Category Archives: Medication

Statins or Omega 3 fish oil?

Statins are a type of drug often prescribed to lower cholesterol levels. They are usually given to people who have high cholesterol and are therefore at risk of developing, heart disease and atherosclerosis or at risk of having a stroke. These drugs are very effective at reducing cholesterol as they work by inhibiting a chemical in the liver that helps to produce cholesterol.

Are they all they’re cracked up to be?

Statins are widely prescribed and have been for some time but their use is still controversial. Some studies have linked prolonged use of statins with certain types of cancer but the results have not been consistent.

They can, however, produce a number of side effects which include headache, stomach pain, bloating, nausea, skin rashes, and occasionally more serious side effects such as muscle pain and kidney failure.

Omega 3 fatty acids

Omega 3 fish oil is now well known to reduce the risk of heart disease as well as many other health conditions including everything from arthritis to skin problems and even depression. The reason for this is that Fish oil produced from oily fish such as Salmon, Sardines and Tuna, contains important Omega 3 fatty acids that the body needs but cannot make. One of the most important Omega 3 fatty acids is Eicosapentaenoic acid or EPA which is believed to be largely responsible for the beneficial effects on health.

Many studies to date have shown that fish oil reduces inflammation, thins the blood, and helps to maintain healthy arteries, lowers blood pressure, as well as lower triglyceride levels and levels of so called bad cholesterol.

Fish oil is considered safe to use and carries very few side effects, the most common being a fishy aftertaste in the mouth and fishy burps.

What about both?

Most people won’t question the use of Statins and will take them because they have been prescribed by their doctor, however, more and more people, including doctors are becoming aware of the health benefits associated with fish oil. It has to be said though that most doctors are still unlikely to prescribe or recommend fish oil alongside or instead of statins but this is starting to change.

Fish oil with a kick

It takes time for the results of studies to filter down into the doctor’s surgery but now, drug regulators in Australia have approved a concentrated form of Omega 3 fish oil for use by people who have had a heart attack or who are already taking Statins and beta blockers. It’s only available on prescription though. Experts have described the new Omega 3 “drug” as “fish oil with a kick”.

 

According to Yahoo News Professor Gerald Watts, from the University of WA’s school of medicine and pharmacology at Royal Perth Hospital, welcomed the approval of the new drug,

“It’s safe, it’s simple and will cost the punter some money but it will probably be pretty appealing as an extra insurance against a heart attack” he said.

The Japanese JELIS study

Probably the most major study to show the benefits of taking fish oil alongside Statin therapy is a Japanese study led by Dr Mitsuhiro Yokoyama from the Kobe University Graduate School of Medicine, Japan. The results of The Japan EPA Lipid Intervention Study (JELIS) were published in the March 31st 2007 issue of the Lancet.

The Japanese JELIS study involved 19,466 people all of whom were taking a low dose of statins for high cholesterol. Of these, 9326 were given a daily dose of 1800 mg of a highly concentrated and purified form of EPA alongside their statins, and the remainder received statins alone. Cholesterol levels were identified at the beginning of the trial and were checked after six months, after 12 months, and then yearly after that.

Reduction in risk

At a follow up just over 4 and a half years later, the results revealed that in the group taking EPA alongside statins there was a 25 percent reduction in cholesterol levels in both groups.

In the group that was given EPA alongside statins there was a 19 percent reduction in the risk of major coronary events which included death from heart disease, heart attack, unstable angina, and the need for revascularization.

“The beneficial effects of EPA could have stemmed from many biological effects that lead to the attenuation of thrombosis, inflammation, and arrhythmia, in addition to a reduction of triglycerides” said the authors.

“Overall, this study shows that EPA, at a dose of 1800 mg per day, is a very promising regimen for prevention of major coronary events, especially since EPA seems to act through several biological mechanisms.”

