Blood Test Predicts Which Antidepressant Will Work

New blood tests could take the guessing out of antidepressant prescriptions.

New blood tests could take the guessing out of antidepressant prescriptions.

Up until now doctors have essentially been guessing which antidepressant medication might work for patients.

But now researchers have identified a blood test that could help.

Dr Madhukar Trivedi, who led the research, said:

“Currently, our selection of depression medications is not any more superior than flipping a coin, and yet that is what we do.

Now we have a biological explanation to guide treatment of depression.”

The blood test measures the levels of C-reactive protein (CRP).

They tested the connection between CRP and two antidepressants called escitalopram (‎Cipralex, Lexapro etc.) and bupropion (Wellbutrin, Elontril, Zyban etc.).

They found that CRP levels could help predict which combination would work.

Dr Trivedi thinks the same approach could be used with other antidepressants.

CRP is a measure of inflammation in the body, which studies suggest is linked to depression.

CRP levels are not the only biological markers that might provide clues as to which antidepressant will work.

Dr Trivedi said:

“Both patients and primary-care providers are very desperately looking for markers that would indicate there is some biology involved in this disease.

Otherwise, we are talking about deciding treatments from question-and-answer from the patients, and that is not sufficient.”

Giving up

Currently, around one-third of patients do not improve after taking the first medication they are prescribed.

Fully 40% of people given antidepressants stop taking them within three months.

Dr Trivedi said:

“This outcome happens because they give up.

Giving up hope is really a central symptom of the disease.

However, if treatment selection is tied to a blood test and improves outcomes, patients are more likely to continue the treatment and achieve the benefit.”

The study was published in the journal Psychoneuroendocrinology (Jha et al., 2017).

The Surprising Way Antidepressants Help Depressed People

Antidepressants can help to fight a little-known symptom of depression.

Antidepressants can help to fight a little-known symptom of depression.

Antidepressants increase the feeling of being in control among people who are depressed, new research finds.

This may help because depressed people often report feeling helpless and having little control.

[See also: Antidepressants: 10 Shocking Studies Everyone Should Know]

Generally feeling in control has a protective effect on mental health.

Feeling in control of one’s emotions, thoughts and the environment is usually beneficial.

Control is also linked to taking action — something which people who are depressed often avoid as there is a tendency to feel helpless.

In the research a group of people were given a modern type of SSRI antidepressant for seven days.

Some of the participants were depressed, others were not.

After a week, everyone did a computer test to look at people’s sense of being in control.

The results showed that when depressed people were given an antidepressant, it increased their sense of being in control.

Depressed people interacted more with the game in comparison to those given a placebo.

They felt the environment was controlling them less and they could take action.

The results could help to explain why antidepressants take so long to work and only work for some individuals.

Professor Robin Murphy, who led the study, said:

“Other research from members of our group has emphasized the effects these drugs have on processing of emotions, here we focussed on our sense of agency, on how we learn to be ‘in control’.

In addition to the direct chemical effect, the drug seems to contribute to learning to be in control, less constrained by the environment, and perhaps this might be a link to how these drugs contribute to the alleviation of depression.”

The study was published in the journal Neurobiology of Learning and Memory (Msetfi et al., 2016).

Only One Antidepressant Has More Benefits Than Risks For Young

Do antidepressants work for young people?

Do antidepressants work for young people?

Most antidepressants do not work for children and young people, new research finds.

In fact some of the drugs may do more harm than good.

This is set against the fact that increasing numbers of children and adolescents are being prescribed the drugs.

In the United States, for example, between 2005 and 2012, the percentage of those under 20-years-old taking antidepressants rose from 1.3% to 1.6%.

For the research, scientists reviewed every study that tested the effects of antidepressants on children and adolescents.

Each was rated on the basis of how acceptable they were, whether they worked and continued to be taken and what the associated risks were.

Only fluoxetine — also known as Prozac, Animex-On, Sarafem, Adofen and Deprex — emerged as having more benefits than risks.

One drug — venlafaxine (known as Effexor) — was found to increase the risk of suicidal thoughts and attempts.

