Depression

While the disease Hepatitis C can cause patients to become depressed, a standard treatment for it, interferon, can also cause varying degrees of depression, including thoughts of suicide, say researchers at Loyola University.

In fact, anywhere from 10-40% of hepatitis C patients will become depressed during the course of their illness.

Interferon can cause depression because it affects the level of serotonin, a neurotransmitter which helps in mood-regulation.

In a review article, Dr. Murali S. Rao and his team examined the complexities of sorting out the causes of depression in hepatitis C patients and effectively treating it.

Rao suggests that patients with a history of depression and suicide should be carefully screened and evaluated prior to treatment with interferon.

In addition, treatment with a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) - which includes such medications as Zoloft, Celexa and Prozac - has been shown to be effective in patients receiving interferon therapy.

The study was published in the International Journal of Interferon, Cytokine and Mediator Research.

Antidepressant use may be doing more harm to patients than good, according to Paul Andrews, a evolutionary biologist at McMaster University.

"We need to be much more cautious about the widespread use of these drugs," he said in an article published in the online journal Frontiers in Psychology.  "It's important because millions of people are prescribed anti-depressants each year, and the conventional wisdom about these drugs is that they're safe and effective."

Andrews and his research team came to this conclusion after examining previous studies comparing the risks versus the benefits of various antidepressants.

Antidepressants can cause unwanted side effects because their action is not limited to the brain, where they work to increase serotonin and relieve depression.   Serotonin also has effects all throughout the body, where it is involved in such diverse processes as digestion, blood clot formation, reproduction and development.

Some of the areas of risk identified by the researchers include:

• Developmental problems in babies
• Problems with sexual function and sperm development
• Digestive problems
• Abnormal bleeding and stroke in the elderly

In the elderly in particular, the researchers noted that there was an increased risk of death among antidepressant users.

Andrews suggests that with all of these negative effects to consider, it may be wise to reevaluate the routine usage of these drugs.

The journal is available online at http://www.frontiersin.org/.

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Newer antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and Effexor, may be able to help relieve depression in Parkinson's disease patients without aggravating disease symptoms, such as tremor or rigidity, researchers say.

In a study of 115 Parkinson's disease patients, the study subjects were treated with either Paxil (an SSRI), Effexor or an inactive placebo pill.  The patients were then followed for 12 weeks, during which time their depression symptoms improved while the motor symptoms associated with the disease did not worsen.

On average, patients taking Paxil had a 59% improvement, while those taking Effexor had a 52% improvement.  Patients receiving the placebo also experienced improvement, although it was significantly lower at 32%.

"Depression is the number-one factor negatively affecting the quality of life for people with Parkinson's disease," said study author Dr. Irene Hegeman Richard.  "It causes a great deal of suffering among patients.  The great news here is that it's treatable.  And when the depression is treated adequately, many of the other symptoms become much more manageable for patients."

Depression in Parkinson's disease is caused by the disease itself, not the stress of dealing with a chronic illness, Richard noted.

Treating this depression can be difficult because care must be taken to not exacerbate the symptoms of the disease.

The study was published in the April 17, 2012 issue of Neurology.

If you live alone, you may have an almost 80% greater risk of becoming depressed, according to a study published in March 2012.

The study included 3,500 working-age men and women in Finland who were followed by the researchers for seven years.

In women, one-third of increased depression risk was also linked to factors such as low income and lack of education, while the main risk factors for men were heavy drinking and a lack of support at work and in their private lives.

"This kind of study usually underestimates risk because people who are the most at risk tend to be the people who are least likely to complete the follow up," noted study author Laura Pulkki-Raback.

While living alone was associated with depression, the study was not able to prove a cause-and-effect relationship between the two.

The study was published in the journal BMC Public Health.

People with common mental illnesses like depression are less likely to receive support from friends and family than people who have less common mental illnesses like schizophrenia, which may have a more severe effect on behavior, says one researcher.

Study author Brea L. Perry examined interviews with 165 people with a range of mental illnesses, including bipolar disorder, schizophrenia, major depression and other less severe disorders, who were undergoing first-time treatment.

What she found was that people who had more common - and therefore more social-accepted - illnesses like depression, did not receive a strong reaction from family and friends.  This probably means, noted Brea, that they will also not be strongly supported by these people when they need help coping with the effects of their illness.  Even though illnesses like depression are accepted as legitimate by the medical community, the general public may not see them as a justification for treating someone as being "sick."

Illnesses which have more obvious symptoms like schizophrenia and bipolar disorder, however, are more likely to receive a supportive reaction, even though they may be more strongly stigmatized by strangers.

The article was published in the Journal of Health and Social Behavior.