Taking into consideration the results of the JELIS study it would appear there is some benefit to be had by supplementing with fish oil whilst taking statins, however, it’s important to note that the fish oil used in the study was a highly concentrated and purified form of fish oil. Anyone who wishes to take fish oil alongside statin therapy should speak to their doctor or health care professional first.

Childhood Mental Ailments Targeted With New Treatments

The causes which underlie childhood obsessive compulsive disorder along with Tourette’s are to be targeted by new treatment options.

To date there have been many similarities in how these two disorders have been treated, pertaining to their sharing of similarities in their psychiatric features, the genetic factors inherent, and the environment in which they present themselves.

But more effective treatments are now being put forward.

The Journal of Child and Adolescent Psychopharmacology is a peer-reviewed journal that in its latest issue contains the new ideas. The Guest Editor, one Barbara J. Coffey, MD, MS concludes that “studies are still few, and validated predictors, moderators and mediators of treatment response are still very much needed.”

Riluzole

Promise has been shown for the treatment of the conditions by Riluzole, a drug used for the treatment of neurodegenerative disease amyotrophic lateral sclerosis. It is evidential from clinical trials taking place that it can also be used for treatment of OCD in children, however there is further study needed to access the side effects. The potential of this drug being used in this way is outlined by Jane Song, Paul Grant, and Susan Swedo of the National Institute of Mental Health as, being of potential benefit in helping to control the symptoms of OCD.

Pancreatitis

This benefit is possible based on Riluzole’s ability to block the releasing of glutamate from nerve cells. It has been used at therapeutic doses, yet there have been instances of pancreatitis in children to date as a side effect of use, which is causing concern obviously.

Tourette’s Breakthrough

The vocal tics associate with Tourette’s have undergone new study too, with the avenue of new treatments the goal. It has been determined that these vocal tics occur because of how neural networks, brain circuits, and chemical neurotransmitters behave in the affected person.

Brain Images

It is now expected that new brain scanning technology will help to find a better treatment allowing for more specific targeting of brain regions as can be pin pointed through the brain imaging.

Infectious Disease Onset

It is also being discussed in this new edition of the journal how infectious diseases may lead to the onset of such conditions, with Streptococcus becoming increasingly linked with certain Paediatric Autoimmune Neuropsychiatric Disorders.

There is a push given for the link between infectious diseases and these conditions to be further explored, and a panel of experts setup for the exploration of new treatments based on the infectious disease mechanism.

Background

Tourette’s syndrome affects the brain. It is mainly evident in its causing movements outside of the control of the individual and leading to the development of nervous tics. In milder cases it is less likely that the condition will ever be diagnosed.

In the main if Tourette’s is to present itself in the individual then it will do so when the child is quite young, usually between the ages of five and seven years old.

Therapies

There are new behaviour therapies for Tourette’s increasingly becoming available. These can be in the restraining therapy form, which can serve to counter the nervous tic associated with the condition.

Exposure and response therapy is another method of treatment which has the same function. Talking therapy has been found to deal with the condition also. Here it is evident that just talking through the condition with a psychotherapist, may lead to the individuals’ ability to cope with their condition.

The bulk of the medicines currently in use to better the condition are along the lines of neuroleptics, they do however come with certain side effects which may leave the individual having a ‘jerk’ response giving the illusion that the condition is getting worse and not better. This is only at first however and the condition will become less severe with time.

It is Only the Most Depressed who Benefit from Anti-depressants

A new study has shown how it is only the most depressed people who benefit from antidepressant medication. The UK study has made the suggestion that antidepressants are no more useful than a placebo in those people who are anything other than very depressed.

It was a meta-analytical study which systematically pools other studies results. The key man in the studies undertaking was one Dr Irving Kirsch from Hull University. He allowed his findings to be published in PLoS Medicine.

Amongst the antidepressants used in clinical depression treatment the most common ones used are SSRI’s like Prozac and Effexor, these are called in the study “new generation” drugs.

