Chapter 4. The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
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By Erika Beras Marijuana is the drug of choice for people who drink alcohol. And people who use both are twice as likely to do so at the same time than to indulge in just one or the other. That’s according to a study in the journal Alcoholism: Clinical and Experimental Research. [Meenakshi S. Subbaraman and William C. Kerr, Simultaneous Versus Concurrent Use of Alcohol and Cannabis in the National Alcohol Survey The data came from self-reported answers that more than 8,600 people provided to what’s called the National Alcohol Surveys, done by phone in 2005 and 2010. People who used pot and alcohol were about twice as likely to drive drunk than those who just drank. And they doubled their chances of what are referred to as negative social consequences, such as arrests, fights and job problems. Meanwhile, another new study finds that if you’re chronically stoned, you’re more likely to remember things differently from how they happened, or not at all. Researchers showed a series of words to people who do not use marijuana and to regular pot users who had not partaken in a month. A few minutes later, all participants were shown the same list of words along with other words. The volunteers were then asked to identify only the original words. The pot smokers thought more of the new words were in the original list than did the nonusers. And brain scans revealed that the regular pot users showed less activity in brain regions associated with memory and cognitive resources than did the nonusers. The study is in the journal Molecular Psychiatry. [J. Riba et al, Telling true from false: cannabis users show increased susceptibility to false memories] © 2015 Scientific American
by Colin Barras Men often lose their sex drive with age – and so, it seems do male Drosophila. Tsai-Feng Fu at the National Chi Nan University in Taiwan and his colleagues suspected that low levels of dopamine in the flies were to blame. Almost 300 neurones in the fruit-fly brain use dopamine. Comparing those linked to sexual function in elderly 40-day-old male flies and sprightly 10-day-old flies, Fu found the older neurones carried 10 times less dopamine. Boosting levels lengthened the time the older flies spent trying to mate. There are obviously big differences between a man's brain and that of a male Drosophila, but Fu says that the new results could provide a useful starting point for in-depth studies that may have clinical implications. For instance, that research might eventually identify ways to fine-tune dopamine levels in humans, perhaps to reverse age-related declines in sexual drive, or even to suppress an overactive libido. We already have therapies for treating male sexual dysfunction – notably the drug viagra. But probing the link between dopamine and sexual dysfunction is still important. For instance, dopamine-replacement therapy is one of the most effective treatments for Parkinson's disease – but the therapy can lead to harmful compulsive sexual behaviour. But Wendi Neckameyer at the Saint Louis University School of Medicine in Missouri isn't sure we should talk about potential implications for men just yet – it's enough to say that the researchers "have begun to tease out an incredibly complex neural circuit", she says. © Copyright Reed Business Information Ltd
Keyword: Sexual Behavior
Link ID: 21115 - Posted: 07.01.2015
By Megan Cartwright Don’t pet the platypus. I know it’s tempting: Given the chance, I’d want to stroke their thick brown fur, tickle those big webbed feet, and pat that funny duck bill. And why not? What harm could come from this cute, egg-laying mammal from eastern Australia? Plenty. As someone who doesn’t enjoy “long lasting excruciating pain that cannot be relieved with conventional painkillers,” I’d really regret petting a platypus. Especially a male platypus, in late winter, when there’s only one thing on his mind and, even worse, something nasty on his feet. When British biologist Sir Everard Home got ahold of some platypus specimens in 1801, he told his fellow nerds at the Royal Society how the male specimen had a half-inch long “strong crooked spur” on the heel of each rear foot. The female, however, was spur-free. Home suggested that it “is probably by means of these spurs or hooks, that the female is kept from withdrawing herself in the act of copulation.” A very reasonable suggestion. But a wrong one. To be fair to Home, he could only study dead platypuses. If Home could have spent a year hanging out with living platypuses in their river homes, he would’ve seen that this “shy, semi-aquatic, mainly nocturnal” mammal is mostly interested in hunting on the river bottom for delicious insect larvae, crayfish, and shrimp. In other words, the platypus is usually an eater, not a lover. © 2014 The Slate Group
