Chapter 12. Psychopathology: The Biology of Behavioral Disorders

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By BENEDICT CAREY New York University’s medical school has quietly shut down eight studies at its prominent psychiatric research center and parted ways with a top researcher after discovering a series of violations in a study of an experimental, mind-altering drug. A subsequent federal investigation found lax oversight of study participants, most of whom had serious mental issues. The Food and Drug Administration investigators also found that records had been falsified and researchers had failed to keep accurate case histories. In one of the shuttered studies, people with a diagnosis of post-traumatic stress caused by childhood abuse took a relatively untested drug intended to mimic the effects of marijuana, to see if it relieved symptoms. “I think their intent was good, and they were considerate to me,” said one of those subjects, Diane Ruffcorn, 40, of Seattle, who said she was sexually abused as a child. “But what concerned me, I was given this drug, and all these tests, and then it was goodbye, I was on my own. There was no follow-up.” It’s a critical time for two important but still controversial areas of psychiatry: the search for a blood test or other biological sign of post-traumatic stress disorder, which has so far come up empty, and the use of recreational drugs like ecstasy and marijuana to treat it. At least one trial of marijuana, and one using ecstasy, are in the works for traumatized veterans, and some psychiatrists and many patients see this work as having enormous promise to reshape and improve treatment for trauma. But obtaining approval to use the drugs in experiments is still politically sensitive. Doctors who have done studies with these drugs say that their uncertain effects on traumatic memory make close supervision during treatment essential. © 2016 The New York Times Company

Keyword: Drug Abuse; Stress
Link ID: 22371 - Posted: 06.28.2016

by German Lopez and Javier Zarracina After years of struggling with treatments for his worsening cancer, Roy was miserable — anxious, depressed, hopeless. Traditional cancer treatments had left him debilitated, and it was unclear whether they would save his life. But then Roy secured a spot in a clinical trial to test an exotic drug. The drug was not meant to cure his cancer; it was meant to cure his terror. And it worked. A few hours after taking a little pill, Roy declared to researchers, "Cancer is not important, the important stuff is love." His concerns about his imminent death had suddenly vanished — and the effects lasted for at least months, according to researchers. It was not a traditional antidepressant, like Zoloft, or anti-anxiety medication, like Xanax, that led Roy to reevaluate his life. It was a drug that has been illegal for decades but is now at the center of a renaissance in research: psilocybin, from hallucinogenic magic mushrooms. Psychologists and psychiatrists have been studying hallucinogens for decades — as treatment for things like alcoholism and depression, and to stimulate creativity. But support for studies dried up in the 1970s, after the federal government listed many psychedelics as Schedule 1 drugs. But now researchers are giving the drugs another look. © 2016 Vox Media, Inc.

Keyword: Drug Abuse; Depression
Link ID: 22370 - Posted: 06.28.2016

By Sara Chodosh Although scientists have learned a lot about the brain in the last few decades, approaches to treating mental illnesses have not kept up. As neuroscientists learn more about brain circuits, Stanford psychiatrist Amit Etkin foresees a time when diagnoses will be based on brain scans rather than symptoms. Etkin, who will be speaking at the World Economic Forum’s Annual Meeting of the New Champions in Tianjin, China, from June 26 to 28, spoke with Scientific American about his research on the neurological basis of emotional disorders and the future of mental health treatment. The high cost of treating mental illness doesn’t get talked about very much. Why is that? It’s a really interesting issue. The costs associated with mental illness are not just the care of people who have an illness, which often starts early in life and continues as a lifelong process, but also the cost to employers in decreased productivity and the cost to society in general. A report that came out recently in Health Affairs showed that spending within our health system in the U.S. is greater for mental illness than for any other area of medicine, and yet our understanding of these illnesses is incredibly backwards. Treatments are no different than they were 40 years ago, so that feels like a problem that is only getting bigger without an obvious solution. Why hasn’t there been much progress? It was really not until about 10 years ago that [mental health professionals] started realizing how little difference we have made. There are a few fundamental issues and mistakes we’ve made. One is that in the absence of knowing what the causes of the illnesses that we treat are, we focus on the symptoms, and that has already led us down the wrong path. If you go to another country and you ask somebody to tell you their symptoms, as a clinician you might have the sense that they have anxiety or depression. In Asian countries they express that in a somatic way: “I can’t sleep” or “I feel weak.” The biology cannot be that different, but the symptoms are different because they’re culturally bound. If you look at different parts of the U.S. you’ll see people expressing symptoms in different ways depending on their local culture. If that’s the case, then a symptom-based definition is problematic. The long and short of it is that people have named syndromes or disorders that they don’t actually know represent a valid entity that is distinct from another entity. © 2016 Scientific American

