Ketamine: Leading the Way Toward Fast-Acting Antidepressants

2013-01-09

It’s an anesthetic popular with veterinarians, but the latest studies show ketamine also shows promise as a potential antidepressant.

Ketamine produces hallucinations, out-of-body feelings, disorientation and even amnesia that can last a few hours, which has made it not just a staple in veterinary clinics but occasionally in nightclubs as well, as a recreational drug.

In a research review published last October in the journal Science, however, researchers called the growing connection between ketamine and depression “the most important advance in the field” in the depression field over the past 50 years. And now scientists report on two formulations of drugs with ketamine’s benefits, but without its consciousness-altering risks, that could advance the drug even further toward a possible treatment for depression.

Prozac and other methods of stabilizing mood, including talk therapy, take weeks, not hours, to show benefits. A rapid-acting antidepressant like one based on ketamine could potentially be lifesaving for those with depression, since those waiting for treatment to take effect are often at high risk of suicide.

In late November, the first randomized controlled trial of a ketamine-like drug, AZD6765 (made by AstraZeneca), was published in Biological Psychiatry. The study, which was funded by the National Institute of Mental Health, included 22 participants with depression who had failed to respond to other treatments. Those randomly assigned to the ketamine compound showed a 32% improvement in mood, typically within an hour, compared with only 15% of those assigned to placebo. Overall, 18% of patients reached full remission, lasting two days, on the drug, in contrast with 10% of those taking placebo.

But while the drug had no significant side effects, the ketamine mimic was not nearly as effective as ketamine itself. “The antidepressant effects of AZD6765 were not as robust or sustained as those observed in our previous study of ketamine,” the authors write. With ketamine, 71% of patients had a significant positive response within a day of taking the drug — more than double that seen with the new medication — and the effects lasted for a week, not just two days.

Despite its weaker performance, AZD6765 does have an advantage over the original — it does not seem to impair consciousness, so it could still prove to be a useful medication. “Future studies with this compound are warranted on the basis of the positive antidepressant signal here, particularly those exploring efficacy and tolerability associated with higher or repeated doses,” the study concludes.

Preliminary data on another ketamine-like antidepressant, GLYX-13, was also presented at the December meeting of the American College of Neuropsychopharmacology. A safety test on 116 people with treatment-resistant depression found that the drug did not impair consciousness, had minimal side effects and did significantly reduce depression symptoms for up to two weeks.

However, because this trial was designed to test the agent’s safety, its effects were not compared with those of a placebo.

But with the emerging evidence suggesting a connection between ketamine and improved mood and with both of the ketamine-like compounds still under study, some clinicians are starting to offer ketamine to patients whose depression is not responding to other approaches. Since it is FDA-approved for use as an anesthetic, doctors can provide the drug off-label to patients, as long as they inform users that the medication has not been tested for use as an antidepressant.

Others, like Dr. James Murrough, assistant professor of psychiatry at the Icahn School of Medicine at Mount Sinai, are conducting clinical trials of ketamine as a treatment for depression but are reluctant to offer the drug outside of research. “I’m excited because it has potential, but it’s not quite ready yet,” Murrough says. If the studies do support the safety and effectiveness of ketamine or ketamine-like agents for treating depression, however, these drugs could become an important part of the psychiatric arsenal in addressing symptoms of mood disorders quickly — before they lead to more serious symptoms like suicide.

Understanding Why Music Moves Us

2013-01-01

They say that writing about music is like dancing about architecture. But why don’t we dance to paintings— or for that matter, buildings— anyway? The latest research hints at why.

According to a study published in the Proceedings of the National Academy of Sciences, music and dance share a parallel expression of emotion. The new research suggests that the two disciplines can express a mood together, with complementary methods of generating the dynamics of feeling.

The intuitive link between our feelings and movements is so strong that even the word “emotion” includes the word “motion.” And across cultures, the three-way connection between music, motion and feelings is maintained, such that being “moved” by either feelings or music is not just a concept of English-speaking people.

