Prenatal antidepressants linked to preterm births

Antidepressant drug use during pregnancy, but not depression itself, is associated with an increased risk of preterm birth and lower fetal age at delivery, according to results of a study published in the American Journal of Psychiatry.

"Depressive symptoms are not uncommon during pregnancy, and...symptoms may occur more frequently during pregnancy than in the postpartum period," write Dr. Rita Suri and colleagues from the University of California, Los Angeles. Depression during pregnancy and just after delivery "has been associated with low maternal weight gain, increased frequency of cigarette, alcohol, and substance use, and ambivalence about the pregnancy."

To further investigate, the researchers examined the effects of maternal depression and antidepressant drug use on fetal age and risk of preterm birth in a study of 90 pregnant women.

READ MORE @ REUTERS

Indications for Antidepressant use in patients with chronic pain disorders

....USE OF ANTIDEPRESSANTS IN THE MANAGEMENT OF CHRONIC PAIN
Pain and depression are closely intertwined, strongly hinting at a shared neurophysiology. As a consequence, one prevailing pharmacologic strategy identifies a central role for serotonin and norepinephrine reuptake inhibitors (SNRIs).1 Other justifications, even without a common biologic rationale, strongly support the use of antidepressants in the management of chronic pain. For example, chronic pain characteristically causes sleep problems, anxiety, and depression, all of which may improve with antidepressant treatment.2 Providing an effective, nonhabituating sleep medication that also improves mood may significantly enhance the patient’s quality of life....

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Antidepressant Gatekeeper - Structural and functional studies point to tricyclics' mechanism of action

AN IMPORTANT CLASS of drugs-tricyclic antidepressants (TCAs)—binds in a surprising place. That finding, based on studies with a bacterial protein, could influence the design of new drugs for depression.

According to two new studies, TCAs seal off a molecular passageway in a bacterial counterpart of human neurotransmitter transporter proteins (Nature, DOI: 10.1038/nature06038 and Science, DOI: 10.1126/science.1147614). The work indicates a molecular mechanism of action for this compound class.

Since the 1950s, TCAs such as desipramine (Norpramin and Pertofrane) have been prescribed to treat symptoms of depression. They prevent reuptake of serotonin and norepinephrine by binding to corresponding membrane-spanning neurotransmitter transporter proteins

READ MORE @ CHEMICAL & ENGINEERING NEWS

U.S. deems Wyeth schizophrenia drug not approvable

U.S. health officials have determined that a schizophrenia drug developed by Wyeth and two other drugmakers is not approvable, the companies said on Friday, dealing Wyeth a second setback in a month on a product potentially close to the market.

And in another blow to Wyeth, its partner on an experimental hepatitis C drug, ViroPharma Inc., said on Friday that the companies were stopping a clinical trial of the medicine due to safety concerns.

READ MORE @ REUTERS

Cheerful news for antidepressant research

Two research groups have independently reported new findings on the mechanism of action of an important class of antidepressant drugs. The work provides key insights into how tricyclic antidepressants interfere with neurophysiology at the molecular scale, and could eventually open the way to the development of more efficient therapies.

Tricyclic antidepressants (TCAs) are molecules that resemble a kite, with a central seven-membered ring trailing a short tail and flanked by two benzene rings. TCAs work by inhibiting neurons from taking up the monoamine neurotransmitters serotonin, norepinephrine and dopamine, which regulate mood. By blocking the re-uptake of these transmitters by their specific transporter proteins, the transmitter molecules remain in circulation for longer, prolonging their action.

However, the precise way in which the drugs work had remained unresolved. Now, Maarten Reith, Da-Neng Wang and colleagues1 at the New York University School of Medicine, US, and a team led by Eric Gouaux2 at the Oregon Health and Science University, US, have independently provided data on how TCA molecules bind to a bacterial analogue of a mammalian neurotransmitter transporter.

READ MORE @ RSC

Tailor-made Antidepressants?

....The most important consequence of research on interaction between genetic and environmental factors is that, in a foreseeable future, scientists will be able to produce measures to predict response to antidepressants taking into account each individual's genotype, i. e. they will be able to design tailor-made drugs according to each person's genetic configuration and their exposure to environmental factors....

READ MORE @ SCIENCE DAILY

Efexor* XL (venlafaxine) May Help Adult Patients Prevent Recurrent Episodes of Depression for Up to Two Years

Clinical trial data showing that Efexor* XL (venlafaxine) helped patients prevent the recurrence of depression for up to two years1a, was presented at the British Association for Psychopharmacology summer meeting in Harrogate. It is the first time that a modern antidepressant has demonstrated prevention of recurrence, versus placebo, over a two year period.2 These findings reinforce guidance from the National Institute for Health and Clinical Excellence (NICE), that anti-depressants should be continued for two years in patients who have had 2 or more episodes. 3

Results from the Prevention of Recurrent Episodes of Depression with VENlafaxine XR for Two Years (PREVENT)1b study demonstrated that 70% of patients continued to respond to treatment with venlafaxine at doses 225mg/day and less over 2 years1c, and were therefore significantly more likely to remain recurrence-free than patients taking placebo.

