Mixing Migraine Meds and Antidepressants Can Be Dangerous

People taking migraine drugs together with some antidepressants are at risk of a life-threatening condition, according to a new FDA advisory.

The problem arises when people take migraine headache drugs called triptans with antidepressants known as selective serotonin/norepinephrine reuptake inhibitors (SSRIs/SNRIs).

The combination can cause seritonin syndrome. The syndrome occurs when the body has too much of the nervous system chemical serotonin.

People taking both drugs classes can experience restlessness, hallucinations, loss of coordination, fast heart beat, rapid changes in blood pressure, increased body temperature, overactive reflexes, nausea, vomiting and diarrhea.

Commonly prescribed SSRIs include Prozac, Zoloft, Paxil and Lexapro. SNRIs include Cymbalta and Effexor. Triptans include Amerge, Axert, Imitrex and Zomig.

The FDA has asked the manufacturers of all three types of drugs to update their prescribing information to warn of the potential risk of serotonin syndrome.

Patients should talk to a doctor before stopping either medication, the FDA said.


FDA health advisory.

Discover Alternative approaches to depression.

SSRI Risk of Suicide Twice That of Placebos

The British Medical Journal reported this week that GlaxoSmithKline, maker of Paxil, recently sent a letter to doctors saying the drug caused a six-fold increase in the risk of suicidal behavior. But Paxil isn't the only SSRI with suicide risks.

An analysis and comment published in the July 8 issue of the BMJ said that current practices and research methods tend to exaggerate the benefits and underestimate the risks of suicide posed by all SSRIs.

The study included a meta-analysis of published trials and found that the likely risk of suicide for patients taking SSRIs compared to a placebo was 2.6 -- more than twice the risk.

The author, David Healy, Professor of Psychiatry at Cardiff University, said bodies like the Food and Drug Administration do not always act in the best interest of patients. Healy said that drugs regulators and manufacturers are "too close".

Antidepressants Increase Diabetes Risk

A new study from the Diabetes Prevention Program, sponsored by the National Institutes of Health, indicates that antidepressants dramatically increase the risk of developing type-2 (onset) diabetes, for those who are already at risk for the disease.

This new finding puts conventional medical approaches in a double bind, because antidepressants are the treatment of choice for most doctors, even when treating depressed patients at risk for diabetes.

Roughly 20 million Americans have clinical depression, and roughly 16 million have diagnosed diabetes. These numbers overlap considerably. In addition, as many as 100 million Americans have metabolic syndrome, which puts them at risk for both diabetes and depression.

Read more about Diabetes, Depression, and Antidepressants.

Paxil Again Linked to Suicide

GlaxoSmithKline, manufacturer of Paxil, has notified doctors that the anti-depressant may increase the likelihood that adults might attempt suicide.

The FDA released a state ment about the new warning, which is the second about suicide from Paxil in two years:

"We are recommending that consumers and prescribers follow current advice to carefully observe adults being treated with antidepressants for worsening of depression and for increased suicidal thinking and behavior. It is essential that patients taking Paxil do not suddenly stop taking their medication."

In Britain, Paxil (Seroxat in Europe) is the number one antidepressant. In response to GlaxoSmithKline's announcement, the British Health Secretary, Patricia Hewitt, declared the end of the "Prozac nation".

The British are launching a program to cut the numbers of patients on drugs such as Prozac and Seroxat and extend counseling to the thousands of people with mild to moderate depression and anxiety.

For information on alternative treatments for depression.

Light Therapy And Fluoxetine Are Equally Effective For SAD

Bright artificial light and the antidepressants fluoxetine (Prozac) are both effective treatments for the winter form of seasonal affective disorder (SAD). A head-to-head comparison conducted in four Canadian cities over three winters is reported in an article in the May issue of The American Journal of Psychiatry, the official journal of the American Psychiatric Association (APA).

Read more about the study comparing light therapy to prozac as well as the advantages of light therapy over antidepressants.

Depression: U.K.'s Biggest Social Problem

Around 15% of the British population suffers from depression or anxiety, says Richard Layard, emeritus professor at the Centre for Economic Performance of the London School of Economics. In an article in the British Medical Journal, he estimates a massive economic cost in terms of lost productivity: 1.5% of UK gross domestic product, or £17bn.

That makes depression, anxiety and other forms of mental illness the greatest social problem in the UK, even greater than unemployment.

These figures are roughly the same in the United States, when differences in population size are taken into account.

In both countries these figures are probably underestimates, since many people suffering from mental illness do not report their problems, or are incorrectly diagnosed. In addition, probably half of diagnosed patients receive inadequate treatment, usually amounting to medication alone, with poor follow-up.

Alternative treatments for anxiety and depression.

Chronic Exposure to Stress Hormone Causes Anxiety and Depression in Mice

Neuroscientists at Harvard Medical School and its affiliate McLean Hospital have shown that long-term exposure to stress hormone in mice directly results in the anxiety that often comes with depression. After years of circumstantial evidence linking stress and depression, this evidence may be the "smoking gun" of what, for some, causes some types of mood disorders. The research appears in the April issue of Behavioral Neuroscience, which is published by the American Psychological Association.

The findings are important for understanding the causes and improving the treatment of depression. Scientists already knew that many people with depression have high levels of cortisol, a human stress hormone, but it wasn’t clear whether that was a cause or effect. Now it appears likely that long-term exposure to cortisol actually contributes to the symptoms of depression.

