October 15, 2004

FDA Warning - Child Anti-Depressant Use

Today it was announced by the Food and Drug Administration that all antidepressants must carry a "black box" warning, the government's strongest safety alert, linking the drugs to increased suicidal thoughts and behavior among children and teens taking them.

Because the warnings are primarily seen by doctors, the agency also is creating an information guide for patients to advise them of the risk.

"Today's actions represent FDA's conclusions about the increased risk of suicidal thoughts and the necessary actions for physicians prescribing these antidepressant drugs and for the children and adolescents taking them," said Dr. Lester Crawford, acting FDA commissioner.

The drug labels also include details of pediatric studies which, thus far, have pointed to Prozac as the safest antidepressant for youths to take.

On average, 2 percent to 3 percent of children taking antidepressants have increased suicidal thoughts, independent experts, working with Columbia University, found.

Posted by szadmin at 7:01 PM | Comments (0)

Depression different for Kids

The Wall Street Journal reported today that an increasing number of depression research studies are suggesting that depression in young people isn't simply a "scaled-down version of depression in adults. The symptoms and the responses to antidepressants are different, indicating different biological activity. Teen brains, scientists are finding, are very different than adult brains."

Rather than feeling deeply and chronically unhappy, teens diagnosed with depression feel bored, moody and irritable.

""It isn't the consistently down, sad, depressed feeling that adults have," says Carol Glod of McLean Hospital in Belmont, Mass., who is leading brain-imaging studies of depression in young people." a quote in the WSJ noted.

When it comes to the biological underpinnings of depression in young people and adults, "the differences far outnumber the similarities," says Robert A. King of the Yale University Child Study Center. "We don't even know if depression that begins in childhood is the same disease as adult-onset depression."

Recent studies suggest that the antidepressants called SSRIs stimulate the birth of new neurons in the brain. Boosting this "neurogenesis" might have different effects on a developing brain than a mature one.

"But in young people with depression, it may be that the influx of new neurons is somehow detrimental to adolescents. Some scientists wonder whether the new neurons could destabilize fragile brain circuits in kids suffering from mental illness."

It sounds like we're a long way from truly understanding depression in children - and much more research needs to be done.

Source: Wall Street Journal

Posted by szadmin at 8:36 AM | Comments (1)

Bad and Good News on Bipolar Disorder Treatments

A recent report published by Decision Resources, Inc., suggest that the number of people receiving treatment for bipolar disorder will grow significantly over the next decade ( from 55% to 65% growth in the United States by 2013; from 40% to 50% in Europe by 2013; and from 40% to 50% in Japan by 2013).

The report goes further, however, and forecasts that new generic drugs (that are generally much less expensive than brand name drugs) will result in significantly lower drug treatment costs.

According to the new Pharmacor study entitled "Bipolar Disorder," sales of anticonvulsants, antipsychotics, and antidepressants will begin a steady decline after 2008 as they lose patent protection.

"Although diagnosis rates for bipolar disorder are on the rise - - the drug market for the disorder will be hurt by generic erosion," said Anathea Waitekus, analyst at Decision Resources.

All of this is good news for consumers.

Source: DRI Pharmacor

Posted by szadmin at 7:56 AM | Comments (4)

Gene Linked to Child Bipolar

A recent study of children with manic-depressive illness (bipolar disorder) has found a gene that may confer susceptibility to this illness, as reported in September's American Journal of Psychiatry.

"As recently as 10 years ago, it was not widely known that the illness existed in children," says Barbara Geller, M.D., a professor of psychiatry at Washington University in St. Louis. The gene, called brain-derived neurotrophic factor [BDNF], has been shown to help determine thinking and memory and the response to medications given to people who have bipolar disorder.

Two studies in adults with bipolar disorder, that used similar methods, have also shown that the BDNF gene may confer susceptibility to the illness. This suggests that adults and children may have some overlap in their vulnerability to manic-depression. Children in the study, whose average age was 10, were noted to be more severely ill and to have more persistent symptoms than adults with bipolar disorder. In a companion study, these children were shown to be seriously ill with manic-depression two-thirds of the time during a four-year follow-up period.

