Depression in the News 2005

Some Drugs Work To Treat Depression, But It Isn't Clear How November 18, 2005 by Sharon Begley in the The Wall Street Journal.  Just what do SSRIs do?

Quoting: "There is little doubt that the SSRIs do what their name says, keeping more serotonin in the brain's synapses. But the fact "that SSRIs act on the serotonin system does not mean that clinical depression results from a shortage of serotonin," says Dr. Leo, professor of anatomy at Lake Erie College of Osteopathic Medicine, Bradenton, Fla. No more so, anyway, than the fact that steroid creams help rashes means that rashes are caused by a steroid shortage.

A clue to how SSRIs do work comes from how long they take to have any effect. They rarely make a dent in depression before three weeks, and sometimes take eight weeks to kick in. But they affect serotonin levels right away. If depression doesn't lift despite that serotonin hit, the drugs must be doing something else; it's the something else that eases depression. The best evidence so far is that the something else is neurogenesis -- the birth of new neurons.

November 16, 2005. MDSG was mentioned in the New York Times today in: Finding Information Online From Peers and Professionals by Amy Harmon. The article mentioned these sources of information on mood disorders: 

• A section of the New York Times web site devoted to Mental Health and Disorders and another devoted to Depression 
• webmd.com has information about medications and forums on mental health, moderated by doctors 
• The Food and Drug Administration maintains Daily Med System with information on dosage guidelines, side effects and the package inserts for prescription drugs
• Dr. Ivan K. Goldberg, our medical advisor and December 2005 lecturer, maintains the Depression Central web site 

Dr. Goldberg recommends being very skeptical of online information from anonymous sources. With that in mind, the article mentioned: 

• rxlist.com has unmoderated discussion groups for each prescription drug
• wingofmadness.com has discussion forums for sharing experiences
• Pendulum is an e-mail list

The article above was a companion article to: Young, Assured and Playing Pharmacist to Friends also by Amy Harmon which appeared on page 1. This article was about people who think they are familiar with prescription drugs, giving them to friends and family or trading and swapping prescriptions. 

Can Brain Scans See Depression? by Benedict Carey in the New York Times October 18, 2005. For a variety of reasons, the hopes and claims for brain imaging in psychiatry have far outpaced the science.

Paxil Alert for Pregnant Women New York Times by Benedict Carey September 29, 2005

The Food and Drug Administration posted the warning on its web site that Paxil may increase the risk of birth defects if pregnant women take it during the first trimester. Some doctors who read the letter said it was not clear whether the F.D.A.'s warning was necessary.

September 1, 2005. Goodbye, Therapist. Hello, Anxiety? The New York Times. By Susan Saulny. Quoting the article: 

"As an estimated 20 million Americans seek therapy each year - the result of a greater public awareness of treatable conditions like depression and a lessening of the stigma involved - one trend is clear: Unlike in decades past, many people currently experience therapy in short installments with various practitioners over time. That means more time spent on hellos and, perhaps more problematically, goodbyes ... Few relationships outside the realm of romance are fraught with as much potential for confusion and unhappiness at their conclusion than that of the client-therapist, a professional union built upon trust and the sharing of intimate detail ... Mental health professionals are taught how to initiate and handle termination ... Patients, however, have no guidebooks and are often left feeling anxious about how to broach the subject of leaving. For some, the anxiety takes on a life of its own." 

August 18, 2005. A 32 minute segment of the Brian Lehrer show on WNYC (93.9 FM) was an interview with Paul Raeburn, former Business Week editor, science writer and the author of  Acquainted with the Night: A Parent's Quest to Understand Depression and Bipolar Disorder in His Children - on the problems of dealing with childhood mood disorders. You can hear the show either by streaming it or by downloading an MP3 version of it. The book is also available in paperback.

April 21, 2005. Larry King did a whole show on depression. The guests were Tanya Tucker, Chad Allen, Linda Dano and Margot Kidder. A free transcript of the show (Panel Discusses Treatments for Depression) is available from CNN. 