The study uncovered that just as had been noted as a possibility from other meta-analytical studies, when you include the findings of unpublished trials there is barely any difference for the majority of users of these antidepressants, than were they to be on a placebo only. The differences are so small that they fall out of clinical significance.

This was evident from previous studies of this type, but what was never covered to this point was the level of depression a patient needs to be suffering from before an impact is realised from taking the drugs. All of the data that has been administered to the FDA was pooled by the UK researchers with regards to this “new generation” of drugs. The fact that the study included unpublished trials was significant. By this means a bias was avoided, as many drug companies cover up their trials and do not publish them when the results show disappointing results for their drugs.

The serotonin reuptake inhibitors that are the “new generation” of drugs work by stabilising the chemicals in our brains, ones that are known to influence our moods. They make more serotonin available to assist with mood. The results found determined that: Drug-placebo differences were seen to heighten as the severity at the point of beginning went up. Also the variation in result was barely noticeable when the initial depression was at moderate levels.

There was however a relatively small amount of difference in results for patients with severe depression. The differences however were only of a clinically important level when these ‘new generation’ drugs were used in the treatment of patients at the extreme end of the depressed scale.

The professors made the deduction in their research that; “Drug-placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients.” They also stated that, “The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication.”

Personality Speaking Antidepressants Work

A new antidepressant treatment study now suggests that it is in personality, and in the changes to that personality through taking particular antidepressant medications like paroxetine (Paxil) that bring about improvement in the patient.

The study shows that it may not be down to the medications ability to lift mood, but may actually be born out of the direct effect of the drug, and by this means depression is lifted.

Where neuroticism is evident in a person, whereby they are more prone to experience negative emotions, and mood swings it is in these people where depression is likely to emerge. This neuroticism is just one of 5 traits of personality which scientists are now using in order to organise the understanding of personality. On the list also are openness, agreeableness, conscientiousness, and extraversion.

Whilst it has become evident that levels of neuroticism decrease when a patient undergoes antidepressant treatment, also reported is an increase in extraversion levels and a lifting of depression symptoms. It was up to this point assumed that these personality traits change was more the result of the lifting of the depression and not the cause.

It is out of studies in twins that evidence has emerged how to a large extent those very same genetic factors underlie risk of both depression and neuroticism. It has also been concluded through research how the neurotransmitter that is serotonin, does play a role in both neuroticism and extraversion expression. The serotonin reuptake inhibitors actually cause an increase to the neurotransmitters availability.

Investigator Tony Tang set about a course of investigation to test out the relationship that exists between SSRIs and the personality of the patient. Tony and colleagues of his at Northwestern University, Evanston, IL, the University of Pennsylvania in Philadelphia, and Vanderbilt University in Nashville, TN, made a random assignment of people suffering from disorders like (MDD) Major Depressive Disorder. These persons were then treated with paroxetine, placebo and cognitive therapy. It was one or the other, with 120 of the 240 individuals in the study using the drug.

The study shows how the placebo didn’t have the effects of the cognitive therapy and the drug. After eight weeks of study this was determined and along with that fact it was seen that the measure of neuroticism in the patient who received these two treatments also dropped. There was an increase in these two sets of patients with regard to rises in extraversion also. The changes were described as ’striking’ by the scientists.

There were small changes with regard to both character traits in the placebo taking patients, but with those who were actually taking the drugs the results showed a change by as much as a factor of eight.  Whilst the degree of improvement in the actual depression may have been the same for the placebo and the drug taking groups, there was a much higher rate of personality change on the drug taking patient. The suggestion from this research is that it is not the result of the drugs lifting depression that brings the personality change but the drug itself.

There were also decreases in depression levels amongst those treated by CT, these persons experienced a heightening in their levels of extraversion, however their levels of neuroticism were not affected.

New Antidepressant Boosts Brain Connections Fast

It has been found that a new and experimental drug has the ability to eradicate depression in mere hours. Its working are based around stimulating the connections between cells in the brain, it is called ketamine and triggers a key enzyme useful in treating depression by quickly generating new synapses.