MORE: How an Appreciation for the Arts May Boost Stroke Recovery

To better understand the roots of this deep connection, researchers at Dartmouth created a computer program that could produce either music or movement. Slider bars— similar to those on a mixing board— were created to control either the motion of an animated ball or the single notes of a piano, but not both at the same time.

Participants in the study included two very dissimilar groups: 50 college students in the U.S., and 87 villagers living in L’ak, a remote area of Cambodia, which is populated by the Kreung people. In this tribal group, music and dance mainly appear in ceremonies like weddings, funerals and animal sacrifices. The Kreung village is so isolated that members had never had any experiences with computers prior to the experiment.

In both the U.S. and Cambodian groups, participants were split into two groups for the experiment. All of them had to use the computer program to represent five different emotions: angry, happy, peaceful, sad and scared. But one group used the program in which the ball represented the emotion in movement, while the other used the program to play music to represent the feeling.

The program the scientists created allowed the participants to depict different aspects of the emotions. One slider bar, for example, controlled “rate,” which regulated how often notes or ball bounces occurred, better known to music lovers and dancers as beats per minute. Another handled “jitter” or the space between the notes or bounces. A third slider controlled the direction of either the music or the ball— whether the pitch or the ball moved up or down. The fourth handled the ratio of large to small movements: i.e., whether the pitch moved up quickly or slowly or the ball took large or small bounces. The final slider managed whether the music was consonant or dissonant or whether the ball moved smoothly or irregularly.

MORE: How Group Drumming May Improve Low-Income Student Behavior

“The study is bold, challenging and interesting,” says Mark Changizi, an independent neuroscientist at the 2Ai Institute, who was not associated with the research but also studies the relationship between music and movement.

The authors write, “The critical question was whether subjects who used music to express an emotion set the slider bars to the same positions as subjects who expressed the same emotion with the moving ball.”

And to a large extent, that was what the researchers found. In the American group, each parameter was used in a similar way to create an image of an emotion, regardless of whether the output was music or motion. “These results strongly suggest the presence of a common structure,” the authors write.

Changizi’s research produced similar findings, although he used a different way of mapping music to movement, explored in his book, Harnessed. “I make the case that music has culturally evolved to sound like evocative human movement and behavior,” Changizi says, “By working out the ‘fingerprint’ of sounds people make when they move, I show that the same peculiar fingerprint is found in the structure of music.”

But is this unique to Western music? Other cultures may represent emotions differently in their music and their movements— or they may have parallel, but different expressions for emotion in music v. dance.

The study of U.S. and Cambodian participants suggests that different cultures may share parallel ways of expressing emotions in music and movement. Combining the data for music and movement together, the Kreung results for each emotion were more similar to the American results for the same emotion than they were to the other feelings, with one exception.

That exception was “angry.” The Kreung idea of “angry” music was closer to the American idea of “scared” music than it was to American rage music. But given the overlap in situations that elicit anger and fear, however, that trend is not entirely surprising.

Overall, the study authors conclude, “[T]he dynamic features of emotion expression are cross-culturally universal, at least for the five emotions tested here… these expressions have similar dynamic contours in both music and movement.”

So what does this tell us about what music and dance are “for”? Changizi notes that painting and sculpture can evoke emotion, but not the contagious type that tends to unify a group. “The visual arts may well evoke great feeling in us,” he says, describing how we may smile or even be moved to tears by a painting. “But [they don’t] make us really move, not like music can. Nearly all music may sound like someone moving about us, but dance music in particular probably sounds like someone engaging in a much more infectious behavior, one that in real life we might join.”

The study’s authors suggest that music may have evolutionary functions that aid survival, from “the soothing power of lullabies and the stimulating, synchronizing force of military marching rhythms” that can bind parents and children or entire nations together. The power of music may indeed be in its ability to move us, both literally and figuratively.

Loneliness, Not Living Alone, Linked to Dementia

2012-12-12

Yes, there is a difference. Why one is more likely to trigger serious memory problems?

