Loose Screws Mental Health News

Ebselen, an experimental bipolar disorder drug, has been found by British researchers to work like lithium but without lithium’s side effects. In mice. In testing, mice that were somehow made manic with “small doses of amphetamine” were placated with ebselen. Researchers are now moving on to testing on healthy human volunteers before studying those suffering with bipolar disorder.


A study, published in JAMA Neurology, discovered that retired NFL players were more likely to suffer from depression and brain impairment. The study comes on the heels of the suicides of Dave Duerson, Ray Easterling, and Junior Seau. Researchers suspect a link between “hard hits to the head and depression.” These problems have also been noted in NHL players and combat soldiers who have suffered a brain injury. Many of the retired NFL players developed a type of brain damage called chronic traumatic encephalopathy (CTE). Duerson and Easterling were found to have CTE during autopsy. In related sports news, the UK’s Telegraph reports that depression is a problem for soccer players in England and Scotland.


According to Time magazine, ketamine—a drug that induces hallucinations and other trippy effects—may hold potential as an antidepressant.

And now scientists report on two formulations of drugs with ketamine’s benefits, but without its consciousness-altering risks, that could advance the drug even further toward a possible treatment for depression.

Ketamine is seen as a fast-acting antidepressant for those at high risk for suicide. GLYX-13, mentioned here previously, is a ketamine-like antidepressant currently in clinical trials. AstraZeneca has AZD6765, a “ketamine mimic” that does not appear to be as effective as actual ketamine.

New research has discovered that people with mental illness are more likely to be victims of domestic violence. Even though the study evaluated men and women, the results for women were overwhelmingly striking.

It finds that women with symptoms of depression were 2.5 times more likely to have experienced domestic violence over their lifetimes than those in the general population, while those with anxiety disorders were more than 3.5 times more likely to have suffered domestic abuse. The extra risk grew to seven times more likely among those with post-traumatic stress disorder.


An analysis of more than 1 million Scandinavian women has shown that taking SSRIs during pregnancy may not increase the risk of stillbirth. This study could help revolutionize treating depression in pregnant women.

“From our study, we don’t find any reason to stop taking your medication, because untreated depression may be harmful for the pregnancy and the baby,” [Dr. Olof Stephansson, the lead author of the new report] told Reuters Health.


Finally, “gender identity disorder” has been removed from the DSM-V and has been replaced by “gender dysphoria,” a condition in which people are concerned about their gender identity. “Gender identity disorder” seemed to stigmatize gays, lesbians, and transgender individuals. The continuing inclusion of “gender dysphoria,” however, ensures that people suffering with gender identity disorder still have access to health care treatment. (In my opinion, the renaming of “gender identity disorder” to “gender dysphoria” is really a politically correct change. Homosexuality was removed from the DSM back in 1973.)

Loose Screws Mental Health News

Portland, Oregon has been recently declared the most depressed city in the country. BusinessWeek determined this based on “antidepressant sales, suicide rates, unemployment, divorce, and crappy weather.” Philly didn’t make the top 20 list. That’s because we’re too busy enjoying the highest suicide rate in the country.


smokingA great way to avoid depression, however, is to simply stop breathing. Yes, that’s right. Just stop breathing. A new study presented at an American Psychological Society meeting shows people who are consistently exposed to secondhand smoke are twice as likely to suffer from depression. So that’s my recommendation to you: STOP BREATHING. I guarantee you won’t be depressed after a while. (By the way, that’s a joke so you can go ahead and take a deep breath now.)


Apparently all this talk of an economic depression is causing people to be depressed enough to buy more antidepressants. I don’t get how it works but it seems as though antidepressant prescriptions (along with sleeping aid prescriptions) are rising alongside the unemployment rate in this country. Big Pharma isn’t filing for bankruptcy anytime soon. And if they do, it’s their own freakin’ fault.


In what appears to be a landmark ruling (correct me if I’m wrong), the U.S. Supreme Court ruled that pharmaceutical companies are still liable for injuries cause by FDA-approved drugs and devices and juries can legitimately award damages. The buzzword I’ve learned for this case is preemption.

A woman who was injected with an antinausea drug (Phenergan, if you’re wondering) brought a damage suit against Wyeth after her arm had to be amputated. After a jury awarded her with $6.7 million, Wyeth took the case to the U.S. Supreme Court, expecting a cool victory after the court sided with Medtronic in last year’s Riegel v. Medtronic case. Wyeth, the defendant in the case, hoped the Supreme Court would rule in their favor since the FDA had already evaluated their product for safety—a preemptive act. However, this time the court ruled 6-3 in favor of allowing the woman to keep her award money. The decision also sets a precedent for pharmaceutical consumers to sue pharmaceutical companies for injuries despite FDA approval—striking down preemption. For further information, check out Doug Bremner’s and Philip Dawdy’s blogs that have already covered this. In the meantime, I leave you with this:

Ronald Rogers, a spokesman for Merck, said, “We believe state courts should not be second-guessing the doctors and scientists at the F.D.A.”Merck was hit with several huge damage awards over its painkiller Vioxx before agreeing to a $4.85 billion settlement in 2007. Allowing juries to make determinations about drug risks, Mr. Rogers said, would cause “mass confusion.”

