said a U.S. Senate committee probing payments to doctors by drug and medical-device makers has asked about company support of psychiatric professional groups.

J&J, of New Brunswick, New Jersey, is responding to the request, received Oct. 23 from the Senate Committee on Finance, the company said today in a regulatory filing. The letter asks about ``any payments or benefits to a number of specified psychiatrists associated with psychiatric professional associations or otherwise authorities in their field.''

Committee members Charles Grassley, an Iowa Republican, and Herb Kohl, a Wisconsin Democrat, sent a similar request Oct. 16 to J&J, Medtronic Inc. and Abbott Laboratories about support for a medical-device conference. Grassley has also said he is probing payments by AstraZeneca Plc and Eli Lilly & Co. to psychiatrists and disclosures by Stanford University professor Alan Schatzberg, president-elect of the American Psychiatric Association.

READ MORE @ BLOOMBERG

Fears over new drug orders for mental health patients - Powers to administer compulsory treatment come into force today

Campaigners have expressed concern about the potential misuse of new powers for the compulsory treatment of people with mental illness that come into force in England today.

Under changes to mental health legislation, some patients discharged from hospital may be placed under a community treatment order (CTO) that forces them to take their medication – even where they may have damaging side-effects and be of limited use.

The changes are designed to help so-called "revolving door" patients, those stuck in a cycle where they stop taking their medication and become so unwell that they require hospital admission.

Now where a patient refuses to take medication, they can be held and treated in hospital for 72 hours. If they still refuse, the CTO is revoked and they become a detained patient again.

READ MORE @ THE GUARDIAN

Wyeth latest drugmaker to narrow focus of research

Like many of the top pharmaceutical companies, Wyeth is narrowing its research focus to far fewer diseases as it tries to produce more successful new drugs, particularly for conditions lacking good treatments.

Wyeth is even ending research in its signature areas in women's health - contraceptives and menopause treatments - and switching to other female health problems with an unmet need, such as ovarian cancer and lupus.

The Madison, N.J.-based company is scaling back from doing research in its current 14 therapeutic areas to just six, Dr. Evan Loh, a Wyeth vice president, said Wednesday. Instead of doing research on a total of 55 diseases, it now will work on 27.

READ MORE @ SEATTLE POST INTELLIGENCER

Heart Patients Should Be Screened, Treated for Depression

Studies show that depression is about three times more common in patients following a heart attack than in the general community. Heart patients should be screened for depression, and treated if necessary. Heart patients should be screened for depression - a common condition that can profoundly affect both prognosis and quality of life -according to the American Heart Association's first scientific statement on depression and coronary heart disease. The statement was published in Circulation: Journal of the American Heart Association.

The recommendations, which are endorsed by the American Psychiatric Association, include:

-early and repeated screening for depression in heart patients;
the use of two questions to screen patients -if depression is suspected the remaining questions are asked ( 9 questions total );
coordinated follow-up for both heart disease and depressive symptoms in patients who have both.

“The statement was prompted by the growing body of evidence that shows a link between depression in cardiac patients and a poorer long-term outlook,” said Erika Froelicher, R.N., M.A., M.P.H., Ph.D., a professor at the University of California San Francisco, School of Nursing and Medicine and co-chair of the writing group. Dale Briggs, who experienced depression after his heart valve surgery, said the statement is welcome news. “I think it’s long overdue. It is unfortunate that some patients aren’t warned of the possibility of some depression after surgery,” he said.

READ MORE @ MEDIA NEWSWIRE

Medication insufficient for depression due to traumatic head injury

In a large clinical sample of patients with traumatic brain injury with symptoms of major depression, antidepressant medication has been shown to lead to remission of symptoms in a minority of patients.

"Although citalopram treatment was associated with a statistically significant reduction in depressive symptoms, the results of this study show the response rate in the present sample is substantially lower than previously reported in past research," says Dr. Mark Rapoport, lead investigator of the study and geriatric psychiatrist at Sunnybrook Health Sciences Centre. "Our findings suggest that other multidisciplinary treatment modalities will be needed to achieve adequate control of depressive symptoms following traumatic brain injury (TBI)."

The goal of the study was to examine the rates of response and remission in patients treated with a selective serotonin reuptake inhibitor (SSRI), citalopram in this case, for major depression following TBI.
In the past, open-label studies of SSRIs have shown statistically significant reductions on depression, but methodological problems in the studies and the small samples limited the ability to interpret the results.
Therefore the goal of this study was to assess the response of patients in a larger sample of clinical patients with mild-to-moderate TBI.

READ MORE @ MARKETWIRE

Drug-therapy combo best for anxiety in kids -study

A combination of a common antidepressant and a specialized form of talk therapy offer the best treatment for children and youth with anxiety disorders, U.S. researchers said on Thursday.

