Chapter 4. The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Follow us on Facebook and Twitter, or subscribe to our mailing list, to receive news updates. Learn more.
By BARRY MEIER Four years and a lifetime ago, a new war began for Sgt. Shane Savage. On Sept. 3, 2010, the armored truck he was commanding near Kandahar, Afghanistan, was blown apart by a roadside bomb. His head hit the ceiling so hard that his helmet cracked. His left foot was pinned against the dashboard, crushing 24 bones. Sergeant Savage came home eight days later, at age 27, with the signature injuries of the conflicts in Iraq and Afghanistan: severe concussion, post-traumatic stress and chronic pain. Doctors at Fort Hood in Killeen, Tex., did what doctors across the nation do for millions of ordinary Americans: They prescribed powerful narcotic painkillers. What followed was a familiar arc of abuse and dependence and despair. At one point, Sergeant Savage was so desperate that he went into the bathroom and began swallowing narcotic tablets. He would have died had his wife, Hilary, not burst through the door. Today Sergeant Savage has survived, even prevailed, through grit, his family and a radical experiment in managing pain without narcotics. When off-duty, he pulls on cowboy boots and plays with his children, does charity work and, as part of a therapy program, rides horses. The only medication he takes for pain is Celebrex, a non-narcotic drug. “You have to find alternative ways to get out and do stuff to stay active, to get your brain off the thought process of ‘I’m in pain,’ ” said Sergeant Savage, whose ears push out from under a Texas A&M baseball cap. The story of Sergeant Savage illuminates an effort by experts inside and outside the military to change how chronic, or long-term, pain is treated. By some estimates, tens of millions of Americans suffer from chronic pain, and the use of opioids — drugs like hydrocodone, methadone and oxycodone (the active ingredient in painkillers like OxyContin) — to treat such conditions has soared over the last decade. © 2014 The New York Times Company
By Brian Palmer The Journal of Neuroscience recently published a study linking recreational marijuana use to subtle changes in brain structure. The researchers, led by Jodi Gilman of Massachusetts General Hospital, identified increased gray matter density in the left nucleus accumbens and some bordering areas. The study was fine, but the media coverage was abysmal. Reporters overstated the findings, mischaracterized the study, and failed to mention previous research done on pot smoking and health. Goldfish may not have a three-second memory, but some journalists seem to. When a new paper comes out, it’s often treated as the first ever and final word on the topic. There is a significant body of literature on the neurological and wider health effects of marijuana, and to ignore it when covering new studies seems to me a form of journalistic malpractice. A press release from the Society for Neuroscience trumpeted the Gilman study’s importance because it looked at casual users rather than regular pot smokers, who form the basis of most marijuana studies. That claim is dubious in the extreme. The subjects averaged 3.83 days of smoking and 11.2 total joints per week. Characterizing these people as casual pot smokers was a great media hook, but it defied common sense. Occasional users wondered if they’d done permanent damage, and parents were concerned that their teenagers might face profound neurological changes from experimenting with pot. Any reporter who read the study, however, should have known not to take that bait. Even by the standards of past medical studies, it’s a stretch to call these subjects casual pot smokers. © 2014 The Slate Group LLC.
Keyword: Drug Abuse
Link ID: 19559 - Posted: 05.03.2014
By MATTHEW PERRONE WASHINGTON (AP) — The Food and Drug Administration announced Friday it will convene a public meeting in October to review the risks of psychiatric and behavioral side effects with Pfizer’s anti-smoking drug Chantix. The agency said in a federal notice it will convene its panel of psychiatric drug experts to discuss the pill’s risks and how to best manage them. Since 2009 Chantix has carried the government’s strongest safety warning — a ‘‘black box’’ label — because of links to hostility, agitation, depression and suicidal thoughts. The warning was added after the FDA received dozens of reports of suicide and hundreds of reports of suicidal behavior among patients taking the smoking-cessation drug. At that time, the FDA also required Pfizer to conduct additional studies to determine the extent of the side effects. A spokeswoman for Pfizer said Friday that the company recently submitted new data to the FDA comparing the drug’s psychiatric safety to placebo and other anti-smoking techniques. The FDA first began investigating potential side effects with Chantix in 2007, the year after the twice-a-day pill hit the market. The drug’s labeling tells patients to stop taking Chantix immediately if they experience agitation, depressed mood, suicidal thinking and other behavioral changes. Doctors are advised to weigh the drug’s risks against its potential benefits in helping patients quit smoking.