Patricia Neighmond A report finds mixed results when it comes to how well medical marijuana works to calm pain and control symptoms. And, an editorial says states legalizing pot for medical use may be jumping the gun. DAVID GREENE, HOST: Twenty-three states plus the District of Columbia have approved pot for medical use. But a new study in the Journal of the American Medical Association is raising questions about its safety and effectiveness. Here's NPR's Patti Neighmond. PATTI NEIGHMOND, BYLINE: Researchers from the University of Bristol in the United Kingdom reviewed findings from 79 different studies looking at the effect of marijuana on symptoms ranging from chronic pain to sleep difficulties and mental illness. At best, they found only moderate evidence indicating that marijuana reduced nerve pain and pain from cancer. When it came to other conditions, like nausea and vomiting due to chemotherapy, difficulties sleeping or weight loss among HIV patients, there was some anecdotal evidence suggesting that people may be helped by marijuana, but it was just that - anecdote. D'SOUZA: Which is really the bulk of the evidence that the states have used in approving medical marijuana. NEIGHMOND: In an editorial accompanying this study, Dr. Deepak Cyril D'Souza says states legalizing marijuana for medical use may be jumping the gun before good quality evidence is in. D'SOUZA: If a pharmaceutical company, for example, wanted to get a drug approved for a medical condition and they only submitted anecdotal data, there's absolutely no chance that that drug would be approved. NEIGHMOND: D'Souza is a psychiatrist with Yale University's School of Medicine. For years, he's studied the impact of marijuana on mental health. And the big question, he says, is how routine daily use - the way one might use marijuana to treat a medical condition - affects the body and the brain over the long term. Concerns have been raised about memory loss, panic, paranoia and other severe disorders. © 2015 NPR
Keyword: Drug Abuse
Link ID: 21089 - Posted: 06.25.2015
By Nicholas Bakalar Exposure to air pollution may hasten brain aging, a new study has found. Researchers studied 1,403 women without dementia who were initially enrolled in a large health study from 1996 to 1998. They measured their brain volume with M.R.I. scans in 2005 and 2006, when the women were 71 to 89 years old. Using residential histories and air pollution data, they estimated their exposure to air pollution from 1999 to 2006. They used data recorded at monitoring sites on exposure to PM 2.5 — tiny particulate matter that easily penetrates the lungs. Each increase of 3.49 micrograms per cubic centimeter cumulative exposure to pollutants was associated with a 6.23 cubic centimeter decrease in white matter, the equivalent of one to two years of brain aging. The association remained after adjusting for many variables, including age, smoking, physical activity, blood pressure, body mass index, education and income. Previous studies have shown that air pollution can cause inflammation and damage to the vascular system, but this study, in The Annals of Neurology, showed damage to the brain itself. “This tells us that the damage air pollution can impart goes beyond the circulatory system,” said the lead author, Dr. Jiu-Chiuan Chen, an associate professor of preventive medicine at the Keck School of Medicine at the University of Southern California. “Particles in the ambient air are an environmental neurotoxin to the aging brain.” © 2015 The New York Times Company
By Nicholas Bakalar A new study has found a simple way to significantly reduce teenage smoking: raise the tobacco sales age to 21. In 2005, Needham, Mass., did just that, while surrounding communities kept their age limit at 18. Researchers surveyed 16,000 high school students in Needham and 16 surrounding communities four times between 2006 and 2012, gathering data on their smoking habits. The study is in Tobacco Control. Over the seven years, the number of children under 18 buying cigarettes in Needham decreased to 11.6 percent from 18.4 percent, while in the surrounding communities it hardly changed — down to 19 percent from 19.4. In 2006, 12.9 percent of students in Needham and 14.8 percent of students in surrounding communities reported having smoked in the past 30 days. By 2010, 6.7 percent of Needham students reported smoking, compared with 12 percent in other towns. At the end of the study in 2012, smoking had declined to 5.5 percent in Needham and 8.5 percent outside. “More than 80 percent of smokers begin before 18,” said the lead author, Shari Kessel Schneider, project director at the Education Development Center in Waltham, Mass. “Our findings provide strong support for initiatives going on all across the country to increase the sales age as a means for decreasing youth access to cigarettes, initiation of smoking, and ultimately addiction.” © 2015 The New York Times Company