Keyword: Depression; Schizophrenia
Link ID: 22364 - Posted: 06.27.2016

Lisa Fine Jess Thom says the word "biscuit" about 16,000 times every day. Her brother-in-law counted once. That's just one of the tics that Thom, a London-based performance artist, has to manage as part of her life with Tourette's syndrome, a neurological disorder characterized by involuntary vocal or motor tics. Specialists say the condition affects as many as 300,000 children in the United States, though many are undiagnosed. Thom has had tics since childhood, but she wasn't diagnosed until her 20s. "What disables me ... is other people's misunderstanding," she says. "What's exciting is that it's something we all have power to change." The condition is far more common than many people realize, and many misperceptions about it still exist, says Kevin McNaught, executive vice president of the advocacy group Tourette Association of America. "It's not a rare disorder," McNaught says, citing an estimated 1 in 100 school-age children with the condition, including many who aren't diagnosed until adulthood, if at all. Michael Chichioco, a California high school senior who has Tourette's syndrome, says he used to be bullied at school, with kids trying to trigger him to have outbursts. His tics come out more prominently when he is nervous or excited. © 2016 npr

Keyword: Tourettes
Link ID: 22335 - Posted: 06.18.2016

Angus Chen Rachel Star Withers runs a YouTube channel where she performs goofy stunts on camera and talks about her schizophrenia. Since 2008, when the then 22-year-old revealed her diagnosis online, tens of thousands of people have seen her videos. Some of them have a psychotic disorder or mood disorders themselves, or know people who do. They say her explanation about what a symptom like hallucinations feels like can be really helpful. So can Rachel's advice on ways to cope with them, like getting a dog or a cat. If the animal doesn't react to the hallucination, then it's probably not real, she says. We talked with people about how Withers' videos have helped them understand these diseases. What follows is a Q&A with two of these people. The interviews have been edited for length and clarity. Julia Billingsley is 22 years old and from Peoria, Ill. She learned she has schizophrenia last year, but she says her earliest encounter with the disease was back when she was very young. Her mother has schizophrenia, too, Billingsley says, and often had a delusion that their home was bugged. Julia, you started developing symptoms last year. Do you remember the first thing that happened to you? I'd just started dating my current boyfriend. And I'd be over at his house and I'd go to the bathroom. And this thought, this intrusive thought that wasn't my own at all would pop into my head like with force. And it would be like, hey. This room is bugged. And I was like, what? It made me stop. I stopped what I was doing and I didn't understand why my brain was thinking that. © 2016 npr

Keyword: Schizophrenia
Link ID: 22312 - Posted: 06.13.2016

By ROBERT F. WORTH In early 2012, a neuropathologist named Daniel Perl was examining a slide of human brain tissue when he saw something odd and unfamiliar in the wormlike squiggles and folds. It looked like brown dust; a distinctive pattern of tiny scars. Perl was intrigued. At 69, he had examined 20,000 brains over a four-decade career, focusing mostly on Alzheimer’s and other degenerative disorders. He had peered through his microscope at countless malformed proteins and twisted axons. He knew as much about the biology of brain disease as just about anyone on earth. But he had never seen anything like this. The brain under Perl’s microscope belonged to an American soldier who had been five feet away when a suicide bomber detonated his belt of explosives in 2009. The soldier survived the blast, thanks to his body armor, but died two years later of an apparent drug overdose after suffering symptoms that have become the hallmark of the recent wars in Iraq and Afghanistan: memory loss, cognitive problems, inability to sleep and profound, often suicidal depression. Nearly 350,000 service members have been given a diagnosis of traumatic brain injury over the past 15 years, many of them from blast exposure. The real number is likely to be much higher, because so many who have enlisted are too proud to report a wound that remains invisible. For years, many scientists have assumed that explosive blasts affect the brain in much the same way as concussions from football or car accidents. Perl himself was a leading researcher on chronic traumatic encephalopathy, or C.T.E., which has caused dementia in N.F.L. players. Several veterans who died after suffering blast wounds have in fact developed C.T.E. But those veterans had other, nonblast injuries too. No one had done a systematic post-mortem study of blast-injured troops. That was exactly what the Pentagon asked Perl to do in 2010, offering him access to the brains they had gathered for research. It was a rare opportunity, and Perl left his post as director of neuropathology at the medical school at Mount Sinai to come to Washington. © 2016 The New York Times Company

