New research adds to evidence of potentially better molecular targets in the brain to treat depression and other mental disorders, according to NIMH-funded scientists.

The researchers suggest that imbalances in the activity of an enzyme called GSK3ß may be closer to the root cause of mental illnesses than are low serotonin levels. Serotonin, a brain chemical, is the ultimate target of several current medications that work by indirectly increasing it to relieve symptoms. In preliminary findings, the scientists suggest that GSK3ß might be a more fundamental – and thus, perhaps, better and faster – target for new medications.

In the new study, even when serotonin levels stayed low, the scientists were able to correct abnormal, mental-illness-like behaviors in mice by blocking GSK3ß. When activated, GSK3ß plays a crucial role inside brain cells by sending chemical signals that help regulate cell function – but this activity must occur at the right time and in the right amount for the brain to function properly.

To assess the effects of blocking GSK3ß, the scientists measured anxiety- and depression-like behaviors shown earlier to be linked to low serotonin levels in mice. For example, compared to normal mice, those with low serotonin gave up sooner when held back by their tails and were slower to come out of dark hiding places to explore their surroundings.

These abnormal behaviors were reversed when scientists blocked GSK3ß in mice with low levels of serotonin. The scientists blocked the enzyme with either genetic engineering or a chemical compound. Success with both approaches strengthens the case for GSK3ß’s involvement in mental illnesses – and its potential, with further research, as a new target for medications, the researchers say.

A study in Denmark yielded insight into patients who were at the greatest risk for dying by suicide.

The study indicated that the risk of suicide:

 
• was slightly higher for people who lived in urban areas. 

   

• slightly increased with unemployment and low income. 

   

• significantly increased for those who were admitted to a psychiatric hospital. 

Almost 50% of the people who died by suicide had been admitted to a psychiatric hospital at least once. And patients were at the greatest risk for suicide shortly after their admission and the first week after their discharge.

Thus special care needs to be given at admission and after discharge to minimize the risk of suicide for patients.

Although many patients have died by suicide during or after a visit to a psychiatric hospital, it should be noted that most patients are effectively treated at hospitals and their condition improves. Also, many people who should go to a psychiatric hospital never do, and die by suicide because of the lack of treatment.

It should not be concluded from this data that simply being admitted to a psychiatric hospital causes people to die by suicide, but rather people who are admitted have serious disorders and thus are in a high risk category.

by Kevin Caruso

Along with exercising and eating a sensible diet, taking vitamins is important when you are suffering from depression.

A deficiency in vitamins and minerals may be part of the cause of your depression. Thus, it is imperative that you take vitamins every day.

So which vitamins should you take?

There has been much debate about which vitamins you should take for depression, and in what amounts. You could do an extensive study and still be bemused about what you should do.

So, the best thing to do is to buy the best multivitamin that you can, and make sure that it is high in the B-complex vitamins – B-complex vitamins are definitely important to fighting your depression. Compare labels on the vitamin boxes and buy the vitamins with the highest dosages of all vitamins, but particularly the highest B-complex dosages.

The best place to buy vitamins is at a health food store. Ask the clerk at the store for recommendations. And again, compare labels before you make your decision. If you do not have a health food store in your area, you can consider buying vitamins on the internet.

Also, ask for recommendatations for multivitamins from your doctor and psychiatrist or therapist.

Let me give you some additional information on vitamins, but keep in mind that you want to buy the best multivitamin that you can find, and make sure that it is high in B-complex vitamins. Keep the process for purchasing vitamins simple.

Vitamins are essential nutrients that your body needs for proper functioning. And your body cannot manufacture the vast majority of them, so you need to take vitamin supplements.

Also, vitamins are either water soluble or fat soluble. The fat-soluble vitamins are A, D, E and K. And the water-soluble vitamins are B-complex and C.

Water soluble vitamins are not stored in your body for very long, thus you need to be sure that you take your multivitamin every day so these vitamins can be replaced. Numerous studies have indicated that the B-complex vitamins are vital to mental health, and since the B-complex vitamins are water soluble, they need to be replaced daily.

And remember to compare labels to make sure that you are taking high dosages of B-complex vitamins.

Label information for vitamins and minerals will indicate the name of the vitamin or mineral and the dosage. The dosages will be shown as one of the following:

• mg – milligrams (one milligram = one thousandth of a gram)
• mcg – micrograms (one microgram = one millionth of a gram)
• IU – international units (IU is a quantity that produces a particular biological effect. Thus, each vitamin would have a different conversion ratio to milligrams.)

The vitamins and minerals will also be listed with “daily values.” These are values that are set by the government, but for many vitamins you want to be well above the “100%” level.