The study’s authors write:

“Consequently, the question of whether to use antidepressant drugs for the treatment of major depressive disorder in young people and, if so, which antidepressant would be preferred, remains controversial.”

Professor Peng Xie, one of the study’s co-authors, said:

“The balance of risks and benefits of antidepressants for the treatment of major depression does not seem to offer a clear advantage in children and teenagers, with probably only the exception of fluoxetine.

We recommend that children and adolescents taking antidepressants should be monitored closely, regardless of the antidepressant chosen, particularly at the beginning of treatment.”

Some of the adverse effects of antidepressants may turn out to have been hidden, some researchers think.

Even fluoxetene (Prozac) may be worse than nothing, according to Dr Jon Jureidini, writing in a linked editorial:

“The effect of misreporting is that antidepressants, possibly including fluoxetine, are likely to be more dangerous and less effective treatments than has been previously recognised, so there is little reason to think that any antidepressant is better than nothing for young people.”

The study was published in The Lancet (Cipriani et al., 2016).

Antidepressants: 10 Shocking Studies Everyone Should Know

Do antidepressants work? What are the real side-effects? And more…

Do antidepressants work? What are the real side-effects? And more…

1.Antidepressants are very hit-and-miss

Unfortunately, for around half of depressed patients, the first antidepressants prescribed do not work.

On top of that, around one-third of patients do not respond to any types of drugs (although psychological therapies may be useful).

At the moment, the only way to know is to try them and see what happens.

This means that many depressed people have to wait around three months to see if the drugs will work.

(From: Depression Breakthrough: Blood Test Predicts Correct Treatment)

2. Science of antidepressants based on backward facts

The scientific basis behind commonly used antidepressants is completely backwards, according to a new review of the research.

For almost 50 years it has been believed by scientists and the public alike that depression is related to low levels of serotonin in the brain.

In fact, the new review finds, the very best evidence available suggests people who are depressed actually have higher levels of serotonin in their brains, not lower.

This means that commonly used antidepressants are actually making the situation worse, not better.

3. Some scientists say they don’t work

New generation ‘SSRI’ antidepressants like Prozac or Seroxat mostly fall, “below the recommended criteria for clinical significance”, according to some scientists.

In other words, the most modern drugs prescribed for depression generally don’t work.

Their review of the evidence found the drugs had different effects on people with different levels of depression:

  • Mild depression: not tested as mild depression is usually treated with a ‘talk therapy’ rather than antidepressants.
  • Moderate depression: antidepressants made “virtually no difference”.
  • Severe depression: antidepressants had a “small and clinicallyinsignificant” effect.
  • Most severe depression: antidepressants had a significant clinical benefit – but see the full article.

For the full story: SSRI Antidepressants ‘Clinically Insignificant’ For Most People

4. Hidden side-effects

A recent survey of people taking antidepressants has found higher than expected levels of emotional numbness, sexual problems and even suicidal thoughts associated with the medication

The study, published in the journal Psychiatry Research, found that as many as half the people they surveyed had psychological problems due to their medication.

Of the 20 adverse effects that people were questioned about:

  • 62% said they had ‘sexual difficulties’,
  • 52% said they ‘didn’t feel like themselves’,
  • 42% noticed a ‘reduction in positive feelings’,
  • 39% found themselves ‘caring less about others’,
  • and 55% reported ‘withdrawal effects’.

Set against these findings, though, 82% said that the drugs had been useful in tackling their depression.

5. Most linked to weight gain

Bupropion, which is marketed as Wellbutrin, is the only antidepressant linked to weight loss, new research finds.

In contrast, those taking fluoxetine (known mainly as Prozac) gained an average of 4.6 pounds in the same time.

So, those taking Wellbutrin weighed an average of 7 pounds less than those who took Prozac over the two years.

6. Memory loss

The older type of antidepressants — known as tricyclics — have been linked to memory loss.

Some of the drug names include:

  • desipramine (Norpramin),
  • imipramine (Tofranil),
  • clomipramine (Anafranil),
  • and doxepin (Sinequan).

Around half of people taking them report problems concentrating and one-third say they have memory loss.