Almost half of 346,000 deaths from 12 cancers among U.S. adults in one year are attributed to cigarette smoking, despite 50 years of progress on butting out, new research suggests. Cancer researchers updated the estimate on deaths due to cigarette smoking to reflect changes in smoking patterns and how some data now suggest that the risk of cancer death among smokers can increase over time. Of 345,962 cancer deaths in the U.S. in 2011, 167,805 or 48.5 per cent were attributed to smoking cigarettes, Rebecca Siegel and her co-authors said in a research letter published in Monday's issue of JAMA Internal Medicine. The largest proportions of cancer deaths linked to smoking among those 35 and older were for cancers of the lung, bronchus and trachea (125,799 of 156, 855 deaths or 80 per cent) and larynx (2,856 of 3,728 deaths or nearly 77 per cent). About half of the deaths from cancers of the oral cavity, esophagus and urinary bladder were also attributable to smoking. Smoking was also cited as the cause of many deaths from cancer of the colon, kidney, liver, pancreas, stomach, cervix, and from myeloid leukemia. "Cigarette smoking continues to cause numerous deaths from multiple cancers despite half a century of decreasing prevalence," Rebecca Siegel from the American Cancer Society in Atlanta and her co-authors said. Dr. Norman Edelman, a senior scientific advisor to the American Lung Association, said when people hear about smoking and cancer, their thoughts often turn to lung cancer alone. ©2015 CBC/Radio-Canada.
Keyword: Drug Abuse
Link ID: 21057 - Posted: 06.16.2015
By BENEDICT CAREY Marijuana use did not increase among teenagers in the states in which medical marijuana has become legal, researchers reported Monday. The new analysis is the most comprehensive effort to date to answer a much-debated question: Does decriminalization of marijuana lead more adolescents to begin using it? The study found that states that had legalized medical use had higher prevailing rates of teenage marijuana use before enacting the laws, compared with states where the drug remains illegal. Those higher levels were unaffected by the changes in the law, the study found. The report, published in The Lancet Psychiatry, covered a 24-year period and was based on surveys of more than one million adolescents in 48 states. The research says nothing about the effect of legalizing recreational use, however. A primary concern on both sides of the debate over medical marijuana has been that loosening marijuana restrictions might send the wrong message to young people, and make the drug both more available and more appealing. Teenagers who develop and sustain a heavy, daily habit increase their risk of having cognitive difficulties later on, several studies now suggest. Previous research on usage trends in the wake of the laws has been mixed, some reporting evidence of an increase among adolescents and others — including two recent, multistate studies — finding no difference. The new analysis should carry far more weight, experts said, not only because of its size and scope but also because the funders included the National Institute of Drug Abuse, whose director has been outspoken about the risks of increased use. © 2015 The New York Times Company
Keyword: Drug Abuse
Link ID: 21056 - Posted: 06.16.2015
By Michael Balter Alcoholic beverages are imbibed in nearly every human society across the world—sometimes, alas, to excess. Although recent evidence suggests that tippling might have deep roots in our primate past, nonhuman primates are only rarely spotted in the act of indulgence. A new study of chimpanzees with easy access to palm wine shows that some drink it enthusiastically, fashioning leaves as makeshift cups with which to lap it up. The findings could provide new insights into why humans evolved a craving for alcohol, with all its pleasures and pains. Scientists first hypothesized an evolutionary advantage to humans’ taste for ethanol about 15 years ago, when a biologist at the University of California, Berkeley, proposed what has come to be called the “drunken monkey hypothesis.” Robert Dudley argued that our primate ancestors got an evolutionary benefit from being able to eat previously unpalatable fruit that had fallen to the ground and started to undergo