In a study published in the Journal of Neurology Neurosurgery & Psychiatry, Tjalling Jan Holwerda of the VU University Medical Center in Amsterdam found that participants who reported feeling lonely — regardless of how many friends and family surrounded them — were more likely to experience dementia than those who lived on their own. The scientists focused on nearly 2,200 older adults living in Amsterdam, ages 65 to 86, who did not show signs of dementia and were not living in institutions like nursing homes, and visited them twice over three years. About half of the participants lived alone and 20% reported feelings of loneliness. Almost two-thirds of the elderly in the study were women.

Prior research suggested that having a supportive social network is linked with positive health outcomes, from psychological health to physical health, while lacking such support can be harmful. Indeed, a growing body of studies find that loneliness itself can kill, typically by raising blood pressure and increasing risk for heart disease and stroke. High blood pressure is also a risk factor for dementia.

Continue reading Loneliness, Not Living Alone, Linked to Dementia →

Young people and social media: Docs examine pitfalls By Pat Etheridge, Special to CNN

2012-11-26

They’re called “Generation M2”: highly tech-savvy children ages 8 to 18, whose lives are immersed in electronic media.

Now, the nation’s top pediatric organization is mobilizing efforts around their well-being.

“As pediatricians who are trying to help children behave in ways that keep them healthy and safe, we have to pay a lot of attention to what’s happening in social media,” said Dr. David Hill, chairman-elect of the American Academy of Pediatrics’ council on communications and media.

The council led a panel called “Social Media: The Good, the Bad and the Ugly,” at the group’s annual conference last month in New Orleans. The goal of the presentation: getting pediatricians current on issues to discuss with young patients during regular wellness checkups.

The American Academy of Pediatrics established the council in 2007 with the recognition that growing media platforms touch on virtually every health concern pediatricians have about young people: aggression, sex, drugs, obesity, self-image and eating disorders, depression and suicide — even learning disorders and academic achievement.

Continue reading Young people and social media: Docs examine pitfalls By Pat Etheridge, Special to CNN →

Happy Teens Grow Up to Be Wealthier Too…….

Which comes first, happiness or money? Much scholarly head tapping has been devoted to examining whether richer people are happier and if so, how much richer? Nobel prize-winners have even looked into it. But a new study suggests that the question could perhaps be looked at the other way around. Happier teenagers, this study suggests, grow up to be richer adults.

The study, which appeared recently in the Proceedings of the National Association of Sciences Teenagers, looked at thousands of teenagers and found that those who felt better about life as young adults tended to have higher incomes by the time they turned 29. Their happiness was measured on a scale of 1 to 5. Those who were happiest earned an average of $8,000 more than those who were the most despondent.

Continue reading Happy Teens Grow Up to Be Wealthier Too……. →

Jobless ‘face increased heart attack risk’ By Michelle Roberts Health editor, BBC News online

2012-11-20

Being unemployed in your 50s and early 60s may raise heart-attack risk by a similar magnitude as smoking, findings suggest.

The study of more than 13,000 people in the US indicated heart-attack risk went up by a quarter in the first year after job loss and increased incrementally with further sackings or redundancies.

The same was not seen in people who gave up work voluntarily, Archives of Internal Medicine reports.

Experts suspect stress may be to blame.

Continue reading Jobless ‘face increased heart attack risk’ By Michelle Roberts Health editor, BBC News online →

You’re Spoiling the Kids! When Parents Disagree on Spending

2012-10-30

By Suzanna de Baca
Since I write about the impact finances have on families, I often have friends and colleagues confide about financial issues they face at home. One friend recently shared that he and his wife frequently bicker about spending on their kids. More specifically–her spending. In his opinion, she spoils their two young children, splurging on toys, clothes and birthday gifts for their friends. “She buys them whatever they want,” he explained, “and I don’t think it’s necessary.”

Most arguments about finances have two sides and I suspected this might be the case for my friend. Often, our spending habits (on kids or other things) are a reflection of our values and priorities – which aren’t always perfectly aligned between family members. Arguments about money are a common source of discord among couples in the United States. According to a new survey by the American Institute of CPAs (AICPA), money fights prompt an average of three arguments each month – making it the most volatile topic for spouses.