(From: 5 Common Prescription Drugs Linked To Memory Loss)

7. Natural supplements can boost effectiveness

Four natural supplements have been found by new research to increase the effectiveness of antidepressants.

The supplements are:

  1. Omega 3 fish oils,
  2. S-adenosylmethionine (SAMe),
  3. methylfolate (bioactive form of folate),
  4. and vitamin D.

The conclusions come from a new review of 40 clinical trials carried out worldwide.

Each tested the use of common antidepressants in tandem with dietary supplements.

8. Antidepressants linked to autism

Mothers who use antidepressants during pregnancy could double their children’s risk of develop autism.

The conclusions come from a new study covering 145,456 pregnancies.

Since around 7% of pregnant women take antidepressants, the study could have very important implications.

9. Self-harm and suicide

A common antidepressant thought safe for adolescents is actually ineffective, new research finds.

Worse, it has been linked to serious side-effects.

The drug is called paroxetine, which is marketed as Paxil, Seroxat and Aropax.

Read more about the study here.

10. Antidepressants and social anxiety

Social anxiety disorder is most commonly treated with antidepressants, but these are not the most effective treatment.

A new study finds that cognitive behavioural therapy (CBT) is more effective and the benefits continue after the initial treatment has finished.

The researchers found that it was the psychological therapies that were the most effective.

As a result these should be the first choice treatment.

Antidepressants were also effective, but were associated with side-effects, and they don’t work for some people.

4 Natural Supplements Found To Boost Antidepressant Effectiveness

Antidepressants are more effective in concert with four common dietary supplements — evidence from 40 clinical trials.

Antidepressants are more effective in concert with four common dietary supplements — evidence from 40 clinical trials.

Four natural supplements have been found by new research to increase the effectiveness of antidepressants.

The supplements are:

  1. Omega 3 fish oils,
  2. S-adenosylmethionine (SAMe),
  3. methylfolate (bioactive form of folate),
  4. and vitamin D.

The conclusions come from a new review of 40 clinical trials carried out worldwide.

Each tested the use of common antidepressants in tandem with dietary supplements.

Dr Jerome Sarris, the study’s first author, said:

“The strongest finding from our review was that Omega 3 fish oil – in combination with antidepressants – had a statistically significant effect over a placebo.

Many studies have shown Omega 3s are very good for general brain health and improving mood, but this is the first analysis of studies that looks at using them in combination with antidepressant medication.

The difference for patients taking both antidepressants and Omega 3, compared to a placebo, was highly significant.

This is an exciting finding because here we have a safe, evidence-based approach that could be considered a mainstream treatment.”

Other supplements showed more mixed results, including Vitamin C, zinc, and tryptophan (an amino acid).

There was little evidence for the beneficial effect of folic acid.

Dr Sarris said:

“A large proportion of people who have depression do not reach remission after one or two courses of antidepressant medication.

Millions of people in Australia and hundreds of millions worldwide currently take antidepressants.

There’s real potential here to improve the mental health of people who have an inadequate response to them.

Medical practitioners are aware of the benefits of omega 3 fatty acids, but are probably unaware that one can combine them with antidepressant medication for a potentially better outcome.”

There are no concerns about mixing nutritional supplements with antidepressants, but it is better to consult a professional, Dr Sarris said:

“We’re not telling people to rush out and buy buckets of supplements.

Always speak to your medical professional before changing or initiating a treatment.”

The study was published in the American Journal of Psychiatry (Sarris et al., 2016).

https://www.spring.org.uk/2015/02/9-nutrients-which-should-be-in-your-diet-for-good-mental-health.php

Only One Antidepressant Is Linked To Steady Weight Loss

Most antidepressants lead to weight gain in the long-term.

Most antidepressants lead to weight gain in the long-term.

Bupropion, which is marketed as Wellbutrin, is the only antidepressant linked to weight loss, new research finds.

Non-smokers lost an average of 2.4 pounds while taking bupropion over two years.

In contrast, those taking fluoxetine (known mainly as Prozac) gained an average of 4.6 pounds in the same time.