fermentation. The hypothesis received a boost last year, when a team led by Matthew Carrigan—a biologist at Santa Fe College in Gainesville, Florida—found that the key enzyme that helps us metabolize ethanol underwent an important mutation about 10 million years ago. This genetic change, which occurred in the common ancestor of humans, chimps, and gorillas, made ethanol metabolism some 40 times faster than the process in other primates—such as monkeys—that do not have it. According to the hypothesis, the mutation allowed apes to consume fermented fruit without immediately getting drunk or, worse, succumbing to alcohol poisoning. Nevertheless, researchers had turned up little evidence that primates in the wild regularly eat windfall fruit or are attracted to the ethanol that such fruit contains. Now, a team led by Kimberley Hockings, a primatologist at the Center for Research in Anthropology in Lisbon, concludes from a 17-year study of chimps in West Africa that primates can tolerate significant levels of ethanol and may actually crave it, as humans do. © 2015 American Association for the Advancement of Science
By Sue Bailey, The Canadian Press Scientific studies increasingly suggest marijuana may not be the risk-free high that teens — and sometimes their parents — think it is, researchers say. Yet pot is still widely perceived by young smokers as relatively harmless, said Dr. Romina Mizrahi, director of the Focus on Youth Psychosis Prevention clinic and research program at the Centre for Addiction and Mental Health. She cites a growing body of research that warns of significantly higher incidence of hallucinations, paranoia and the triggering of psychotic illness in adolescent users who are most predisposed. "When you look at the studies in general, you can safely say that in those that are vulnerable, it doubles the risk." Such fallout is increasingly evident in the 19-bed crisis monitoring unit at the Children's Hospital of Eastern Ontario in Ottawa. "I see more and more cases of substance-induced psychosis," said Dr. Sinthu Suntharalingam, a child and adolescent psychiatrist. "The most common substance that's abused is cannabis." One or two cases a week are now arriving on average. "They will present with active hallucinations," Suntharalingam said. "Parents will be very scared. They don't know what's going on. "They'll be seeing things, hearing things, sometimes they will try to self-harm or go after other people." Potential effects need to be better understood She and Mizrahi, an associate professor in psychiatry at University of Toronto, are among other front-line professionals who say more must be done to help kids understand potential effects. "They know the hard drugs, what they can do," Suntharalingam said. "Acid, they'll tell us it can cause all these things so they stay away from it. But marijuana? They'll be: 'Oh, everybody does it."' Mizrahi said the message isn't getting through. ©2015 CBC/Radio-Canada.
By Sandra G. Boodman When B. Paul Turpin was admitted to a Tennessee hospital in January, the biggest concern was whether the 69-year-old endocrinologist would survive. But as he battled a life-threatening infection, Turpin developed terrifying hallucinations, including one in which he was performing on a stage soaked with blood. Doctors tried to quell his delusions with increasingly large doses of sedatives, which only made him more disoriented. Nearly five months later, Turpin’s infection has been routed, but his life is upended. Delirious and too weak to go home after his hospital discharge, he spent months in a rehab center, where he fell twice, once hitting his head. Until recently he did not remember where he lived and believed he had been in a car wreck. “I tell him it’s more like a train wreck,” said his wife, Marylou Turpin. “They kept telling me in the hospital, ‘Everybody does this,’ and that his confusion would disappear,” she said. Instead, her once astute husband has had great difficulty “getting past the scramble.” Turpin’s experience illustrates the consequences of delirium, a sudden disruption of consciousness and cognition marked by vivid hallucinations, delusions and an inability to focus that affects 7 million hospitalized Americans annually. The disorder can occur at any age — it has been seen in preschoolers — but disproportionately affects people older than 65 and is often misdiagnosed as dementia. While delirium and dementia can coexist, they are distinctly different illnesses. Dementia develops gradually and worsens progressively, while delirium occurs suddenly and typically fluctuates during the course of a day. Some patients with delirium are agitated and combative, while others are lethargic and inattentive.
