Blood test for efficacy of antidepressants in the future?

Scientists have found that a biomarker for depression could show whether a person's antidepressant is working. The discovery could lead to something everyone in the psych world has been waiting for: a blood test of some kind.

The researchers looked at the interaction of neurotransmitters and a protein called Gs alpha. In brain cells, the protein acts like a kind of butler, passing messages from neurotransmitters on the outside and amplifying their messages, [study co-author Mark] Rasenick explained.

When the protein is working properly, it's like a butler whose "hands are just flying, cooking and cleaning at the same time," he said. But when the brain is depressed, "it just sits there in the corner."

That's an interesting observation. This might finally explain the difference between "depressed" brain activity and normal brain activity on an MRI. (By the way, has anyone had an MRI performed for depression?)

Researchers compared the proteins in the brains of people who committed suicide as a result of depression to those who did not. "They found the protein would have worked less effectively in the brain cells of the suicide victims."

Dr. Gregory Simon conceded that doctors cannot determine which antidepressant will work for which person.

"There's a long history of research using patterns of symptoms or biological measures — chemicals measured in blood or spinal fluid — to predict response to a particular antidepressant. None of those hoped-for predictors have significant value.

[Genetic tests] would not eliminate trial-and-error, but it would reduce the waiting time with each trial. But it's a long way from a study like this one to a test that's useful to patients and doctors."

Good news for the skeptics about this research study: It was funded by the U.S. Public Health Service and the American Foundation for Suicide Prevention. But a test simply to see if an antidepressant is working has the smell of pharma somewhere on it.

(Hat tip: Ephphatha)

Blogs around the way

I’m catching up on reading my fellow bloggers’ posts (see Blogroll to the right), so if you’re not reading their site already, I’d encourage you to do so. Below  are some posts that caught my attention. Some might be a little dated.

Gianna at Bipolar Blast: Has a video up of Gwen Olsen, an ex-pharma rep who says that pharmaceutical companies aren’t in the  business of curing but in the business of "disease maintenance and symptom management." It’s nothing new but here are two quotes that caught my attention:

"And what I’m saying is provable is that the pharmaceutical industry doesn’t want to cure people. You need to understand specifically when we’re talking about psychiatric drugs in particular that these are drugs that encourage people to remain customers of the pharmaceutical industry. In fact, you will be told if you’re given a drug such as an anxiolytic, or an antidepressant, or an antipsychotic drug, that you may be on the drug for the rest of your life. And very frequently, people find that they are on the drug for a very long period of time, if not permanently, because they’re almost impossible to get off of. Some of them can have very serious withdrawal symptoms – most of them can have extremely serious withdrawal symptoms if they’re stopped cold turkey – but some people experience even withdrawal symptoms when they try to titrate or they try to eliminate the drug little by little, day after day."

"We have got to start making the pharmaceutical industry accountable for their actions and for the defective products they’re putting on the market. It won’t be long before every American is affected by this disaster and we need to be aware of what the differences are between diseases between disorders and between syndromes. Because if it doesn’t have to be scientifically proven, if there are no tests, if there are no blood tests, CAT scans, urine tests, MRIs – if there is nothing to document that you have disease, then you in fact, do not have a disease, you have a disorder and it has been given and has been diagnosed pretentiously and you need to get yourself educated and understand that there are options and those options are much more effective than drugs."

I’ve always wondered why doctors don’t run tests to diagnose any psychiatric disorders. From NIMH:

Research indicates that depressive illnesses are disorders of the brain. Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression. The parts of the brain responsible for regulating mood, thinking, sleep, appetite and behavior appear to function abnormally. In addition, important neurotransmitters–chemicals that brain cells use to communicate–appear to be out of balance. But these images do not reveal why the depression has occurred.

If MRIs have shown that the people with depression have a part of the brain that functions abnormally then why isn’t it standard for all people diagnosed with depression to have an MRI done to confirm this? I have one of two hypotheses:  it’s too expensive to get an MRI done for each person and that insurance won’t pay for it or the abnormal functioning cannot be detected in the brain of every depressed person.  Therefore, is major depressive disorder really a made-up diagnosis?

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Diagnosing Myself

I've been away from this journal for a while for a number of reasons. I'll be candid:

1. Work has become busy. The yearly schedule at work is in line with tax season (even though I don't work in anything related to accounting) so I'm usually busy from January through May. Expect tons of blogging in June and July — there is NOTHING to do.

