Archive for the 'Mental Health' Category

Pleasant Music is Good for the Mind and Body

PianoListen to music you like for 15 to 20 minutes a day — and consider it a healthful a practice like regular exercise and a healthy diet, says Dr. Michael Miller from the Center for Preventive Cardiology, in an article by Health Day.

Involve your child in music on a daily basis, says the Nemours Foundation.  

A growing body of research is pointing to the healthful benefits of listening to pleasant music.  It has been found to help with such things as pain, stress, depression, intelligence, memory, and sleep to name a few.

One recent study found that soothing music was associated with a  reduction in heart rate, respiratory rate, and blood pressure in patients with coronary heart disease. And another study found that music, like laughter, may benefit heart health. 

Music therapy is being used successfully with stroke patients. Finnish researchers recently found that listening to music for a few hours a day was associated with a stroke patient’s early recovery.

“Listening to music offers many benefits to children, research indicates. Musically inclined kids appear better at math and reading, have shown better focus, improved self-esteem and seem to play better with other children,” report experts in a recent article by Health Day. 

Much more research needs to be done, but the healthful benefits of music are surfacing in almost every area of our lives. 

Source: “Health Tip: Introduce Your Child to Music”, Health Day, March 1, 2010
Source: “Tune Up Your Health”, Health Day, January 29, 2010
Source: Michael Miller, M.D., professor, medicine, and director, Center for Preventive Cardiology, University of Maryland Medical Center, Baltimore
Source: Aniruddh Patel, Ph.D., Esther J. Burnham senior fellow, Neurosciences Institute, San Diego
Source: Robert Zatorre, Ph.D., Montreal Neurological Institute, and professor, department of neurology and neurosurgery, McGill University, Montreal
Source: Bradt J, et al “Music for stress and anxiety reduction in coronary heart disease patients” Cochrane Database of Syst Rev 2009; DOI: 10.1002/14651858.CD006577.pub2

Generics Versus Brand Names

The FDA allows a variance of 20% when it comes to generic medicationsBrand named drugs are becoming more and more expensive these days and many people just can’t afford them.  Often insurance companies won’t pay for a brand name if a generic equivalent is available, so more than ever people are faced with the question–are the generics equally effective and safe?

Both the FDA and generic drugmakers say that the generics are clinically identical to the brand named medications, but is this always the case?

Generic drugs have to meet the requirements of the FDA which requires ”90% confidence intervals for maximal concentration and the area under the concentration-time curve must be no less than 80% and no more than 125% of the means for the branded drug”, according to MedPage Today.  In other words, yes there can be some variation. 

This variation may or may not be a problem.  It can be serious if the disease requires very specific blood levels of the drug, however, such as in a seizure disorder.  

Carbamazepine (Tegretol) is a drug used to treat seizure disorders.  The levels of the drug need to be predictable, reliable and effective, otherwise a seizure may occur.  In a recent study at John Hopkins University, generic versions varied markedly in FDA-sanctioned bioequivalence studies.  So in the case of carbamazepine, this variability could have significant clinical consequences for patients who switch from the branded product or from one generic version to another.

Another drug of concern is generic thyroid.   Fortunately a blood test (TSH) can determine if you’re getting the right amount of thyroid medication, but it should only be done two months after taking the medication on a daily basis. Also, the problem might arise if the pharmacy switches generic brands, which they have been known to do.  So if you have a choice, choose the brand name when it comes to thyroid medicine. If you’re forced to take the generic option, let your doctor know and pay attention to the color and appearance of the pill.  If it ever changes, ask the pharmacist.  If the pharmacy does switch generics, let your doctor know so a blood test can be scheduled. 

 As a health care practitioner, I’m concerned about generic alendronate (Fosamax).  While the generic version may contain the correct amount of the drug, you may not be getting the absorption needed for it to be effective.  This is particularly important for medications that have poor GI absorption to begin with. The absorption of the generic may be even worse than the brand name with the end result being little or no benefit when it comes to improving bone density. 

Venlafaxine (Effexor), a popular drug for depression was recently studied by Franck Chenu, PharmD, PhD, of the University of Ottawa.  The researchers found that the side effects of the generic version was three times more common than with the branded version, Effexor. Their findings were reported in the July 2009 issue of the Journal of Clinical Psychiatry.

When it comes to generics it’s always a good idea to talk it over with your doctor before you make the decision of generic versus brand name.  And if you can only afford generic, let your doctor know. 

Source: “AAN: Wide Variability in Generic Versions of Epilepsy Drug”, MedPage Today, May 1, 2009
Source: “Generics versus Brands: Are They Really Equivalent?”, MedPage Today, August 25, 2009

Animals Can Be a Therapeutic Stress Relief

Baby GooseRelax with your pet and lower your blood pressure.   Many studies have found scientific evidence of the therapeutic benefits of pet ownership.