By Brady Dennis, The Food and Drug Administration will for the first time regulate the booming market of electronic cigarettes, as well as cigars, pipe tobacco and hookahs, under a proposal to be released Thursday. The move would begin to place restrictions on e-cigarettes, a nearly $2 billion industry that for years has operated outside the reach of federal regulators. If adopted, the government’s plan would force manufacturers to curb sales to minors, stop handing out free samples, place health warning labels on their products and disclose the ingredients. Makers of e-cigarettes also would be banned from making health-related claims without scientific evidence. The FDA’s proposal stops short of broader restrictions sought by many tobacco-control advocates. Regulators at this point are not seeking to halt online sales of e-cigarettes, curb television advertising, or ban the use of flavorings such as watermelon, grape soda and piña colada — all tactics that critics say are aimed at attracting young smokers and that have been banned for traditional cigarettes. Those restrictions might come eventually, FDA officials said, but not before more rigorous research can establish a scientific basis for tougher rules. “Right now, for something like e-cigarettes, there are far more questions than answers,” said Mitch Zeller, director of the FDA’s Center for Tobacco Products. Thursday’s action is about expanding FDA’s authority to products that have been “rapidly evolving with no regulation whatsoever,” in order to create a foundation for broader regulation in the future, he said. “It creates the framework. We’re calling this the first step. . . . For the first time, there will be a science-based, independent regulatory agency playing a vital gate-keeping function.” © 1996-2014 The Washington Post
Keyword: Drug Abuse
Link ID: 19529 - Posted: 04.24.2014
by Bethany Brookshire Many of us have experienced that depressing sight: The bottom of the ice cream pint. You get to the end of your favorite movie and suddenly realize the ice cream is gone — and you’re far too full for comfort. We’re left wondering why we did it. But when it comes to forgetting ourselves and bingeing on the pint, the power of habit can be strong. It could be that our previous eating experiences make us helpless to our habits. A new study in rats, published April 2 in the Journal of Neuroscience, shows that long-term exposure to bursts of sweet, fatty foods produces animals that appear to seek food not out of hunger, but out of habit. And neural changes associated with habit formation accompany the behavioral changes. The results suggest that repeated binges on sugar and fat could tilt the neural balance from taking a few scoops of Cherry Garcia toward mindlessly reaching the bottom of the bowl. But while the results show us the power of habit, bad habits don’t necessarily make us food addicts. Teri Furlong and her colleagues at the University of Sydney in Australia were interested in how animals control behaviors. Some behaviors are goal-directed, while others are more efficiently taken care of with habits. Furlong describes habits as “behaviors where we are not thinking about the consequences as we do them.” Many habits can be useful things to develop — eating breakfast daily or brushing your teeth, for example. But other habits can become maladaptive, such as drug abuse — or binge eating. © Society for Science & the Public 2000 - 2013.
Muscle weakness from long-term alcoholism may stem from an inability of mitochondria, the powerhouses of cells, to self-repair, according to a study funded by the National Institutes of Health. In research conducted with rats, scientists found evidence that chronic heavy alcohol use affects a gene involved in mitochondrial repair and muscle regeneration. “The finding gives insight into why chronic heavy drinking often saps muscle strength and it could also lead to new targets for medication development,” said Dr. George Koob, director of the National Institute on Alcohol Abuse and Alcoholism, the NIH institute that funded the study. The study is available online in the April issue of the Journal of Cell Biology. It was led by Dr. Gyorgy Hajnoczky, M.D., Ph.D., director of Thomas Jefferson University’s MitoCare Center, Philadelphia, and professor in the Department of Pathology, Anatomy and Cell Biology. Mitochondria are cellular structures that generate most of the energy needed by cells. Skeletal muscle constantly relies on mitochondria for power. When mitochondria become damaged, they can repair themselves through a process called mitochondrial fusion — joining with other mitochondria and exchanging material such as DNA. Although well known in many other tissues, the current study is the first to show that mitochondria in skeletal muscle are capable of undergoing fusion as a repair mechanism. It had been thought that this type of mitochondrial self-repair was unlikely in the packed fibers of the skeletal muscle cells, as mitochondria have little opportunity to interact in the narrow space between the thread-like structures called myofilaments that make up muscle.
