Archive for the 'Psychiatric Problems' 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

Food Addiction Can Become Similar to Drug Addiction

Measuring tapeDo you ever feel like the more you eat, the more you want to eat?  There are several complex mechanisms that do indeed create this viscious cycle. 

One factor was recently studied by researchers from the Brookhaven National Laboratory on New York’s Long Island. In their recent study, the brain activity of hardcore drug and alcohol addicts was similar to obese participants who were ”addicted” to food.  The researchers conducted several brain imaging studies of obese patients using PET-CT scans.  Very close similarities were found in brain activity between patients addicted to cocaine or alcohol, and those who were obese and ”addicted” to eating.  

In other experiments, the researchers also found a higher body mass index (BMI) was linked with lower prefrontal cortex function — the area of the brain that regulates inhibitory control. In other words, those who were more obese had less impulse control. 

So the more we overeat, the less we’ll be able to control our desire to overeat, or possibly control other impulsive negative behaviors as well. Not a pleasant thought.

The studies also revealed that a higher BMI was linked to a decrease in memory and executive functioning.

These are all very good motivating factors to curb any overeating now, before it’s too late.  And if it is too late, you might want to consider getting some professional help, as overeating is a very serious problem. 

Whether or not you have an eating problem, a program of regular exercise is an excellent way to live a happier, healthier and longer life. Regular exercise will fight the fat, boost your energy, improve your mood and self esteem, increase immune function, fight cancer, ward off viruses, improve the quality of your sleep, strengthen your muscles and your heart, lower high blood pressure, improve arthritis and many other common conditions.  

Read more about getting started on an exercise program.

Source: “Doctor’s Orders: Brain’s Wiring Makes Change Hard”, MedPage Today/ABC News, February 2010

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

Critical Illness can Trigger Depression

Critical illness can trigger depressionFrequently patients who survive critical illnesses later become clinically depressed, according to researchers from Johns Hopkins University.  In their recent study of intensive care (ICU) patients who suffered either multiple organ failure, underwent surgery, or received high doses of benzodiazepine (Xanax, Valium) while in the ICU, 26% of the participants were suffering symptoms of depression at six months after ICU discharge.

Depression is a true medical condition that strikes people of all ages, backgrounds, and ethnic groups. The exact cause of it is not entirely certain, but we do know: depression tends to run in families, it is cyclical and tends to recur, it is usually triggered by a stressful event, and it is associated with an imbalance of chemicals in the brain.

Normal function of the brain involves a complex interaction of chemicals, called neurotransmitters. Depression is associated with an imbalance of these neurotransmitters.

Depression occurs in waves, or spells, and can last for months or even years if left untreated.  Sometimes people who are depressed try to feel better by using alcohol or drugs. This doesn’t help the depression in the long run; in fact, alcohol and illegal drug use are well known for making depression worse and can easily lead to a vicious downhill path of substance abuse and addiction.

Depression is not a sign of weakness or a character flaw. It is a true medical condition like diabetes or hypertension, and it is often an overwhelming disease. Depression deeply affects not only the person who is depressed, but close family and friends are usually greatly impacted as well.

More people suffer from depression than you might think. Twenty-five percent of all women and up to 12% of all men in the U.S. will experience an episode of major depression some time in their lives. A person who is depressed to the point that it interferes with daily activities should seek medical care.

There are many treatments available. Prescription medicines for depression or anxiety may be helpful. Talking to a mental health professional and your friends and family about your feelings and the experience can also help. Regular daily exercise, if you are medically able, is extremely helpful in treating depression.

Read about

Source: Dowdy D, et al “Are intensive care factors associated with depressive symptoms 6 months after acute lung injury?” Crit Care Med 2009; DOI: 10.1097/CCM.0b013e31819fea55.

Compulsive Gambling Linked with Requip and Mirapex

Gambling

Two prescription medications commonly prescribed for Parkinson’s, and also used to relieve the symptoms of restless legs syndrome, have again been linked to compulsive gambling and hypersexuality.  A recent study from the Mayo Clinic found that of 66 patients who were taking either pramipexole (Mirapex) or ropinirole (Requip) for Parkinson’s, seven developed one of the destructive behaviors which resolved after the medications were discontinued or the doses were reduced.

Previous studies have identified a link between these drugs and compulsive behavior as well. In addition to gambling and hypersexuality, therapeutic levels of the medications have also been associated with compulsive eating, as well as excessive shopping or spending.  Less destructive behaviors such as compulsive gardening, excessive fishing or hobby work have also been related to these drugs.