Dr Ronald Duman who led the research team is a Yale University man. Their findings have been released and published in the journal Science. Dr Ronald has stated, “Discovery of this cellular mechanism helps point the way to development of a ketamine-like agent that could become a practical, rapid-acting treatment for depression.”

With the antidepressants currently on offer not working for 40% of those who are depressed, and slow to commence working, the dramatic effects of ketamine are quite astounding. Studies have found to this point that with ketamine use in the treatment of both bipolar depression and depressive disorder, that 70% of patients who had been treatment resistant in the past showed a dramatic improvement just a day after receiving their first dose.

The drug must be administered through the veins of the patient, and there are significant side effects possible out of its use, as a result the doctors have concluded that ketamine is not a practical treatment in itself, but it has moved researchers into hunt mode for similar agents that might work by the same means as ketamine.

It was the research of these scientists which have now managed to ascertain the means by which the drug works. Whilst those drugs which are currently prescribed, work through the chemical messengers of the brain with regards to serotonin release, ketamine works through another system, the glutamate system. The Serotin drugs work by triggering events stimulating the creation of new neurons, and by this means establishing new connections (synapses) with other neurons, and thereby improving activity in the brain circuitry, this explains the delay in working.

Ketamine on the other hand offers speedy results using the glutamate system which acts more directly, in a way it works with those elements of the brain that are at the root of the problem. Whilst it was a known that ketamine does a blocking job on the binding of glutamate with receptor proteins on the membranes of the cell (NMDA receptor) the team took an approach of determining the pathway the signal takes when triggered by the blockade of the receptor.

When research was conducted with rats, the researchers found that in the rats prefrontal cortex (front of the brain) when a low level of ketamine was introduced it activated activity of the enzyme. This then went on to make proteins, which in turn went quickly on to form new connections (synapses) between neurons. Its activities are determined to be different than those of normal antidepressants or ECT treatment.

It has been found that depression and stress produce in the body the very opposite of what ketamine achieved. These mental ailments cause the synapses to shrivel. The ketamine however boosts the creation of these synapses in as little as two hours. In rats it was found that the drug reduces symptoms of depression brought about courtesy of stress in a day and the effects are ongoing for at least seven days.

10% of Americans are taking antidepressants

31 million USA Citizens have been shoving pills down their throats in order to alleviate the feelings of sadness that have become paramount in our society. Worldwide the figures are less staggering, primarily due to less diagnosis of the issue in conjunction with a ban on TV advertisements for pharmaceuticals. TV advertisement of drugs has led the USA to the point where an American enters into their doctor with a request for a particular type of medication. European and other world nation nationals have not been so eager to eat up Celexa, Luvox, Prozac in greater quantities as have the Americans.

The use of antidepressants in this manner contributes to the coffers of pharmaceutical firms in The USA to the tune of almost $10bn per annum. For all of the eating pills like M&M’s though it seems that the bulk of those doing so, might as well be eating M&M’s. Sugar pill placebos have been found to be exactly as useful in combating the symptoms of depression as antidepressant pills. That is according to a new landmark study published in the Journal of the American Medical Association.

It is the American mentality of turning to meds without dealing with their own behaviour first that has led to this epidemic of pill popping, according to the study. Changes in lives need to be made before doctors medicate ‘unhappiness’ according to one of the key authors of the report. Maryland medical doctor Ronald Dworkin said, ‘If you are beating your nose with a hammer, do you stop hitting yourself, or do you continue, and take a pain pill?

There is evidence too that the results of many studies that outline how antidepressant tablets do not work have been swept under the carpet so to speak. There is no difference in many cases between a small and a large dose of such anti-depressant medications. Less than 50% of people who take even multiple types of antidepressant medications ever become symptom free. And even those who do manage to achieve results often slip back into a depressive state.