2. My personal life has become quite busy too. I don't really have a free night except for Sundays and I'm left exhausted from doing something every single night of the week. Free Friday nights tend to be a rare commodity.

3. I feel awful that I can't keep up on anyone's blog at the moment. There are so many wonderful blogs that I'm addicted to reading and it's much too time-consuming at the moment. (I have this tendency to read the first post and then read back entries all the way to January. Before I know it, I've spent 2 hours at work wasting time.)

4. I'm a perfectionist who meticulously reads over most of my previously written posts and corrects grammar, spelling, etc.

There's probably more that I can't remember at the moment, but you get the picture. Now, on to diagnosing myself…

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Brain Shivers quote

"The brain shivers are even scarier. If I straighten my head to fast or look up too quickly I get this out of body experience where it feels like I’m being electrocuted. It feels like my brain bounces back and forth. And for those few seconds I am unreachable."

I can totally relate. (quote courtesy Graham’s Blog)

Venlafaxine withdrawal symptoms

Work has got me busy, folks, so posts may drop significantly in the next coming days/months. Possibly through April or May. (I’ll probably have one of those work days when I end up doing more blogging than working. It happens every now and then.) But don’t be surprised if Saturday quotes, Wednesday puppies, and Sunday stats are what pops up each week. I’ve got many of those backlogged through April. I’ll try to backlog some other posts on bipolar disorder and depression for the coming weeks and quickly blog on anything that’s timely.

electric shockIn the meantime, I had to take a sick day today. It’s my third day off of the Effexor and I’m having some weird side effects (see Case 1: Standard Dose under the link). Whenever I turn or move too quickly (consider your “natural” body turn), I “kind of” see stars and the whole world slightly spins beyond my field of vision for about 3 seconds before coming back into focus. After doing some light research on the side effects of venlafaxine (Effexor’s generic name), I’ve found out that side effects can incude vertigo, dizziness, light-headedness (associated with dizziness), and something called “brain shivers,” which are a form of electric shock sensations. You know that feeling when you get an electric shock from somebody? Yeah, imagine feeling that throughout your whole body. Precisely; not a good feeling. Nancy Schimelpfening, blogger for depression.about.com, found a newsgroup posting on the brain shiver effect, mainly associated with venlafaxine:

It happens to me if I turn my head quickly, or if I stop suddenly, or in general with sudden motion. They’re worse if I’m nervous.

i’ve seen them described as feeling as though your brain keeps going when you turn your head. that doesn’t seem quite adequate to me. it’s more like this:

you turn your head (or your whole body — this happens to me if i whirl around too quickly as i’m taking the stairs. what. doesn’t everyone whirl on the stairs…?), but your brain *stays put* for a micro second, then tries to catch up but only in a stuttering, stopstart motion, accompanied by a staccato ‘zzt zzt zzt’ with each stop. the ‘zzt’ you can feel in your head, an electric sort of vertigo, and it often reverberates in your hands and fingers. some folks feel it in their toes; i haven’t yet.

sometimes your brain overshoots and comes strobing back, then overshoots again.. this all unfolds in just a second or two.

these days i endeavor to go around corners all smooth slow and steadylike. helps to reduce the number of brain shivers per day

Yeah, that’s me. It’s hard to explain to someone who’s never felt it. I got this feeling after not taking Paxil for three days too. The effects eventually wore off, but it was such a weird feeling.

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Loose Screws Mental Health News

VNSCyberonics has its vagus nerve stimulator (VNS) while Neurontics is attempting to promote its Neurostar. The Food and Drug Administration will consider whether Neurontics’ device will be able to compete with Cyberonics’ device on Jan. 26. The VNS, according to FDA standards, is the only device that has been proven to show efficacy in depression treatment for those who do not respond to drug treatment. While the VNS is surgically implanted in the chest and stimulates nerves in the neck to alleviate depression, Neurontics claims that Neurostar is not surgically implanted and uses magnetic pulses over the course of three to six weeks to stimulate a patient’s brain.

In the most shocking news ever, the Australian Mental Health Council has found that marijuana can induce mental illness. [sarcasm] Former Federal Police commissioner Mick Palmer has noted three significant conclusions from the MHC report: Cannabis use can:

  • increase the risk of mental illness in young adults, namely with those who have a family history of psychosis
  • make any current mental illness worse
  • induce poor education and employment outcomes

This report once again reminds us, kids, that we must always say no to drugs. Especially if you’re mentally ill.