According to a new study, Hispanic and black patients are less likely to be prescribed antidepressants than their white counterparts.  In addition, those with Medicare and Medicaid are less likely to receive antidepressants than those with private insurance.

In order to reach these conclusions, University of Michigan School of Public Health researchers looked at data ranging from 1993 to 2007.

Specifically, they found that whites were 1.5 times more likely to receive prescriptions for antidepressants than minority groups were, while Medicare and Medicaid patients were 31% and 38% less likely to receive them than those with private insurance.

They did find, however, that race did not play a role in what type of antidepressant was prescribed, although the type of insurance held by the patient did.  Medicare and Medicaid patients were 58% and 61% less likely to receive newer antidepressants than privately insure patients.  The type of antidepressant prescribed is significant because older antidepressants generally have more side effects and are less well tolerated than newer antidepressants.

These findings show the need for "policy makers to design interventions to improve physician practice guidelines adherence," said lead author Rajesh Balkrishnan.  "This will eliminate unnecessary variations among physician practices and....obtain optimal health care for patients."

The study was published online in the International Journal of Psychiatry in Medicine.

A new study suggests that the sleep disorder obstructive sleep apnea may be linked to major depression.

Obstructive sleep apnea is a type of sleep disorder in which the soft tissue at the back of the throat blocks the upper airway during sleep, causing breathing to temporarily stop.  It also causes symptoms such as gasping, snorting and snoring.

For the study, the U.S. Centers for Disease Control and Prevention surveyed 9,700 Americans and found that 6% of the men and 3% of the women had been diagnosed with obstructive sleep apnea.

The researchers also found a link between the symptoms of the sleep disorder and certain depression symptoms, such as feelings of failure and hopelessness.  One symptom which was not associated with depression, however, was snoring.

"We expected persons with sleep-disordered breathing to report trouble sleeping or sleeping too much, or feeling tired and having little energy," noted lead author Anne Wheaton, "but not the other symptoms," such as hopelessness.

It should be noted, however, that, while a link was found, this does not prove that obstructive sleep apnea causes depression.

The study appears in the April issue of Sleep.

Negative thinking is a contributing factor to depression; and, if you can stop your negative thoughts quickly enough, you can prevent it, says Jaclene Zauszniewski, a researcher from the Frances Payne Bolton School of Nursing at Case Western Reserve University.

Towards this end, she decided to develop an 8-item survey which healthcare providers can use to identify patients who might be able to benefit from interventions aimed at stopping negative thinking.

The Depression Cognition Scale (DCS) asks the patient questions about helplessness, hopelessness, purposelessness, worthlessness, powerlessness, loneliness, emptiness and meaninglessness using a scale ranging from "strongly agree" to "strongly disagree."  It has previously been successfully used to screen for depressive symptoms, but Zauszniewski wanted to further develop it as a tool to look for the exact point where negative thought patterns might slip into being clinical depression.

For the study, DCS scores from 629 adults who took the survey via the Internet were compared to scores for the Center for Epidemiologic Studies Depression Scale (CES-D), which is considered to be the "gold standard" for identifying clinical depression.  The goal in making this comparison was to determine whether there was a cut off point on the DCS where individuals could prevent clinical depression by learning skills to change their negative thinking.

It was found that a score of 7 on the DCS represented this point where depression prevention was still possible.  This score also represented the point at which patients were om the cusp of becoming clinically depressed, based upon their CED-D score.

Zauszniewski believes this tool can be useful because "clinicians need guidelines and measures to know when negative thinking has reaching a tipping point and has begun to spiral into clinical depression."

The study was published in Issue 34 of the Western Journal of Nursing Research.

Related Articles:

• Common Negative Thought Patterns and How to Defeat Them
• Best Strategies for Stopping Negative Thoughts

On March 14, 2012, the U.S. Food and Drug Administration approved the first generic version of the antidepressant Lexapro (escitalopram).

The generic version of the drug will be manufactured by Teva Pharmaceutical Industries/VAX Pharmaceuticals, an American company which produces many generic medications, and they will be the sole provider of the generic form of the drug for six months.

Teva will provide the drug in 5-, 10- and 20-mg doses, and, like the brand-name version, it is approved for the treatment of adult depression and generalized anxiety disorder.

Escitalopram belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs), whose mode of action involves blocking the reuptake of serotonin by brain cells causing more of this important mood regulator to be available for use.

Common side effects of SSRIs include insomnia, ejaculation disorder, nausea, increased sweating, fatigue, sleepiness and decreased sex drive.

As with other antidepressants, escitalopram may cause increased risk of suicidal thoughts and behaviors in children, teens and young adults under the age of 25 when treatment is first begun.

Related Articles:

• Drug Profile for Lexapro (Escitalopram)
• The Risk of Suicide in Depressed Children Using Antidepressants