Link ID: 21010 - Posted: 06.02.2015
by Jessica Hamzelou IF YOU knew you were about to go through a stressful experience, would you pop a pill to protect yourself from its knock-on effects? It's an idea that has been mooted after a drug seemed to make mice immune to the negative impacts of stressful events. But could we rationalise prescribing such a drug? We all experience stress during our lives, whether it be a one-off event, such as a loved one dying, or chronic, low-level stress that results from struggling to make ends meet, for example. While most people find ways to cope, for some a particularly stressful event can trigger depression. What if there was a way to boost our stress resilience and thus shield us from depression? Rebecca Brachman at Columbia University in New York stumbled across the idea while she was giving ketamine to mice with the symptoms of depression. Even though the ketamine-taking mice had been chronically stressed, when they were dropped in a pool of water – a one-off stressful event – they were unperturbed and swam to an exit. Mice not given the drug made no attempt to escape, a classic sign of depression in rodents. There was also no change in the ketamine-taking animals' cognitive abilities or metabolism – both of which are altered in human depression. "It's really remarkable," says Brachman. "They basically look like mice that haven't been stressed." A single dose of ketamine protected mice from developing the symptoms of depression after stressful events for four weeks. But the drug only seemed to stop the symptoms of depression – some of the animals still exhibited anxiety behaviours. "It seems to protect against depression rather than anxiety," says Brachman, who controversially describes it as a depression "vaccine". The work will be published in Biological Psychiatry. © Copyright Reed Business Information Ltd
By FRANCES ROBLES MIAMI — A hazardous new synthetic drug originating in China is being blamed for 18 recent deaths in a single South Florida county, as police grapple with an inexpensive narcotic that causes exaggerated strength and dangerous paranoid hallucinations. On Thursday, the Fort Lauderdale police killed a man, reportedly high on the man-made street drug, alpha-PVP, known more commonly as flakka, who had held a woman hostage with a knife to her throat. The shooting of Javoris Washington, 29, was the latest in a series of volatile episodes that the police in South Florida have faced with highly aggressive drug users. Law enforcement agencies have had difficulty tamping down a surge in synthetic drugs, which were banned after becoming popular in clubs five years ago only to re-emerge deadlier than ever under new formulations. As soon as legislation catches up with the latest craze, manufacturers design a new drug to take its place, federal and local law enforcement agencies say. In Broward County, which includes Fort Lauderdale and is considered ground zero for the new drug, there have been 18 flakka-related fatalities since September, the chief medical examiner there said. “I have never seen such a rash of cases, all associated with the same substance,” said James N. Hall, an epidemiologist at Nova Southeastern University who has studied the Florida drug market for decades. “It’s probably the worst I have seen since the peak of crack cocaine. Rather than a drug, it’s really a poison.” © 2015 The New York Times Company
Keyword: Drug Abuse
Link ID: 20974 - Posted: 05.25.2015
by Michael Le Page Humble fungi and a home-brewing kit could soon do what the combined might of the West failed to – halt the thriving poppy industry in Afghanistan, the source of 80 per cent of the world's opium. Genetically engineered yeasts could make it easy to produce opiates such as morphine anywhere, cutting out the international drug smugglers and making such drugs cheap and more readily available. If home-brew drugs become widespread, it would make the Sisyphean nature of stopping the supply of illegal narcotics even more obvious than it is now. "It would be as disruptive to drug enforcement policy as it would be to crime syndicates," says Tanya Bubela, a public health researcher at the University of Alberta in Edmonton, Canada. "It may force the US to rethink its war on drugs." A growing number of drugs, scents and flavours once obtainable only from plants can now be made using genetically modified organisms. Researchers want to add opiates to that list because they are part of a family of molecules that may have useful medicinal properties (see box, below). Plant yields of many of these molecules are vanishingly small, and the chemicals are difficult and expensive to make in the lab. Getting yeast to pump them out would be far cheaper. Yeasts capable of doing this do not exist yet, but none of the researchers that New Scientist spoke to had any doubt that they soon will. "The field is moving much faster than we had previous realised," says John Dueber of the University of California, Berkeley, whose team has just created a yeast that produces the main precursor of opiates. Until recently, Dueber had thought the creation of, say, a morphine-making yeast was 10 years away. He now thinks a low-yielding strain could be made in two or three years.