Contact with farm animals appeared to be therapeutic for patients with mental illness according to Norwegian researchers. These findings were similar to previous studies which have shown that animal-assisted therapy involving cats and dogs was associated with decreased stress and improved self-confidence, social competence, and overall quality of life.

In a study from the Minnesota Stroke Institute in Minneapolis, people who owned cats had a lower risk of dying from a heart attack or other cardiovascular disease, including stroke. Whereas people who did not own cats had a 40% higher risk of dying from a heart attack than people who were cat owners. 

It’s very important, however, to find the pet that will fit into your lifestyle.  Impulsive purchases of a cute puppy, for instance, can be disasterous and can actually turn into a source of a huge amount of stress and unhappiness.  

Source: Berget B, et al “Animal-assisted therapy with farm animals for persons with psychiatric disorders: effects on self-efficacy, coping ability and quality of life, a randomized controlled trial” Clin Pract Epidemol Ment Health 2008; 4: 9.

Source: Qureshi A et al, “Cats as domestic pets reduce the risk of cardiovascular diseases: Results from the Second National Health and Nutrition Examination Study Mortality Follow-up Study.” ASA Meeting 2008.

Psychiatric disorders are prevalent, yet undertreated, in college kids

College drinkersThe college years are a particularly vulnerable time of development. What’s more, the academic and social pressures can be overwhelming for a college student, living in a new, transitional, and highly influential environment. 

The major task of this age is to become their own person. They need to learn to make choices and commitments, follow through with them, and stand up independently in the world. But college-aged kids swing back and forth between dependence and independence as they work on these tasks.   What’s more, college-aged individuals may have less well-developed coping mechanisms or less experience than older adults with romantic disappointments and interpersonal difficulties, making them particularly vulnerable to the effects of these and related stressors. 

A recent large Columbia study of 5,000 individuals, aged 19 to 25, found that mental health problems are highly prevalent among both college students and nonstudents alike.   In this study, an alarming 46%  of students and 48% of non-students in this age group technically had a psychiatric disorder according to objective DSM-IV criteria.

That is not to say that almost half of our youth will go on to suffer mental illness for the rest of their lives.  Many of the 19 to 25 year olds who use healthy coping mechanisms will overcome this challenging and emotional phase of their lives.  Regular exercise, adequate sleep, a well-balanced diet, choosing friends wisely, and seeking professional counseling when needed will build a solid foundation for happiness and success in their later years.  Others who turn to alcohol, heavy partying, excessive sleeping, smoking, or drugs to deal with their stressors, will more likely go on to develop more serious mental illness. Continue reading ‘Psychiatric disorders are prevalent, yet undertreated, in college kids’

Dogs raise spirits at the nursing home

Golden retrieverNursing home visits by a dog, brings out positive behavior from dementia patients, in a recent Australian study.  Researchers from the University of Adelaide, conducted therapy sessions, lasting for one week,  consisting of a one-hour group session twice a week with a group of dementia patients. The therapy group consisted of an activities therapist, two visiting dog handlers, and one dog.  Residents could pat and interact with the dog as the handler walked it around the group. 

They found that the group of dementia patients who participated in the group session tended to laugh, smile, and respond more, and these positive effects lasted for the next six weeks. 

Although this was a small study, the researchers felt that the dogs did indeed make a difference. In an article by MedPage Today, the researcher said, ”One of the hardest things for residents is leaving their pet behind.”

via MedPage Today, August 27, 2008 

via Wordley AM, et al “Animal-Assisted Therapy for People with Dementia Living in Residential Aged Care Facilities” DCC 2008; PS-19.

Know the warning signs of a harmful, teen dating relationship

One in eleven high school students reports being a victim of dating abuse. And this is not just physical abuse - it can come in many forms - verbal, emotional, physical and even sexual.

In a recent survey, many teens did not know the warning signs of an abusive relationship, and many parents didn’t know what was going on in their teens’ relationships.

Dating abuse isn’t an occasional argument or a bad mood, it is a pattern of controlling behavior that someone uses against a girlfriend or boyfriend. The following are warning signs of this type of dysfunctional and harmful relationship: 

  • Giving up activities or hobbies that they previously enjoyed
  • Withdrawing from family or friends
  • Spending excessive time with only the person they’re dating
  • Signs of jealousy and possessiveness
  • Constant contact by phone calls, texting or sending instant messages
  • Signs of threats, insults or inappropriate control of temper from the person they’re dating

Early sexual activity tends to fuel this dysfunctional behavior the researchers report.  The solution, experts say, are programs to help parents and their kids recognize unhealthy relationships, and to stop them before they start.

Parents, if it’s too late for preventive efforts and you need help now, first learn about the problem, and then consult professionals whom you trust, before venturing into a problem-solving conversation with your child.   This is not a situation to be ignored, taken lightly, or bluntly confronted, and can easily become an explosive and divisive chasm between you and your child, pushing your teen away from you and even closer to their dating partner. It’s essential to talk to your child and keep the lines of communication open, but beware of blundering into a dangerous situation unprepared. 