Girl, InterruptedAn article from the UK Guardian points out that Hollywood’s depiction of mental illness is NOT what people experience on a normal basis. Tim Lott states the reality of mental illness quite well:

“Genuinely accurate depictions of mental illness are still rare in all the art forms. Why? For the very good reason that real mental illness is boring. Depressives are toxic and dull. Manic depressives are irritating. People with schizophrenia or autism are largely indecipherable.”

Just in case you didn’t know, depression can be a problem during the holidays. Oh and p.s. from the article: those who abuse anti-depressants are more likely to commit suicide. You know… just in case you were wondering. Amy Alkon at the Advice Goddess Blog rightly shoots down the holiday-suicide increase myth.

NBC5 in Chicago has reported that “brain music” can help fight depression. Brain waves are recorded through an EEG (electroencephalogram) and then the recordings are turned into a music CD containing two files. According to Dr. Galina Mindlin, who introduced the therapy to the U.S. from Russia, says one file helps a patient relax and the other file helps increase “concentration, performance and productivity.” Mindlin adds that the “relax” music helps decrease anxiety levels in a patient and helps the patient fall asleep and stay asleep. The treatment, according to NBC5, has been used in Europe for the past 15 years, but is not widely available in the U.S. BUT if you’re itching to try it, you’d better have some dough in your pocket: it’s not covered by insurance and costs $550.

Just another day: Part II

Originally written October 16, 2006 (Updated edits in bold red)

On the heels of discussing my cynicism about pharmaceutics and pharmaceutical companies (namely, psychiatric-related), I have a few questions regarding the approach of psychiatric evalutations:

1. Why aren’t people tested for biochemical imbalances?
2. Is there a way to determine from blood work or an MRI what kind of mental illness a person is suffering from (in conjunction with the patient’s psychiatric assessment)?
3. How do doctors know the appropriate dosage for a patient? Does s/he start a patient off on what is considered “normal” for an average person and then increase or reduce the dosage based on reactions and side effects?
4. How does a doctor know when to increase a dosage? (Figuring out when to reduce a dosage SHOULD be much easier.)


Psychiatry is an inexact science. For the most part, I think much of it — regarding medication, Freud, and now, the pharmaceutical industry — is a crock.

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More Loose Screws Mental Health News

I’ve been kind of out of the mental health news bit for a while but I’m going to blog about what I can and forget the rest. I don’t have the unlimited time to devote to it like I used to and there are so many other blogs that are way ahead of me. Makes me wonder why I blog about some of this stuff sometimes.

Anyway, instead of dwelling on my pointlessness in cyberspace, I bring you more mental health news…

Pennsylvania becomes the latest state in Wal-mart’s new push to offer a 30-day’s supply of generic drugs at the low, low price of $4!  The average price of a generic drug, according to the Bucks County Times article is $28.92. D-Mac on Will Do names Paxil, as one of a host of anti-depressants that have generics to be offered for cheap. Wal-mart, as with everything they sell, buys so much of the generic drugs in bulk that they are able to sell them cheaply and still make a profit.  Don’t expect pharmacies like CVS or Eckerd’s to follow suit though. The article adds that those companies thrive on “convenience and location.” Meh, if your insurance is accepted at Wal-mart, go for it. I just feel sorry for the poor mom and pop pharmacy store on the corner.

Interesting: depressed people and alcoholics have asymmetrical brain activity.

What a Not-So Novel Idea!

Jotting down a few ideas:

Brain scanHow about a psychiatrist does a blood test on, oh say, 10 different people who seem to have depression… chart symptoms of the same kind, check to see if blood levels are the same or similar, low or high blood pressure, regular pulse, etc? Maybe perform an MRI of the brain and monitor brain activity as the brain is triggered by happy thoughts and then sad thoughts…? What would be the difference (if any)? How about a thyroid check? Why isn’t there a way to measure dopamine and serotonin levels? How can we accurately treat these different neurotransmitters in people if there isn’t a current way to test for those transmitter levels?

Really, I’m not thinking anything new. Hasn’t anyone already thought of/done this?

It also strikes me that when it comes to treating mental illness, neurologists and psychiatrists need to function as one unit.