So, those taking Wellbutrin weighed an average of 7 pounds less than those who took Prozac over the two years.

Dr David Arterburn, the study’s first author, said:

“We found that bupropion is the only antidepressant that tends to be linked to weight loss over two years.

All other antidepressants are linked to varying degrees of weight gain.”

Along with Wellbutrin, bupropion is also marketed as Zyban and Elontril.

It is one of the most widely used antidepressants.

However, it is generally not recommended for anyone who has a history of seizures.

Professor Gregory Simon, one of the study’s co-authors, said:

“A large body of evidence indicates no difference in how effectively the newer antidepressants improve people’s moods.

So it makes sense for doctors and patients to choose antidepressants on the basis of their side effects, costs, and patients’ preferences—and, now, on whether patients are overweight or obese.”

The conclusions come from a study of over 5,000 US patients who were followed up to two years.

Obviously, anyone considering a change should consult their physician first.

Antidepressants Side-Effects Higher Than Previously Thought

The study was published in the Journal of Clinical Medicine (Arterburn et al., 2016).

Image credit: cora alvarez

These Antidepressants Linked to Mania and Bipolar Disorder

The study is based on the medical records of 21,000 adults treated for major depression over seven years in London.

The study is based on the medical records of 21,000 adults treated for major depression over seven years in London.

SSRI antidepressant medications are linked to a greater risk of mania and bipolar disorder, a new study finds.

SSRIs include the most commonly prescribed antidepressant medications, marketed under names like Prozac, Paxil and Zoloft.

The study also found that an antidepressant called venlafaxine was also linked to the increased risk.

However, the researchers say patients should not stop their treatment suddenly.

The study is based on the medical records of 21,000 adults treated for major depression over seven years in London.

The results showed that treatment with SSRIs and venlafaxine increased the risk of developing bipolar disorder and/or mania by about one-third.

However, the real risk of developing these conditions is already low, so the increase does not make as much difference as it might sound.

The study’s authors write:

“…regardless of underlying diagnosis or aetiology the association of antidepressant therapy with mania demonstrated in the present and previous studies highlights the importance of considering whether an individual who presents with depression could be at high risk of future episodes of mania.

Our findings also highlight an ongoing need to develop better ways to predict future risk of mania in people with no prior history of bipolar disorder who present with an episode of depression.”

The study was published in the journal BMJ Open (Patel et al., 2015).

Image credit: cora alvarez

Antidepressants Linked To This Common Neurodevelopmental Disorder

By 2020 depression will be the second leading cause of death in the world, but what damage are antidepressants doing?

By 2020 depression will be the second leading cause of death in the world, but what damage are antidepressants doing?

Mothers who use antidepressants during pregnancy could double their children’s risk of develop autism.

The conclusions come from a new study covering 145,456 pregnancies.

Professor Anick Bérard of the University of Montreal, who led the study, said:

“The variety of causes of autism remain unclear, but studies have shown that both genetics and environment can play a role.

Our study has established that taking antidepressants during the second or third trimester of pregnancy almost doubles the risk that the child will be diagnosed with autism by age 7, especially if the mother takes selective serotonin reuptake inhibitors, often known by its acronym SSRIs.”

The Canadian researchers used data from the Quebec Pregnancy Cohort which followed 145,456 children until they were ten-years-old.

The results showed a number of factors that contributed to the risk of the child developing autism, including:

  • Higher maternal age.
  • Depression.
  • Poverty.

Each of these were taken into account but antidepressants still emerged as a risk factor, said Professor Bérard:

“We defined exposure to antidepressants as the mother having had one or more prescription for antidepressants filled during the second or third trimester of the pregnancy.

This period was chosen as the infant’s critical brain development occurs during this time.

Amongst all the children in the study, we then identified which children had been diagnosed with a form of autism by looking at hospital records indicating diagnosed childhood autism, atypical autism, Asperger’s syndrome, or a pervasive developmental disorder.

Finally, we looked for a statistical association between the two groups, and found a very significant one: an 87% increased risk.”

Since around 7% of pregnant women take antidepressants, the study could have very important implications.