Keyword: Drug Abuse
Link ID: 20951 - Posted: 05.19.2015
Andrew Griffin Evidence that ecigs help people stop smoking real ones is lacking, according to a new analysis. Electronic cigarettes seem to work for the first month, but there isn’t enough evidence to say that they work for longer periods, researchers said. "Until such data are available, there are a number of other smoking cessation aids available that have a more robust evidence base supporting their efficacy and safety,” said lead author of the study Riyad al-Leheb, from the University of Toronto. The analysis looked at four studies of how effective and safe ecigs were, which together had studied 1011 patients. It found that after one month, using ecigs had significantly improved the amount of people that had stopped smoking. But that effect appeared to have gone at three or six months. That included studies on people who had used a placebo against those who had used ecigarettes, as well as those who had used nicotine patches. As well as the apparent lack of permanent help, the analysis found that some studies had found people reported dry cough, throat irritation and shortness of breath. While those adverse effects weren’t any worse among those that used placebo ecigs, they were much less prevalent among those that had used nicotine patches.
Keyword: Drug Abuse
Link ID: 20943 - Posted: 05.18.2015
John Crace After over a year working in Westminster as this paper’s parliamentary sketchwriter, I thought I had learned a thing or two about bearpits. That was before I agreed to second Prof Allan Young in speaking against the motion that “This House believes that the long-term use of psychiatric medications is causing more harm than good”. It turned out that politicians are almost models of decency compared to psychiatrists fighting their own corner. I had wondered why I had been invited. I have no scientific knowledge of the subject under discussion; all I had to offer was my own personal experience of living with episodes of depression and acute anxiety for more than 20 years. For me, a combination of medication and therapy has proved effective; not so effective as to prevent recurrences of these mental health problems all together, but effective enough for me to have managed them without having to return as an in-patient at the psychiatric hospital I wound up in 20 years earlier. I could perhaps have done more to look after myself, I suppose. I could have given up my Spurs season ticket. But apart from that … Having raised concerns about my credentials, I was assured that it was important to have a patient’s voice heard. I thought so, too. So I agreed. But on the way home from the debate last night, I did wonder if the reason I had been asked was because everyone else had turned them down. Things didn’t get off to a great start, when there was a pre-debate vote in the packed theatre at King’s College’s Institute of Psychiatry, Psychology and Neuroscience, which had apparently sold out within hours of the tickets being made available in March. 126 people – a mixture of mental health practitioners, students and members of the public – believed the motion to be correct; 28 abstained, and only 64 were on my side. © 2015 Guardian News and Media Limited
Link ID: 20936 - Posted: 05.16.2015
By SABRINA TAVERNISE WASHINGTON — What would make a smoker more likely to quit, a big reward for succeeding or a little penalty for failing? That is what researchers wanted to know when they assigned a large group of CVS employees, their relatives and friends to different smoking cessation programs. The answer offered a surprising insight into human behavior. Many more people agreed to sign up for the reward program, but once they were in it, only a small share actually quit smoking. A far smaller number agreed to risk the penalty, but those who did were twice as likely to quit. The trial, which was described in The New England Journal of Medicine on Wednesday, was the largest yet to test whether offering people financial incentives could lead to better health. It used theories about human decision making that have been developed in psychology and economics departments over several decades and put them into practice with more than 2,500 people who either worked at CVS Caremark, the country’s largest drugstore chain by sales, or were friends or relatives of those employees. Researchers found that offering incentives was far more effective in getting people to stop smoking than the traditional approach of giving free smoking cessation help, such as counseling or nicotine replacement therapy like gum, medication or patches. But they also found that requiring a $150 deposit that would be lost if the person failed to stay off cigarettes for six months nearly doubled the chances of success. “Adding a bit of a stick was much better than a pure carrot,” said Dr. Scott Halpern, deputy director of the Center for Health Incentives and Behavioral Economics at the University of Pennsylvania School of Medicine, who led the study. © 2015 The New York Times Company
Keyword: Drug Abuse
Link ID: 20925 - Posted: 05.14.2015