The findings come from the largest study of anxiety in children yet and offer much-needed guidance about how best to treat young people with separation anxiety, social phobia and generalized anxiety disorder -- conditions that affect as many as 20 percent of children and teenagers in the United States.

The study "clearly showed that combination treatment is the most effective for these children," Dr. John Walkup of Johns Hopkins University in Baltimore, who worked on the study, said in a statement.

But he said either therapy alone or sertraline alone helped well. Sertraline is the generic name of Pfizer Inc's (PFE.N: Quote, Profile, Research, Stock Buzz) Zoloft, which is one of a class of antidepressants called selective serotonin reuptake inhibitors.

READ MORE @ REUTERS

Depression often untreated in black heart patients

African Americans with heart disease are as likely to suffer from depression as their white counterparts, but they are less likely to be on medication for it, a new study suggests.

The study of 864 adults with coronary heart disease found that 35 percent of African Americans and 27 percent of whites had symptoms of depression. Yet black patients were less than half as likely to be on an antidepressant medication.

The findings are important, the researchers say, because depression in people with heart disease has been linked to a two- to four-fold higher risk of complications.

Studies have found that depressed heart disease patients have higher risks of a heart attack or stroke, and may die earlier than those without depression.

READ MORE @ REUTERS

Anti-Inflammatory Medications May Become A Treatment For Schizophrenia

Many of the structural and neurochemical features of schizophrenia are present long before the full syndrome of schizophrenia develops. What processes tip the balance between the ultra-high risk states and the development of schizophrenia? One candidate mechanism is cerebral inflammation, studied by Dr. Bart van Berckel and colleagues in the November 1st issue of Biological Psychiatry.

Using positron emission tomography, or PET, imaging, the researchers provide evidence of a brain inflammatory state that may be associated with the development of schizophrenia. The authors reported increased binding levels of [11C]PK11195, a radiotracer with high affinity for the peripheral benzodiazepine receptor (PBR) in patients who had carried the diagnosis of schizophrenia for five years or less. PBR is a molecular target that is present at higher levels in activated microglia. Microglia are activated during inflammatory states. Drs. van Berckel and Kahn further explain: “It was found that microglia activation is present in schizophrenia patients early after disease onset, suggesting brain cells are damaged in schizophrenia. In addition, since microglia can have either a protective or a toxic role, activated microglia may be the result, but also the cause of damage to brain cells.”

READ MORE @ SCIENCE DAILY

Zyprexa and Seroquel Side Effects May Increase Heart Disease Risk

New research suggests that Zyprexa and Seroquel may increase the risk of heart disease when compared to other antipyschotic medications.

Eli Lilly’s Zyprexa (olanzapine) and AstraZeneca’s Seroquel (quetiapine fumarate) are both blockbuster medications which are part of a class of drugs known as “atypical” antipsychotics. They are commonly used to treat symptoms of schizophrenia, but have also been widely used for other conditions like bipolar disorder, dementia, autism and obsessive-compulsive disorders.

Both drugs have previously been linked to a number of serious side effects, including severe weight gain, diabetes and pancreatitis. However, a new study published in the October 2008 issue of the journal Schizophrenia Research raises the potential for concerns about a small increased risk of coronary heart disease associated with the drugs.

read more @ AboutLawsuits.com

States Taking Pharma to Court for Risky Antipsychotic-Prescribing Spree

Certain antipsychotics are leaving legions of children and elderly in chemical straightjackets for treatment of conditions they didn't even have.

Some state legislators are mad as hell and not going to take it anymore.

They've seen state outlays for controversial antipsychotics like Zyprexa grow as much as twelvefold since 2000, with a corresponding growth in side effects like weight gain, blood sugar changes and cholesterol problems.

In March, Alaska won a $15 million settlement from Eli Lilly in a suit to recoup medical costs generated by Medicaid patients who developed diabetes while taking Zyprexa.

Last year Bristol-Myers Squibb settled a federal suit for $515 million charging that it illegally hawked the antipsychotic Abilify to children and the elderly, bilking taxpayers.

Now Idaho, Washington, Montana, Connecticut, California, Louisiana, Mississippi, New Mexico, New Hampshire, Pennsylvania, South Carolina, Utah, West Virginia, Arkansas and Texas are taking pharma to court over its antipsychotic prescrib-athon that has left the poor and mentally ill in even worse health and legions of children and elderly in chemical straightjackets for treatment of conditions they didn't even have.

The atypical antipsychotics Zyprexa, Risperdal, Seroquel, Abilify and Geodon can be thought of as the credit swaps of the pharmaceutical world.

READ MORE @ ALTERNET