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Research Updates This section contains notes on new research and promising therapies for mood disorders. Click on the title to read more: New antioxidant for
bipolar depression Savella: a new antidepressant
for fibromylagia Creativity and recovery from depression Provigil effective for bipolar depression Agomelatine: a new antidepressant Research has shed some interesting light on how our work
environment influences mood. Here is a
brief summary: ·
People who routinely work more than 11 hours per day have
double the risk of depression. ·
Long commute times (especially greater than 45 minutes)
are associated with depression, obesity, insomnia, chronic pain and marital
stress. ·
Night shift work increases the risk of depression. One study found that varying shifts were
harder on women, while continuous night shift was harder on men. Night-shift work is also associated with
stomach problems, heart disease, obesity and sexual dysfunction. About 15% of people have significant
difficulty adapting to night shift work. · Volunteering can have a positive impact on mood, and some research suggests its benefits can be greater than paid work. The impact of volunteering is greatest when it involves helping people through direct, personal contact; and when it involves helping people who would otherwise be strangers to you. 1.13.2012 Cognitive Training Cognitive problems
are often the last part of a mood disorder to recover. Although we do no “feel” cognitive problems
like we do depression and anxiety, they can be just as impairing to our
lives. They include our ability to
prioritize, focus, remember, and make decisions. Unfortunately,
medications are usually much better at helping the physical and emotional
symptoms of mood than they are at improving cognition. So it is exciting news that a cognitive
training program can improve these abilities in people recovering from mental
illness. Cognitive training
is a computer-assisted program which engages people in exercises designed to
enhance their mental abilities. Most
of this research was conducted in people with schizophrenia (which is not a
mood disorder), but a few studies suggest that the same methods may prove
beneficial for people recovering from bipolar or depression. If you plan to
undertake some cognitive training, keep in mind that the methods work best if
practiced regularly (e.g. an 20-60 minutes daily). Also know that there is just as much
research suggesting that physical exercise (e.g. walking briskly 30 minutes a
day) is as helpful as mental exercise for memory and cognition. Other things that improve cognition are
good sleep (e.g. 8-9 hours/day) and a diet low in saturated fats and simple
sugars. You can read more about Cognitive Training and try out the exercises at HappyNeuron, Lumosity or Cognitive-Remediation.com. (Note: these sites also have free apps; type them as key words in your itunes store). 3.10.2011 New antidepressant “Viibryd” Viibryd (vilazodone) was just approved as a new
antidepressant. It has similar
properties to the SSRIs (e.g. Prozac, Paxil, Zoloft, Celexa,
Lexapro, Luvox) but
impacts additional brain areas (the 5HT1a receptor) so is likely to produce
different effects than the SSRIs.
Although Viibryd is effective for
depression, it is not yet clear that this medicine is significantly more
effective or better tolerated than other available antidepressants. 3.10.2011 Silenor, a new sleep aid Silenor is not
a new medicine but rather a new way of using an old medicine. It is based on the older antidepressant Doxepine. Silenor is a very small, micro-dose of doxepine, and was FDA-approved for insomnia last
year. It appears that, when given in
these small doses, silenor does not have the side
effects that doxepine dose and in fact does not
even touch the same receptors in the brain.
Sleep is frequently a problem in depression and
bipolar disorder, and treating sleep can help people recover faster and stay
well. It is not yet clear if silenor will be safe in bipolar disorder – given the
dangers of using antidepressants in that condition – but it appears to not
work like an antidepressant at this dose and there is no known risk with it
in bipolar disorder. 5.1.2009 New antioxidant for bipolar depression One of the ways that stress causes depression is by
injuring brain cells through a process called oxidation. Oxidation also contributes to heart disease,
dementia and aging. Fortunately the
body has natural antioxidants to protect against this damage. Antioxidants are behind many of the health
benefits we get from exercise, eating fruits, vegetables and vitamins, and avoiding nicotine and saturated fats. Although some psychiatric medications have antioxidant
properties, until now there has never been a medication that treats
depression directly through this mechanism.
In a study lasting six months, researchers in Australia discovered
that the medicine acetylcysteine improves bipolar depression. Acetylcysteine works by increasing a natural antioxidant
called glutathione in the brain. Prior to this study, acetylcysteine’s
main uses were to treat Tylenol overdose and reduce mucous in the lungs. Acetylcysteine is
well tolerated and not associated with major medical risks. 3.22.2009 Savella: a new antidepressant for fibromyalgia Savella (Milnacipran) was recently
approved in the U.S. for the treatment of fibromyalgia. Although not approved for depression, Savella has been used as an antidepressant in other
countries since 1998 and has proven effective for this in 6 research
studies. It resembles the
antidepressants Cymbalta (duloxetine) and Effexor (venlafaxine) in being a serotonin and norepinephrine
reuptake inhibitor. Antidepressants
which increase norepinephrine are often used to
treat physical pain; in fact Cymbalta is also
FDA-approved for fibromyalgia.
However, increases of norepinephrine can be
dangerous in bipolar disorder, sometimes leading to mania and
aggression. 8.2.2008 Creativity and recovery from depression Researchers in 7.24.2008 New research in weight loss Mood disorders can affect metabolism in ways that make it difficult to lose weight. Unfortunately, some medications which help mood can also cause weight gain. Until this year, there have been few options to address this problem. Recent research has shed light on two treatments which can help prevent weight gain from atypical mood stabilizers: provigil and metformin. Each of these medications can have side effects and risks. You can read more about the relationships between mood, diet and weight on this site. 3.8.2007 Suicidality
and medication Two recent updates have been added to the original article on this subject. First, a gene has been discovered which may explain why some people develop suicidal thoughts after starting antidepressants. More research is needed in this area, as first-time discoveries of genes in the brain often turn out to be false-leads. Second, a warning about suicidal thoughts has been added to anticonvulsants, which are used to treat seizures as well as mood disorders. They include lamictal (lamotrigine), depakote (valproate), equetro (carbamazepine) and gabapentin (neurontin). It’s important to understand that this risk is very small and is a risk of suicidal thoughts, not of attempting suicide. The risk with mood stabilizers is very low (around 2 people in 1,000) and is estimated to be 10-times less than the risk with antidepressants. 9.12.2007 Provigil effective for bipolar depression Provigil, a medication designed for disorders of sleep/fatigue such as narcolepsy, now has promising evidence to help bipolar depression. Although there is only one good study supporting its use, this is an important advance as there are few treatments for bipolar depression available. Provigil has also been studied for attention-deficit disorder and atypical depression, which are common in bipolar disorder. Common side effects with Provigil include anxiety, headache and insomnia. Rarely, Provigil has been associated with mania, but it is not yet known if it causes mania. Update 12.15.2007 Agomelatine: a new antidepressant This is the first antidepressant that works through melatonin, a hormone-receptor involved in sleep. Initial studies indicate that agomelatine may have fewer side effects than other available antidepressants. In particular, agomelatine improves sleep quality without causing fatigue. This is unique among antidepressants, many of which can disrupt sleep. Agomelatine is not currently available in the U.S. and will likely be released in Europe soon. Its brand name is Valdoxan. |
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