Archive for depression
FDA fails to reduce accessibility of paracetamol despite 450 deaths/ year
It’s just Tylenol, right? Give it to your child to lower a fever, right? (Despite the fact that antipyretic therapy–lowering fever-has NEVER been studied as either safe OR effective!) Try to figure this one out– L-tryptophan, a very effective treatment for depression that was heavily used until 1989 when 37 deaths occurred due to contaminated shipments (95% of which came from one single out of the US company…), was banned by the FDA and still is not available. If my math is correct, since that time, 5,850 deaths have occurred due to UNCONTAMINATED paracetamol. Can you say “bias?”
bmj.com Moynihan 325 (7366): 678
Folic acid, ageing, depression, and dementia
The concept that nutrition and physiological function play a role in psychological health has an astounding amount of literature to back it up. That would include problems with thyroid function, adrenal function, heavy metal toxicity, hypoglycemia, B vitamin status…the list is virtually endless. This concept, however well founded and research, still has made it nowhere near clinical psychological or psychiatric practice. This needs to change. Too many times I see many patients in my office that have been on changing antidepressants for years without any real success. Remember that these drugs in no way, shape, or form address either underlying physiological dysfunction NOR psychological issues.
DHA Fatty Acids May Reduce Postpartum Depression
With all the hype in the past few months on postpartum depression with the Andrea Yates trial, this article is quite timely. This article cuts across so many issues related to the intake of DHA, an essential fatty acid, in the mother’s diet. Improvement of early infant development while nursing, lowered incidence of postpartum depression, heavy metal contamination of seafood and DHA deficiency during pregnancy (especially in light of a standard Western diet). Very important article for anyone dealing with pregnancy and infant development.
ACS Abstract: AGFD 28 (495307). April 8, 2002.
Several studies summarized at the 223rd national meeting of the American Chemical Society on April 8 suggest that docosahexaenoic acid (DHA) fatty acid supplements given to nursing mothers may improve early infant development. DHA supplements may also reduce the incidence of postpartum depression.”We believe that the high incidence of postpartum depression in the United States may be triggered by a low dietary intake of DHA,” presenter David J. Kyle, PhD, from the Mother and Child Foundation and Advanced BioNutrition Corp in Columbia, Maryland, said in a news release. “The higher the intake of DHA, the lower the incidence of depression.”A 1998 study by Joseph Hibbeln of the National Institutes of Health found a significant inverse correlation between DHA intake and incidence of clinical depression, and a more recent study by Hibbeln found the same relationship between DHA levels in breast milk and incidence of postpartum depression. During pregnancy, the placenta pumps DHA from the expectant mother to the fetus, increasing the mother’s susceptibility to depression. Maternal diet influences the level of DHA in breast milk. “The DHA content of mother’s milk in the United States is among the lowest in the world,” Kyle said, noting that daily dietary intake of DHA is about 40-50 mg in US women, 200 mg in European women, and about 600 mg in Japanese women.DHA supplements of 200 mg daily double the DHA content of nursing mothers’ milk relative to those who received placebo, according to a study by Craig Jensen from the Baylor College of Medicine in Houston, Texas.”The toddlers who were nursed from the mums getting the extra DHA performed significantly better [on standard neurological motor function tests] than those toddlers nursed from mums who were getting the placebo,” Kyle said.Last year, the FDA approved the addition of DHA to infant formulas. Women who want to increase their DHA levels can take dietary supplements or eat more tuna, salmon, algae, and other foods rich in DHA. To avoid mercury contamination, however, current guidelines suggest limiting fish to 12 ounces of cooked fish per week during pregnancy and breastfeeding, and avoiding shark, swordfish, king mackerel, and tilefish.
Effects of Ethyl-Eicosapentaenoate in Patients with Ongoing Depression Despite Apparently Adequate Treatment With Standard Drugs
1 gram/day of EPA shows a dramatic improvement in depressive ratings for patients in this small study with no side effects. This is not the first trial to show a benefit for essential fatty acids and psychological health.
A Dose-Ranging Study of the Effects of Ethyl-Eicosapentaenoate in Patients With Ongoing Depression Despite Apparently Adequate….
As I’m sure you’re well aware, drugs to lower cholesterol are among the most successful in history. But the list of side effects is quite long, and it just got longer.
I have covered many of the common cholesterol lowering drug side effects in a previous article that can be read by clicking here. Many of these side effects can be predicted based on the fact that statins, while lowering your cholesterol number (and let’s face it–that’s pretty much all they do is lower the number of a single marker in your bloodstream) they also block the production of a compound called Coenzyme Q10, or CoQ10.
