NPR reports on how ketamine is being used off-label to treat depression. While highlighting some of the reported benefits, the report also details some limitations. “One is that its ability to keep depression at bay can fade pretty quickly,” another limitation is the price, which can run “about $500 for each injection and $1,000 for an intravenous infusion.” There is also concern that ketamine clinics are opening up all over the country “as pure business models."
While publication bias has been known to overestimate the efficacy of antidepressant treatments, a new study suggests that research on the use of psychotherapy in depression suffers from a similar bias.
The October edition of the Journal of World Psychiatry, the 3rd ranked journal of Psychiatry, will publish a reanalysis of antidepressant efficacy versus placebo in major depression. When the researchers, Arif Khan and Walter Brown, analyzed the data from the FDA archives for antidepressants approved between 1985 and 1997, “it was evident that the conventional wisdom of 70% response with antidepressants was at best an overestimate.” In fact, “the magnitude of symptom reduction was about 40% with antidepressants,” compared to “about 30% with placebo.”
An article for the Los Angeles Times, entitled “His 83-year-old Wife jumped to her death from a Kaiser clinic- why?” tells the story of Barbara Ragan who stepped off a roof in front of her mental health clinic with traces of Xanax, Prozac and an antidepressant in her blood. Her son complained that she did not receive adequate treatement. "All they do is distribute drugs," he said. "She was upfront with them and gave them every opportunity to help her out, but it was just, 'This is all we're going to do for you and we hope it works.'"
On Wednesday, JAMA Psychiatry released a meta-analysis comparing the results of cognitive-behavioral therapy and antidepressant medication in severely depressed populations. Currently, many practice guidelines suggest that antidepressants be used over psychotherapy for major depressive disorder. The analysis, however, found that “patients with more severe depression were no more likely to require medications to improve than patients with less severe depression.”
Bloomberg reports that the FDA asked Pfizer in August “to modify safety warnings for its antidepressant Zoloft (sertraline) and acknowledge for the first time that some studies linked the mood-altering medication to heart defects in newborns.” According to the Bloomberg report, “Pfizer is fighting lawsuits by hundreds of women who say they weren’t adequately warned the drug could cause defects in their newborns.” “While some legal experts say the label change could help the company fend off future lawsuits, it could also help bolster claims by those who have already sued over Zoloft, once the most prescribed antidepressant in the U.S.”
New research published in the July issue of The Journal of Clinical Psychiatry found that the use of mood stabilizers, antipsychotics, antidepressants, and hypnotics during pregnancy is associated with increased health risks to the infant.
Individuals between the ages of 15 and 24 are more likely to commit a violent crime if they are taking an SSRI antidepressant than if they are not, according to new research out of Sweden. The study published in PLoS Medicine on Tuesday, suggests "warnings about the increased risk of violent behavior among young people taking SSRIs might be needed.”
In a major story, the New York Times presents the re-analysis by David Healy, Jon Jureidini, Mickey Nardo and others of Study 329, published in the British Medical Journal yesterday, that finds "five of six adverse events labeled 'emotional lability' in the original study involved suicidal thinking or behavior but were not presented as such." The re-analysis, according to the Times, "reverses an earlier conclusion that caused a long-running dispute, and opens the way for journals to post multiple interpretations of the same experiment."
The authors of Study 329 began recruiting adolescents for a comparative study of Paxil, imipramine and placebo in 1994 and finished their investigations in 1997. They dropped a large number of their original cohort, so the randomness element in the study must be open to question. Late in 1998, SmithKline Beecham, the marketers of Paxil, acknowledged in an internal document that the study had shown that Paxil didn’t work for adolescents in terms of the two primary and six secondary outcomes they had established at the start of the study. In a nutshell, Study 329 was negative for efficacy and positive for harm, contrary to their succinct upbeat conclusion.
Probiotics have certainly become quite the rage across the world for the treatment of all kinds of ailments from irritable bowel syndrome (IBS) to infectious diarrhoea to stress to low mood. Some might say that the enthusiasm has been rather slow to develop. Recently, the popular press has propagated the idea that probiotics are the next antidepressants.