Mirapex and Requip are used alone or with other medications to treat the symptoms of Parkinson’s disease.  They are also used in lower doses to help relieve the symptoms of restless legs syndrome. They are in a class of medications called dopamine agonists. A natural substance in the brain, Dopamine is needed to control movement.

Patients, as well as spouses or family members, need to be aware of this potential dangerous side effect of these drugs.   ”The onset can be insidious and overlooked until life-altering problems develop”, according to the researchers in an article in MedPage Today.  Contact your health care provider if new symptoms arise while on either of these drugs. 

Source: Bostwick J, et al “Frequency of new-onset pathologic compulsive gambling or hypersexuality after drug treatment of idiopathic Parkinson disease” Mayo Clin Proc 2009; 84: 310-316.

Source: “Parkinson’s Drugs May Increase Compulsive Behavior”, MedPage Today, April 9, 2009 

Smoking Pot Linked with Testicular Cancer

Marijuana plantsSmoking marijuana increases the risk of testicular cancer, according to researchers from the Fred Hutchinson Cancer Research Center.  In their recent study, men diagnosed with testicular cancer were 70% more likely to be current marijuana users, although the risk was especially elevated in men who had started using the drug before they were 18 or who used it frequently. Much of the increased risk is associated with tumors which typically peak between the ages of 20 and 35 and account for about 40% of all cases of testicular cancer.

Although little is known about the long-term health consequences of marijuana, it is known to have adverse effects on the reproductive system.  Researchers have also found a link between long-term heavy cannabis use and shrinkage in certain areas of the brain.  In addition, studies have found an increased risk of mental illness in pot smokers, such as depression and schizophrenia.

Marijuana is the most widely used illicit drug in the developed world.  The naive notion that smoking pot is harmless takes its toll on our society. Marijuana is not harmless and it is addictive. More young people are now in treatment for marijuana dependency than for alcohol or for all other illegal drugs combined.  Photo courtesy of the U.S. Drug Enforcement Administration

Source: Daling JR, et al “Association of marijuana use and the incidence of testicular germ cell tumors” Cancer 2009; DOI: 10.1002/cncr.24159.

Many OTC weight-loss pills are from China and dangerous

PillsMore and more products with  unidentified and harmful ingredients are finding their way into the U.S. marketplace, and the FDA is quickly taking action to file criminal charges and help ensure that these products are removed from the store shelves.  It is an extensive process, however, and dangerous products are still advertised on the TV and radio and readily available online as well as on the shelves of local grocery stores, pharmacies, and health food stores in the U.S. 

Most of the dangerous and illegal products are for weight loss, but there are also many for erectile dysfunction, diabetes and hair loss.  Usually they are labeled as dietary supplements or supplements. Often the manufacturer is not listed on the label or in the advertisements.  However, the FDA has discovered that most of the products with illegal and undeclared ingredients have been manufactured in China.

Some of these ingredients are known to be carcinogenic and cause damage or mutations to DNA.  Other known side effects include increased blood pressure, stroke, tachycardia, seizure, depression, anxiety, insomnia, aggressiveness, and suicidal thoughts.  

The FDA urges all consumers to be aware of the following signs of health fraud:

  • Promises of an “easy” fix for problems like excess weight, hair loss, or impotency.
  • Claims that the product is safe because it is “natural.”  
  • Claims such as “scientific breakthrough,” “miraculous cure,” “secret ingredient,” and “ancient remedy.”
  • Impressive-sounding terms, such as “hunger stimulation point” and “thermogenesis” for a weight loss product.
  • Undocumented case histories or personal testimonials by consumers or doctors claiming amazing results.
  • Promises of no-risk, money-back guarantees.

In other words, if it’s too good to be true, it is.  The only OTC drug approved for weight loss in the United States is Ally.  Orlistat is the active ingredient in Ally which helps produce weight loss by decreasing the intestinal absorption of fat.  Some people have lost weight with Ally, but there are a number of people who shouldn’t take Ally.  Click on the link below for more about Ally.

Read more:

Depression linked with increased mortality in heart failure patients

A man who appears depressedDepression increases the risk of death in patients with heart failure, but the risk apparently disappears with antidepressant use, according to a recent study from Duke University Medical Center.

Depression is not a sign of weakness or a character flaw. It is a true medical condition like diabetes or hypertension, and it is often an overwhelming disease.

More people suffer from depression than you might think. Twenty-five percent of all women and up to 12% of all men in the U.S. will experience an episode of major depression some time in their lives. A person who is depressed to the point that it interferes with daily activities should seek medical care.

Read about the symptoms of depression from Bay Area Medical Information

Source: Archives of Internal Medicine, November 10, 2008.