Depression in the News 2000

December 21,2000. ABC News. Primetime. Carrie Fisher tells Diane Sawyer on PrimeTime Thursday "I have a chemical imbalance that, in its most extreme state, will lead me to a mental hospital." Fisher, the actress who turned Star Wars’ Princess Leia into a superheroine, tells Sawyer her manic depression creates such a roar of energy in the brain that she is left with uncontrollable mood swings and frenzied thoughts, and suffers sleepless nights.

December 15, 2000. Study Reveals How Antidepressants Work. Reuters Health.  In a study conducted in rats, regular use of antidepressants promoted the growth of new cells in the hippocampus, an area of the brain where cells are known to waste away in people who are depressed. The hippocampus plays a role in learning, memory and mood. Several types of medications have been shown to treat symptoms of depression, but exactly how these drugs work remains a mystery. 

A researcher cautioned that it is too early to know whether the growth of new brain cells is the primary line of action of antidepressants. The rats were given the antidepressants tranylcypromine, fluoxetine and reboxetine, each representing a different class of antidepressant medication. Rats were also given electroconvulsive seizure therapy and an antipsychotic drug. The article is in The Journal of Neuroscience, the December 15, 2000 issue and is called Chronic Antidepressant Treatment Increases Neurogenesis in Adult Rat Hippocampus. As of Dec. 18, 2000, the article was not available online.

December 12, 2000. The Wall Street Journal. Page B1. By Thomas M. Burton.

A new study was just reported on that compared Zyprexa to Depakote in treating the acute manic phase of bipolar disorder. The article focuses on the financial impact the study might have on Abbott Laboratories, makers of Depakote and Eli Lilly which makes Zyprexa. It calls Zyprexa the "hottest new treatment" and notes that Depakote is the 17 year old market leader for treating mania. 

The new study, funded by Abbott, suggests that Depakote works just as well as Zyprexa and has far fewer side effects. Typical side effects are weight gain, sleepiness, speech disorders and swelling. Lilly however, has its own study that shows Zyprexa has some advantages in effectiveness over Depakote. A psychiatrist is quoted in the article saying that the doses of Depakote in the Lilly study "were not what someone would use".  The article says that Zyprexa costs about $12 for a typical daily dose vs. $6 for Depakote. Dr. Gary Sachs of Harvard University (who lectured to MDSG recently) was involved in the Abbott study and is quoted in the article as saying that many patients will be treated with both medications.  

December 2000 issue of Consumer Reports Magazine. This article discusses St. John's wort, SAM-e and Kava. It says that SAM-e and St. John's wort will not elevate the mood of a normal person and warns that self-treatment for depression can be dangerous. It cites the lack of strict government control over the content of SAM-e pills as a reason that many physicians haven't been recommending it. The magazine tested 12 brands of SAM-e and fully reported their findings. The findings include the fact that 8 brands had more SAM-e than claimed on the label and 4 brands had less. Only 6 of the 12 brands were enteric coated, an important attribute. The cost of a daily dose of 400mg of SAM-e ranged from $1.80 to $8.75. They also found some labels ambiguous and misleading. Finally, the article mentions a new clinical study of SAM-e where it was found to have the same effectiveness as imipramine, but with fewer side effects.
Note: To read this article on the Consumer Reports web site, requires subscribing to the web site.  

October 2, 2000. Press Release from the University of Michigan. People with bipolar disorder have an average of thirty percent more of an important class of signal-sending brain cells. The discovery is the first neurochemical difference to be found between asymptomatic bipolar and non-bipolar people. The finding, published in the American Journal of Psychiatry, solidifies the idea that the disorder has unavoidable biological and genetic roots, and may explain why it runs in families. Researchers used PET scans to see the density of cells that release dopamine, serotonin and norepinephrine. These monoamines, as the chemicals are called, send signals between brain cells, or neurons. Scientists have hypothesized their role in bipolar disorder for decades, but have never proven it. The study showed a clear difference in the density of monoamine-releasing cells in the brains of bipolar people even when they are not having symptoms. 

September 26, 2000. Salon Magazine. Most Antidepressants suppress sex drive, but some new evidence suggests this one might be different. Fifty to eighty percent of SSRI users report at least one sexual side effect. Unfortunately, few people know that another antidepressant, Wellbutrin (chemical name: bupropion) is as effective as the SSRIs -- but much less likely to cause sexual side effects. In fact, some studies show it has sex-enhancing effects. Wellbutrin is not an SSRI and is chemically unrelated to every other antidepressant. The article explains why so few people are familiar with Wellbutrin.  