The Chronicle of Higher Education has called the soaring rates of anxiety and depression among college students an “Epidemic of Anguish.” PBS interviews Jennifer Ruark, the editor of the Chronicle series, and Micky Sharma, the director of counseling at Ohio State University. Ruark reports that about “1 in 4 students reporting to campus counseling centers now are already on some kind of psychotropic medication.” Sharma adds, “just because a student is crying does not mean he or she needs psychotherapy. Sometimes that’s actually the type of emotional response that I would want to see.”
A new study out of the University of Missouri examines the relationship between forgiveness and depression. Medical Daily reports, “while your therapist might tell you to forgive yourself when times get tough, it’s not always just self-forgiveness that decreases depression. Rather, forgiving others seems to have the most positive impact.”
In the September issue of The Journal of the American Medical Association (JAMA) three FDA advisory committee members describe the convergence of factors that made the committee’s recommendation to approve flibanserin especially challenging and politically charged. The authors of the JAMA editorial, Walid Gellad, Kathryn Flynn, and Caleb Alexander, all served on the FDA scientific advisory committee that ultimately recommended approval of flibanserin for the treatment of hypoactive sexual desire disorder (HSDD). They list all of the following factors as explanations for what made the committee’s decision so difficult in this case, but do not offer a thorough explanation as to why the drug was ultimately approved despite these issues.
In contemporary U.S. culture, people who intentionally hurt their bodies are called “insane.” We may starve ourselves or carve ourselves, taking to the extreme culturally-embedded norms like thinness in an effort to fight against marginalization or cope with internalized shame. But instead of obtaining the voice or place in society we yearn for, we are further ostracized.
In addition to hosting the Panorama programs and The Famous Grouse history of Study 329, Study329.org has a comprehensive timeline on the origins of concerns about the SSRIs and the risk of suicide, initially with Prozac and subsequently with Paxil/Seroxat. The hope is to provide a comprehensive repository for anyone who wants to study SSRIs, RCTs, and Study 329 in particular.
The International Business Times covers a new study showing “trials for new antidepressant medications may not be applicable to the population at large.” “The finding, published in the Mayo Clinic Proceedings, shows recent trials are less generalizable than the prior studies, as researchers excluded most depressed patients from drug company-sponsored treatment studies.”
Writing for Truth-Out, hurricane Katrina survivor G. Maris Jones writes: “To adapt to a changing climate, survivors of these catastrophes - especially those in marginalized, low-income communities - need long-term physical and mental health services.” She adds a concurrent call to “assume our responsibility to make positive change through action on climate change.”
Willingness to interact with someone with a mental health diagnosis may be tied to the misperception that disorders can be transferred from one person to another, according to a new study published in the Journal of Memory & Cognition. More →
In this week’s NY Times Modern Love blog Hannah Louise Poston tells the story of living with her severely depressed boyfriend, Joe, and how her decision to buy a kitten improved their relationship. “The next morning when we woke up, the first words out of Joe’s mouth were, ‘Where’s the kitten?’ And the kitten’s first act, when she heard his voice, was to ice-pick her way up the quilt and jump on his face. That same summer, Joe mustered the energy to make major changes in his life…”
People who have long-term, recurrent depression eventually develop smaller hippocampi in their brains, according to research published in Molecular Psychiatry. And University of Sydney psychiatrist Ian Hickie, a co-author of the study, told The Guardian that there exists "a good bit of evidence" that antidepressants provide a neuroprotective effect against such hippocampal shrinkage. Hickie apparently did not clarify to The Guardian, however, that the particular study he'd just co-authored had actually found the exact opposite -- that antidepressants were associated with greater hippocampal shrinkage. More →
Continuing to take antidepressants during pregnancy was associated with higher rates of depressive relapses, hospitalizations and self-harming than stopping antidepressants, according to a study in Pharmacoepidemiology and Drug Safety. More →
The relative effectiveness of Cognitive Behavioral Therapy (CBT) in alleviating depression has been declining steadily for the past 40 years, according to a study in Psychological Bulletin. More →
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