Keyword: Stress; Brain Injury/Concussion
Link ID: 22311 - Posted: 06.11.2016

Most available antidepressants do not help children and teenagers with serious mental health problems and some may be unsafe, experts have warned. A review of clinical trial evidence found that of 14 antidepressant drugs, only one, fluoxetine – marketed as Prozac – was better than a placebo at relieving the symptoms of young people with major depression. Another drug, venlafaxine, was associated with an increased risk of suicidal thoughts and suicide attempts. Blood test could identify people who will respond to antidepressants Read more But the authors stressed that the true effectiveness and safety of antidepressants taken by children and teenagers remained unclear because of the poor design and selective reporting of trials, which were mostly funded by drug companies. They recommended close monitoring of young people on antidepressants, regardless of what drugs they were prescribed, especially at the start of treatment. Professor Peng Xie, a member of the team from Chongqing Medical University in China, said: “The balance of risks and benefits of antidepressants for the treatment of major depression does not seem to offer a clear advantage in children and teenagers, with probably only the exception of fluoxetine.” Major depressive disorder affects around 3% of children aged six to 12 and 6% of teenagers aged 13 to 18. In 2004 the US Food and Drug Administration (FDA) issued a warning against the use of antidepressants in young people up to the age of 24 because of concerns about suicide risk. Yet the number of young people taking the drugs increased between 2005 and 2012, both in the US and UK, said the study authors writing in the Lancet medical journal. In the UK the proportion of children and teenagers aged 19 and under taking antidepressants rose from 0.7% to 1.1%. © 2016 Guardian News and Media Limited

Keyword: Depression; Development of the Brain
Link ID: 22303 - Posted: 06.09.2016

By Sarah DeWeerdt, Spectrum Brains from people with autism show patterns of gene expression similar to those from people with schizophrenia, according to a new analysis. The findings, published May 24 in Translational Psychiatry, deepen the connections between the two conditions, says study leader Dan Arking, associate professor of genetic medicine at Johns Hopkins University in Baltimore, Maryland. People who have either autism or schizophrenia share features such as language problems and difficulty understanding other people’s thoughts and feelings. They also have genetic risk factors in common. “And now I think we can show that they share overlap in gene expression,” Arking says. The study builds on previous work, in which Arking’s team characterized gene expression in postmortem brain tissue from 32 individuals with autism and 40 controls. In the new analysis, the researchers made use of that dataset as well as one from the Stanley Medical Research Institute that looked at 31 people with schizophrenia, 25 with bipolar disorder and 26 controls3. They found 106 genes expressed at lower levels in autism and schizophrenia brains than in controls. These genes are involved in the development of neurons, especially the formation of the long projections that carry nerve signals and the development of the junctions, or synapses, between one cell and the next. The results are consistent with those from previous studies indicating a role for genes involved in brain development in both conditions. “On the one hand, it’s exciting because it tells us that there’s a lot of overlap,” says Jeremy Willsey, assistant professor of psychiatry at the University of California, San Francisco, who was not involved in the work. “On the other hand, these are fairly general things that are overlapping.” © 2016 Scientific American