READ MORE @ HEALTHCARE REPUBLIC

Suicide risk in adults lowered by antidepressants

Adults with depression who are treated with a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) have a lower rate of suicide attempts, the results of a new study indicate.

In October 2004, the U.S. Food and Drug Administration (FDA) ordered drug labeling to warn of a possible link between antidepressant drug treatment and suicidal thoughts, or "ideation," and behavior in children and adolescents, the researchers note in the American Journal of Psychiatry. In May 2007, the warning was extended to include young adults.

Dr. Robert D. Gibbons, of the University of Illinois at Chicago, and colleagues examined the association between antidepressant treatment and suicide attempts in adult patients treated in the Veterans Administration health care system.

READ MORE @ SCIENTIFIC AMERICAN

Antipsychotics in the Treatment of Comorbid Anxiety in Bipolar Disorder

The comorbidity of anxiety disorders with bipolar disorder is a rule, not an exception, with a negative impact on both course and treatment outcome. So far, there are no guidelines or consensus for the treatment of this comorbidity. There are also no efficacy data that support the use of antidepressants or benzodiazepines in the treatment of anxiety disorder in this population. Benzodiazepines, the second-line agents for some primary anxiety disorders, may be riskier for patients with bipolar disorder because they are associated with a high rate of comorbid substance use disorder. Some preliminary data have shown that antipsychotics, especially atypical anti- psychotics, may be a viable alternative for patients with comorbid bipolar and anxiety disorders with or without substance use disorder.

READ MORE @ PSYCHIATRIC TIMES

Success Or Failure Of Antidepressant Citalopram Predicted By Gene Variation

A variation in a gene called GRIK4 appears to make people with depression more likely to respond to the medication citalopram (Celexa) than are people without the variation, a study by the National Institute of Mental Health (NIMH), part of the National Institutes of Health, has found.

The increased likelihood was small, but when people had both this variation and one in a different gene shown to have a similarly small effect in an earlier study, they were 23 percent more likely to respond to citalopram than were people with neither variation.

The finding addresses a key issue in mental health research: the differences in people's responses to antidepressant medications, thought to be based partly on differences in their genes. Some patients respond to the first antidepressant they attempt, but many don't. Each medication takes weeks to exert its full effects, and patients' depression may worsen while they search for a medication that helps. Genetic studies, such as the one described here, may lead to a better understanding of which treatments are likely to work for each patient.

READ MORE @ SCIENCE DAILY

Are antidepressants taking the edge off love?

Sure, we know about the sexual side effects of SSRIs. But researchers now wonder if that's the only aspect of romance the drugs can influence.

LOVE'S first rush is a private madness between two people, all-consuming and, if mutually felt, endlessly wonderful.

Couples think about the other obsessively -- on a roller coaster of euphoria when together, longing when apart.

"It's temporary insanity," says Helen Fisher, an evolutionary anthropologist at Rutgers University.

Now, from her studies of the brains of lovers in the throes of the initial tumble, Fisher has developed a controversial theory. She and her collaborator, psychiatrist J. Anderson Thomson of the University of Virginia, believe that Prozac, Zoloft, Paxil and other antidepressants alter brain chemistry so as to blunt the intense cutting edge of new love.

READ MORE @ LOS ANGELES TIMES

RCP: Healthy siblings of people with schizophrenia have problems recognising facial emotion

People with schizophrenia and their healthy siblings have problems recognising facial emotion in others, according to a new study.

Research suggests that schizophrenia has a substantial genetic component. Cognitive and social abilities, as well as the volumes of brain regions involved in emotion processing, such as the amygdala, have been found to vary along a continuum when people with schizophrenia, their siblings and controls are compared.

This study, published in the August 2007 issue of the British Journal of Psychiatry, set out to establish whether facial expression recognition is impaired in healthy siblings of people experiencing their first episode of schizophrenia.

READ MORE @ politics.co.uk

Shire's new ADHD medication now available

Shire says Vyvanse, its once-daily medication approved to treat the symptoms of attention deficit hyperactivity disorder, is now available in US pharmacies nationwide.

In a clinical study, Vyvanse provided consistent ADHD symptom control throughout the day based upon parent reports in the morning (approximately 10am), afternoon (approximately 2pm), and early evening (approximately 6pm).

READ MORE @ PHARMACEUTICAL BUSINESS REVIEW

BIPOLAR DISORDER: a new holistic approach

Treatment of mood disturbance in bipolar disorder is undergoing a paradigm shift. Traditionally, drug therapy has been focussed on efficacy in acute mania or depression. Now psychiatrists are realising the need to evaluate drug treatments from other perspectives, Their full effects as acute and mood-stabilising agents, side effect profiles, effects on neurocognitive functioning, quality of life, and on psychosocial functioning, are also important when considering therapy.