September 26, 2000. The New York Times. By Laurie Tarkan. An estimated 50% of athletes suffer some symptoms of depression after being injured. Athletes lose not only the actual physical activity, but also the gratification they get from competing and the social aspects of the sport. Among the examples cited in the article is Picabo Street the skier from the 1998 Olympics, who suffered a serious depression at the realization of how long and difficult the recovery from her injuries would be. Another example cited is of a women who ran as a hobby, but when forced to give it up for a few months became depressed, moody, irritable, gained weight, could no longer take criticism at work and started to hate her job, her boss and all of New York. Of course, some people participate in sports as a way of moderating depression or stress (see the article below).  For information on obtaining articles from the New York Times, click here.

September 25, 2000. AP and InteliHealth. A new study from Duke University reported in the October issue of the journal Psychosomatic Medicine shows not only that exercise helps depression, but also that it helps prevent relapses. After four months of treatment people who exercised recovered from their depressions about as well as people on Zoloft and people who did both. 

Six months later, those who had exercised only had a lower rate of depression relapse than those taking Zoloft or taking the antidepressant and exercising. For each 50-minute increment of exercise, there was an accompanying 50 percent reduction in relapse risk. Quoting from the article: "The studies do not prove exercise relieves depression, in part because the exercisers worked out in a group, so group dynamics may have played a role... A new study will attempt to find out, by comparing supervised group exercisers with people who were simply given an exercise plan and sent home". Click here for another article on the same story. 

On the same subject, Consumer Reports Magazine has an article How to Take a Healthy Walk that describes just how much walking is required to improve your mood. 

September 20, 1999. Depression topic of at the About.com web site by Nancy Schimelpfening. The introduction to this article reads: "Perhaps the only thing worse than depression is having depression and not being able to afford treatment. I frequently get letters from those of you who are in just this predicament. I've collected here all of the free and low-cost resources and ideas that I have come across in the past couple of years."

August 9, 2000. ABC News and the Associated Press. A federal court scuttled Eli Lilly and Co.’s hopes of extending the patent protection on Prozac through 2003. As a result, Prozac could face generic competition as early as August 2001. The ruling is good news for consumers, which will be able to buy a cheaper version of Prozac two years earlier than expected. The decision is a blow to Lilly, for which Prozac represents about a quarter of its total sales.  

July 20, 2000. The New York Times. The Sports section of the paper has a story called A Hurdler's Difficult Decision. It is about Derrick Adkins who won an Olympic gold medal in 1996 in the 400-meter hurdles in Atlanta. Three months prior to the 1996 Olympics, he had been diagnosed with major depression and started taking Luvox. However, it left him feeling sedated and fatigued. Luvox causes tendon and muscle weakness, affects your oxygen-carrying capacity and inhibits the adrenaline rush that athletes use to prepare for races. Shortly before the Atlanta Games, without telling anyone, he stopped taking the medication so that he could perform better. Adkins has decided to tell his story in hopes of educating and encouraging others who suffer from depression. He still has hopes of qualifying for the 2000 Summer Olympics in Sydney, Australia.  

April 30, 2001. Newsweek Magazine, May 7, 2001 issue. Mr. Adkins wrote his own story. His depression started at age 13 at he started running because it made him feel better. However, no amount of athletic success, even an Olympic gold medal, got rid of the depression. He has been taking medication since just after the 1996 Olympics and it has eliminated his depression. His advice: "Don't be too proud to seek help". 

Two new books on mood disorders have been recently reviewed by the New York Times. The books are: 

• Prozac Backlash : Overcoming the Dangers of Prozac, Zoloft, Paxil, and Other Antidepressants with Safe, Effective Alternatives by Joseph Glenmullen
    
• Malignant Sadness : The Anatomy of Depression by Lewis Wolpert  

June 28, 2000: Janet Maslin reviewed Prozac Backlash in a story called Exploring a Dark Side of Depression Remedies. July 2, 2000: Both books are discussed in a  review called Anatomies of Melancholy by Abraham Verghese. 

July 18, 2000: Erica Goode wrote an article Once Again, Prozac Takes Center Stage In Furor on the front page of the Science Times section about two books that say Prozac and other SSRIs are often indiscriminately prescribed and pose the risk of serious side effects, but critics of those views call them alarmist and overblown. 

July 25, 2000: Reader comments about the July 18th article are printed in the Science Times Section of the New York Times. 
The New York Times also makes available the first chapter of Prozac Backlash and the first chapter of Malignant Sadness. 

