Category Archives: treatment

Stem Cell Research Shows How Antidepressants Make New Brain Cells

The means by which antidepressants perform their function of making new brain cells is now understood. This it is believed will now help drug researchers develop more efficient ways to fight depression with developed medications.

It had been show by way of previous studies being carried out that the tricyclics a type of antidepressant along with the serotonin reuptake inhibitors do in fact generate new brain cells, but it was unknown up to now how this was achieved.

Key Protein

The new findings used Pfizer’s Zoloft and other antidepressants as their study matter. Researchers at Kings College London’s Institute of Psychiatry determined that this was done through a process involving glucocorticoid receptor (GR) which it is known is one of the key proteins used in the response to stress.

It was found that it is only with GR that new brain cells can be built.

Study Leader’s Words

Christoph Anacker, who is a doctorate student at the IoP and led the study, said,””Having identified the glucocorticoid receptor as a key player in making new brain cells, we will now be able to use this novel stem cell system to model psychiatric illnesses in the laboratory, test new compounds and develop much more effective, targeted antidepressant drugs.”

Global Benefit

That is the result, but what will be the real knock on benefit. Given that depression is so common, and believed to be suffered by more than 120 million individuals worldwide, it is no surprise to note how it is one of the world’s leading causes of disability. The reality is that only a quarter of these sufferers have any access to a means of treatment.

It has been shown in recent studies that there is a reduction in the process of ‘neurogenesis’ in depressed patients – This ‘neurogenesis’ is the process of developing new brain cells. This lack of being able to build new cells it is believed by researchers is why low mood and impaired memory occur in depressed persons.

Stem Cells

His team used stem cells in their work (human hippocampal) what are known as the source of new cells in the brain to show the effects play out of antidepressants, but this time on brain cells in the lab Petri dish.

The cells were treated with Zoloft which is similar in effect to Eli Lilly’s Prozac and other drugs like Paxil, these are all the SSRI class of drugs. The findings from the experiments however hold true for a different class of drugs also (serotonin and norepinephrine reuptake inhibitors (SNRIs) drugs like Pfizer’s Effexor and Eli Lilly’s Cymbalta.

Clinically Relevant Model

In a statement regarding the findings of the study Anacker said, “For the first time in a clinically relevant model, we were able to show that antidepressants produce more stem cells, and also accelerate their development into adult brain cells.”

The findings showed that the glucocorticoid receptor is positively essential; it needs to be in place for the growth to occur. This protein is then activated by the antidepressants converting immature stem cells into the needed adult brain cells.

Target

It is evident that it will not come overnight that new antidepressants will emerge as a result of the findings, but according to those involved with the study, it will take up to five years from now for new drugs to get to the point of patient testing. The scientists conclude that whilst they do now have some tools to probe the glucocorticoid receptor, there is not yet a drug that can do it effectively. It does however give the drug companies a target to reach.

Combating Depression During Pregnancy with Light Therapy

A study on the effects of light treatment conducted in Switzerland on 27 females has provided results that may give a tool beyond antidepressants for depression treatment in pregnant patients. The findings will be of use to doctors who are unwilling to treat pregnant women with antidepressants for fear damage to the foetus may occur.

“A lot of people feel like they’re in between a rock and a hard place.”

This is according to Dr. C. Neill Epperson, head of the Penn Centre for Women’s Behavioural Wellness in Philadelphia. This doctor was not involved in the Swiss study, yet she said it is a consistent worry amongst the very same doctors that a lack of treatment may lead to complication in the birth.

One in Ten

Research shows that as many as one in every ten pregnant women is experiencing the effects of depression. The depression puts them at a heightened risk of delivering the child preterm, with the consequent low birth weight.

Seasonal Defective Disorder

The study into how light therapy can affect women in this space, came about as a result of light therapy being proven to benefit people with seasonal defective disorder. This condition means that people are more prone to being depressed when there is less sunlight as determined by the seasons. There was evidence of effect on this sphere, but there were suggestions too that light therapy could be of benefit with non seasonal depression also.

