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Posted by john on August 26th, 2007 — in Paxil Top News
Knocking out a single gene in mice can produce symptoms of obsessive-compulsive disorder (OCD), researchers report in tomorrow’s issue of Nature. Their experiments provide clues about the neural circuits and signaling pathways involved in compulsive behavior and may provide a useful animal model for studying OCD and evaluating treatments.
More than 2 million people in the United States suffer from OCD, which is characterized by intrusive, anxiety-provoking thoughts and repetitive behaviors meant to alleviate them–an obsessive fear of germs, for example, that leads to compulsive hand washing. Although drugs like Prozac, which increase levels of the neurotransmitter serotonin, seem to help some people, little is known about the mechanisms behind the disorder.
In the new study, neuroscientist Guoping Feng of Duke University in Durham, North Carolina, and colleagues, including Nicole Calakos and William Wetsel, didn’t set out to tackle OCD per se. Feng studies proteins that form the synaptic connections between neurons, and his original goal was simply to see whether defects in such proteins could cause abnormal behavior. Indeed, when the researchers knocked out the gene for one synaptic protein, called SAPAP3, in mice they noticed something odd: After a few months, the animals developed lesions on their heads and necks.
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At first, the researchers suspected a skin problem, but that wasn’t the case. Cameras set up in the rodents’ cages revealed that the knockout mice groomed their faces far more than normal mice do. The grooming was so excessive that the animals sometimes destroyed their eyes and ears. Additional behavioral tests suggested that the mutant mice were unusually anxious, another symptom of OCD. Both the anxiety and the excessive grooming were alleviated by Prozac.
Digging for the root of the problem, the team experimented with slices of brain from the mutant mice. This pointed to a defect in the striatum, part of a circuit involved in controlling actions. Some studies with human OCD patients have hinted at abnormal activity in this same circuit. In the knockout mice, at least, one problem is that synapses that respond to the neurotransmitter glutamate didn’t transmit signals reliably.
The findings should spur research on the potential role of the striatum and glutamate synapses in human OCD, says Steven Hyman, a psychiatrist at Harvard University and former director of the National Institute of Mental Health (NIMH) in Bethesda, Maryland. The clue to glutamate, Hyman says, “reminds us of what we never should have forgotten”–that even though Prozac and other serotonin-modulating drugs can work, the underlying problem may lie elsewhere. The study may also lead to clues about the mysterious genetics of OCD, adds Husseini Manji, director of the Mood and Anxiety Disorders Program at NIMH. “I think you’ll see a flurry of activity to look at this gene and its partners,” Manji says.
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Posted by john on August 19th, 2007 — in Paxil Top News
At last - an expert talking sense. “It is normal to feel depressed,” writes Professor Gordon Parker in the latest edition of the British Medical Journal. How many of his fellow psychiatrists have shrunk from that statement of the bleeding obvious?
Tony Hancock
Quintessential British gloom: Tony Hancock
Normal? You bet it is. People have been feeling depressed since the first Neanderthal crawled out of his cave and discovered it was raining.
The Old Testament is full of gloomy old gits moaning about plagues and floods. It is only our generation that regards feeling down in the dumps as a sickness.
We have become so relentlessly upbeat that people are made to feel guilty, abnormal, and dysfunctional the minute anything goes wrong in their lives. An unhappy love affair, or a boss who forgets their birthday, and they are reaching for the Prozac.
Prof Parker practises in Australia, where they call a spade a spade, and has lost patience with the culture that sees someone with a hang-dog expression and thinks: “Ah-ha. Clinical depression.” Quite right, too.
I wear a hang-dog expression most of the time. It is my face of choice, you might say - particularly when the English summer is misbehaving, or I am stuck in a motorway tailback, or some moron in the supermarket queue is jabbering into her mobile phone.
But it is not because I was abused as a child or because I am a closet psychopath. I just like to have a good moan.
Like my patron saint, Victor Meldrew - the sanest man in Britain - I would rather grumble and let off steam than go around smiling at people for the sake of smiling.
A grumble can be relaxing and therapeutic, whereas smiling at people indiscriminately can be incredibly stressful. If you smile at A, you have to smile at B and C, or B and C might feel offended, and before you know it, your jaw muscles are aching as if you have just had major dental surgery.