Hm. Make of that what you will.

Loose Screws Mental Health News

As reported by The New York Times, people with bipolar disorder have a higher risk of suffering from fatal illness according to a study (that reviewed 17 other studies involving more than 331,000 people) reported in the February issue of Psychiatric Services.

In the larger studies, almost every cause of death was higher among bipolar patients: cardiovascular, respiratory, cerebrovascular (including strokes), and endocrine (like diabetes). In the smaller studies, mortality from cerebrovascular disease was higher among those with bipolar illness, but they showed inconsistent results, probably because they used smaller samples or less representative populations.

Gianna at Beyond Meds provides here take here.


Some crazy nurse in Minnesota convinced a Canadian college student to kill herself and walked her through the process of appropriately hanging herself. Ed Morrissey of Hot Air calls the nurse "the first serial suicide-inciter of the modern age." Couldn't have said it better myself.


Philip Dawdy at Furious Seasons is on a roll, holding AstraZeneca accountable for its actions regarding hidden information about Seroquel and now he hosts the Seroquel documents — alongside Lilly's Zyprexa documents — that indicate buried studies. Dawdy's also running a spring fundraiser and I suggest you get your butt in gear and donate to him if it's important to you that someone holds pharmaceutical companies accountable for their actions. I've already done my part.


Sorry this post isn't filled with my normal snark and cynicism. I'm behind on a lot personally — still trying to get the hang of this self-employment thing — and this is what I can throw out for now.

Concerta ADHD Ad

Of all the examples to use for an ADHD medication ad, I thought the “before” symptoms were terrible. I’m not ashamed to admit I did all of those things at one time or another (not in the same sequence). But then again, teachers tried to tell my mother I had (what used to be known as) ADD. Whatever. People these days call it ADHD. I call it being a normal kid. (Side rant: Teachers these days don’t want to deal with disciplining children in school when they misbehave or act out of turn so they recommend medicating them as a way to keep them docile and under control. And parents go along with it since they feel it will make their lives easier at home too. Not to say that some children don’t legitimately suffer from ADHD, but based on casual conversations I’ve had with a few people, it seems as though the number is rising.)

Below is a photo that I snapped of a Concerta ad which recently appeared in Shape magazine followed by 2 pages of side effects and indications. (Click on the picture to view its full size.) Feel free to post your thoughts in the comments.

Concerta ad

…and on to AstraZeneca's problems with Seroquel

Eli Lilly seems to be passing along its misfortune off to AstraZeneca, which now appears to be having issues with masking evidence of Seroquel side effects. From Furious Seasons:

A great article appeared in the St. Petersburg Times over the weekend, revealing that lawyers for AstraZeneca will argue in court later this month that the company wants documents introduced into a federal court hearing in a case over various allegations around Seroquel sealed and hidden from public view. They want an upcoming hearing in the federal class action lawsuit against AZ closed to the public as well. Lawyers argue that they are protecting patients and, oddly, the public at-large.

Read the rest of Philip's post.

Antidepressant rankings: Zoloft and Lexapro considered best overall

A number of antidepressants were recently ranked in different surveys:

Zoloft and Lexapro came in first for a combination of effectiveness and fewer side effects, followed by Prozac (fluoxetine), Paxil (paroxetine), Cymbalta, and Luvox among others.

The first was efficacy — or how likely patients were to experience the desired effects of the drug.

Efficacy:

1. Remeron (Mirtazapine)
2. Lexapro (Escitalopram)
3. Effexor (Venlafaxine)
4. Zoloft (Sertraline)
5. Celexa (Citalopram)
6. Wellbutrin (Buproprion)
7. Paxil (Paroxetine)
8. Savella (Milnacipran)
9. Prozac (Fluoxetine)
10. Cymbalta (Duloxetine)
11. Luvox (Fluvoxamine)
12. Vestra (Reboxetine)

The second was acceptability — the likelihood that a patient would continue using a drug for the duration of the study (it is generally assumed that a high ratio of patients dropping out indicates the presence of undesirable side effects for a drug).