Clicking on the book titles above will take you to Amazon.com where you can both read more about the books and purchase them. Purchases made by following these links result in a referral fee being paid by Amazon to MDSG, at no cost to you. As of July 2000, Prozac Backlash is selling for $17.50, Malignant Sadness for $16.80, but these prices are subject to change. 

June 25, 2000. The Sunday New York Times. Front page of Men & Health (Section 16). By Nancy Wartik.

The focus of this article is depression in men. It notes that in any given year three million to four million men in the US suffer from clinical depression and that men are less likely than women to seek help. Men commit suicide at four times the rate women do. Some experts feel that the mental health profession may be underestimating the rate of depression in men, in part because the symptoms may be different. Summarizing this, a doctor is quoted as saying "Men get irritable; women get depressed." One doctor thinks that the illness is not diagnosed in the 60 to 70 percent of of depressed men who do not exhibit classic symptoms. Another doctor suspects that some antidepressants might work better for men, others for women.

Click here for the front page of the Men's Health section or here for this story. 

March 28, 2000. This web page presents results of lab tests conducted on 13 brands of SAM-e to see what the pills really contain. The company that conducted these tests, ConsumerLab.com was featured in a story in the New York Times on June 20, 2000 called Putting Dietary Supplements to the Test written by Clara Hemphill. They make an important point about SAM-e product labels and how some brands that appear to have (for example) 200mg of SAM-e really contain 100mg of SAM-e and 100mg of a stabilizing compound. They found that 6 out of 13 of the products "did not pass testing". The web page lists eight brands that passed the tests, but not the brands that failed. They also issued a press release about the test results. 

May 2, 2000. Annals of Internal Medicine. The American College of Physicians-American Society of Internal Medicine (ACP-ASIM) released guidelines for drug treatment of depression aimed at helping internists, together with their adult patients, make informed choices about treating depression with antidepressant drugs and herbal therapies. 

Studying other studies they concluded that both older and newer antidepressant drugs are effective, and that St. John's Wort may be effective in treating mild depression in the short term, but with caveats. There are two papers: Pharmacologic Treatment of Acute Major Depression and Dysthymia and a background paper, A Systematic Review of Newer Pharmacotherapies for Depression in Adults: Evidence Report Summary

May 17, 2000. AP and InteliHealth. Eat fish, be happy? A large study in Finland found evidence that people who rarely ate fish ran a 31 percent higher chance of mild to severe depression than people who frequently eat fish. That's reason for this is suspected to be the omega-3 polyunsaturated fatty acids (PUFA) in fish. But it's too early to recommend that people eat fish or take PUFA to avoid depression. Last year, other researchers reported that capsules of omega-3 fatty acids helped treat manic-depression.

May 2000(?) From the Depression section of About.com. The article suggests buying medications in pills with double the intended dosage and splitting the pills. However, it warns that not all pills can be split without losing their effectiveness and to ALWAYS check with your doctor before doing this. In a related feature, it lists some drugs that can be split; among them are Effexor, Luvox, Paxil, Risperidal, Zoloft and Zyprexa. 

May 15, 2000. New York Magazine cover story. The selling of Celexa. Before a drug like Celexa can ease the minds of patients, marketers must capture the minds of doctors -- using free gifts, dinners, propaganda, and research funds. A hard look at the hard sell. Since its launch in September 1998, Celexa has captured over 13 percent of new prescriptions in its class of antidepressants (which includes Prozac, Paxil and Zoloft). Celexa is the only one whose market share is growing. It has achieved this spectacular growth without any decisive advantages over its predecessors. The reason for its success is not science, but marketing. An interesting point from the article: Howard Solomon is the chief executive at Forest Laboratories, the company that sells Celexa in the US. His son suffers from depression.

From the Depression section of the About.com web site. Even after one works up the courage to seek help, finding an antidepressant or combination of antidepressants that relieves the depression without unbearable side-effects can a frustrating proposition. Each medication requires a trial of several weeks before it can be declared ineffective and another tried. Several trials may be required to fine tune your medications. Some unlucky individuals may hang on for literally years without a satisfactory solution being found.  In the coming weeks, we are going to take a look at this problem by examining what we know about the neurobiology of depression, how antidepressants work, how doctors currently go about matching antidepressants with your needs, why getting treated by your family doctor can hinder your progress. 

May 16, 2000  The Chemistry of Depression 

May 29,2000   How antidepressants affect our brain chemistry and relieve depression

June 12,2000   How doctors match the antidepressant with the patient.