Continue reading You’re Spoiling the Kids! When Parents Disagree on Spending →

Exercise Trumps Brain Games in Keeping Our Minds Intact

2012-10-24

By Alexandra SifferlinOct. 23, 2012

It’s inevitable that as we age, our brains get smaller. Nerves die off, losing their connections, and that leads to a thinned out network feeding our thinking functions. But brain shrinkage isn’t inevitable, according to the latest study of elderly adults.

In recent years, as more research reveals the benefits of staying both physically and mentally active into the golden years, health officials have been urging older people to exercise more and stay mentally engaged by maintaining a rich network of friends and family connections and by learning new skills to keep their brains sharp. Crossword puzzles, learning a new language, playing board games — anything that requires some thought can do the trick.

Continue reading Exercise Trumps Brain Games in Keeping Our Minds Intact →

Is PMS a Myth?

2012-10-23

For many women, premenstrual syndrome, or PMS, is a familiar preamble to their monthly cycle. But a new review of the data suggests that mood changes aren’t as closely tied to menses as many have assumed.

A team led by Dr. Sarah Romans of the University of Otago in New Zealand reviewed 47 studies that followed women’s moods across the menstrual cycle. Only 15% of the studies found that women tended to have “classic” PMS: moods that worsened as the menstrual period approached and lifted when menstruation occurred. An additional 38% found PMS that lasted into menstruation or another cycle phase.

Continue reading Is PMS a Myth? →

Why Does Bad News Stress Women Out More than Men?

2012-10-16

By Alexandra Sifferlin
It’s hard to avoid the news, thanks to Twitter feeds, Facebook updates and the ubiquity of newsfeeds eager to flood your screen with both calamity and celebration. But how are all these current events affecting our psyche?

To figure out whether our increasing exposure to 24-hour news coverage — especially negative news — has an impact on our stress levels, researchers from University of Montreal recruited 60 men and women to read news stories and submit to certain stressful situations. Turns out, women are more sensitive to negative news stories than men are, and they remember the details of such events better.

(MORE: Background TV: Children Exposed to Four Hours a Day)

For the study, the researchers divided the participants, aged 18 to 35, into four groups to read news stories. One group of men and one group of women read “neutral” news stories, about park openings or movie premieres, for example, while the other groups read negative news stories — about murders and accidents. To determine the participants’ stress levels after reading these stories, the research team took saliva samples and analyzed each for the stress hormone cortisol. The higher the level of hormone, the more stressed the participants likely were.

The study participants then completed stress-inducing tasks involving memory and intellect, and then provided a second round of saliva samples. The following day, the participants discussed the news stories they read the day before with researchers over the phone. The scientists found that although women’s stress levels didn’t rise after reading the negative news stories, the stories did make them more reactive to the stressful situations they endured afterward: women’s cortisol levels were higher after the memory and intellect tasks if they had first read negative news stories than if they read the neutral ones. Researchers didn’t see the same effect in men. What’s more, women who read stories about accidents and murders remembered more about them than did women who read “neutral” news. Again, the same phenomenon wasn’t seen among the male participants.

“When our brain perceives a threatening situation, our bodies begin to produce stress hormones that enter the brain and may modulate memories of stressful or negative events,” Sonia Lupien, director of the Centre for Studies on Human Stress, explained in a statement. “This led us to believe that reading a negative news story should provoke the reader’s stress reaction.”

(MORE: Human Kindness Gene Withstands Threats and Fear)

What might explain the gender difference? The researchers speculate that evolutionary factors could play a role. Women’s invested interest in the survival of their offspring may make them more sensitive to potentially threatening situations or events. “Women tend to be more empathic than men,” says lead author Marie-France Marin. “It could be that they carry the [emotional] load longer than men, which could also influence their memory.”

The authors argue that understanding and appreciating individual reactions to bad news is increasingly important in our plugged-in society. “We are consuming news more and more. With smartphones, you can always see what’s going on. Our brain is constantly detecting stressors, and more and more stress hormones get back to the brain, which can affect attention, mood and cognition,” says Marin.

For women, perhaps recognizing that they may be particularly vulnerable to news-related stress could help them lessen the burden by simply being mindful of the potential effect of mass media, or by engaging in coping mechanisms like meditation and exercise.

The study was published in the journal PLoS One.