Small yet Conclusive

Anna Wirz-Justice of the University Hospital Basel in Switzerland conducted the study along with her research colleagues to determine if the suggestion that this type of treatment works would stand up against the needs of pregnant women. Whilst the study was small the findings are conclusive.

How Evaluated

46 depressed women were taken, and randomly assigned to being treated with either a non-therapeutic dim red light, (The placebo) or a bright fluorescent light (The Treatment). The women were directed to sit under the light for one hour every day, they would begin the therapy session within a few minutes of their rising from slumber. Over the course of the 5 week study the participants would come to meet the researchers at regular intervals, at which point evaluations were made.

27 Remained out of 46

Nineteen of the women had to leave before the project was completed due to their commencing a course of antidepressants or otherwise, therefore 27 good specimens remained for the conclusion of the study.

Depression Symptoms Reduced

The study showed by the end, that out of these 27 the 16 women who received the actual light therapy as opposed to the placebo demonstrated remarkable benefits from the treatment. Improvements in depression symptoms were experienced by 13 women out of this 16 with a 50% reduction in symptoms found, with 11 of the subjects no longer presenting any symptoms of depression.

Of the placebo group 4 women no longer suffered any symptoms with just under half of the recipients of the placebo also demonstrating a drop in depression symptoms.

Safe Treatment

Dr Anna Wirz said; “The light therapy had no side effects, it’s like going outside for an hour a day but without the risks associated with UV light.” The Doctor also suggested that there would be no fall off in benefit if the women were to continue their treatment beyond the 5 week period. She added that the therapy can be used leading right up to the birth and beyond. This would lessen the likelihood of depression emerging in the wake of the birth which is a very common occurrence.

As Good as Drugs

Yet Time Consuming

The results are according to the doctor as good as the results affected by the taking of antidepressant drugs, but it is the need to devote an hour each day to the treatment that may be too much time to be a feasible treatment method for most women. She said that the downfall of this type of treatment is that there really needs to be a motivation to pursue the course. But she is positive that the research that has proven the effectiveness of light therapy will be welcome news to medical practitioners looking for another treatment method.

The associated costs aren’t all that different from each other either, with antidepressants averaging at £15 per month against the acquisition of a therapeutic light costing close to £145. The study is ongoing in an attempt to realise the same results in other groups of depressed and pregnant women.

So Close to a Depression Treatment we can Taste It

It may be credible to use our sense of taste to determine if an individual is depressed. Sounds strange doesn’t it. New research however points out that we can also use taste in determining which drug is most suitable for our depression treatment.

It is University of Bristol scientists who have headed up the research that has figured out the link. They have uncovered that our ability to know flavours shows improvement with pharmaceuticals used in the treatment of depression.

Antidepressants heighten the production levels in the body of serotonin, neurotransmitters and adrenaline. These antidepressants in the study were given to a range of healthy subjects. With use, the subjects showed a marked improvement in their being better at detecting flavours than they were previously, even when these flavours were at very low concentrations.

Overall their taste and recognition ability with the sense, was improved with use of the antidepressant drug.

Senior author of the study Dr Lucy Donaldson said, “When we increased serotonin levels we found that people could recognize sweet and bitter taste and much lower concentrations than when their serotonin levels were normal.” She went on to say that, “With increased nor-adrenaline levels the same people could recognize bitter and sour tastes at lower concentrations. Salt taste doesn’t seem to be affected at all by altering either of these neurotransmitters.”

Many have been excited by the findings of the study with Dr. Jan Melichar the lead psychiatrist on the study not being the least of them. She is ‘very excited’ by the finding and sees the breakthrough as the chance to not just get the medication right for the patient 60-80% of the time as is the standard. There is potential to get it right all of the time. Getting the drug right first time every time, as opposed to having to wait up to four weeks to determine if the right drug has been given is the new opportunity.

Other findings of the research include a throwing away the belief of old that taste was a genetic hand me down, unchangeable through our lives, it is now seen that taste can be altered by mood and chemicals.