Bipolar disorder, the condition where mood swings between varying degrees of mania, hypomania, mixed states, depression and major depressive disorder, is now the sixth leading cause of disability according to the World Health Organization (1). But although bipolar disorder is as common as diabetes, much of it still goes unrecognised and inadequately treated. Official estimates put prevalence at between 1 to 4 per cent of the population but some researchers believe the real figure is closer to 10 per cent if the whole spectrum of bipolar disorder is included (2).

READ MORE @ PHARMWEB

Regional training to help law enforcement officers manage psychiatric crises

Some two dozen law enforcement officers from around the region will undergo intensive training this week in how to safely and effectively deal with people in psychiatric crisis.

Organizers hope to help them learn how to defuse the tension that often surrounds these crises and reduce the likelihood of a tragic outcome.

It’s something that’s needed, said Michele Periolat, a trainer with the Minnesota Crisis Intervention Team Officers Association.

READ MORE @ West Central Tribune

Kid has a problem? Put 'em on drugs

The number of Florida children taking powerful anti-psychotic drugs has increased about 250 percent in the last seven years, despite concerns about the long-term affects on children and the cost to state taxpayers, a newspaper reported Sunday.

Doctors are increasingly using drugs called "atypicals" to control aggressive children and calm kids with attention deficit hyperactivity disorder, or ADHD, the St. Petersburg Times reported.

In Florida, more than 18,000 children on Medicaid were given anti-psychotic drugs last year, including 1,100 under the age of 6. The drug can be used on kids under 6 only in extreme cases.

READ MORE @ ST PETERSBURG TIMES

Ashes of 2 Oregon mental-hospital patients laid to rest after six decades

For more than six decades, the cremated remains of brothers Robin and Wade Graham were stored in anonymous little copper canisters on shelves of the crumbling Oregon psychiatric hospital made famous as the movie set of "One Flew Over the Cuckoo's Nest."

The Grahams were finally buried next to their parents in Grangeville's Prairie View Cemetery, after a service Sunday attended by more than 20 family members — some of whom never knew the two existed — after their years in exile at the former Oregon State Hospital in Salem, Ore.

The weekend burial in this north-central Idaho town comes after Oregon lawmakers in April passed a law making it easier for families of patients who lived out their lives at the mental hospital to reclaim their ashes. The unclaimed bodies of 3,600 mental patients were cremated and the remains put in copper canisters from the early 1900s to the 1970s.

READ MORE @ Associated Press
LEARN MORE @ Mental Health Association of Portland

Oregon Hospital to End Psychiatric Program

Salem Hospital plans to end a 10-year-old program that provides outpatient psychiatric care for older adults.

The Psychiatric Geriatric Outpatient Consultation Clinic will cease operations by September, said Sherryll Johnson Hoar, spokeswoman for Salem Hospital. Staffing shortages led to the decision to close the clinic, she said.

Salem Hospital determined it had to focus its resources on those patients in an "emergent psychiatric crisis," who cannot be treated on an outpatient basis and require a hospital stay.

READ MORE @ SALEM STATESMAN JOURNAL

Lilly Posts Ends Strong Numbers With Cialis, Cymbalta

Eli announced its second quarter results, reporting sales were up 20 percent, worldwide. Eli Lilly reported Q2 sales reached $4.63 billion, with volume up 11 percent, led by the antidepressant drug Cymbalta and the erectile dysfunction drug Cialis.

In January, Eli Lilly acquired Cialis' maker, ICOS Corp. for $2.3 billion. The second quarter return is the first full period incorporating Cialis profits into Eli Lilly's numbers. The take-over kicked marketing and administrative expenses up 23 percent to $1.52 billion.

"We are very pleased to have delivered another quarter of strong financial results," CEO Sidney Taurel said. "Our accelerated, double-digit sales growth in this quarter was fueled by increased volume, driven by several products launched this decade, most notably Cymbalta."

Russia: Activist Sent To Psychiatric Unit After Exposing Health Facilities

A Russian opposition activist has been locked in a mental-health institution in Murmansk Oblast for criticizing health professionals, her husband and human-rights groups claim.

Dmitry Tereshin has hardly slept since July 5, the day his wife, Larisa Arap, telephoned him from the local hospital in Murmansk to say doctors were forcibly admitting her to a psychiatric unit. She had gone to the hospital for a routine check-up she needed to renew her driver's license.

"In my opinion, it may have been because of the article, because the doctor had read the article Larissa wrote," said Tereshin. "The article was entitled 'Madhouse,' and it revealed what goes on in psychiatric clinics."

READ MORE @ RADIO FREE EUROPE - Russia: Activist Sent To Psychiatric Unit After Exposing Health Facilities
READ MORE @ BBC - Psychiatric abuse claim in Russia
READ MORE @ MOSCOW TIMES - Opposition Spokeswoman Sent to Psychiatric Hospital