Keyword: Autism; Schizophrenia
Link ID: 22294 - Posted: 06.07.2016

By Perri Klass, M.D. When girls come in for their physical exams, one of the questions I routinely ask is “Do you get your period?” I try to ask before I expect the answer to be yes, so that if a girl doesn’t seem to know about the changes of puberty that lie ahead, I can encourage her to talk about them with her mother, and offer to help answer questions. And I often point out that even those who have not yet embarked on puberty themselves are likely to have classmates who are going through these changes, so, again, it’s important to let kids know that their questions are welcome, and will be answered accurately. But like everybody else who deals with girls, I’m aware that this means bringing up the topic when girls are pretty young. Puberty is now coming earlier for many girls, with bodies changing in the third and fourth grade, and there is a complicated discussion about the reasons, from obesity and family stress to chemicals in the environment that may disrupt the normal effects of hormones. I’m not going to try to delineate that discussion here — though it’s an important one — because I want to concentrate on the effect, rather than the cause, of reaching puberty early. A large study published in May in the journal Pediatrics looked at a group of 8,327 children born in Hong Kong in April and May of 1997, for whom a great deal of health data has been collected. The researchers had access to the children’s health records, showing how their doctors had documented their physical maturity, according to what are known as the Tanner stages, for the standardized pediatric index of sexual maturation. Before children enter puberty, we call it Tanner I; for girls, Tanner II is the beginning of breast development, while for boys, it’s the enlargement of the scrotum and testes and the reddening and changing of the scrotum skin. Boys and girls then progress through the intermediate changes to stage V, full physical maturity. © 2016 The New York Times Company

Keyword: Depression; Hormones & Behavior
Link ID: 22288 - Posted: 06.06.2016

By ANNA FELS ONE of the most painful experiences of being a psychiatrist is having a patient for whom none of the available therapies or medications work. A while back, I was asked to do a consultation on just such a patient. This person had been a heroin addict in her early 20s. She had quit the opioid five years earlier, but her life was plagued with anxiety, apathy and self-doubt that prior treatments had not helped. At the end of the session, almost as an afterthought, she noted with irony that the only time in her adult life when she had been able to socialize easily and function at work was when she had been hooked on heroin. We are in the midst of a devastating and often lethal opioid epidemic, one of whose victims, we learned last week, was the pop star Prince. At such a time, it is hard to remember that there are multiple opioids naturally produced in our brains and required for our well-being. The neural circuitry utilizing these substances controls some of our most fundamental feelings of pain, stress and hopelessness, as well as pleasure and even euphoria. There is obviously a need for extreme caution, but research suggests that certain opioids may actually be useful in treating psychiatric diseases that have proved frustratingly unresponsive to current medications. It is the potentially addictive subset of opioids, whose natural ancestors were originally derived from poppies, that we associate with the word. These substances have been with us for most, if not all, of human civilization. Poppy seeds have been found at archaeological sites of Neolithic man. The Sumerians wrote about “the joy plant”; an Egyptian papyrus from the second millennium B.C. described the use of a product of poppies to stop the crying of children. Hippocrates suggested its use for female ailments, and a ninth-century Persian physician advocated the use of opium for melancholia. Millenniums later, during the American Civil War, the Union Army used 10 million opium pills to treat wounded soldiers. And then there were the two Opium Wars fought between China and Britain. Unquestionably, no other psychoactive substance has played such a central role in human affairs. © 2016 The New York Times Company

Keyword: Depression; Drug Abuse
Link ID: 22287 - Posted: 06.06.2016

Amanda Aronczyk At first Giselle wasn't sure what to put on her medical school application. She wanted to be a doctor, but she also wanted people to know about her own health: years of depression, anxiety and a suicide attempt. (We're using only her first name in this story, out of concern for her future career.) "A lot of people were like, you don't say that at all," she said. "Do not mention that you have any kind of weakness." Giselle remembers having her first intense suicidal thoughts when she was 10 years old. Her parents had split up and she had moved from the coast of Colombia to Chicago. She started having extreme mood swings and fighting with her mom. And then, when she was 16 years old, she tried to kill herself. "Yeah, lots of pills." After her suicide attempt she began therapy and eventually started taking antidepressants. That worked extremely well. After finishing high school, she took an unconventional route. She went to Brazil to work with a women's community health group, worked as a research assistant for a doctor, and trained as a doula to assist women in labor. It was while working as a doula and witnessing what she saw as insensitive behavior from a doctor that she resolved her own career indecision: She would become a different kind of doctor. When she applied to medical school, she told them this whole story in her application. In the fall of 2014, she started at the University of Wisconsin School of Medicine and Public Health. © 2016 npr