This longitudinal study, reported in the May Archives of General Psychiatry and funded by the National Institute of Mental Health, does much to dispel the mistaken notion that children cannot have manic-depression. Dr. Geller's colleagues on these studies were Edwin H. Cook, Jr, M.D., Judith A. Badner, M.D., Ph.D., Rebecca Tillman, M.S., James L. Craney, M.P.H., J.D., Susan L. Christian, Ph.D., and Kristine Bolhofner, B.S.

Source: Washington University in St. Louis

Posted by szadmin at 7:46 AM | Comments (3)

Noted Bipolar Author Publishes New Book

Kay Jamison, the well-known psychologist and author with bipolar disorder has published a new book titled "Exuberance".

Salon.com published a good interview with her last week - here is a short excerpt:

"Over the last decade, psychologist Kay Redfield Jamison has become perhaps our foremost chronicler of the mind's darkest weather. In 1993 she published "Touched with Fire," her exploration of the relation between creative genius and manic depression, and followed that up in 1995 with "An Unquiet Mind," a memoir of her own struggle with the illness. "Night Falls Fast," her most recent book, studied suicide. So it might come as a bit of a shock to find her cavorting with the likes of Tigger, rough-riding Teddy Roosevelt, and other exceptionally irrepressible characters in her latest book, "Exuberance," which attempts to define what it's like to be touched with another, more joyful, sort of fire.

Exuberance, Jamison writes, "denotes a mood or temperament of joyfulness, ebullience, and high spirits, a state of overflowing energy and delight. It is more energetic than joy and enthusiasm but less intense, although of longer duration, than ecstasy." It's got the dynamism that marks the manic half of manic depression -- but without the danger of falling into psychosis or debilitating lows."

More info:

Baltimore Sun review of new book:
http://www.baltimoresun.com/news/health/bal-bk.exuberance03oct03,0,4368123.story?coll=bal-health-headlines

For full story - see:
www.salon.com/mwt/feature/2004/10/11/exuberance/

Posted by szadmin at 7:39 AM | Comments (21)

Bipolar people Innactive

Source: University of Indiana

Indiana University professors focus on daily lives of people with serious mental health conditions

Study participants surprisingly inactive

BLOOMINGTON, Ind. -- A study by two Indiana University Bloomington professors in the School of Health, Physical Education and Recreation is beginning to suggest how people with severe and persistent mental illnesses (SPMI) live their everyday lives.

SPMI is a condition in which disorders such as bipolar disorder and, particularly, schizophrenia affect daily living. Building upon studies suggesting that people with SPMI fare better in developing countries than in the United States, associate professors Bryan McCormick, in the Department of Recreation and Park Administration, and Georgia Frey, in the Department of Kinesiology, recruited study participants from community mental health programs in both the American Midwest and Serbia.

McCormick and Frey asked study participants to wear motion sensors to record physical activity continuously for seven consecutive days. During the same seven days, participants also wore watches programmed to signal seven times daily at random intervals. At the signal, participants were to note in a booklet what they were doing, who they were with, their mood and other aspects of daily activity. This unique pairing of research tools provided data that were more reliable than surveys which rely on a person's recall.

Among the findings:

The study participants were surprisingly inactive. Inactivity is important to note, Frey said, because physical activity is considered a major health indicator for chronic diseases. During waking hours of the study, the participants wore uniaxial accelerometers, which measured activity levels. The intensity was recorded in "counts per minute." Frey compared the findings to a sedentary population, people who have mental retardation and people who exercise regularly. The study participants' activity level averaged approximately 305 counts per minute, compared to 312 counts per minutes averaged by the sedentary comparison group, 330 counts per minute averaged by the comparison group with mental retardation, and 550 counts per minute averaged by the active comparison group.