MSNBC. May 1, 2000. Unable to regain the form that made him a four-time All-Star, Vin Baker has admitted to seeking help for depression. Once considered one of the NBA’s rising stars, the Sonics’ Vin Baker has fallen well short of expectations. His shortcomings have been especially evident in the playoffs as Seattle has struggled against Utah. This is a video. Note: as of May 17, 2000 this story seems to have been deleted from the MSNBC web site.

February 10, 2000. RISK OF DRUG INTERACTIONS WITH ST JOHN’S WORT. FDA researchers believe the dietary supplement speeds the liver's processing of drugs and dilutes their effectiveness. Because herbal products are widely used in the United States and are available in various forms such as combination products and teas, it is important that health care professionals ask patients about concomitant use of products that could contain St. John’s Wort. 

May 1, 2000. USA Today. Study shows St. John's Wort might weaken birth control. Much of the February FDA advisory concerns interactions with HIV medications. But the notice warns that the herb might disrupt many prescriptions, including heart disease drugs, some cancer drugs and oral contraceptives. Experts fear that significant numbers of these women might take St. John's Wort for mild depression without telling their physicians.

MSNBC also covered this story on May 1, 2000. 

April 25, 2000. The New York Times. Reflections column by Erica Goode. Despite the title, this story is not about Prozac. Rather it asks "How good are Prozac and its relatives at treating depression"? Some critics of antidepressants claim that up to 75% of the improvement shown by patients is due to a placebo effect. 

Scientists from Columbia University published a report in the American Journal of Psychiatry that reviewed these claims in detail and concluded they were wrong, that antidepressants do work. Another study, reported in the Archives of General Psychiatry, analyzed 45 drug trials involving seven antidepressants and found that the drugs helped 41% of the patients, whereas the placebo helped 31%. The article describes another review of 80 drug trials that found 50% of the patients responded to antidepressants, while 32% improved with placebos. http://www.nytimes.com/library/national/science/health/042500hth-reflections.html 

March 14, 2000 Boston Globe and InteliHealth. It's not always easy to be happy. In a departure from decades of research on depression, psychologists are now actively studying what makes us happy. One doctor believes that an optimistic outlook is a key component to happiness and that it can be learned. New studies are investigating the brain activity of happy people. One doctor reported that in numerous studies he found people were most happy when they had spiritual faith of some kind and the support of a network of close relationships, including marriage. These studies confirm the view that depression's grip on the modern American psyche has much to do with individuals losing traditional social networks. 

March 7, 2000. Associated Press and InteliHealth. Prozac, the drug that changed the way America thinks about mental illness and became a part of pop culture, is losing its title as the nation's top-selling antidepressant.

March 6, 2000.  The Depression section of About.com conducted an online chat with an attorney that specializes in assisting Social Security disability claimants, who offered tips for successful disability claims. The transcript of the chat is available online. The web site also has other links relating to depression and Social Security Disability.

March 1, 2000. The following is from a NAMI press release: We applaud the courage of U.S. Representative Patrick J. Kennedy (D-RI) in disclosing publicly that he has battled depression since adolescence, takes medication, and regularly sees a psychiatrist. His candor will help to break down the stigma that still surrounds mental illness. His example may make a difference in the lives of millions of Americans who otherwise suffer in silence. Treatment works-if you get it. 

We especially applaud his acknowledgement that when people don't get adequate treatment, they may pursue wrong solutions-such as substance abuse. But that doesn't mean that a person can't recover. Patrick Kennedy stands today as a model of someone who not only recovered, but prevailed. Significantly, Representative Kennedy now joins Representative Lynn Rivers (D-MI) as one of only two members of Congress who have talked publicly about their experience with mental illness. A story about this called Prozac Politics is available from the Boston Phoenix.

March 2, 2000. Medical Tribune and InteliHealth. Recovery after coronary artery bypass surgery depends as much on the patient's state of mind as it does on the condition of the patient's heart, according to a new study. The study found that depressed patients were at least three times more likely to experience a cardiac problem within the next 12 months than those who were not depressed. The research is the first of its kind to evaluate the impact of depression on women following bypass surgery. The women in the study had a three times greater risk of future cardiac events than did the men. Women who were depressed had the highest risk. http://www.intelihealth.com/enews?271233

February 7, 2000. NBC Nightly news with Tom Brokaw did a story on SAM-e in conjunction with Good Housekeeping Magazine. On the pro side, they profiled a woman who was helped by SAM-e. On the con side, Dr. Robert Packman of Washington University said: "What I think is actually happening in the case of SAM-e is that we’re really seeing a placebo response."  Like the article from Better Homes and Gardens Magazine below, they warned about how the pills don't necessarily match the labels on the outside of the SAM-e box. The Good Housekeeping lab tested 8 brands of SAM-e and found that 5 had more SAM-e than the label claimed, 2 had less, and one brand had none at all.You can even watch the video on the Internet (if you have the right software). http://www.msnbc.com/news/367231.asp

