"What you want to avoid is panic. What you want to teach yourself is that you deserve better than lying alone in a dark room, imagining yourself buried." || Diana Spechler for NYT's Opinionator: 10 Things I'd Tell My Former (Medicated) Self, the final installment in Going Off, a series of essays recounting the challenges Spechler has faced in gradually discontinuing her regimen of psychiatric medications.
SLNYT - Suicdal treatment-resistant depression vs. DBT One man's experience with dialectical behavior therapy, or DBT. Previously, and again. [more inside]
Could depression be an infectious disease? Might hallucinogenic mushrooms be an effective treatment for depression (New York Times link)? Do antipsychotic drugs hinder long-term recovery from episodes of schizophrenia?
Insomnia causes depression as much as depression causes insomnia: Three surprising points from a fascinating episode of KQED Forum [audio, no transcript] with guest Dr. Michelle Primeau of the Stanford School of Medicine.
First story: Treating Insomnia to Heal Depression,
Follow up a couple of days later: Double Effectiveness of Depression Treatment by Treating Insomnia,
Two readers (both psychiatrists) respond, and
A NYT editorial. [more inside]
- Insomnia has long been taught to be a symptom of depression, but in many cases is a cause of depression.
- CBT (Cognitive Behavioral Therapy) is an effective treatment for both insomnia and depression.
- CBT can be more effective and longer lasting than sleeping pills
A pilot study testing for statistically significant blood biomarkers found in early-onset MDD: "Discovery of blood transcriptomic markers for depression in animal models and pilot validation in subjects with early-onset major depression" [PDF], published by the online, open source journal Translational Psychiatry**, April 2012, Volume 2. [more inside]
Falling STAR*D?: It is common practice for psychiatrists to switch depressive patients between different antidepressants if their current drug does not evince a symptomatic response. Despite clinical wisdom supporting this, little empirical, controlled evidence exists to direct “switching” protocols (e.g. if a patient with Z characteristics is on drug X, is it usually better to switch to drug A, B, or C? Will switching help at all?) in the psychopharmacological treatment of depression. The NIMH-funded STAR*D (Sequenced Alternatives to Relieve Depression) study aimed to address these questions of treatment direction in a very large (n>4000), “real-world” sample using a multi-phase treatment plan with different drugs (and cognitive therapy) at every step to maximize chances of eventual remission. Overall, the NIMH reported that about 67% of patients eventually achieved remission, with few differences in effectiveness between different types of treatment at each step. However, researchers and commentators have raised concerns regarding inconsistent reporting of outcomes, after-the-fact changes in study design and analysis, and other issues that may have inflated, partially invalidated, or misrepresented widely reported treatment outcomes. These inequities may also have implications for the secondary moderator analyses (i.e. does trait A predict switching to X or Y is better?) that were a major reason for the study. [more inside]
The epidemic of mental illness plaguing the Americans and the overmedication of psychiatric patients are in part artifacts of the diagnostic method. [more inside]
Is the contemporary epidemic of mental illness fueled by useless or even harmful anti-depressants and other psychoactive drugs? A review of books by Irving Kirsch, Robert Whitaker, and Daniel Carlat, notes that per Kirsch, "[a]n active placebo is one that itself produces side effects...there was no difference between the antidepressant and the active placebo" (new research claims very severe cases are different). Whitaker argues that psychoactive drugs may actively "disturb neurotransmitter function" and cause mental illnesses which a mounting cascade of drugs are then needed to manage. (previously, previously)
The Prozac, Paxil, Zoloft, Wellbutrin, Celexa, Effexor, Valium, Klonopin, Ativan, Restoril, Xanax, Adderall, Ritalin, Haldol, Risperdal, Seroquel, Ambien, Lunesta, Elavil, Trazodone War New York Magazine's Jennifer Senior writes on prescription drug (ab)use among soldiers and veterans of Iraq and Afghanistan. [more inside]
"Researchers found that failing to publish negative findings inflated the reported effectiveness of all 12 of the antidepressants studied." See also: Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature. [more inside]