April 5, 2005. A new study has found that cognitive therapy can help as much as antidepressants in alleviating initial chronic depression and provide longer lasting effects. 

The author of the study said:  “We believe that cognitive therapy might have more lasting effects because it equips patients with the tools they need to learn how to manage their problems and emotions ... Pharmaceuticals, though effective, offer no long-term cure for the symptoms of depression". However, the effectiveness of cognitive therapy depends entirely on the expertise of the therapists administering it. The study was published in the April issue of the journal Archives of General Psychiatry. 

• Cognitive Therapy Successful Against Depression  Health Day News  
• Talk therapy backed to treat depression Knight Ridder Newspapers 
• Cognitive therapy as good as antidepressants, effects last longer Medical News Today

March 22, 2005.  Hypomanic? Absolutely. But Oh So Productive! By BENEDICT CAREY in the New York Times. In recent decades, scientists have found that bipolar disorder is widely variable, and that its milder forms are marked by hypomanias, currents of mental energy and concentration that are less reckless than full-blown manic frenzies, and unspoiled, in many cases, by subsequent gloom. One person with hypomania said he tells people he just had a lot of coffee to explain away the firing off in all directions and the talking about anything. Dr. Kay Redfield Jamison, a professor of psychiatry at Johns Hopkins University said "... many people who are inclined to hypomanic or manic symptoms have an underlying resilience. They may get trashed by their peers, laid low, but they respond very strongly." 

In a new book, "Exuberance," Dr. Jamison argues that flights of joyous energy similar to hypomanic states frequently accompany scientific and literary inspiration. Psychiatrists have known for more than a century that bipolar disorder, unlike any other mental illness, is often associated with some financial and professional accomplishment. Mania can inspire destructive shopping or gambling sprees, but it can also generate bursts of creative and focused work.  Read more about Exuberance : The Passion for Life by Kay Redfield Jamison at Amazon.com (opens in a new window).

March 10 ,2005. USA Today. Lorraine Bracco is  ready to talk about her fight with depression in hopes of knocking out stigmas about antidepressants and their effects. She went to drug manufacturer Pfizer in hopes of getting the word out, which she'll do with a web site and a series of commercials. Bracco said she was dealing with depression for over a decade. It wasn't until 1997, after she'd been cast in The Sopranos, that she followed the suggestion of a friend to seek professional help. "I was very afraid to go on any kind of medication because I was afraid it was going to dull me, which is not true," said Bracco. "I think a lot of people think you'll become a zombie."

February 24, 2005. USA Today. Light therapy prime treatment for seasonal melancholy. Consistently dreary weather, cold temperatures and long, dark nights can lull even the most buoyant and cheery person into a depressive funk during winter. But when the funk recurs year after year and starts to impair a person's ability to function in daily life, doctors might begin to attribute this depression to seasonal affective disorder, or SAD. SAD peaks for most people in January and February and usually wears off in the spring by March or April. SAD takes at least two years to diagnose. The most viable treatment is light therapy. The article recommends not spending over $300 on a lighting unit. 

Dispute Puts a Medical Journal Under Fire by Barry Meier in the New York Times  January 17, 2005. Quoting: "On New Year's Day, the British medical journal BMJ  published a news article suggesting that "missing" documents from a decade-old lawsuit indicated that Eli Lilly & Company, the maker of Prozac, had minimized data about the drug's risks of causing suicidal or violent behavior. Within days, the article was cited in hundreds of television and newspaper reports."  

It turns out the situation is not that simple, not that black and white. Eli Lilly refuted the assertions in the article and this article makes a case that the assertions were not true. Regardless, some depressed patients taking Prozac during clinical trials experienced side effects like agitation, insomnia and nervousness. Quoting: 

"Such side effects, which are sometimes referred to as "activation," reflect the fact that some depressed patients who take Prozac and drugs like it often experience a surge of physical energy well ahead of psychological recovery. Some experts have long expressed concerns that such reactions can be so severe in a few patients that they may ultimately act on suicidal or violent impulses."

Time Magazine January 17, 2005 issue was devoted to Happiness.  The articles are not available for free, but can be read for  $1.99.