What’s in your SAM-e?
February 4, 2000. Another NBC report on SAM-e and the Good Housekeeping lab tests was done by WNBC in New York City. Their story notes that since SAM-e is sold in the U.S. as a food supplements, it is not subject to the same rigorous testing as drugs. In other countries SAM-e is sold by prescription. This story has more details on the lab tests. Nature Made, Solgar, Nature’s Plus, GNC and Now had more SAM-e than stated on the label; Aspen and Food Science of Vermont had less. Nature’s Vision had none.   http://www.msnbc.com/local/wnbc/670058.asp

The New York Times. February 1, 2000. This story is about an article in the journal Archives of General Psychiatry which suggested that some forms of depression might have their roots in evolutionary history. Although some types of depression clearly result from disorders of brain chemicals, other types don't fit this mold. The story is told of a woman who strived to become a musician because it was her mothers dream for her. However, without the talent she came up short for years and ended up depressed and resistant to normal depression treatments. However, her depression lifted when she gave up the quest to be a musician and instead focused on an obtainable career. Depression might be a useful response to situations in which a desired goal in unattainable. http://www.nytimes.com/library/national/science/health/020100hth-behavior-depression.html

The original article is available from the Archives of General Psychiatry Volume 57. Number 1. January 2000.

Is Depression an Adaptation? by Randolph M. Nesse, MD. Topics include: GLOBAL EVIDENCE, POSSIBLE FUNCTIONS OF LOW MOOD AND DEPRESSION, IN WHAT SITUATIONS IS LOW MOOD USEFUL?, ARE THE CORE ASPECTS OF DEPRESSION EVER USEFUL?, TESTS and CONCLUSIONS.
http://archpsyc.ama-assn.org/issues/v57n1/full/ynv8408.html

February 1, 2000. Reuters/San Jose Mercury News. A cautionary note about Internet health web sites. A survey done in January 2000 found several lapses in maintaining privacy. Many web sites ask or require users to register, either to see additional information or to customize the information presented. Twenty one of the most popular medical information web sites shared personal information with other companies despite a pledge not to do so. Among the offending web sites were drkoop.com, webmd.com, ivillage.com, yahoo.com and onhealth.com. www.sjmercury.com/svtech/news/breaking/internet/docs/160309l.htm

February 2000. Better Homes and Gardens Magazine. SAMe, an over-the-counter antidepressant, is a hug seller, but does it really work? Topics in the article include: Is it too good to be true?, How SAMe works, Side effects, Buyers beware and Diagnosing real depression. The Buyers beware topic says that SAMe is difficult to produce because the active ingredients are unstable. Dr. Richard Brown had a lab analyze eight major brands of SAMe and found that two brands contained no SAMe while others had less than half the amount claimed on the package. Dr. Brown recommends the GNC, Nature Made, Life Extension Foundation and Solgar brands. As of early February 2000, this article had not yet appeared on their web site www.bhg.com/toc 

January 12, 2000. The Wall Street Journal Health column by Rhonda L. Rundle. Page B9. It doesn't take expensive technology to help depressed patients. Doctors and clinics that make a modest effort to identify depressed patients and help them get treatment can see dramatic improvements. A study published in the Journal of the American Medical Association found that only 25% to 35% of people suffering from depression get good care. The study showed how doctors in ordinary clinics can identify depressed patients. The choice of treatment - medication or psychotherapy - was less important than the identification of depression and compliance with whichever treatment program was selected.

January 10, 2000. Medical Tribune reporting on a study in the December issue of the Journal of Clinical Psychiatry.
Some people have suffered painful headaches, tooth grinding,  jaw clenching and broken teeth as side effects of taking Zoloft, Paxil and Prozac. The symptoms went away with the addition of an anti-anxiety drug. A doctor is quoted as saying "We don't know how common this problem is..."    www.intelihealth.com/enews?263400

January 10, 2000.  Los Angeles Daily News. The Associated Press. Bad foods equal bad moods. Feed a brain with the right mix of carbohydrates, fats and proteins and your mind will be razor sharp and awash in a sea of happy hormones. Go for the quick fix - a doughnut or a bowl of Frosted Flakes - and spend the day on an emotional roller coaster guaranteed to leave you tired and ticked off. www.intelihealth.com/enews?262016