“Old” news in depression

depressionFine wine, record players and Tom Brokaw. All wonderful old things! But older isn’t always better – except, sometimes, it is. At least, researchers think it is. That’s the take-home message from a round-up of new research into all-things depression this week.

A report on mental health trends in Health Affairs found that senior citizens are using psychiatric drugs twice as often as they were 10 years ago. Around 16 percent of Americans over 65 have been diagnosed with a mental illness and 15 percent overall are taking antidepressants or anti-psychotics. The report doesn’t suggest that older people are suffering from mental illness more often. Instead, researchers think that the elderly often went undiagnosed in years past.

At least they’ve got a slew of drug options, thanks to the meds that all those crazy kids in them laboratories have been coming up with! Dozens of anti-depressants are on the market, but a systematic review by The Cochrane Institute found that if it aint broke, you shouldn’t try to fix it: older medications were more effective than the new releases. Zoloft, which has been available for acute depression since 1991, was the best of 12 meds, based on data from 10,000 patients.

…That assumes those patients weren’t “cherry picked,” making their results inapplicable to the general population. That’s the claim of a report led by the University of Pittsburg Graduate School of Public Health, in the May issue of the American Journal of Psychiatry. According to their research, only 22% of patients taking a particular anti-depressant met critera to participate in phase III FDA approval trials. That raises concerns that traditional FDA efficacy studies may not be applicable to the general population of anti-depressant users.

Seniors are more depressed, new medication isn’t getting us anywhere and results from studies on anti-depressant medication is tainted? I feel a few grey hairs coming on…


Psychiatrists and Psychotropics: An unholy alliance?

ritalin2One hundred million people worldwide are taking psychotropic medications: compounds designed to alter brain function with the goal of treating disorders like depression, ADD and anxiety. Psychotropics are often controversial, particularly if you ask those whose medical ideologies don’t mesh with the typical approach of western medicine.

Some of the anti-psychotropic arguments? The drugs can be addictive, cause mood or personality changes, and sometimes worsen psychotic behavior. And those are just the big ones. Like most meds, psychotropics can also cause all sorts of physical reactions, from nausea and headaches to insomnia and constipation.

Recently, Dr. Joseph Mercola, an alternative-med guru with his own website, newsletter and series of bestselling books, released a 10-part online documentary on the troubling connection he sees between psychiatric medicine and psychotropic drugs.

According to Mercola, the drugs fuel a $330-billion dollar psychiatric industry in the United States, and the problem is only growing, as new “psychiatric disorders” are named by the Diagnostic and Statistical Manual of Mental Disorders (published by the American Psychiatric Association) each year. Once a disorder exists, medication to treat it can be produced, patented, and sold. Among some of the newest psychiatric disorders:

Overdoing it on coffee and then suffering from trouble sleeping: “Caffeine-Induced Sleep Disorder.”

A child who argues with adults, loses his temper or annoys people: “Oppositional Defiant Disorder.”

Arguing with a brother or sister: “Sibling Relational Problem.”

I’m not sure that a big-league pharmaceutical company would take a stab at a drug to treat “Sibling Relational Problem,” but I’m intrigued to see how broad, and bizarre, the DSM has become. The first edition, published in 1952, contained 109 disorders. The most recent version now contains over 300. Do we know more about mental health, or do we just have more money-hungry drug makers to appease?