So as to ensure that there was an actual taste differential after the drugs were consumed, the subjects had their tasting abilities checked first before the drugs were administered. Their anxiety levels were also checked, and there was a correlation in how high levels of anxiety lead to a lessening in our abilities to recognise salty and bitter tastes.

Messaging Online as Useful as Face to Face in Depression Treatment Follow Up

The efficiencies of using online means of communication in organising follow up care for depression patients are quite effective, it has been found by a new trial.

The randomized trial soliciting feedback from 208 patients found that the results of the online process met with strong results after a 5 month period.

The findings here were against those who received ‘usual care,’ with the half of the trial patients sampled who were given three online care management contacts showing a marked decrease in depression symptoms. These persons were treated online via a trained psychiatric nurse. They were also found to be more likely to actually take their anti depressant medication, and most gave feedback that declared they were ‘very satisfied’ with their treatment.

All of the respondents in the trial were in the opening phase of taking their prescribed medications, with the online group more likely to have taken the medication as prescribed. “While more Americans are taking antidepressants, the quality of care for depression remains among the lowest scores on the U.S. health care report card,” it was stated by Gregory E. Simon, MD, MPH, a Group Health psychiatrist and Group Health Research Institute senior investigator. He felt that especially with regard to primary care, the place where the treatment for depression begins by and large there is a failure for many patients on the side of the health provider to give adequate follow up communication.

It had been noted as a consequence of previous studies that telephone calls had allowed for a greater delivery of follow on communication. It is a means of reaching out to patients, a means to determine advancement and a means to access how well they are observing the guidelines of taking their medication. The follow on contact is the method by which continuity of care is assured if you will.

The frequency and the changing of doses can be directed over the phone or via the online. Switches to other medications can be directed, and the side effects of the antidepressants can be determined from these points of contact. The continuity allows in essence the tailoring of medication usage to bolster an individual’s response. The findings show that this is all possible without direct face to face contact with the patient

The reasoning behind the move from phone based follow up care is the inefficiencies of what the doctors call ‘phone tag.’ Much time is lost in trying to connect over the phone at times which may not suit the patient. Online does not require the two persons to be in instantaneous contact, as a result there is no time lost in tracking the individual down, and with that result comes efficiency of care.

There are protocols of course that must be followed in providing medical advice online, but the team has discovered that their existing electronic medical record can improve care for chronic medical conditions. It was also uncovered in the findings that it is the patients suffering from depression who are most likely to respond to this form of communication.

“We worried that patients might need live voice contact in real time to be understood, and feel supported,” Dr. Simon admitted, however he also stated. “But this online care management helped these patients, even though they never met the trained psychiatric nurse in person or talked with her on the phone. And because she spent only one hour per patient to deliver this intervention, it promises to make high-quality depression care more affordable.”

Break Negative Thought Patterns To Combat Depression

According to recent research, the key to helping people overcome moderate to severe depression is to break those negative thought patterns. What we’re talking about here is Cognitive Therapy, which focuses more on changing how you think about things as opposed to changing how you behave.

The study, which was carried out by Daniel Strunk from Ohio State University, Melissa Brotman of the National Institute of Mental Health and Robert DeRubeis of the University of Pennsylvania,  found that behaviour changing techniques had little effect on depression symptoms whereas breaking negative thought patterns did.

The study involved 60 patients who had been diagnosed with major depression. Each of the participants saw one of six cognitive therapists in a series of sessions and all of the participants agreed to their sessions with therapists being recorded on video.

The tapes of these recordings were then studied by trained raters who identified whether cognitive techniques or behavioural techniques were being used by the therapists. The patients were also asked to complete a depression questionnaire after each session.

On analysing the data the researchers noticed that depression symptoms improved significantly when the therapist used cognitive techniques.

“There has been a lot of attention recently on behavioural approaches to treating severe depression, and that may lead some people to suspect that cognitive techniques are not important for more severely depressed patients,” said Daniel Strunk, co-author of the study and assistant professor of psychology at Ohio State University.