Acceptability:

1. Zoloft (Sertraline)
2. Lexapro (Escitalopram)
3. Wellbutrin (Buproprion)
4. Celexa (Citalopram)
5. Prozac (Fluoxetine)
6. Savella (Milnacipran)
7.
Remeron (Mirtazapine)
8. Effexor (Venlafaxine)
9. Paxil (Paroxetine)
10. Cymbalta (Duloxetine)
11. Luvox (Fluvoxamine)
12. Vestra (Reboxetine)

antidepressantsMy experience with Lexapro was a disaster and I’ve written about Zoloft’s connection with irritability and rage. Paxil’s side effects are especially rough (see Bob Fiddaman’s Seroxat page) while Effexor’s withdrawal effects proved to be significantly challgenging. Although Prozac offset Effexor’s withdrawal symptoms, it causes severe somnolence that can impair cognitive functioning. And last but not least, Cymbalta contributed to the unfortunate death of Traci Johnson who had no history of depression.

These drugs may be effective for many people but it’s still a guessing game. Dr. Mark I. Levy, quoted in ABC News’s article on the rankings, mentioned that while psychiatrists may not have much use for the rankings, he sees them as beneficial for primary care physicians. And Dr. Harold G. Koenig, a professor at Duke University Medical Center, adds:

“I would be likely to start patients on either Zoloft [because it’s cheaper] or Lexapro … Unfortunately, that is almost none of my patients. By the time they get to me [a psychiatrist], the primary-care doctors have tried Zoloft and other antidepressants, so my patient are not the “new to medication” kind of patients,” he said.

I won’t rehash my thoughts on PCPs prescribing antidepressants and other psych meds. You can read about them here.

Done deal: Pfizer buys Wyeth for $68 billion

Pfizer-Wyeth merger

The New York Times puts it this way:

The deal, if completed, would not only create a pharmaceutical behemoth but would be a rarity in the current financial tumult: a big acquisition that is not a desperate merger of two banks orchestrated by the government. [emphasis mine]

Funny the writers decided to add that. A year ago, that clause would have never been considered yet alone thought of.

Pfizer isn’t doing badly; in fact, despite the credit crunch, they’ve been able to snag $22.5 billion in loans since they also have $26 billion cash on hand. The NYTimes also reports that this merger would be the biggest since AT&T and BellSouth merged back in March 2006. But of course, with mergers always come layoffs. And what a time to have layoffs. Pfizer today announced that they’ll be cutting 8,000 jobs.

But as I said in a previous post, Pfizer’s biggest challenge is get some pipeline products out to market soon since some of the patents on their big names (ie, Lipitor) are expiring soon. Don’t hold me to this but I think Wyeth has a bit more sitting in their pipeline, hence why the merger would make sense. But I hope Wyeth can produce a new blockbuster drug for Pfizer otherwise Pfizer’s really going to be hurting for money. Especially since Wyeth’s best-selling drug, Effexor, is now generic and Pristiq isn’t completely cutting it.

Pfizer may be buying Wyeth

Pfizer-Wyeth merger

Is Wyeth being hurt by the failing economy? I’m not so sure but Pfizer may be buying up Wyeth for up to $60 million. According to news reports, this could help the pharmaceutical giant by bringing in some of Wyeth’s brand name products while many of Pfizer’s own manufactures (think Lipitor) go generic. However, it could also be a drawback as one of Wyeth’s biggest sellers—our favorite antidepressant Effexor (venlafaxine)—has gone generic. Also, Pfizer doesn’t have the best track record of buying up other companies and turning them into blockbuster gold. Should be interesting to see what happens in the next few years if the deal does go through.

Pristiq's side effects: Too close to Premarin and Prempro for comfort?

Back in January 2007, I’d mentioned that Wyeth was not only seeking to market Pristiq (desvenlafaxine) for depression but also for the use of vasomotor symptoms in menopausal women.

I just learned that Wyeth produces two major menopause drugs, Premarin and Prempro, that allegedly has produced hormones causing cancer in more than 5,000 women. This added up to a loss of 40 million users and $1 billion annually.

With Effexor going generic in 2 years and the introduction of Pristiq to the market, Wyeth hopes to lure some of those customers back and net an annual $2 billion. However, serious questions linger about Pristiq’s side effects in menopausal women.

Why did two women in the study group taking Pristiq have heart attacks
and three need procedures to repair clogged arteries compared with none
taking placebo? How can Wyeth assure long term safety when 604 of the
2,158 test subjects took Pristiq for only six months and 318 for a year
or more? And what about serious liver complications seen in the studies?

Martha Rosenberg, reporting on Pristiq’s use as a menopausal drug, culled comments from CafePharma’s message boards and found one thread rife with mixed comments on the new drug. From an Anonymous commenter:

Continue reading “Pristiq's side effects: Too close to Premarin and Prempro for comfort?”