|By Janali Gustafson Cravings—we all have them. These intense desires can be triggered by a place, a smell, even a picture. For recovering drug addicts, such memory associations can increase vulnerability to relapse. Now researchers at the Florida campus of the Scripps Research Institute have found a chemical that prevents rats from recalling their drug-associated memories. The study, published online in Biological Psychiatry last fall, is also the first of its kind to disrupt memories without requiring active recollection. Over the course of six days the rats in this study alternated between one of two chambers. On days one, three and five, the animals were injected with methamphetamine hydrochloride—the street drug known as meth—and placed in one room. On the even-numbered days they received a saline placebo and entered a different chamber. After two more days, half the rodents were given a choice between the rooms. As expected, they showed a clear preference for the place they visited after receiving meth. The other half of the animals were injected with a solution containing Latrunculin A (LatA). This chemical interferes with actin, a protein known to be involved in memory formation. These animals showed no preference between rooms, even up to a day later: their choices seemed not to be driven by a memory of meth. Previous research has suggested that drugs of abuse alter the way actin functions, causing it to constantly refresh memories associated with these drugs rather than tucking them away into typical memory storage, which is more inert. As a result of their active status, drug memories might remain susceptible to disruption long after their initial formation. © 2014 Scientific American
Associated Press NEW YORK -- A small study of casual marijuana smokers has turned up evidence of changes in the brain, a possible sign of trouble ahead, researchers say. The young adults who volunteered for the study were not dependent on pot, nor did they show any marijuana-related problems. "What we think we are seeing here is a very early indication of what becomes a problem later on with prolonged use," things like lack of focus and impaired judgment, said Dr. Hans Breiter, a study author. Longer-term studies will be needed to see if such brain changes cause any symptoms over time, said Breiter, of the Northwestern University Feinberg School of Medicine and Massachusetts General Hospital. Previous studies have shown mixed results in looking for brain changes from marijuana use, perhaps because of differences in the techniques used, he and others noted in Wednesday's issue of the Journal of Neurosciences. The study is among the first to focus on possible brain effects in recreational pot smokers, said Dr. Nora Volkow, director of the National Institute on Drug Abuse. The federal agency helped pay for the work. She called the work important but preliminary. The 20 pot users in the study, ages 18 to 25, said they smoked marijuana an average of about four days a week, for an average total of about 11 joints. Half of them smoked fewer than six joints a week. Researchers scanned their brains and compared the results with those of 20 nonusers who were matched for age, sex and other traits. The results showed differences in two brain areas associated with emotion and motivation - the amygdala and the nucleus accumbens. Users showed higher density than nonusers, as well as differences in shape of those areas. Both differences were more pronounced in those who reported smoking more marijuana. © 2014 Hearst Communications, Inc.
