Jan 6, 2010: Esteemed Journal of the American Medical Association (JAMA), publishes findings that depression drugs may be hardly better than placebo.
It looks as though the current standard of treatment for depression may have little or no therapeutic benefit over placebo in patients with mild to moderate depression.
Snippets from the news:
The study published in JAMA found that in six human trials involving treatment with GlaxoSmithKline’s Paxil, Seroxat, imipramine (the generic version) or placebo, the benefits of medication versus placebo were “non-existent to negligible” among patients with mild, moderate or even severe symptoms of depression, whereas in patients with very severe depression, the effects were substantial.
This meta-analysis of randomized, placebo-controlled trials was conducted by the University of Pennsylvania, Philadelphia, Department of Psychology. Lead investigator, Jay Fournier told Medscape Psychiatry:
"I think the most surprising part of the findings was how severe depression has to be in order to see this clinically meaningful difference emerge between medication and placebo and that the majority of depressed patients presenting for treatment do not fall into that very severe category."
Food for thought: The number of Americans taking antidepressants has doubled in the past decade, according to medical editors at FoxNewsHealth.com
DHEA as an Antidepressant
“We have never seen a depressed patient with optimal levels of DHEA. And no one we’ve seen with optimal levels of DHEA is depressed.” (C. Norman Shealy, M.D., Ph.D.)
Dr. Owen Wolkowitz at the University of California San Francisco Center for Neurobiology has performed much of the work identifying links between DHEA and depression. Double-blind, placebo-controlled human clinical trials found DHEA to be an effective antidepressant. Simply restoring this natural hormone to the level that the body once produced showed great positive impact on the disruption in the anabolic/catabolic balance.
*Suggested Reading:
Chapter 4 of The Metabolic Plan: Stress & the Aging Process
- On DHEA and depression
- On Stress and depression
- On Exercise and depression
- On Weight Mgmt and depression
- *See references list below
Omega-3s show promise
Omega-3 fatty acids—found in cold water fish such as salmon, flax seeds, and walnuts—have significant impact on brain health, nerve function, and maintenance of cell membranes. Studies led by NIH clinical researcher Joseph Hibbeln, M.D., suggest that dietary omega-3s raise brain levels of the mood-elevating neurotransmitter called serotonin (Hibbeln JR et al. 1998). This is the very same effect by which drugs such as Prozac are thought to bring about their benefits.
Omega-3s and SSRIs (selective serotonin re-uptake inhibiting drugs) such as Paxil and Prozac each foster growth of cells and connections between cells in the brain’s hippocampus region, an effect associated with reduced depression risk and symptom severity.
In mouse studies, both omega-3s and Prozac have the capacity to restore brain cells’ ability to take on new roles and form new connections, which may ease symptoms of depression (Sahay A, Hen R 2008; Venna VR et al. 2009).
In 2006, the Committee on Research on Psychiatric Treatments of the American Psychiatric Association (APA) performed a scientific literature, and concluded that people who consume higher amounts of omega-3s from fish enjoy reduced risks of mood disorders.
In 2008, the largest-ever clinical trial comparing omega-3s to antidepressants bolstered this conclusion, finding that omega-3 fish oil may significantly benefit half of all sufferers of clinical depression.
Specifically, omega-3 fish oil seemed to help the 50 percent of depression patients who are free from diagnosed anxiety disorders … about as much as the leading class of antidepressant drugs: selective serotonin re-uptake inhibitors (SSRIs) such as Prozac and Paxil.
References:
Fournier JC et al. Antidepressant Drug Effects and Depression Severity: A Patient-Level Meta-analysis. JAMA. 2010;303(1):47-53.
Carey B. Popular Drugs May Help Only Severe Depression. The New York Times, January 6, 2010. Accessed at http://www.nytimes.com/2010/01/06/health/views/06depress.html
http://www.medscape.com/viewarticle/714847
http://www.mayoclinic.com/health/antidepressants
http://www.pharmatimes.com/ClinicalNews/article.aspx?id=17169
http://www.forbes.com/2010/01/05/antidepressant-paxil-placebo-business-healthcare-depression.html
http://health.blogs.foxnews.com/2010/01/06/first-health-warning-of-2010-antidepressants/
http://www.mayoclinic.com/health/antidepressants
Shealy CN. DHEA The Youth and Health Hormone. New Canaan, CT. Keats Publishing, 1996, pg 43.
Wolkowitz OM, Reus VI, Keebler A, Nelson N, Friedland M, Brizendine L, Roberts E. Double-blind treatment of major depression with dehydroepiandrosterone. Am J Psychiatry. 1999 Apr;156(4):646-9.
Wolkowitz OM, Reus VI, Roberts E, Manfredi F, Chan T, Raum WJ, Ormiston S, Johnson R, Canick J, Brizendine L, Weingartner H. Dehydroepiandrosterone (DHEA) treatment of depression. Biol Psychiatry. 1997 Feb 1;41(3):311-8.
Wolkowitz OM, Reus VI. Treatment of depression with antiglucocorticoid drugs. Psychosom Med. 1999 Sep-Oct;61(5):698-711.
Fish Oils Rival Antidepressants in Clinical Trial. Accessed at http://newsletter.vitalchoice.com/e_article001512671.cfm?x=bfT6hQ1,b7b1jv7h
More Suggested Reading:
Majewska MD. Neuronal actions of Dehydroepiandrosterone. Possible roles in brain development, aging, memory and affect. Ann New York Acad Sci 1995; 774:111-119.
Majewska MD. Actions of steroids on neuron; role in personality, mood, stress, and disease. Integrative Psychiatry 1987; 5:258-73.
Melchior CL, Ritzmann RF. Dehydroepiandrosterone is an anxiolytic in mice on the plus maze. Pharmacol Biochem Behav 1994 Mar;47(3):437-41
Frye CA, Lacey EH. The neurosteroids DHEA and DHEAS may influence cognitive performance by altering affective state. Physiol Behav. 1999 Mar;66(1):85-92.
Zinder O, Dar DE. Neuroactive steroids:their mechanism of action and their function in the stress response. Acta Physiol Scand 1999 Nov;167(3):181-8
Noda Y, Kamei H, Nabeshima T. Sigma-receptor ligands and anti-stress actions. Nippon Yakurigaku Zasshi 1999 Jul;114(1):43-9
Holsboer F, Grasser A, Friess E, Wiedemann K. Steroid effects on central neurons and implications for psychiatric and neurological disorders. Ann N Y Acad Sci 1994 Nov 30;746:345-59; discussion 359-61
Reus VI, Wolkowitz OW, Roberts E, Chan T, Turetsky N, Manfredi F, Weingartner H. Dehydroepiandrosterone (DHEA) and memory in depressed patients. Neuropsychopharmacology 1993; 9:66