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Better, surely, to start off with an all-purpose scowl that you can relax if circumstances permit.
Nobody who has seen serious depression at first hand can doubt that it is a frightening and debilitating condition: complex in origins and difficult to treat. But for how many people has depression become a grand-sounding term for nothing more dramatic than a glum outlook on life - an outlook which, once analysed, is not necessarily unhealthy at all?
In that old distinction between viewing a glass as half full or half empty, it has become axiomatic that the person who views it as half full is, emotionally, the wiser of the two. But isn’t that rather simplistic?
Think of the glass as a tumbler of whisky in a pub. The person seeing a half-full tumbler may have totally deluded expectations that, if he keeps grinning and doing his David Brent impressions, someone else will top it up for him. The person seeing a half-empty tumbler realises that it will soon be empty and, very properly, starts calculating whose turn it is to buy a round. Perspective is all.
I remember going to watch an England-Australia Test match with a friend who is even more pessimistic than I am. As Australian wickets tumbled, I was up on my feet, punching my fist in the air. “Steady, Max,” said the friend, looking sombre, as if his mother had just died. “The Aussies will win. They always win.”
When the inevitable turn-around happened, he had the satisfaction of saying, “I told you so”, while I felt only deflation. He had anticipated the deflation, like a man leaving the house with an umbrella. And who is to say that was a bad strategy?
No character in all the novels of childhood plucks at the heart-strings as much as the immortal Eeyore, the glummest character in all fiction. Did we, as children, love him less than we loved Pooh, or Piglet? Of course not. We recognised, in that doleful grey face, a piece of ourselves. We intuited, even when we very young, that we all had a bit of the Eeyore in us, but that that was all right, because life was about light and shade: different moods for different circumstances.
Eeyore’s creator, A A Milne, was an Englishman, which is no coincidence. The character could never have been conceived in America, where optimism is a religion, doubters are vilified as losers, and there is a self-help book for every aspiration, however asinine.
In England, where the habits of scepticism are ingrained, there has always been a place for the melancholic, from Hamlet to Tony Hancock.
When we have not had the weather to moan about, we have found something else to moan about. And long may it remain so. A little light depression keeps real sickness away.
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Posted by john on August 15th, 2007 — in Paxil Top News
The generic prescription drug program of Regence BlueCross/BlueShield in Utah said on Monday that people who are being prescribed antidepressants for the first time need prior authorization in order to be prescribed brand name antidepressants, but can obtain generic antidepressants without the prior authorization.
The program does not require prior authorization for patients already being prescribed antidepressant medications. Prior authorization means that the brand name medicine must be approved by Regence under the patient’s individual drug plan. According to the press release using a generic antidepressant could save about $50 a month on the cost of medication.
Regence is a not-for-profit company. They formed a Pharmacy Benefit Program (PBP) in 2000 to oversee the prescription program. The name of the program is RegencyRx, and it as well as Regence is non-profit, rare for Pharmacy Benefit Programs - at least according to the press release.
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David Clark, the Vice President of Medical Services as well as VP of the Pharmacy was quoted as saying: “Evidence indicates that most antidepressants are equally effective when comparable doses are used.” He pointed out the efficacy of the program in encouraging generic antidepressants for first time antidepressant users. Clark also explained the concept of generic drugs and how they must have equivalent active ingredients and effectiveness to the brand named drugs in order to be approved by the Food and Drug Administration (FDA). He further explained that antidepressants and the literature and data surrounding their use had been researched thoroughly before the prior authorization program was put into effect.
Clark said that the generic drugs suggested for treatment for depression by RegencyRx have good track records. Fluvoxamine and fluoexetine are two of the approved generic anti-depressants. Another topic Clark addressed was the use of antidepressant medication for more diverse purposes such as treating obsessive-compulsive disorders, bulimia, post traumatic stress disorder, etc. He stated that most of the time generic antidepressants are effective in treating these disorders as well. He implied that the prior authorization program applied to antidepressant prescriptions regardless of the whether the diagnosis involved was depression or another disorder.