By CATHERINE SAINT LOUIS Doctors are prescribing opioid painkillers to pregnant women in astonishing numbers, new research shows, despite the fact that risks to the developing fetus are largely unknown. Of 1.1 million pregnant women enrolled in Medicaid nationally, nearly 23 percent filled an opioid prescription in 2007, up from 18.5 percent in 2000, according to a study published last week in Obstetrics and Gynecology, the largest to date of opioid prescriptions among pregnant women. Medicaid covers the medical expenses for 45 percent of births in the United States. The lead author, Rishi J. Desai, a research fellow at Brigham and Women’s Hospital, said he had expected to “see some increase in trend, but not this magnitude.” “One in five women using opioids during pregnancy is definitely surprising,” he said. In February, a study of 500,000 privately insured women found that 14 percent were dispensed opioid painkillers at least once during pregnancy. From 2005 to 2011, the percentage of pregnant women prescribed opioids decreased slightly, but the figure exceeded 12 percent in any given year, according to Dr. Brian T. Bateman, an anesthesiologist at Massachusetts General Hospital, and his colleagues. Their research was published in Anesthesiology. Dr. Joshua A. Copel, a professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine in New Haven, Conn., said he was taken aback by the findings, which come even as conscientious mothers-to-be increasingly view pregnancy as a time to skip caffeine, sushi and even cold cuts. “To hear that there’s such a high use of narcotics in pregnancy when I see so many women who worry about a cup of coffee seems incongruous,” he said. In both studies, the opioids most prescribed during pregnancy were codeine and hydrocodone. Oxycodone was among the top four. Women usually took the drugs for a week or less; however, just over 2 percent of women in both studies took them for longer periods. © 2014 The New York Times Company
By GRETCHEN REYNOLDS It’s possible that some of us are born not to run. According to an eye-opening new genetics study of lab rats, published in The Journal of Physiology, the motivation to exercise — or not — may be at least partly inherited. For years, scientists have been bedeviled by the question of why so few people regularly exercise when we know that we should. There are obvious reasons, including poor health and jammed schedules. But researchers have begun to speculate that genetics might also play a role, as some recent experiments suggest. In one, published last year, sets of fraternal and identical adult twins wore activity monitors to track their movements. The results indicated that the twins were more alike in their exercise habits than a shared upbringing alone would explain. Their willingness to work out or sit all day depended to a large extent on genetics, the researchers concluded. But which genes might be involved and how any differences in the activity of those genes might play out inside the body were mysteries. So scientists at the University of Missouri recently decided to delve into those issues by creating their own avid- or anti-exercising animals. They accomplished this task by inter-breeding normal rats that had voluntarily run on wheels in the lab. The male rats that had run the most were bred with the female rats that also had run the most; those that had run the least were likewise mated. This scheme continued through many generations, until the scientists had two distinct groups of rats, some of which would willingly spend hours on running wheels, while the others would skitter on them only briefly, if at all. In their first experiments with these rats, the researchers found some intriguing differences in the activity of certain genes in their brains. In normal circumstances, these genes create proteins that tell young cells to grow up and join the working world. But if the genes don’t function normally, the cells don’t receive the necessary chemical messages and remain in a prolonged, feckless cellular adolescence. Such immature cells cannot join the neural network and don’t contribute to healthy brain function. © 2014 The New York Times Company
Keyword: Drug Abuse
Link ID: 19470 - Posted: 04.10.2014
By SABRINA TAVERNISE Federal health regulators approved a drug overdose treatment device on Thursday that experts say will provide a powerful lifesaving tool in the midst of a surging epidemic of prescription drug abuse. Similar to an EpiPen used to stop allergic reactions to bee stings, the easy-to-use injector — small enough to tuck into a pocket or a medicine cabinet — can be used by the relatives or friends of people who have overdosed. The hand-held device, called Evzio, delivers a single dose of naloxone, a medication that reverses the effects of an overdose, and will be used on those who have stopped breathing or lost consciousness from an opioid drug overdose. Naloxone is the standard treatment in such circumstances, but until now, has been available mostly in hospitals and other medical settings, when it is often used too late to save the patient. The decision to quickly approve the new treatment, which is expected to be available this summer, comes as deaths from opioids continue to mount, including an increase in those from heroin, which contributed to the death of