To review, you need to take a multivitamin every day. Take the very best multivitamin that you can find, and remember that the B-complex vitamins are extremely important, so ensure that the mulivitamin that you take is high in B-complex vitamins. A vitamin deficiency can cause or exacerbate your depression, so, again, take a multivitamin every day.

September 14, 2004

Top Food and Drug Administration officials acknowledged for the first time that antidepressants appear to raise the risk of suicide in some children and teenagers.

Testifying before two FDA advisory committees, the officials indicated that a recent Columbia University study that was contracted by the FDA showed that the drugs significantly increased the incidence of suicidal behavior in children and teenagers.

“I think that we now all believe that there is an increase in suicidal thinking and action [among children and teenagers] that is consistent across all the drugs, said Dr. Robert Temple, director of the FDA’s office of medical policy.

This acknowledgement has come a year after the agency withheld conclusions of Dr. Andrew Mosholder, the FDA’s drug safety analyst, who found a link between antidepressants and suicide in children and teenagers. Internal FDA memos indicated that many believed the data to be unreliable, and thus the FDA requested additional research at Columbia University.

The testimony was given to an advisory committee consisting of 31 independent experts.

Angry family members of suicide victims castigated the agency for waiting so long to divulge the information.

Mathy Milling Downing of Laytonsville, Md., whose 12-year-old daughter hanged herself in January, said: “Candace’s death was entirely avoidable had we been given the appropriate warnings.The blood of these children is on your hands.”

Thomas Woodward, a businessman from North Wales, Pa., whose 17-year-old daughter, Julie, hanged herself a week after beginning therapy with Zoloft, said: “The senior leadership at FDA drag their feet and make Orwellian statements such as ‘Just because these drugs have been proven to be effective does not necessarily mean they’re ineffective’ . [The FDA officials] know the truth and therefore have blood on their hands.”

(A memorial page to Julie Woodward is on Suicide.org. Please click the following link to visit Julie’s Memorial: Julie Woodward Memorial)

Raul Languerre of Newburgh, N.Y., said his son may spend many years in prison because of an act of violence he committed when he was on antidepressants. (Languerre did not want to give the name of his son or details about the incident because his son has not yet gone to trial.)

“Before he took these drugs he was a gentle, lovable kid who never hurt himself or any other person,” said Languerre. “The FDA needs to step up and protect the consumer and crack down on these drug companies before more lives are lost.”

Alice Erber said Paxil caused her 21-year-old son, Jake Steinberg, to jump to his death from the 24th floor of a Manhattan office building.

But the drug companies and some doctors maintain that the medicines need to remain available for the treatment of children and teenagers.

Dr. David Fassler, who testified on behalf of the American Psychiatric Association, said that each antidepressant was effective for some young patients.

“Most clinicians believe, and I would concur, that for children and adolescents who suffer from depression, the potential benefit from these medicines far outweighs the risk,” said Fassler.

Drug company representative were not in agreement as to whether the FDA should consider the antidepressants individually or collectively with respect to regulatory action.

Dr. Steven Romano of Pfizer said that suicidal behavior should be considered much more seriously than suicidal thought with respect to regulatory action. (Pfizer produces the antidepressant Zoloft, which was linked to more instances of serious suicidal thought than suicidal behavior in the Columbia University study.) “The risk or benefit of antidepressant use should be assessed on an individual product basis,” Romano said.

But Dr. Joseph Camardo of Wyeth Pharmaceuticals said that the data did not justify treating one antidepressant different from the other. “The information should be consistent for all of the antidepressants,” he said.

Effexor, a Wyeth Pharmaceuticals drug, has consistently shown the highest ratio of serious suicidal thought and behavior (of all the drugs studied) compared with patents taking placebos.

As you can see, the self-serving statements spewed by the representatives of the drug companies focus on protecting their drugs and profits instead of protecting our children and teens!

The advisory committee will advise the FDA on how to respond the problem with antidepressants and young people.

“I think the work is cut out for us,” said Wayne Goodman, chairman of the advisory committee.

————————————

It should be noted that antidepressants have helped many children and teens overcome their depresssion and suicidal thoughts, so the option of taking them should at least be explored; but proceed with great caution and consider all other options before making a decision.

And conduct as much research as possible. You want to be extremely knowledgable about antidepressants. Know all of the risks.

And if a phsychiatrist recommends antidepressants, you may want to get a second or even a third opinion from other psychiatrists.

And please monitor your child as closely as possible if you do allow him or her to take antidepressants and immediately report any significant change in behavior to the psychiatrist.

The decision as to whether or not your child takes antidepressants will be up to you and your child — do not let anyone force something upon you that you do not want to do.

And make sure that all of your questions are answered before you allow your child to take antidepressants.

And if you do not like the psychiatrist who is treating your child, consider finding another one.