Keyword: Depression
Link ID: 22276 - Posted: 06.02.2016

By Gary Stix Scientists will never find a single gene for depression—nor two, nor 20. But among the 20,000 human genes and the hundreds of thousands of proteins and molecules that switch on those genes or regulate their activity in some way, there are clues that point to the roots of depression. Tools to identify biological pathways that are instrumental in either inducing depression or protecting against it have recently debuted—and hold the promise of providing leads for new drug therapies for psychiatric and neurological diseases. A recent paper in the journal Neuron illustrates both the dazzling complexity of this approach and the ability of these techniques to pinpoint key genes that may play a role in governing depression. Scientific American talked with the senior author on the paper—neuroscientist Eric Nestler from the Icahn School of Medicine at Mt. Sinai in New York. Nestler spoke about the potential of this research to break the logjam in pharmaceutical research that has impeded development of drugs to treat brain disorders. Scientific American: The first years in the war on cancer met with a tremendous amount of frustration. Things look like they're improving somewhat now for cancer. Do you anticipate a similar trajectory may occur in neuroscience for psychiatric disorders? Eric Nestler: I do. I just think it will take longer. I was in medical school 35 years ago when the idea that identifying a person's specific pathophysiology was put forward as a means of directing treatment of cancer. We're now three decades later finally seeing the day when that’s happening. I definitely think the same will occur for major brain disorders. The brain is just more complicated and the disorders are more complicated so it will take longer. © 2016 Scientific American

Keyword: Depression; Genes & Behavior
Link ID: 22267 - Posted: 05.31.2016

Sara Reardon Children from impoverished families are more prone to mental illness, and alterations in DNA structure could be to blame, according to a study published on 24 May in Molecular Psychiatry1. Poverty brings with it a number of different stressors, such as poor nutrition, increased prevalence of smoking and the general struggle of trying to get by. All of these can affect a child’s development, particularly in the brain, where the structure of areas involved in response to stress and decision-making have been linked to low socioeconomic status. Poor children are more prone to mental illnesses such as depression than their peers from wealthier families, but they are also more likely to have cognitive problems. Some of these differences are clearly visible in the brain structure and seem to appear at birth, which suggests that prenatal exposure to these stressors can be involved2. But neurodevelopment does not stop at birth. Neuroscientist Ahmad Hariri of Duke University in Durham, North Carolina, suspected that continual exposure to stressors might affect older children as well. He decided to test this idea by studying chemical tags known as methyl groups, which alter DNA structure to regulate how genes are expressed. There is some evidence that methylation patterns can be passed down through generations, but they are also altered by environmental factors, such as smoking. © 2016 Nature Publishing Group,

Keyword: Depression; Epigenetics
Link ID: 22248 - Posted: 05.25.2016

By Diana Kwon More than one in 10 Americans older than 12 takes antidepressants, according to a 2011 report by the National Center for Health Statistics. A significant but unknown number of children younger than 12 take them, too. Although most such drugs are not approved for young children, doctors have prescribed them off-label for years because they have been thought to have relatively mild side effects. Yet recent reports have revealed that important data about the safety of these drugs—especially their risks for children and adolescents—have been withheld from the medical community and the public. In the latest and most comprehensive analysis, published in January in the BMJ, researchers at the Nordic Cochrane Center in Copenhagen showed that pharmaceutical companies have not been revealing the full extent of serious harm in clinical study reports, which are detailed documents sent to regulatory authorities such as the U.S. Food and Drug Administration and the European Medicines Agency (EMA) when applying for approval of a new drug. The researchers examined reports from 70 double-blind, placebo-controlled trials of two common categories of antidepressants—selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs)—and found that the occurrence of suicidal thoughts and aggressive behavior doubled in children and adolescents who used these drugs. The investigators discovered that some of the most revealing information was buried in appendices where individual patient outcomes are listed. For example, they found clear instances of suicidal thinking that had been passed off as “emotional lability” or “worsening depression” in the report itself. This information, however, was available for only 32 out of the 70 trials. “We found that a lot of the appendices were often only available on request to the authorities, and the authorities had never requested them,” says Tarang Sharma, a Ph.D. student at Cochrane and lead author of the study. “I'm actually kind of scared about how bad the actual situation would be if we had the complete data.” © 2016 Scientific American

Keyword: Depression; Development of the Brain
Link ID: 22242 - Posted: 05.24.2016