the actor Philip Seymour Hoffman in February. Federal health officials, facing criticism for failing to slow the rising death toll, are under pressure to act, experts say. “This is a big deal, and I hope gets wide attention,” said Dr. Carl R. Sullivan III, director of the addictions program at West Virginia University. “It’s pretty simple: Having these things in the hands of people around drug addicts just makes sense because you’re going to prevent unnecessary mortality.” The scourge of drug abuse has battered states across the country, with deaths from overdoses now outstripping those from traffic crashes. Prescription drugs alone now account for more than half of all drug overdose deaths, and one major category of them, opioids, or painkillers, take the lives of more Americans than heroin and cocaine combined. Deaths from opioids have quadrupled in 10 years to more than 16,500 in 2010, according to federal data. © 2014 The New York Times Company
By James Gallagher Health and science reporter, BBC News The illegal party drug ketamine is an "exciting" and "dramatic" new treatment for depression, say doctors who have conducted the first trial in the UK. Some patients who have faced incurable depression for decades have had symptoms disappear within hours of taking low doses of the drug. The small trial on 28 people, reported in the Journal of Psychopharmacology, shows the benefits can last months. Experts said the findings opened up a whole new avenue of research. Depression is common and affects one-in-10 people at some point in their lives. Antidepressants, such as prozac, and behavioural therapies help some patients, but a significant proportion remain resistant to any form of treatment. A team at Oxford Health NHS Foundation Trust gave patients doses of ketamine over 40 minutes on up to six occasions. Eight showed improvements in reported levels of depression, with four of them improving so much they were no longer classed as depressed. Some responded within six hours of the first infusion of ketamine. Lead researcher Dr Rupert McShane said: "It really is dramatic for some people, it's the sort of thing really that makes it worth doing psychiatry, it's a really wonderful thing to see. He added: "[The patients] say 'ah this is how I used to think' and the relatives say 'we've got x back'." Dr McShane said this included patients who had lived with depression for 20 years. Stressed man The testing of ketamine has indentified some serious side-effects The duration of the effect is still a problem. Some relapse within days, while others have found they benefit for around three months and have since had additional doses of ketamine. There are also some serious side-effects including one case of the supply of blood to the brain being interrupted. Doctors say people should not try to self-medicate because of the serious risk to health outside of a hospital setting. BBC © 2014
|By Hal Arkowitz and Scott O. Lilienfeld A commercial sponsored by Pfizer, the drug company that manufactures the antidepressant Zoloft, asserts, “While the cause [of depression] is unknown, depression may be related to an imbalance of natural chemicals between nerve cells in the brain. Prescription Zoloft works to correct this imbalance.” Using advertisements such as this one, pharmaceutical companies have widely promoted the idea that depression results from a chemical imbalance in the brain. The general idea is that a deficiency of certain neurotransmitters (chemical messengers) at synapses, or tiny gaps, between neurons interferes with the transmission of nerve impulses, causing or contributing to depression. One of these neurotransmitters, serotonin, has attracted the most attention, but many others, including norepinephrine and dopamine, have also been granted supporting roles in the story. Much of the general public seems to have accepted the chemical imbalance hypothesis uncritically. For example, in a 2007 survey of 262 undergraduates, psychologist Christopher M. France of Cleveland State University and his colleagues found that 84.7 percent of participants found it “likely” that chemical imbalances cause depression. In reality, however, depression cannot be boiled down to an excess or deficit of any particular chemical or even a suite of chemicals. “Chemical imbalance is sort of last-century thinking. It's much more complicated than that,” neuroscientist Joseph Coyle of Harvard Medical School was quoted as saying in a blog by National Public Radio's Alix Spiegel. © 2014 Scientific American
Link ID: 19432 - Posted: 04.01.2014