All this and one would wonder, what is the point? The user must deal with insomnia, nausea just two examples of the negative side effects attributed in many cases to the taking of such medications. Diarrhea and sweatiness also abound for many amongst the 31 million users. There is the problem of withdrawal in addition. Popping a pill will not help sort out the factors in life which lead to happiness, the intangible things like life, love, and family that bring about our ultimate satisfaction.

Antipsychotic medication and risk of blood clots

A new study has highlighted an increased risk of dangerous blood clots when taking certain types of antipsychotic drugs like the ones used to treat mental illnesses like bipolar disorder and schizophrenia. These antipsychotics can also be used on occasions to combat persistent nausea and are sometimes given to patients with dementia to calm them down.

Other studies in the past have suggested a link between having a stroke and antipsychotic medication but this latest study is the strongest one yet.

The study was conducted by researchers from Nottinghamshire County Teaching Primary Care Trust and involved analysis of data on over 25,000 people with blood clots and 90,000 people with no blood clots.

What the results revealed was that there was a 32 percent increase in the risk of suffering from a blood clot like deep vein thrombosis (DVT) or a clot in the lung (pulmonary embolism) if you took these antipsychotics.

Almost 16,000 of the 25,000 people in the study who had suffered a clot developed a DVT and just over 9000 suffered a clot in the lung and those most at risk were the ones taking the newer so called ‘atypical’ antipsychotics. They had a 73 percent increased risk compared to a 28 percent increased risk when taking other types of antipsychotics, furthermore, the riskiest time seemed to be shortly after starting to take the new drug.

“Although the overall risk of a stroke is low, the results of this study remind us that antipsychotics are powerful drugs and should be prescribed carefully, with regular follow-ups” said Dr Sharlin Ahmed from the Stroke Association.

However, as the researchers did note and the NHS news pointed out, this risk is still very small and that overall, the people in the study only had a 0.1 percent chance of having a blood clot each year.

The NHS is therefore saying that people taking these antipsychotics should not be overly concerned by this news and should not stop taking their medication but if they are worried they should speak to their doctor.

NHS news also say that a systematic review would now be the best way to look at the evidence and point out that the authors themselves recommend further study before changes in clinical practice be recommended.

If further research confirms these findings then it may be that the drugs have to be used more cautiously in high risk patients.

This latest research has been published in the British Medical Journal.

Music Prescriptions For Depression Instead Of Drugs?

Scottish scientists from Glasgow Caledonian University are looking at ways of combining sound engineering technology and psychology which could pave the way for offering music therapy as a treatment for depression and other mental health problems and maybe even pain.

It has long been known that music can have an impact on mood but this research takes that a lot further and backs up that belief with science.

A group of volunteers have been identifying which emotions were associated with certain music and the researchers have been carrying out a detailed analysis of that music’s rhythm, tone, pitch, lyrics and melodic range as well as other factors.

“The impact of a piece of music on a person goes so much further than thinking that a fast tempo can lift a mood and a slow one can bring it down” said Dr Don Knox, an audio engineer and leader of the project

“Music expresses emotion as a result of many factors. These include the tone, structure and other technical characteristics of a piece. Lyrics can have a big impact too.

“But so can purely subjective factors: where or when you first heard it, whether you associate it with happy or sad events and so on. Our project is the first step towards taking all of these considerations – and the way they interact with each other – on board.”

The scientists hope that as a result of the research they will be able to develop a mathematical model that will explain the ability of certain music to communicate a range of emotions and create computer software that would identify which music would be the best music to help treat patients.

“By making it possible to search for music and organise collections according to emotional content, such programs could fundamentally change the way we interact with music” said Dr Knox.

“Some online music stores already tag music according to whether a piece is ‘happy’ or ‘sad’

“Our project is refining this approach and giving it a firm scientific foundation, unlocking all kinds of possibilities and opportunities as a result”.

The project which was started nearly three years ago is due to be completed later this year.

The implications of the research are that patients could one day be prescribed music to treat their depression, and music that has been tailored specifically to their needs.