“But our results suggest that it was the cognitive strategies that actually helped patients improve the most during the first critical weeks of cognitive-behavioural therapy.”

The research also revealed that patients who got more involved with the therapy process showed greater improvement.

“If you’re a patient and willing to fully commit to the therapy process, our data suggest you will see more benefit,” Strunk said.

The research is being continued at Ohio State’s Depression Treatment and Research Clinic and the researchers are hoping to shed more light on cognitive therapy and how it can help combat depression.

“We’re trying to understand if cognitive therapy leads people to a profound change in their basic self view, or if it teaches them a set of skills that they have to continually practice over time,” said Strunk.

The results have been published in the online version of the journal Behaviour Research and Therapy.

Telephone Therapy For Depression And Anxiety, Does it Work?

A brand new study published in the June edition of Behaviour Therapy has found that telephone consultations with a therapist can be just as effective as clinic visits involving face to face meetings with a therapist for depression treatment.

The trial run was carried out by Brigham Young University and led by Diane Spangler, a psychology professor at the university.

The study included 30 people who had been newly diagnosed with major depression. The participants received no anti-depressant medication or visits to a clinic during the trial and instead had a series of phone calls to a therapist which covered the same information that would have been covered in a face to face meeting. The calls lasted between 21 and 52 minutes.

Six months later at a follow up, the researchers found that 42 percent of the participants had recovered from their depression. By comparison, the recovery rate is 50 percent for those who have face to face visits.

“Offering a phone or webcam option for psychotherapy does appear warranted from an efficacy point of view,” said Dr Spangler,

“It’s more user- friendly — no commutes, more flexibility of place and time — and has no side effects.”

However, it’s important to note that some people appear to prefer the face to face contact with a therapist as a third of those originally identified as suitable for the study, declined the offer of telephone sessions and opted for face to face sessions instead.

Although this was a small scale study, it still shows that for those who really don’t want the hassle of travelling to see a therapist, who don’t enjoy busy waiting rooms and who don’t mind sitting in the comfort of their own home whilst talking to an understanding voice at the end of the telephone, this type of therapy would not only be cheaper but could be just as effective.

Statistics show that around 1 in 4 people are suffering from some form of depression at any one time, which represents around a fifth of the population.

However, what isn’t known is how many people there are out there who might be suffering from depression and who for any number of reasons don’t go and seek help.

Perhaps if the option of telephone consultations was available, more people would seek help when they need it.

Suffering from depression? Get a massage!

Anyone who has ever had a massage will know how good it feels, and how beneficial it can be for relieving stress and promoting a relaxed state of being. So if we know this why don’t we arrange to have a massage more often?

As human beings we need human touch, this is nothing new, but most of us don’t bother. Now research into massage has revealed just how important touch is for our mental health and how it can help alleviate depression and given the unpleasant side effects experienced by many antidepressant drugs, the possibility of new treatment options for depression is welcome news indeed.

Dr Wen-Hsuan Hou of I-Shou University in Kaohsiung in Taiwan and colleagues recognised that research into the possible benefits of massage was problematic. First of all, it isn’t possible to carry out ‘blind’ studies but at the same time there is good evidence that massage therapy can be an effective treatment for depression.

They also recognised and stated in their report that depression is a major public health problem and that the treatment for depression is often inadequate.

What the researchers did to investigate the benefits of massage for depression was look at 17 previous trials involving a total of 786 people, where massage therapy had been used on depressed patients.

In four of these trials, those given massage had been compared to those receiving no treatment at all. In the remaining 13 trials, massage had been compared to either Chinese herbs or relaxation techniques. To determine the effects, the studies used a variety of methods for evaluating depression and mood.

Dr Hou and his colleagues found that massage therapy had potentially significant effects in alleviating the symptoms of depression.

So what is it about massage that is so beneficial?

According to the researchers, massage can reduce stress, induce relaxation, and build a sense of trust between the therapist and the patient leading to release of Oxytocin. They are now calling for well designed longer follow up studies including accurate outcome measures. Their research was published in the American Journal of Psychiatry.