By Diana Kwon A number of factors, including elements of the social environment (such as inequality and isolation) and physical stressors (such as pollution and noise) could explain how the city erodes well-being Credit: Thomas Koehler/Getty Images Life in the city can be taxing. City dwellers often face higher rates of crime, pollution, social isolation and other environmental stressors than those living in rural areas. For years studies have consistently linked the risk of developing schizophrenia to urban environments—but researchers are only beginning to understand why this association exists. Addressing the link is increasingly urgent: According to a recent U.N. report, the proportion of people living in cities will rise from 54 percent of the world’s population in 2014 to 66 percent by 2050. Researchers first suggested in the 1930s that urban living might increase schizophrenia risk. Since then many large epidemiological studies have reported an association between the two, primarily in European countries such as Sweden and Denmark. Converging evidence has revealed that growing up in the city doubles the risk of developing psychosis later in life. Studies have also begun to find that urban environments may heighten the risk of other mental health issues such as depression and anxiety. A number of factors, including elements of the social environment (such as inequality and isolation) and physical stressors (such as pollution and noise) could explain how the city erodes well-being. Conversely, people predisposed to mental illness may simply be more likely to move into urban environments. Two studies published this month shed new light on these effects and suggest both scenarios could be involved. © 2016 Scientific American, a Division

Keyword: Schizophrenia; Depression
Link ID: 22234 - Posted: 05.21.2016

Zoe Cormier A hallucinogenic drug derived from magic mushrooms could be useful in treating depression, the first safety study of this approach has concluded. Researchers from Imperial College London gave 12 people psilocybin, the active component in magic mushrooms. All had been clinically depressed for a significant amount of time — on average 17.8 years. None of the patients had responded to standard medications, such as selective serotonin re-uptake inhibitors (SSRIs), or had electroconvulsive therapy. One week after receiving an oral dose of psilocybin, all patients experienced a marked improvement in their symptoms. Three months on, five patients were in complete remission. “That is pretty remarkable in the context of currently available treatments,” says Robin Carhart-Harris, a neuropsychopharmacologist at Imperial College London and first author of the latest study, which is published in The Lancet Psychiatry1. The equivalent remission rate for SSRIs is around 20%. The study's authors are not suggesting that psilocybin should be a treatment of last resort for depressed patients. “Our conclusion is more sober than that — we are simply saying that this is doable,” says Carhart-Harris. “We can give psilocybin to depressed patients, they can tolerate it, and it is safe. This gives us an initial impression of the effectiveness of the treatment.” © 2016 Nature Publishing Group

Keyword: Depression; Drug Abuse
Link ID: 22224 - Posted: 05.17.2016

By CLYDE HABERMAN At respected research centers in the United States and other countries, scientists have spent much of their professional lives in drug rehabilitation. It is not because they themselves struggle with addiction. What they are trying to rehabilitate are the drugs. Their focus is on mind-altering compounds that fell far from grace nearly half a century ago, LSD prominent among them. Along with other psychedelics, it was outlawed by the federal government, damned as bearing a high potential for abuse and offering no accepted medical benefit. But in recent years, researchers have sought to rescue hallucinogens from exile by examining their efficacy in treating certain disorders of the mind, and perhaps even in understanding the nature of consciousness and spirituality. The work of these scientists now draws the attention of Retro Report, a series of video documentaries that examine major news stories of the past and their enduring significance. Psychoactive substances, often derived from mushrooms, have been part of human cultures from Central and South America to the Sahara for thousands of years. But there is no need to look that far back; 1938 will do. That was when Albert Hofmann, a Swiss chemist searching for a drug to combat circulatory ailments, happened to synthesize lysergic acid diethylamide: LSD or, more familiarly, acid. Five years later, Dr. Hofmann, who died in 2008 at age 102, accidentally ingested a small dose of his creation and discovered its mind-blowing potential as he embarked on the first known acid trip. Many more such journeys would follow, for him and for countless others. © 2016 The New York Times Company