Another name for CoQ10 is ubiquinone is because it is present everywhere in our cells. And it’s there because it’s important for every single cell to generate energy for that cell to function the way it was supposed to function. Kind of makes you wonder why Mother Nature put the path to create cholesterol on the same path as something as critically important as CoQ10, huh?
So basically, when a cholesterol lowering drug lowers CoQ10 in the cell, all kinds of bad things can happen to pretty much every cell in the body, the worst side effect being death from fatal rhabdomyolosis, a condition where your muscle essentially melt away from the massive damage. The debris that gets kicked into your circulation essentially shuts down the kidneys.
Most notably, any cell with a high metabolic activity that requires lots of energy (in the form of ATP) can suffer from the statin class of drugs. That is why the heart can be damaged by statins (kind of ironic, don’t you think) and why muscle aches and pains are the greatest problems with statin use.
However, the largest utilizer of glucose in the human body at rest is the central nervous system. Yes–your brain.
So, could this class of drugs to lower cholesterol lead to brain damage? It certainly makes sense and is supported by the results in this particular study.
Granted, the group of patients studied were patients who had pre-existing cardiovascular disease (and would almost all be put on statins) and had an implantable cardioverter defibrillator (ICD) put in as a result. So maybe not your average population and probably doesn’t apply to you directly. However, it is highly likely that the brain cells of these patients with the ICD function pretty darn close to the way your brain cells function, so don’t dismiss the results too quickly.
For those of you in the mental health field, researchers used both the Hospital Anxiety and Depression Scale and the Medical Outcomes Study Short Form 36-item Health Survey. Overall, of 409 patients in this study, 60% were on statins.
Here’s what they found on statin use (regardless of the type of statin used or the dosage):
- Associated with poorer physical role limitations (basically–physical things were more challenging).
- Poorer social functioning
- Poorer emotional role limitations
- There was an association with depression and physical functioning as well, but the relationship was not as strong.
- Overall, statin therapy was associated with impaired health status on 3 of the 8 on the SF36-item Health Survey (Tweet this).
Overall, it was clear that, at least in this specific population, statin drugs led to a deterioration in health and mental health status as a result of taking drugs to lower cholesterol. To be fair, the benefits of the statin class of drugs IS better in secondary preventation (preventing a second heart attack) so the risk / benefit ratio may be different than in primary prevention (preventing that first heart attack).
However, remember that lifestyle changes (my recommendations can be found by clicking here) do NOT worsen cognitive function or damage muscles or increase the risk of arthritis or make your eyeballs pop out and dangle by the optic nerve.
Brain health involves conditions such as migraines & seizures, dementia & Parkinson’s, depression & anxiety. Self help for depression centers on good brain health.
This is certainly not the first time I’ve discussed the research as it relates to functional medicine and depression and / or anxiety. While many may think that depression is what it is and there is little that we can do to effect it (either positively or negatively), this is far from reality.
As I have mentioned before, exercise is arguably one of the most potent brain tonics on the planet. Unfortunately, when you’re in the throes of depression, exercise is likely the last thing you’re going to be able to pull off. I have argued that, in this case, there are clearly lifestyle changes that can be done to improve your mood that even someone in severe depression can adopt. These can be as simple as avoiding artificial sweeteners and diet soda, as I have covered in a recent article that can be read by clicking here.
Much like everything else when it comes to chronic disease, prevention is always infinitely easier than a cure. Incidentally, for pancreatic cancer, prevention really is the only answer…
Well, depression is no different. You need to adopt and maintain the optimal lifestyle to lower your risk of developing depression in the first place. But it’s all family history and situational, isn’t it? There’s nothing you can really do to change whether clinical depression will strike or no.
Not according to researchers in this particular study.
Here are the details that researchers put together:
- 4215 participants in the Whitehall II Study (an ongoing study done in UK civil service employees).
- Healthy diet scores were computed in 1991–1993 and then again in 2003–2004.
- For the detail oriented, recurrent depressive symptoms were defined as having a Center for Epidemiologic Studies Depression Scale score ≥16 or self-reported use of antidepressants in 2003–2004 and 2008–2009.
Basically, the participants were evaluated according to accepted scales of depression or by his or her use of antidepressant medications over a period of 5 years and compared this to how healthy his or her lifestyle was. Here are the results:
- Better lifestyle was related to a 59% lower risk of recurrent depressive symptoms in women, but not in men (Tweet this).
- Women who maintained high lifestyle scores or during the 10-y measurement period had 65% lower odds of subsequent recurrent depressive symptoms.
- Women who improved their scores had a 68% lower risk of another depressive episode within the study timeframes.
- Specifically, vegetable, fruit, trans fat, and the ratio of polyunsaturated fat (such as olive oil and nuts) to saturated fat components were associated with recurrent depressive symptoms.