Again, conduct as much research as possible, monitor your child very closely, and do not hesitate to get another opinion or change psychiatrists

September 6, 2007

The U.S. suicide rate for 10- to 14-year-old girls rose 76 percent from 2003 to 2004, according to a report by the Centers for Disease Control and Prevention (CDC).

Additionally, the CDC reported a 32.3 percent increase among 15- to 19-year-old girls, and a 9 percent increase among 15- to 19-year-old boys.

And the overall youth suicide rate rose 8 percent.

The dramatic increase sharply contrasts with the 28.5 percent decrease in youth suicide rates since 1990, thus causing alarm in the suicide prevention community.

“Our news today is sobering. This is a dramatic and huge increase and it raises great concern for us, but we don’t yet know if this is a short-lived increase or if it’s the beginning of a trend ” said Dr. Ileana Arias, director of the CDC’s National Center for Injury Prevention and Control, which produced the new report. “Suicide is the third leading cause of death among people ages 10 to 24, surpassed only by car crashes and homicides.”

The cause for the increased rate may be attributed to the 20 percent decrease in teen antidepressant prescriptions since “black box” warnings were mandated by the FDA in 2004. These warnings ordered manufacturers of antidepressants, such as Prozac and Zoloft, to print its strictest, “black box” warning on the boxes to inform doctors and patients that the medicines could increase the risk of suicidal thoughts or actions in children and teens.

Bottom line: Some young people who may need antidepressants are not getting them.

Dr. Mark Riddle, director of child and adolescent psychiatry at the Johns Hopkins Children’s Center, said, “There’s been concern that the black box would lead to a reduction in prescribing and therefore an increase in suicides, and my guess is that’s what’s happening. Some doctors are reluctant to prescribe an antidepressant to a child if it comes with the FDA’s most stringent warning label.”

And Dr. Benjamin N. Shain, an associate professor of psychiatry at Northwestern University and a liaison to the American Academy of Child and Adolescent Psychiatry, said, “One major factor that changed was the prescribing of antidepressant medications. Most likely, that’s what was responsible for the decrease in suicide rates.”

And several recent studies suggest that antidepressants are more likely to reduce suicide risk than increase it.

One such study, which was published in The American Journal of Psychiatry on September 5, 2007, found that a decrease in antidepressant prescriptions for young people in the U.S. of just a few percentage points coincided with a 14 percent increase in suicides; and in the Netherlands, the suicide rate spiked almost 50 percent in young people when prescription rates declined.

“There is a lot of evidence to believe the black box warnings have led to decreases in prescriptions, and there is also evidence that the number of suicides was on the rise as those prescriptions dropped. The highest risk period for suicide is right before treatment is started, and the risk actually comes down once pharmacotherapy or psychotherapy is started,” said Robert Gibbons, a professor of biostatistics and psychiatry at the University of Illinois in Chicago and the lead author of the study.

But Ileana Arias from the CDC said, “There is a wide range of factors that may be accounting for the increase, and we’re not aware of anyone who has done an analysis to account for those. In addition to changes in prescribing habits, other changes might include increased rates of mental health disorders or increased rates of alcohol or drug use.”

And Dr. Thomas Laughren, director of the division of psychiatry products at the F.D.A., said that the CDC would need to see more data over time, linking declines in prescriptions to suicide risk before revisiting any of its decisions.

“It is true that antidepressant prescribing in pediatric patients has gone down, and that coincides with this one-year uptick in adolescent suicide, and that is a concern for us,” said Laughren, “We do have an obligation to alert prescribers and patients of risks we find with drugs, [but] you simply cannot reach causal conclusions from the new CDC data.”

The CDC found that in 2004 there were 4,599 suicides in Americans ages 10 to 24, up from 4,232 in 2003, for a rate of 7.32 per 100,000 people that age. But the rate had dropped to 6.78 per 100,000 in 2003 from 9.48 per 100,000 in 1990.

The CDC also reported that 161,000 youths between the ages of 10 and 24 went to an emergency room because of a self-inflicted injury in 2004 – so the number of attempted suicides is extremely high.

The CDC report also indicated that hanging was the most common method for 10- to 14-year old girls, with 71 percent using that method.

Clearly, the one-year spike could be an aberration, but immediate action needs to be taken to ensure that the rate is reduced. Suicide.org and ProjectCare.com have been working diligently with young girls and youths to help prevent suicides as well as offer assistance and support for mental disorders, rape, molestation, eating disorders, self-injury, drug consumption, and other serious issues.

“Young people are particularly vulnerable to depression,” said Kevin Caruso, executive director of Suicide.org. “And untreated depression is the number one cause for suicide. So we need to do all that we can to reach these young people who are suicidal and ensure that they receive immediate, effectual treatment as well as long-term loving, caring support.”