Treatment For Minor Depression
Treatment for Minor Depression
In a new approach to research on minor depression, the National Institutes of Health (NIH) has launched a four-year study to determine the safety and effectiveness of St. John's wort, a common herbal supplement, and citalopram, a standard antidepressant, compared to placebo.
The trial is being conducted at three sites. A total of 300 participants with minor depression will be randomly assigned a standardized extract of St. John's wort (Hypericum perforatum), citalopram, or placebo in a twelve-week double-blind trial. Researchers will assess changes in patients' symptoms, functioning, and quality of life. Those who show no improvement will receive the active treatment they hadn't been assigned before, while patients with improved symptoms will take their assigned treatment for another 14 weeks for a total of 26 weeks.
The more than million collaborative study is funded by the National Institute of Mental Health (NIMH), the National Center for Complementary and Alternative Medicine (NCCAM), and the Office of Dietary Supplements (ODS).
Minor depression is a common disorder that may impair a person's functioning and quality of life and is a serious risk factor for major depression. Yet it is underdiagnosed and undertreated. The study addresses a need for definitive data on therapy for this significant health problem. Patients with minor depression who seek treatment from family doctors are often treated with prescription antidepressants, if their mood disorder is diagnosed at all. Many people use St. John's wort without consulting a physician. This study will help determine how the herbal agent and the antidepressant fit in the overall management of the disorder.
"If the trial demonstrates that citalopram or St. John's wort benefits patients with minor depression, it will expand our understanding of this underrecognized mood disorder and offer new evidence-based treatment recommendations for either primary care or mental health clinicians," explained Matthew Rudorfer, M.D., Associate Director of Treatment Research, Division of Services and Intervention Research, NIMH.
"There is high public interest in herbal remedies for depression," according to Stephen E. Straus, M.D., NCCAM Director. "Our intent is to study St. John's wort for the spectrum of depressive conditions for which the public considers its use. This new study extends our earlier research efforts from the more serious form of depression to a clinically less serious one, yet one that is, in fact, of considerable public health significance," he said.
Men and women age 18 to 85 who meet diagnostic criteria for minor depression are eligible to participate. They must have experienced depressive symptoms for at least 6 months but less than 2 years continuously without meeting criteria for a major depressive episode or dysthymia within the past year. Additional exclusionary criteria include other mental disorders, such as schizophrenia, bipolar disorder, anxiety and substance use disorders. Individuals with some active physical illnesses, such as cardiovascular, renal, respiratory, endocrine, neurological, or blood diseases also are not eligible for the study.
Participants are interviewed at an initial screening visit, during the initial two-week period when they are withdrawn from all psychotropic medications, at baseline, and every two weeks thereafter during the study. At the screening visit, Week 12, and Week 20, patients will undergo a complete blood count with laboratory tests. Well validated scales will be used to assess symptoms, dysfunction, and well-being.
Minor depression affects about 7.5 percent of Americans during their lifetime. Although there is broad knowledge about the scope of suffering and disability due to major depressive disorder, less is known about the day-to-day struggles faced by people with minor depression. Its symptoms are the same as those of major depression, though fewer in number and causing less impairment. They include:
* Either a depressed mood most of the day, nearly every day
* Or a markedly diminished interest or pleasure in daily activities
* Plus two to four of the following symptoms:
o Significant weight loss or gain, or decrease or increase in appetite
o Disturbance in sleep pattern
o Noticeable agitation or slowness
o Fatigue or loss of energy
o Inappropriate feelings of worthlessness or guilt
o Diminished ability to concentrate, indecisiveness
o Recurrent thoughts of death or suicide
* Symptoms must last at least 6 months but less than 2 years continuously.
Trials are being conducted in:
Boston, Massachusetts, at Massachusetts General Hospital. Andrew A. Nierenberg, M.D., is the principal investigator. The coordinator is Megan Hughes at 617-726-3129; mhughes3@partners.org
Los Angeles, California, at Cedars-Sinai Medical Center. Mark Rapaport, M.D., is the principal investigator. The coordinator is Rachel E. Maddux at 310-423-4473; madduxr@cshs.org
Pittsburgh, Pennsylvania, at the University of Pittsburgh. Robert Howland, M.D., is the principal investigator. The coordinator is Michael Lightfoot at 412-624-5035; lightfootm@msx.upmc.edu
For more information, contact www.ClinicalTrials.gov. For press calls at NIMH, 301-443-4536; NCCAM, 301-496-7790; and ODS, 301-496-4819. NIMH Web site: www.nimh.nih.gov
NIMH, NCCAM, and ODS are part of the National Institutes of Health (NIH), the Federal Government's primary agency for biomedical and behavioral research. NIH is a component of the U. S. Department of Health and Human Services.
Although depression itself can lower libido and impair sexual performance, SSRIs and some other antidepressants can provoke sexual dysfunction.
The confusion and disorientation experienced upon awakening after ECT typically clear within an hour.
Indian Institute of Science student commits suicide (The Times of India)
A Ph.D student of the Indian Institute of Science (IISc) in Bangalore committed suicide due to 'depression' by hanging himself in his hostel room.
Washington Explores Help for Those Who Can't Pay Mortgages (US News & World Report)
"Liquidate labor, liquidate stocks...liquidate real estate. It will purge the rottenness out of the system.... People will work harder, live a more moral life." That was how Herbert Hoover once described Treasury Secretary Andrew Mellon's unsympathetic attitude as the Great Depression began to unfold.
Headway in developing a faster-acting antidepressant (Los Angeles Times)
The key might be provided by studying the effect that ketamine, an anesthetic, has on a neurotransmitter. After years of little progress, scientists are making headway in the search for a better, faster-acting antidepressant. Experiments with an anesthetic called ketamine have yielded important clues about the biology of depression, leading scientists to attack the mood disorder in new ways.
Mental Health support group (Almaguin News)
The Family Mental Health Initiative of Simcoe Countys support group for family members, friends and caregivers of persons with depression and/or manic depression has changed where and when it meets.
New Data Suggest Cymbalta Reduced Pain In Fibromyalgia Patients With And Without Depression (Medical News Today)
New data suggest that patients with fibromyalgia treated with 60mg or 120mg of Cymbalta (duloxetine HCl) experienced greater reduction in pain severity beginning one week after starting duloxetine than those taking placebo (sugar pill), as measured by the Brief Pain Inventory Average Pain Score (BPI). click link for full article
Other Depression Article Snippets:
Men And Depression
"Despite the enormous advances in brain research in the past 20 years, depression often goes undiagnosed and untreated."
Antidepressant Medications
"In focus groups conducted by the National Institute of Mental Health (NIMH) to assess depression awareness, men described their own symptoms of depression without realizing that they were depressed."
Symptoms Of Depression And Mania
"Two of the short term psychotherapies that research has shown to be effective for depression are cognitive behavioral therapy (CBT) and interpersonal therapy (IPT)."
Diagnostic Evaluation And Treatment
"Patients often are tempted to stop medication too soon ans they may feel better and think they no longer need the medication or they may think the medication isn't helping at all."