By ANDREW POLLACK A study of an obesity drug has ended after the manufacturer released early and ultimately misleading data, researchers said on Tuesday. The company, Orexigen Therapeutics, disclosed in March that early results from a clinical trial of its drug Contrave had shown a 41 percent reduction in the risk of heart attacks, strokes and death from cardiovascular causes. Orexigen’s stock shot up, and the information no doubt helped lift sales of Contrave. But the academic researchers who oversaw the study said on Tuesday that Orexigen had violated an agreement that the early results were not going to be shared widely, even within the company. Moreover, as participants in the trial were followed for a longer period of time, the benefit of the drug in reducing cardiovascular risks vanished. The researchers, in a news release issued by the Cleveland Clinic, said they took the unusual step of terminating the study and releasing the more updated results. “We felt it was unacceptable to allow misleading interim data to be in the public domain and be acted upon by patients and providers,” Dr. Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic and head of the trial’s steering committee, said in an interview. He said Orexigen had “acted improperly and unethically in violating the data access agreement” and the premature release of data had made it difficult to continue the study. It’s unlikley that patients would want to stay in the trial and risk getting a placebo if they thought the drug, which is already available on the market, could reduce their risk of heart attacks. © 2015 The New York Times Company
Link ID: 20921 - Posted: 05.13.2015
Sarah Boseley Health editor Psychiatric drugs do more harm than good and the use of most antidepressants and dementia drugs could be virtually stopped without causing harm, an expert on clinical trials argues in a leading medical journal. The views expressed in a British Medical Journal debate by Peter Gøtzsche, professor and director of the Nordic Cochrane Centre in Denmark, are strongly opposed by many experts in mental health. However, others say the debate around the use of psychiatric drugs is important and acknowledge that there has been overuse of antipsychotics to quieten aggressive patients with dementia. Gøtzsche says more than half a million people over the age of 65 die as a result of the use of psychiatric drugs every year in the western world. “Their benefits would need to be colossal to justify this, but they are minimal,” he writes. He claims that trials carried out with funding from drug companies into the efficacy of psychiatric drugs have almost all been biased, because the patients involved have usually been on other medication first. They stop their drugs and often experience a withdrawal phase prior to starting the trial drug, which then appears to have a big benefit. He also claims that deaths from suicide in clinical trials are under-reported. In trials of the modern antidepressants fluoxetine and venlafaxine, says Gøtzsche, it takes only a few extra days for depression in the placebo group – given dummy pills – to lift as much as in the group given the drugs. He argues that there is spontaneous remission of the disease over time. © 2015 Guardian News and Media Limited
Aaron E. Carroll When I was a kid, my parents refused to let me drink coffee because they believed it would “stunt my growth.” It turns out, of course, that this is a myth. Studies have failed, again and again, to show that coffee or caffeine consumption are related to reduced bone mass or how tall people are. Coffee has long had a reputation as being unhealthy. But in almost every single respect that reputation is backward. The potential health benefits are surprisingly large. When I set out to look at the research on coffee and health, I thought I’d see it being associated with some good outcomes and some bad ones, mirroring the contradictory reports you can often find in the news media. This didn’t turn out to be the case. Just last year, a systematic review and meta-analysis of studies looking at long-term consumption of coffee and the risk of cardiovascular disease was published. The researchers found 36 studies involving more than 1,270,000 participants. The combined data showed that those who consumed a moderate amount of coffee, about three to five cups a day, were at the lowest risk for problems. Those who consumed five or more cups a day had no higher risk than those who consumed none. Of course, everything I’m saying here concerns coffee — black coffee. I am not talking about the mostly milk and sugar coffee-based beverages that lots of people consume. These could include, but aren’t limited to, things like a McDonald’s large mocha (500 calories, 17 grams of fat, 72 grams of carbohydrates), a Starbucks Venti White Chocolate Mocha (580 calories, 22 grams of fat, 79 grams of carbs), and a Large Dunkin’ Donuts frozen caramel coffee Coolatta (670 calories, 8 grams of fat, 144 grams of carbs). I won’t even mention the Cold Stone Creamery Gotta-Have-It-Sized Lotta Caramel Latte (1,790 calories, 90 grams of fat, 223 grams of carbs). Regular brewed coffee has 5 or fewer calories and no fat or carbohydrates. © 2015 The New York Times Company
Keyword: Drug Abuse
Link ID: 20908 - Posted: 05.12.2015