By ABIGAIL ZUGER, M.D. One legend says it all began when a North African herder saw his goats eat some wild berries, then frolic with unusual verve. Another story cites a few small leaves blown off a nearby bush into the Chinese emperor’s mug of hot water. Either way, whether caffeine entered the life of man by coffee bean or tea leaf, happiness ensued. Happiness, that is, for all but the poor souls charged with saving us from our drugs, for no regulatory challenge trumps the one posed by caffeine, molecule of elegant enjoyment and increasing abuse, man’s best friend and occasional killer. As Murray Carpenter makes clear in his methodical review, our society’s metrics are no match for this substance’s nuances, whether among athletes, teenagers, experimental subjects or the average dependent Joe. (Read an excerpt of “Caffeinated.”) Pure caffeine is a bitter white powder. In the body it blocks the effects of the molecule adenosine, a crucial brake on many physiologic processes. With just enough caffeine in the system, the body’s organs become a little more themselves: the brain a little brainier, the muscles a little springier, the blood vessels a little tighter, the digestion a little more efficient. With too much caffeine, all can accelerate into cardiac arrest. It takes only about 30 milligrams of caffeine (less than a cup of coffee or can of cola) for stimulative effects to be noticeable. A hundred milligrams a day will hook most people: They feel immensely unhappy without their daily fix, and the organs all whine in protest for a few days. It takes more than 10 grams to kill you — a dose impossible to achieve with traditional beverages alone. However, the new caffeine-rich energy shots make it alarmingly easy for party-minded people to achieve the zone between enough and much too much. © 2014 The New York Times Company
Keyword: Drug Abuse
Link ID: 19427 - Posted: 03.31.2014
James Hamblin Forty-one million IQ points. That’s what Dr. David Bellinger determined Americans have collectively forfeited as a result of exposure to lead, mercury, and organophosphate pesticides. In a 2012 paper published by the National Institutes of Health, Bellinger, a professor of neurology at Harvard Medical School, compared intelligence quotients among children whose mothers had been exposed to these neurotoxins while pregnant to those who had not. Bellinger calculates a total loss of 16.9 million IQ points due to exposure to organophosphates, the most common pesticides used in agriculture. Last month, more research brought concerns about chemical exposure and brain health to a heightened pitch. Philippe Grandjean, Bellinger’s Harvard colleague, and Philip Landrigan, dean for global health at Mount Sinai School of Medicine in Manhattan, announced to some controversy in the pages of a prestigious medical journal that a “silent pandemic” of toxins has been damaging the brains of unborn children. The experts named 12 chemicals—substances found in both the environment and everyday items like furniture and clothing—that they believed to be causing not just lower IQs but ADHD and autism spectrum disorder. Pesticides were among the toxins they identified. “So you recommend that pregnant women eat organic produce?” I asked Grandjean, a Danish-born researcher who travels around the world studying delayed effects of chemical exposure on children. “That’s what I advise people who ask me, yes. It’s the best way of preventing exposure to pesticides.” Grandjean estimates that there are about 45 organophosphate pesticides on the market, and “most have the potential to damage a developing nervous system.” © 2014 by The Atlantic Monthly Group.
Daniel Cressey The controversy over electronic cigarettes has been reignited today with the publication of a study claiming that they do not help smokers to quit their habit. Whether or not ‘e-cigarettes’ are an effective aid in the cessation of smoking has become a major issue for the rapidly growing industry that produces the devices, and for the tobacco researchers struggling to assess their impact. There is widespread agreement that inhaling from an e-cigarette, where a heating element vapourizes a liquid containing nicotine, is not as harmful as smoking a conventional cigarette, and proponents say that the products could save millions of lives. But some researchers and tobacco-control activists fear that the devices could make tobacco use seem socially acceptable again and may not assist people in actually reducing their addiction. Pamela Ling, a tobacco researcher at the University of California, San Francisco, and her colleagues followed 949 people who detailed their smoking habits though an online survey, and found that 88 of those who had used e-cigarettes were no more likely to have quit or reduced their smoking after a year than other smokers. “We found that there was no difference in the rate of quitting between smokers who used an e-cigarette and those who did not”, even after controlling for factors such as the user's dependence on tobacco, Ling told Nature in an e-mail. She added: “Advertising suggesting that e-cigarettes are effective for smoking cessation should be prohibited until such claims are supported by scientific evidence.” Her team reports the results today in JAMA Internal Medicine1. © 2014 Nature Publishing Group
Keyword: Drug Abuse
Link ID: 19405 - Posted: 03.25.2014