Horse tranquiliser could be the new magic drug for depression

Most anti-depressant drugs take a few weeks or months before any positive effect is felt but now researchers are claiming that Ketamine, a drug traditionally used as an anaesthetic and a tranquiliser for animals, can reduce the symptoms of depression in humans within hours and the effect lasts for days.

Around 40 percent of people who are diagnosed with depression don’t respond to anti-depressant medication and for many it’s a case of trial and error to find a drug that works and in some cases this can take years. Ketamine appears to be effective even on people who do not respond to other drugs and it gives the anti-depressant effect with relatively low doses.

“It’s like a magic drug – one dose can work rapidly and last for seven to 10 days” said Ronald Duman, professor of psychiatry and pharmacology at Yale and leader of the research.

Professor Duman, who led the study, found that Ketamine works differently to other drugs in that it facilitates “synaptogenesis” meaning it forms new synaptic connections between neurons that have been damaged by stress.

“Our results demonstrate that these effects of Ketamine are opposite to the synaptic deficits that result from exposure to stress and could contribute to the fast antidepressant actions of Ketamine,” the researchers said.

The findings of the Yale study have been published in the August 20th edition of the Journal Science.

The drug is not yet ready to be dished out to depressed patients on a large scale though, as the researchers reckon it needs further analysis and modification before it can be used for the general population.

At the moment Ketamine has to be injected and used under medical supervision and like any drug there can be side effects. Ketamine is highly addictive and can cause hallucinations and other psychotic symptoms.

The drug is also used on the streets and is referred to as ‘K’ or ‘Special K’ and use of this drug is on the increase amongst young people most likely as a result of the banning of the legal high drug mephedrone in April.

The worrying thing is that the class C drug is fairly easy to get hold of on the streets but used without medical supervision it can have some serious side effects such as bladder problems and pain, incontinence, insomnia and blood clotting.

Jasmine can ease anxiety and is as good as valium says German researchers

Aromatherapy is generally considered to be beneficial for relaxing, easing stress and anxiety and helping to alleviate depression; however, there hasn’t been much in the way of scientific evidence to really back these claims up.

Now Professor Hanns Hatt from Ruhr University in Bochum Germany and colleagues, says that results of recent laboratory tests could “be seen as evidence of a scientific basis for aromatherapy” reports the Daily Telegraph.

In lab tests mice whose cages were filled with the aroma of Jasmine and its chemical substitute, quickly calmed down and sat quietly in the corner. The molecules of the scent were breathed into the lungs where they entered the bloodstream and were then transmitted to the brain to produce the effects.

Subsequent brain scans showed that this had an effect on a chemical called GABA, known as gamma-aminobutyric acid, which helps to lower anxiety. Drugs used to increase levels of GABA in the brain have an anti-anxiety effect.

“Vertacetal-coeur (VC) and the chemical variation (PI24513) have the same molecular mechanism of action and are as strong as the commonly prescribed barbiturates or propofol” said the researchers.

Drugs currently used to ease anxiety can also carry unwelcome side effects but if Jasmine has the same effect on humans, then using the scent of Jasmine would carry no side effects.

Apparently after testing hundreds of different fragrances the researchers found that Jasmine increased the effect of GABA by more than five times and acted as strongly as sedatives, sleeping pills and relaxants.

“We have discovered a new class of GABA receptor modulator which can be administered parentally and through the respiratory air” said the researchers.

“Applications in sedation, anxiety, excitement and aggression relieving treatment and sleep induction therapy are all imaginable.”

The German researchers are hoping that if they change the chemical structure of the molecules they may even be able to increase the effects of the scent. The study has been published in the Journal of Biological Chemistry.

However, before rushing out to smell the Gardenias, it’s important to note that the results of this study were based on mice and frogs and as such, it’s a bit premature to presume the same effect will be replicated in humans.

Still, the results are promising and future research will no doubt shed more light on the benefits of Jasmine and aromatherapy for anxiety and indeed other conditions.