Read about the neurological implications of Stress, Anxiety and Depression In Mice.

BRITE: Technological Help For Depression Treatment

A national study called BRITE (Biomarkers for Rapid Identification of Treatment Efficacy in Major Depression) is currently demonstrating the usefulness of a new technology that shortens the time that psychiatrists and patients with major depression need to find a successful treatment.

The new technology, from Aspect Medical Systems, Inc., uses brain monitoring to establish the effectiveness of medications. It can save months of frustrating and emotionally debilitating attempts to find the right medication or combination of medications.

Of course, the technology could probably also be used to monitor the effectivesness of CAM treatments for depression such as light therapy or St John's Wort. But for now, it's being used to evaluate responses to FDA-approved medications (Lexapro, Wellbutrin XL or a combination).

Read more about the BRITE studies.

Brain imaging can predict effectiveness of cognitive behavior therapy for treating depression

Whether or not cognitive behavior therapy (CBT) will help a person recover from depression can be predicted through brain imaging, according to research results published by the University of Pittsburgh School of Medicine in the April issue of the American Journal of Psychiatry, the official journal of the American Psychiatric Association.

According to the lead researcher, "We may be able to predict what therapies will be most effective for individual patients by using imaging technology, bypassing the lengthy trial and error process that is often necessary to find the right treatment."

Read more on Brain Imaging and CBT.

Landmark Studies Break The Code of Stress and Depression

A study in the British Journal of Psychiatry shows more than a fifth of the population has a genetic predisposition to depression in response to a series of stressful life events.

According to the landmark research from Brain Sciences (University of New South Wales), people with genetic predisposition who are exposed to three or more negative life events in a year, have an 80 percent chance of becoming depressed.

In another study funded by NIMH and reported in Nature Neuroscience, provides insight into how chronic stress triggers actual scaring on a molecular level in the brain. These changes are deeper and much more long lasting than the effects of existing antidepressants, which only alleviate the symptoms. "To really cure depression, we probably need to find new treatments," concluded the lead researcher.

These two studies crack the code of depression, and let us see why depression is so widespread and intractable, as well as giving hints about new treatments.

Read more on these landmark studies of stress and depression.

The Rising Toll of Depression

Depression drains more than $83 billion annually from the American economy, affects 19 million Americans, and results in thousands of preventable suicides, reported a landmark new paper that was released today by the Depression and Bipolar Support Alliance(DBSA).

The State of Depression in America report reveals a “crisis-oriented and reactionary” mental health system “focusing on crises, such as suicide attempts, rather than on prevention, proactive treatment andlong-term wellness.” The DBSA report is a first-of-its-kind, comprehensive analysis on depression that combines a thorough review of published literature with extensive interviews involving a broad spectrum of stakeholders – including patient advocates, policymakers, government agencies, health care providers, insurers, pharmaceutical manufacturers and employers.

“The state of depression in America is a national disgrace,” said Lydia Lewis, president of DBSA, the nation’s leading patient-directed national organization focusing on the most prevalent mental illnesses. “By almost any measure, the U.S. is failing to provide adequate, coordinated, and effective care to the millions of individuals with depression and as a result, the entire country, from employers to family members, to those of us living with depression are paying an enormous price.”

Read more on The Rising Toll of Depression.

SSRIS Impact Human Immune System

SSRIs that treat depression by manipulating the neurotransmitter serotonin in the brain may also affect the user's immune system in ways that are not yet understood.

Researchers from from Georgetown University Medical Center and a Canadian research institute have found that serotonin is passed between key cells in the immune system, and that the chemical is specifically used to activate an immune response.

What they do not yet know yet is whether SSRIs (selective serotonin reuptake inhibitors) have either a beneficial or a damaging effect on human immunity.

"The wider health implication is that commonly used SSRI antidepressants, which target the uptake of serotonin into neurons, may also impact the uptake in immune cells," said Gerard Ahern, Ph.D., assistant professor of Pharmacology at Georgetown and lead researcher on the study.

Article on SSRIs Impact Human Immune System.

Poor Diet Linked to Rising Cases of Depression

Increasing rates of anxiety, depression and irritability could be due to a poor diet that lacks the essential chemicals to keep the brain healthy, according to a leading mental health charity.

A report out tomorrow describes the links between the less severe forms of mental disorder, such as anxiety, and the nation's increasing reliance on ready meals and processed food, which are heavy in pesticides, additives and harmful trans fats. Eating a diet without fresh fruit and vegetables, fish, pulses or nuts deprives the brain of the essential vitamins and nutrients needed to regulate it.

Read more about diet, anxiety, and depression.

Nobelist Discovers Antidepressant Protein in Mouse Brain

A protein that seems to be pivotal in lifting depression has been discovered by a Nobel Laureate researcher funded by the National Institutes of Health’s National Institute of Mental Health (NIMH).

“Mice deficient in this protein, called p11, display depression-like behaviors, while those with sufficient amounts behave as if they have been treated with antidepressants,” explained Paul Greengard, Ph.D., a Rockefeller University neuroscientist who received the 2000 Nobel Prize in Physiology or Medicine for discoveries about the workings of such neuronal signaling systems. He and his colleagues found that p11 appears to help regulate signaling of the brain messenger chemical serotonin, a key target of antidepressants, which has been implicated in psychiatric illnesses such as depression and anxiety disorders. They report on their findings in the January 6, 2005 issue of Science.

Antidepressant protein in mouse brain.