The study participants were alone less often than expected. Compared to the general population in the United States, the study participants were alone less often then older adults and about as often as working adults. Social contacts are important, in part, because studies have shown isolation has a negative impact on a person's health, McCormick said. The study participants lived in the Midwest and Serbia, in large towns located in rural areas approximately two hours from metropolitan areas. The social contacts of the study participants reflected the conventional family structure in the two countries. Participants in Serbia, where extended families are the norm, spent more time with family members and spouses. The U.S. participants spent more time with friends, who also were likely to be psychiatric patients. As a result, the Serbian participants were likely to have access to more support, McCormick said.

Participants from both countries reported that most of their daily activities were easy. The Serbian participants reported slightly more challenge in their everyday activities. McCormick said he wants to explore whether some people actively seek to avoid challenging activity, since it has been found to be associated with feelings of anxiety, a particularly problematic mood for people with SPMI.

Mental health systems in Serbia, as well as in most Balkan states, are considered "developing" because they have been crippled by a lack of money since the collapse of the former Yugoslavia. Many people living in mental health institutions in Serbia, for example, would be receiving treatment from community mental health services in the United States.

McCormick and Frey are working to move beyond the current focus on diagnosis and control of the symptoms, and assumptions about how people with SPMI live their lives. They want to reach a better understanding of the overall health and quality of life of people with such conditions to determine if scientists can devise interventions to improve their lives.

The next phases of this research involve filling in more of the overall health picture by looking at health indicators such as body mass index, examining connections between mood and activity, creating interventions, and then measuring to see if they actually improve the quality of life of people with SPMI.

The research has received funding from the IU Multidisciplinary Ventures Fund, the IU Dean of Faculties, the IU Department of Recreation and Park Administration, the IU Department of Kinesiology, the Russian and East European Institute's Mellon Endowment Research Grant-in-Aid, and the IU President's Council on International Programs.

Sanghee Chun, a doctoral student in the Department of Recreation and Park Administration, and Chien-Tsung Lee, a doctoral student in the Department of Kinesiology, helped conduct the study. The research team's colleagues in Serbia include Dr. Tomislav Gajic, head of psychiatry, Health Center Valjevo; Dr. Branka Gajic, psychiatrist, Health Center Valjevo; and Dr. Milena Maksimovic, psychologist, Health Center Valjevo.

Posted by szadmin at 7:28 AM | Comments (2)

October 2, 2004

Abilify approved for Bipolar Disorder Mania

Bristol-Myers Squibb (bmy) and partner Otsuka Pharmaceutical received approval of Abilify, a drug for the treatment of acute bipolar mania, from the Food and Drug Administration. Abilify was previously approved in 2002 by the FDA to treat schizophrenia.

Posted by szadmin at 8:02 AM | Comments (4)

October 1, 2004

British Study on Psychosis and Bipolar Mania

A new study published in the October issue of the British Journal of Psychiatry suggests that more than one in 20 people have experienced psychotic symptoms such as paranoid thoughts or hallucinations, research revealed today.

A study of 8,580 people found that 5.5% had experienced one or more of the five psychotic symptoms measured, including feeling their thoughts were being interfered with or suffering strange experiences.

The researchers, from King's College London, found that psychotic symptoms were linked to drug and alcohol dependence, recent stressful life events and lower intellectual ability.

In terms of drug dependence, they concluded that the relationship between cannabis and psychotic symptoms was the strongest.

Researcher Dr Louise Johns, from the Institute of Psychiatry, said: "We looked at factors associated with these symptoms and it was cannabis dependence that was most linked to psychosis.

"What we don't know is the direction - whether cannabis dependence leads to psychosis or psychotic symptoms lead to cannabis use."

The study, published in the British Journal of Psychiatry, said that psychosis was generally thought of as an "all-or-nothing" phenomenon, where people either had it or did not.

But the researchers said there was increasing evidence that psychosis exists in the population as a continuum rather than a categorical diagnosis.

Source: British Journal of Psychiatry

Posted by szadmin at 8:08 AM | Comments (0)