One place to start is the The National Teen Dating Abuse Helpline which is an online resource as well as a phone helpline: 1-866-331-9474 | 1-866-331-8453 TTY.  They have a call center in Austin, Texas, where their staff are trained to offer support, information and advocacy to those involved in dating abuse relationships.  It also will provide help for concerned parents, teachers, clergy, law enforcement, and service providers.

via CDC, “Break the Silence, Stop the Violence”, August 2008

via  Survey sponsored by Liz Claiborne Inc. and and conducted by Teenage Research Unlimited, operates the National Teen Dating Abuse Helpline, August 2008

Omega-3 fatty acids appear to have antidepressant effects

Fish Oil SupplementsIn a review of published clinical trials, researchers again found a significant correlation between increased intake of omega-3 fatty acids with a lower prevalence of depression. Fish and fish oil, as well as flax seed oil, are rich sources of omega-3 polyunsaturated fatty acids (PUFAs).

Omega-3 fatty acids are also thought to reduce cardiovascular disease risk by lowering triglyceride levels, decreasing the growth rate of atherosclerotic plaques, decreasing risk of sudden death and arrhythmias, decreasing thrombosis (blood clots), improving arterial health, and by lowering blood pressure.

via Journal of Clinical Psychiatry, July 2007
via “Omega-3 Fatty Acids and Health” from the Office of Dietary Supplements, National Institute of Health

Read about Fish Oil Supplements from Bay Area Medical Information (

Eating disorders surprisingly common in teen girls

Over 10% of teen girls and 3% of boys reportedly binge eat or purge at least once a week, according to a new study from the Children’s Hospital in Boston.  These results are both surprising and concerning and the study’s authors caution both parents and physicians to stress healthy behaviors and not overemphasize the issue of weight to the children.  In this study, teasing and negative comments about weight were linked with an increased risk for disordered eating.  

An eating disorder is not just a behavior that a child can control. It is a medical condition that requires professional medical attention and treatment.    If you suspect your child has a problem with disordered eating, call your doctor or health care provider for advice and referrals to qualified mental health professionals who have experience treating eating disorders in kids.

 Pediatric and Adolescent Medicine/Medscape, June 2008

Antiseizure medicine linked to increased risk of suicide

The FDA has identified an increased risk of suicidal thoughts in those taking drugs for the treatment of epilepsy.   In their recent analysis of eleven different drugs used to treat epilepsy and other conditions such as nerve pain, migraine headaches, bipolar disorder, and other conditions, patients receiving antiepileptic drugs had approximately twice the risk of suicidal behavior or ideation compared to patients receiving placebo.  The results were generally consistent among the following eleven drugs:   

  • Carbamazepine (Carbatrol, Equetro, Tegretol, Tegretol XR)
  • Felbamate (marketed as Felbatol)
  • Gabapentin (marketed as Neurontin)
  • Lamotrigine (marketed as Lamictal)
  • Levetiracetam (marketed as Keppra)
  • Oxcarbazepine (marketed as Trileptal)
  • Pregabalin (marketed as Lyrica)
  • Tiagabine (marketed as Gabitril)
  • Topiramate (marketed as Topamax)
  • Valproate (marketed as Depakote, Depakote ER, Depakene, Depacon)
  • Zonisamide (marketed as Zonegran)

The FDA issued the following alert for patients, family members, and caregivers of patients on drugs in this list or any other drug in this category:

  • Taking antiepileptic medicines may increase the risk of having suicidal thoughts or actions;
  • Do not make any changes to the medication regimen without first talking with the responsible  healthcare professional;
  • Pay close attention to any day-to-day changes in mood, behavior and actions.  These changes can happen very quickly so it is important to be mindful of any sudden differences.
  • Be aware of common warning signs that might be a signal for risk of suicide.  Some of these are: Talking or thinking about wanting to hurt yourself or end your life, withdrawing from friends and family, becoming depressed or having your depression get worse, becoming preoccupied with death and dying, and giving away prized possessions.   
  • If these or any new and worrisome behaviors occur, contact the responsible healthcare professional immediately.

via FDA, Feb 5, 2008

Marijuana use worsens depression in teens

A recent report reveals that some teens are using drugs to relieve depression, when in fact, marijuana use is known to worsen the problem. Using marijuana increases the risk of developing mental disorders by 40 percent, and teens who smoke pot at least once a month over a yearlong period are three times more likely to have suicidal thoughts than nonusers.

In this report from the White House Office of National Drug Control Policy, during this past year, two million teens felt depressed at some point during the past year, and depressed teens are more than twice as likely as non-depressed teens to self-medicate with marijuana and other illicit drugs.  They are also more than twice as likely as their peers to abuse or become dependent on these drugs.

Overall, marijuana use among teens has decreased 25 percent since 2001. This is down to about 2.3 million kids who used pot at least once a month.

via Office of National Drug Control Policy, May 9, 2008