In addition to Utah, Oregon, Washington and Idaho are served by Regence . The different BlueCross/BlueShield programs provide coverage to three million members.
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Posted by john on August 10th, 2007 — in Paxil Top News
The finding may one day give doctors a better shot at choosing the right antidepressant for the right patient, helping to eliminate the trial-and-error process many people undergo before they find an effective treatment.
“This is definitely a step ahead,” said Dr. Gonzalo Laje, a researcher at the National Institute of Mental Health, in a telephone interview.
He said depression will be the second-leading cause of disability by the year 2020.
“It’s huge. It costs the U.S. over $43 billion every year in terms of direct and indirect medical costs.”
“If we can identify markers that would predict who gets better with which treatment, we can maybe decrease this burden and make the disease easier to treat,” Laje said.
He said researchers will need to identify more markers before the research will be of use, but it helps scientists better understand the disease and gives a clearer picture of who might benefit.
Ideally, Laje would like to be able to find enough gene variants to predict when a patient is 95 percent more likely to benefit.
Celexa is in a class of drugs called SSRIs, or selective serotonin reuptake inhibitors.
Researchers studied DNA samples collected in the $35 million, seven-year Sequenced Treatment Alternatives to Relative Depression, or STAR*D, a study paid for by the National Institute of Mental Health.
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Earlier findings from this study found Celexa sent 37 percent of patients who took it into remission.
In the latest study, researchers examined genetic material from 1,816 patients, comparing data from those who responded to Celexa and those who didn’t.
They found people with a variation in the GRIK4 gene were more likely to respond to the drug, especially when they also had a variation of the HTR2A gene.
Prior studies have shown variations in the HTR2A gene — which makes a protein related to the chemical messenger serotonin — play a role in a patient’s response to Celexa.
The GRIK4 gene makes a protein that is involved with the glutamate system, which also has been linked with depression.
Researchers said the findings are building a better picture of the biological mechanisms that underlie depression, a disease that affects about 121 million people worldwide, according to the World Health Organization.
In the United States, an estimated 21 million adults, or 9.5 percent of the population, have depression at some point. It is the leading cause of suicide
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Posted by john on July 29th, 2007 — in Paxil Top News
Medco Health Solutions Inc., the biggest U.S. manager of drug benefits, said Friday second-quarter earnings rose 26 percent on sales of higher-profit generic medicines, and the company raised its 2007 forecast.
Net income, beating analysts’ estimates, rose to $214.9 million, or 76 cents a share, from $170.9 million, or 56 cents, a year earlier, the Franklin Lakes-based company said Friday. Revenue rose 4.4 percent, to $11 billion.
Medco, the operator of drug plans for employers, benefited from rising sales of generic versions of Pfizer Inc.’s antidepressant Zoloft and other medicines. Sales of treatments that need special handling and garner higher prices, such as Amgen Inc.’s injected rheumatoid arthritis drug Enbrel, also contributed to growth.
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“Our stronger-than expected results show record high generic dispensing rates,” said Chief Executive Officer David B. Snow in a call to investors. “Generics are a place where the interest of our clients, of Medco, and of our investors are clearly aligned.”
The higher forecast reflects the introductions of new generic versions of two blood-pressure medicines, Pfizer Inc.’s Norvasc and Novartis AG’s Lotrel, said Ricky Goldwasser, an analyst with UBS Investment Research in New York.
Shares of Medco rose 63 cents, to $78.82, in New York Stock Exchange composite trading. The stock has climbed 46 percent this year through Thursday.
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Posted by john on July 25th, 2007 — in Paxil Top News
Wellbutrin, also known by its scientific name Bupropion, is a very popular antidepressant. It inhibits the reuptake of both dopamine and norepinephrine. If you have never used Wellbutrin before, you need to familiarize yourself with the drug interactions and the side effects associated with it.
Wellbutrin is metabolized by the liver. In lab experiments performed with rats, the drug was found to cause hepatocellular hypertrophy when administed in high doses (hypertrophy is an increase in the size of the cells). Common side effects include agitation, dizziness, hypertension, dry mouth, tremors, anxiety, loss of appetite, headache, excessive sweating, increased risk of seizure, and insomnia.