Massage therapy hasn’t quite got to the stage where it is prescribed in a doctor’s surgery but given the evidence, perhaps it should be.

According to the Touch Research Institute in Miami, who have conducted over 100 research studies into massage therapy, massage therapy will not only alleviate the symptoms of depression and reduce stress; it will also improve the immune system, reduce pain, enhance attentiveness and promote weight gain in premature babies and much more too.

Men With Depression Are Missing Out On Treatment

According to the mental health charity ‘Mind’, large numbers of men suffering from depression are not getting the treatment they need, not because they are not actually depressed, or seeking help, but because of the way doctors diagnose depression. Basically, it’s not getting picked up.

This is particularly worrying because men are statistically more likely to commit suicide than women.

The problem seems to be that when doctors are looking at the symptoms of depression, the criteria they use to diagnose it is more suited towards female patients, whereas male issues are mostly hidden.

Women are more likely to talk about their problems whereas depression in men is more likely to manifest itself in aggressive behaviour.

“We are working on recommendations for GPs encouraging them to look out for some of the more male symptoms of depression, such as anger or aggression,” said Paul Farmer, Chief Executive of Mind.

The charity is now looking for an improvement in the provision of mental health services so that services geared specifically towards men are included, such as all male service user groups, which Mind claim have been very successful when they do exist.

Also, according to Farmer, it’s not true that women are more likely to suffer from depression than men.

“Statistics tell us that women are more likely to have depression than men, but in reality men are just as likely to experience depression, but are far less likely to seek help, be diagnosed or receive treatment” he said.

“Stereotypes such as ‘real men don’t cry’ can hold men back from getting help, and we are worried that the true extent of men’s mental health problems is further masked by the fact that the symptoms of depression that we look for are more commonly experienced by women than men, such as tearfulness.

“With diagnostic criteria being more geared towards women, we have heard that men’s depression isn’t always picked up and men who do try to reach out are slipping through the net and not receiving the support they need – support that can prove to be life saving. Men make up three quarters of all suicides, and we have to start looking beyond the statistics” said Farmer.

If you think that someone close to you is showing signs of depression or a change in behaviour, encourage them to speak about how they feel and to seek help.

Effective Treatment For Depression – Magnetic Therapy

A new double blind study has found that transcranial magnetic stimulation could be helpful for some people suffering with major depression and who have not responded to other forms of treatment and drugs.

The research, which was conducted by the Medical University of South Carolina, opens the doors for magnetic therapy to be used as an effective treatment for depression in the future.

The study involved almost 200 people, each of whom was required to wear a special type of helmet with electrodes attached to the scalp. You can imagine that it wouldn’t be easy to set up a double blind study like this as the equipment creates a sort of head tapping sensation in the recipients when the magnetic pulses are being administered.

So the researchers got round this by having everyone in the trial wear a similar type of helmet and everyone involved felt the same tingling sensation but in just over half of the participants the magnet was actually blocked off so that the magnetic field could not reach them but they were still able to feel the electrical impulse.

In those that were receiving the magnetic pulses, these pulses passed through their skull and created an electrical current in the brain. Transcranial magnetic therapy was administered to just under half of those taking part for around 37 minutes a day over a three week period. Prior to that, all participants had been taken off their medication for a couple of weeks.

A total of 14 percent of those who were receiving the magnetic therapy reported a reduction in depression symptoms compared to only 5 percent of those who were receiving the sham treatment.

“The results of this study suggest that prefrontal repetitive transcranial magnetic stimulation is a monotherapy with few adverse effects and significant antidepressant effects for unipolar depressed patients who do not respond to medications or who cannot tolerate them,” said Dr Mark George, who led the study.

Transcranial magnetic therapy is considered to be safe, unlike other methods using electrical currents, such as electroconvulsive therapy, which has some unpleasant side effects.

Apparently those that received the magnetic therapy felt the benefits for several months after the treatment stopped.

This study was funded by the U.S. National Institute of Mental Health, and the findings were published in the May 2010 edition of Archives of General Psychiatry.