By MATT RICHTEL A dangerous new form of a powerful stimulant is hitting markets nationwide, for sale by the vial, the gallon and even the barrel. The drug is nicotine, in its potent, liquid form — extracted from tobacco and tinctured with a cocktail of flavorings, colorings and assorted chemicals to feed the fast-growing electronic cigarette industry. These “e-liquids,” the key ingredients in e-cigarettes, are powerful neurotoxins. Tiny amounts, whether ingested or absorbed through the skin, can cause vomiting and seizures and even be lethal. A teaspoon of even highly diluted e-liquid can kill a small child. But, like e-cigarettes, e-liquids are not regulated by federal authorities. They are mixed on factory floors and in the back rooms of shops, and sold legally in stores and online in small bottles that are kept casually around the house for regular refilling of e-cigarettes. Evidence of the potential dangers is already emerging. Toxicologists warn that e-liquids pose a significant risk to public health, particularly to children, who may be drawn to their bright colors and fragrant flavorings like cherry, chocolate and bubble gum. “It’s not a matter of if a child will be seriously poisoned or killed,” said Lee Cantrell, director of the San Diego division of the California Poison Control System and a professor of pharmacy at the University of California, San Francisco. “It’s a matter of when.” © 2014 The New York Times Company
By Ariana Eunjung Cha, Millions of ordinary Americans are now able to walk into a marijuana dispensary and purchase bags of pot on the spot for a variety of medical ailments. But if you’re a researcher like Sue Sisley, a psychiatrist who studies post- traumatic stress disorder, getting access to the drug isn’t nearly so easy. That’s because the federal government has a virtual monopoly on growing and cultivating marijuana for scientific research, and getting access to the drug requires three separate levels of approval. Marijuana offers hope for 6-year-old girl with rare condition: In marijuana, Lydia Schaeffer’s family members think they might have found a treatment that works. Now, they are trying to help legalize the drug. Sisley’s fight to get samples for her study — now in its fourth month — illuminates the complex politics of marijuana in the United States. While 20 states and the District have made medical marijuana legal — in Colorado and Washington state the drug is also legal for recreational use — it remains among the most tightly controlled substances under federal law. For scientists, that means extra steps to obtain, transport and secure the drug — delays they say can slow down their research by months or even years. © 1996-2014 The Washington Post
Sara Reardon Thomas Insel, the director of the US National Institute of Mental Health (NIMH), has had enough of shooting in the dark. He thinks that if a clinical trial of a psychiatric therapy fails, scientists should at least learn something about the brain along the way. Now Insel is translating that belief into action: the NIMH, based in Bethesda, Maryland, has decided to stop funding clinical trials that aim merely to ease patients’ symptoms. “Future trials will follow an experimental medicine approach in which interventions serve not only as potential treatments, but as probes to generate information about the mechanisms underlying a disorder”, he wrote in a 27 February blog post announcing the move. This funding switch, which will affect grants due to be made in a few months’ time, intensifies the NIMH’s apparent shift in emphasis from abstract psychiatry to the neurobiological roots of disease. “It’s a totally new departure for us,” says Bruce Cuthbert, a clinical psychologist and director of the institute’s adult translational-research division. Insel notes that the NIMH spent about US$100 million on clinical trials in 2013, and says that more than half of recipient projects received funding without any requirement to examine the biological processes involved in a disease. In many cases, “if you get a negative result you have no idea why, and you have to try something else at random”, Cuthbert says. “It’s an incredible waste of money.” The new rules, which will apply to the grant cycle that begins in June, also seek to increase transparency by requiring faster online registration of trials and stricter guidelines for reporting results. Insel acknowledges that researchers may have to rework their studies to satisfy the new guidelines. “I think this will be really unpopular,” he says. © 2014 Nature Publishing Group
by Clare Wilson ARE people with obsessive compulsive disorder addicted to their repetitive behaviours? In a test designed to measure decision-making, individuals with OCD performed much like gambling addicts, suggesting their underlying brain problems may be similar. OCD makes people worry obsessively, compelling them to carry out rituals like repeated hand washing. It affects about one in 50 people and can take over their lives. Because sufferers get anxious if they can't complete their rituals, OCD is usually treated as an anxiety disorder with talking therapies to relieve distress or anti-anxiety drugs. These approaches reduce symptoms but only a minority of people are cured. In the new study, 80 people – half of whom had OCD – had to choose cards from four decks, winning or losing money in the process. Two decks were rigged to produce big wins but even bigger losses. The people without OCD learned to choose from the two safer decks but those with the disorder were consistently less likely to make good judgements and finished with a significantly lower final score. Drug and gambling addicts also perform poorly on the test. That doesn't prove OCD is an addiction but a growing body of work, including brain scans and other cognitive tests, suggest it should be recast in this way, says Naomi Fineberg of the University of Hertfordshire in Welwyn Garden City. Both addiction and OCD "share a lack of control of behaviour", she says. © Copyright Reed Business Information Ltd.