Although with the recommended dosing of the drug the probability that a seizure will occur is extremely small, patients using it should still be screened for any health factors that could contribute to or increase the likelihood of a seizure. A doctor may also review other prescriptions the patient might be taking and recommend an appropriate dosage based on that information.
Also, suicidal thoughts and attempts have been reported in children and adolescents. Bupropion has been shown to increase the incidence of suicidal thoughts amongst children and adolescents. When treating major depression in this group of patients, clinical benefits should be weighed carefully against the potential hazards. Usually, Bupropion is not intended for patients under the age of 18.
Another potential side effect is an improvement in sexual function. Bupropion, unlike serotonin reuptake inhibitors such as Prozac, does not appear to reduce the libido of the patient, and more frequently enhances sexual desire. Patients who complain of an impairment in their sex drive as a result of their SSRI have sometimes been prescribed small doses of Wellbutrin to correct it.
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One controversy associated with Bupropion is its propensity to lower the seizure threshold. In combination with other medicines, it has been suspected to cause seizures in some patients who have never had a seizure before.[12] While this is not common, an increase in the number of such cases around the globe probably merits further discussion and investigation.
It is not uncommon for patients to receive treatment with other antidepressant prescriptions in combination with Wellbutrin. For this reason, a doctor should be careful when prescribing it with other medications prone to lowering the seizure threshold. Bupropion has also been known to produce seizures in combination with non-illegal drugs such as cocaine and recreational drugs such as alcohol.
I hope you have found this information helpful. Be sure to disclose to your physician any other drugs you might be taking before requesting a prescrtiption for Wellbutrin. Although some of the side effects and drug interactions we have covered are rare, they can happen unexpectedly to even the most healthy individuals.
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Posted by john on July 22nd, 2007 — in Paxil Top News
Paxil is an antidepressant medication that is part of a family of drugs called Selective Serotonin Re-uptake Inhibitors (SSRI’s). Early results of new studies show that Paxil increases the risk of birth defects such as heart defects.
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When women take Paxil during the first three months of pregnancy the risks are much greater. If you or a loved one has taken Paxil then contact us today. We can help.
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Posted by john on July 17th, 2007 — in Paxil Top News
I commend Laura Zigman for her open and honest account of her battle with depression [”Coping Outside the Box,” July 10]. She captures the experience of so many who struggle not only against depression but also against the stigma associated with its treatment. While her article is well-intentioned, I fear her description of antidepressant use as “the easy way out” reinforces the stigma around this disease. Clinical depression, like any other serious illness, requires serious treatment. We would never consider chemotherapy or insulin injections as the “easy way out” when treating cancer or diabetes.
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The American Psychiatric Foundation is a founding member of the Depression Is Real Coalition (www.DepressionIsReal.org), a group of medical, advocacy and civic groups dedicated to educating the public about depression. Treatments such as antidepressants or psychotherapy can make the difference between life and death. Zigman’s eloquent story underscores the reality that hope and recovery is possible.
Arlington
I found “Coping Outside the Box” moving. I do not suffer from depression but have family and friends who do. I’m ashamed to say that I’ve always struggled with the inability to fully sympathize with those suffering from depression. Part of me just didn’t get it. But a few paragraphs of your story really opened up my heart. Now I feel like I really understand what the depressed have gone through.
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Posted by john on July 15th, 2007 — in Paxil Top News
US Citizens have until August 31 to claim a $100 refund if you bought Paxil for someone under the age of 18.
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The anti-depressant’s makers, GlaxoSmithKline, were successfully sued for failing to warn consumers that it could induce suicide in young adults and children taking the drug.
In other news, a child’s life is worth one-hundred one-dollar bills.
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Posted by john on July 9th, 2007 — in Paxil Top News
July 3 (Reuters) - Caraco Pharmaceutical Laboratories Ltd. (CPD.A: Quote, Profile, Research) said U.S. health regulators granted final approval for its generic version of GlaxoSmithKline PLC’s (GSK.N: Quote, Profile, Research) anti-depressant Paxil.
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For the 12 months ended March 2007, paroxetine HCl generic and brand products had annual sales of about $330 million, according to IMS data. (Reporting by Neetha Mahadevan in Bangalore)
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