Keyword: Depression; Drug Abuse
Link ID: 22219 - Posted: 05.16.2016

By Lisa Damour Parents of teenagers face a confounding crosscurrent. While the legalization of marijuana in several American states now bolsters the common belief among adolescents that the drug is safe for recreational use, research documenting marijuana’s diffuse and possibly permanent harm to the teenage brain continues to pile up. Normally developing teenagers question authority and are likely to be skeptical of adults bearing bad news about a widely used party drug. So how do we have successful conversations about the hazards of marijuana use? An open-ended exchange that credits the adolescent’s own observations may do more good than a single sit-down or lecture. Beyond that, we might consider how the facts are often received by adolescents. With all the talk about cannabis legalization, parents may feel compelled to remind their teenagers that recreational marijuana is still banned for most American adults and for anyone under 21. Adolescents who use marijuana risk immediate legal consequences and, in districts with zero-tolerance policies, may be barred from organized school activities, suspended or expelled. They may also face long-term penalties affecting some jobs, internships, colleges and travel visas. But the repercussions of being caught with marijuana don’t faze all teenagers. Most adolescents can name celebrities, famous athletes and classmates who use marijuana regularly, even flagrantly, without running into trouble. Teenagers tend to bristle at rules that seem arbitrary, such as the state-by-state regulations for marijuana and the fact that alcohol, which has a lot in common with pot, is legal. Further, adolescents can be understandably cynical about laws that aren’t applied evenly to everyone: While African-Americans and whites use the drug at similar rates, African-Americans are nearly four times as likely to be arrested for marijuana possession. However real and lasting the penalties for pot use may be, parents often run into resistance when trying to make this case to teenagers. © 2016 The New York Times Company

Keyword: Drug Abuse; Development of the Brain
Link ID: 22207 - Posted: 05.12.2016

Laura Sanders Ketamine, a drug that has shown promise in quickly easing depression, doesn’t actually do the job itself. Instead, depression relief comes from one of the drug’s breakdown products, a new study in mice suggests. The results, published May 4 in Nature, identify a potential depression-fighting drug that works quickly but without ketamine’s serious side effects or potential for abuse. The discovery “could be a major turning point,” says neuroscientist Roberto Malinow of the University of California, San Diego. “I’m sure that drug companies will look at this very closely.” Depression is a pernicious problem with few good treatments. Traditional antidepressants don’t work for everyone, and when the drugs do work, they can take weeks to kick in. Ketamine, developed in the 1960s as a sedative for people and now used commonly by veterinarians to knock out animals, can ease depression in minutes, not weeks, small studies show. But the new study suggests that a metabolite of ketamine — not the drug itself — fights depression. Inside the body, ketamine gets converted into a slew of related molecules. One of these breakdown molecules, a chemical called (2R,6R)-hydroxynorketamine, is behind the benefits, neuropharmacologist Todd Gould of the University of Maryland School of Medicine in Baltimore and colleagues found. On its own, a single dose of (2R,6R)-HNK reduced signs of depression in mice, restoring their drive to search for a hidden platform in water, to try to escape a shock and to choose sweet water over plain. A type of ketamine that couldn’t be broken down easily into HNKs didn’t ease signs of depression in mice. Finding that a breakdown product, and not ketamine itself, was behind the results was a big surprise, Gould says. © Society for Science & the Public 2000 - 2016

Keyword: Depression; Drug Abuse
Link ID: 22184 - Posted: 05.05.2016

By John Horgan I had to ask Anthony Bossis about bad trips. Bossis, a psychologist at New York University, belongs to an intrepid cadre of scientists reviving research into psychedelics’ therapeutic potential. I say “reviving” because research on psychedelics thrived in the 1950s and 1960s before being crushed by a wave of anti-psychedelic hostility and legislation. Psychedelics such as LSD, psilocybin and mescaline are still illegal in the U.S. But over the past two decades, researchers have gradually gained permission from federal and other authorities to carry out experiments with the drugs. Together with physicians Stephen Ross and Jeffrey Guss, Bossis has tested the potential of psilocybin—the primary active ingredient of “magic mushrooms”--to alleviate anxiety and depression in cancer patients. Journalist Michael Pollan described the work of Bossis and others in The New Yorker last year. Pollan said researchers at NYU and Johns Hopkins had overseen 500 psilocybin sessions and observed “no serious adverse effects.” Many subjects underwent mystical experiences, which consist of "feelings of unity, sacredness, ineffability, peace and joy," as well as the conviction that you have discovered "an objective truth about reality." Pollan’s report was so upbeat that I felt obliged to push back a bit, pointing out that not all psychedelic experiences—or mystical ones--are consoling. In The Varieties of Religious Experience, William James emphasized that some mystics have “melancholic” or “diabolical” visions, in which ultimate reality appears terrifyingly alien and uncaring. Taking psychedelics in a supervised research setting doesn’t entirely eliminate the risk of a bad trip. That lesson emerged from a study in the early 1990s by psychiatrist Rick Strassman, who injected dimethyltryptamine, DMT, into human volunteers. © 2016 Scientific American

Keyword: Drug Abuse; Depression
Link ID: 22179 - Posted: 05.04.2016