Depression

In 2014, then National Institute of Mental Health (NIMH) director, Thomas Insel, speculated that ketamine “might be the most important breakthrough in antidepressant treatment in decades.” A recent review of the research suggests that while ketamine may produce a rapid short-term improvement in depression, the effect is short-lived and the potential for addiction and dependence warrants considerable caution.

A new study on the depression symptoms of over three-thousand patients challenges the criteria used for diagnosing major depression with the latest Diagnostic and Statistical Manual (DSM-5). Current diagnostic systems are based on an assumption that the symptoms of depression point to a common underlying “illness," but research suggests that this framework may be outdated and oversimplified.

Results of a new study reveal that sixty-nine percent, or more than two-thirds, of patients prescribed antidepressant drugs have never, in their medical history, met the criteria for major depression. The study, published in the Journal of Clinical Psychiatry this month, also found that several demographic factors, like race and gender, were associated with the prescription of antidepressants.

A massive number of meta-analyses of antidepressant clinical trials have financial conflicts of interest and are unduly influenced by pharmaceutical companies, according to a review to be published in an upcoming issue of the Journal of Clinical Epidemiology. Researchers also found that meta-analyses with industry ties almost never report any negative findings in their abstracts.

The Scientific American reports on a new analysis of antidepressant trials revealing that the vast majority of meta-analyses have industry links and suppress negative results.

People diagnosed with severe depression show the same changes in brain scans when they respond to a placebo as they do when they take an actual antidepressant, according to a new study. Researchers also found that those whose symptoms were decreased by a placebo were more likely to report relief from antidepressant drugs.

The BMJ states that it takes on average eight weeks from submission of an article to publication. The review process for Restoring Study 329 took a year, with a three-month review process involving six reviewers to begin with, and then a further four reviews in a four-month process, leading to a provisional acceptance in March that was withdrawn.

There is accumulating evidence that taking SSRI antidepressants increases the risk of bleeding and other complications during surgery, according to a review published in the British Journal of Anaesthesia.

The BBC reports that the number of people in Scotland taking antidepressants has increased by 5% in the past year with most of the patients being women and those in the poorest parts of the country. “We are now looking at the flabbergasting statistic of more than one in seven people in Scotland being prescribed antidepressants this year,” Conservative health spokesman Jackson Carlaw said. “We urgently have to look at better alternatives than simply parking people on medication in the hope things don't get any worse, with no aspiration for complete recovery."

One of psychiatry's most obvious vulnerabilities is the fact that various so-called antidepressant drugs induce homicidal and suicidal feelings and actions in some people, especially late adolescents and young adults. This fact is not in dispute, but psychiatry routinely downplays the risk, and insists that the benefits of these drugs outweigh any risks of actual violence that might exist.

Prior use of benzodiazepines, such as Xanax, Librium, or Ativan, may increase the risk of treatment-resistant depression (TRD), according to a new study published in The Journal of Nervous and Mental Disease.

New research is investigating how “poverty reduction promotes cognitive and brain development.”

Nunavut, Canada’s largest and northernmost territory, is suffering from a suicide rate that is 10 times the national average. “In the case of Inuit boys 15 to 19,” CBC News reports, “the suicide rate is 40 times higher than those of their peers in the rest of Canada.”

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.”

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.”

Writing for the Atlantic, David Dobbs examines how much harm has been done in the 14 years since Paxil was wrongly determined to be safe and effective. “Study 329, as it became known, helped spur a huge increase in Paxil prescriptions,” Dobbs writes. “In 2002 alone, over 2 million prescriptions were written for children and teens, and many more for adults.” “Thousands of children, teens, and young adults attempted or committed suicide while on Paxil,” and the reanalysis of Study 329 in BMJ makes it seem “more likely than ever” that many did because of the drug.

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 Chronicle of Education has called the soaring rates of anxiety and depression among college student 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 that “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.”

This month’s issue of JAMA Psychiatry ran an editorial commenting on recent research revealing that the majority of youth prescribed antipsychotics have not been diagnosed with a mental disorder.

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.”

On Tuesday, NPR told the story of DeAngelo Cortijo. DeAngelo became a foster kid at age 3 after his mother attempted suicide. He was “diagnosed with bipolar and anxiety disorders, attachment disorder, intermittent explosive disorder or posttraumatic stress disorder,” and was prescribed “a combination of antipsychotics, antidepressants and stimulants, and was told that taking them was his only hope of being normal.” Through equine therapy, DeAngelo was eventually able to get off all of his medication. Now, California is hoping to pass reforms that would prevent foster kids, like DeAngelo, from being “prescribed antipsychotic drugs at double to quadruple the rate of that not in foster care.”

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.