Overall, this study suggests that, at least in women, lifestyle choices (in this case exclusively dietary choices) play a very strong role in preventing depressive episodes and, even more importantly, preventing a second depressive episode.
One could argue that ANY patient who experiences depression and manages some degree of recovery
I’ve covered many of the risk factors for depression over the years in this blog. Of course, top of the list of powerful tools to manage depression is exercise, but I understand that when you’re depressed, getting the motivation to exercise is just short of impossible. That is why making the right lifestyle choices becomes critical to lower your risk of depression in the first place. Or, once you’re there, there are simple changes you can make to begin to turn your brain health around.
I have covered simple, natural approaches to depression in a prior article that can be read by clicking here. These are simple changes you can make that do not require the motivation that exercise does. That same article covered the long list of potential side effects associated with antidepressant use as well.
Despite all of this, as with everything else, prevention is key. This includes all the same lifestyle choicees that you need to adhere to in order to lower your risk of heart disease, diabetes and cancer. My recommendations can be found by clicking here. It makes sense, though–treat your body right and your brain health will follow. And at least you don’t need to remember a different lifestyle list for each disease you want to prevent. Makes it much easier, right?
So what hidden factor are we talking about in this particular article? Before we go any further, I do need to clarify something. This study has not been published in a peer reviewed journal (yet). Rather, it is a presentation of a completed study that will be given during the 2013 annual American Academy of Neurology meeting. It was also a study looking at seniors, not the general population. However, since a senior’s brain works pretty much the same as everone else’s brain (albeit with maybe a little more clutter), I feel that making the jump to everyone else is not a big one.
No regular reader of this blog will have any doubt that I absolutely despise the use of any form of artificial sweeteners and the bulk of the research suggests that they do nothing good and contribute to diabetes and weight gain. But despite the research, society is firmly entrenched in the use of these substances. So much so that the newest USDA recommendations for food in schools allows diet sodas to be sold in high schools.
Here are the summaries of the findings of a review of 263,295 adults, aged 50-70, (that’s a lot, in case you were wondering):
- 4 cans or cups of sweetened soft drinks each day had a 30% increase in risk of depression.
- The increased risk with diet soda was 31%.
- Regular soda was 22% (yes-diet soda was worse for your brain than regular).
- Diet iced tea upped risk 25%.
- Fruit punch was implicated as well at 38% increased risk.
- Diet fruit punch ramped up risk a massive 51%.
- Regular fruit punch “only” increased risk 8%.
- Overall, aspartame (Nutrisweet) showed a 36% increase risk of depression (Tweet this).
- On the other hand, 4 cups of coffee daily lowered risk 9%.
Clearly, artificially sweeteners are NOT good for the brain. Period. And don’t think that, because you use Splenda instead of Nutrisweet, that you are safe. Don’t count on it.
If you do still consume artificial sweeteners (consider your gum, your drinks, even your mouthwash), would you like to share why?? Inquiring minds want to know…
Morning Light Therapy for Treatment of Antepartum Depression
Now we must be very careful instituting therapy such as this. While we know that many antidepressants are approved by the FDA for use in nursing mothers, this light therapy thing should be avoided until proper studies are done identifying the risks. All kidding aside this small study showed a tremendous benefit for a condition that can be problematic to treat, especially if the mother is nursing. With a therapy like being exposed to light in the morning, why wouldn’t anyone try this as a first line of attack? Couple that with exercise and proper diet and I’m sure response will skyrocket.
American Journal of Psychiatry — Abstracts: Oren et al. 159 (4): 666 -
Addition of Omega-3 Fatty Acid to Meds for Depressive Disorder
While this is only a small study, I feel that it is incredibly important. I know that in my office I see many patients on pschoactive drugs. Many of these patients experience weight gain as a side effect, and are frequently bounced around between meds to see which “works best.”
This study uses fish oil as an adjunct to pharmaceutical intervention. How about using fish oil as one tool in the package to include dietary changes and exercise? I think we would find management of depression in this way much more effective with little or no adverse effects.
American Journal of Psychiatry — Abstracts: Nemets et al. 159 (3): 477 -
Specialists challenge claim that fluoxetine plus talk therapy works best for depressed adolescents
This is a brief article that questions the results of a study comparing placbo to cognitive behavioral therapy to Prosac to a combo of CBT and Prosac. The dialogue is interesting and the author suggests that this very expensive study ($17million) showed no benefit of Prosac to placebo. In one of the Rapid Responses to this article, one author gives references to studies that show a causal association between antidepressants and cancer. This association is new to me but I will keep my ears open.
Specialists challenge claim that fluoxetine plus talk therapy works best for depressed adolescents — Lenzer 329 (7465): 529 .. -