Professor Bérard said:

“It is biologically plausible that anti-depressants are causing autism if used at the time of brain development in the womb, as serotonin is involved in numerous pre- and postnatal developmental processes, including cell division, the migration of neuros, cell differentiation and synaptogenesis — the creation of links between brain cells.

Some classes of anti-depressants work by inhibiting serotonin (SSRIs and some other antidepressant classes), which will have a negative impact on the ability of the brain to fully develop and adapt in-utero”

The study was published in the journal JAMA Pediatrics (Boukhris et al., 2015).

Image credit: cora alvarez

Antidepressant Thought Safe Linked To Self-Harm And Suicide

Drug thought safe for teenagers linked to suicidal and self-harming behaviours.

Drug thought safe for teenagers linked to suicidal and self-harming behaviours.

A common antidepressant thought safe for adolescents is actually ineffective, new research finds.

Worse, it has been linked to serious side-effects.

The drug is called paroxetine, which is marketed as Paxil, Seroxat and Aropax.

The conclusions come from a re-evaluation of a study — known as ‘Study 329’ — carried out in 2001 .

Study 329, which was funded by the pharmaceutical company GlaxoSmithKline, originally claimed paroxetine was effective and safe.

Not only were these conclusions wrong, the new analysis argues, but the drug has worrying side-effects.

Professor Jon Jureidini, who led the research, said:

“Although concerns had already been raised about Study 329, and the way it was reported, the data was not previously made available so researchers and clinicians weren’t able to identify all of the errors in the published report.

It wasn’t until the data was made available for re-examination that it became apparent that paroxetine was linked to serious adverse reactions, with 11 of the patients taking paroxetine engaging in suicidal or self-harming behaviours compared to only one person in the group of patients who took the placebo.

Our study also revealed that paroxetine was no more effective at relieving the symptoms of depression than a placebo.

This is highly concerning because prescribing this drug may have put young patients at unnecessary risk from a treatment that was supposed to help them.”

Professor Jureidini thinks pharmaceutical companies should make their data available for reanalysis.

He said:

“Our reanalysis of Study 329 came to very different conclusions to those in the original paper.

We also learnt a lot about incorrect reporting and the considerable fall out that can be associated with distorted data.

Regulatory research authorities should mandate that all data and protocols are accessible.

Although concerns about patient confidentiality and ‘commercial in confidence’ issues are important, the reanalysis of Study 329 illustrates the necessity of making primary trial data available to increase the rigour of evidence-based research.”

The research was published in the British Medical Journal (Noury et al., 2015).

Image credit: JLA

How Brain Size is Changed By a Very Common Antidepressant

This antidepressant causes different changes in brains of depressed and non-depressed.

This antidepressant causes different changes in brains of depressed and non-depressed.

A common antidepressant changes the brains of depressed and nondepressed people in different ways, a new study finds.

Sertraline, which is marketed as Zoloft, increased brain volume in one area in depressed people, the researchers found.

In nondepressed people, though, it decreased brain volume in the same area.

The areas are critical to learning, memory, spatial navigation, emotion and motivation.

Professor Carol A. Shively, who led the study, said:

“These observations are important for human health because Zoloft is widely prescribed for a number of disorders other than depression.”

The conclusions come from a study of monkeys, which have similar brain structures to humans.

A group of monkeys were fed the antidepressant for 18 months — equivalent to five years in humans.

They were compared with a placebo group.

Brain scans revealed the antidepressant increased brain volume in the anterior cingulate cortex.

In nondepressed patients, though, it decreased brain volume in the same area, as well as in the hippocampus.

Both areas are critical to learning, memory, spatial navigation, emotion and motivation.

It could be that antidepressants can be useful by promoting neuron growth in these critical areas.

Professor Shively said:

“The study’s findings regarding the different effects of sertraline on brain-region volumes in depressed versus non-depressed subjects are compelling.

But given the number of different disorders for which SSRIs are prescribed, the findings need to be investigated further in patient populations to see if these drugs produce similar effects in humans.”

The research was published in the journal Neuropharmacology (Willard et al., 2015).

Shiny brain image from Shutterstock