05 October 2013
European College of Neuropsychopharmacology (ECNP)
BARCELONA, SPAIN (7 October 2013) – Improved understanding of the roles of inflammation and oxidative stress in psychiatric disorders has generated new leads in the search for novel therapies. One such investigative compound currently in clinical trials is an amino acid, N-Acetyl Cysteine (NAC), which appears to reduce the core symptoms of bipolar disorder, schizophrenia, depression, autism and cravings in addictions including cocaine, cannabis abuse and cigarette smoking.
At the start of the decade of the brain, in the early 1990s, there was great hope that a flurry of new treatment discoveries would eventuate. In contrast, today, most pharmaceutical companies have a drying psychiatry and neurology pipeline and many have exited the field entirely. “One of the factors has been an over reliance on typical monoamine pathways as targets for drug discovery,” said Professor Michael Berk, Chair in Psychiatry at Deakin University, Geelong, Australia.
Professor Berk pointed out that the situation regarding new drug development for psychiatric problems was best summarised by former National Institute for Mental Health Director, Steven Hyman:
“drug discovery is at a near standstill for treating psychiatric disorders such as schizophrenia, bipolar disorder, depression and common forms of autism.”
Beyond the monoamine-based drugs, neuroscience has elucidated an array of other important pathways that are involved in most major psychiatric disorders, for example schizophrenia and both unipolar and bipolar depression.
According to Professor Berk, there is now an incontrovertible evidence base that these disorders share inflammation and oxidative stress as part of their disease physiology. In addition, associated pathways including reduction in proteins that stimulate neuronal growth (neurotrophins), and increased cell death (apoptosis), as well as energy generation in organelles called mitochondria are intimately involved. “This understanding provides an entirely new set of treatment targets.”
The amino acid, NAC, seems to have multiple effects on all these pathways: it
- boosts glutathione, which is the body’s major antioxidant defence;
- has anti-inflammatory properties;
- enhances levels of nerve cell growth proteins and the growth of new neurons; and
- reduces cell death pathways.
- It also appears to reduce dysfunction of mitochondria.
These molecular effects of NAC have been investigated in a series of clinical trials, which show that NAC reduces the core symptoms of schizophrenia including negative symptoms such as improved apathy, social interaction and motivation.
It also appears to reduce depression in people with bipolar disorder and at this meeting, new data on its role in unipolar major depression was presented. Furthermore, there is intriguing evidence that it reduces cravings in a number of addictions including cocaine, cannabis and cigarette smoking. “Apart from nausea, it appears to be relatively free of problematic side effects,” said Professor Berk.
In addition to NAC, a range of other compounds that target similar pathways, particularly inflammation, seem to have therapeutic potential. These include aspirin, cyclooxygenase (COX) inhibitors, statins, omega-3 fatty acids and even some anti-diabetic agents such as pioglitazone. “Capitalising on our understanding of inflammation and oxidative stress in major psychiatric disorders appears to give us an entirely new range of potential treatments for these common, severe and disabling conditions,” said Professor Berk.
Binge Drinking During Pregnancy Linked to Negative Emotions
Researchers in Norway found that negative affectivity is linked to light alcohol use and binge drinking during pregnancy. Results published in Acta Obstetricia et Gynecologica Scandinavica, a journal of the Nordic Federation of Societies of Obstetrics and Gynecology, show 16% of women had light alcohol use in the first trimester and 10% in the second trimester.
Binge drinking occurred in 12% of women during their first trimester and 0.5% in the second trimester.
Experts describe negative affectivity as the tendency to experience negative emotions such as anxiety and depression.
Individuals with negative affectivity tend to have an unfavorable view of themselves and the world in general. Previous studies have associated negative affectivity with greater vulnerability to stress, intense emotional reactions to daily life, and inclination to use intoxicants in response to stress.
Mothers who use alcohol while pregnant place their unborn child at risk for premature birth, low birth weight, fetal alcohol syndrome and even fetal death. These serious health risks have led health experts around the world to recommend that women abstain from alcohol while trying to conceive and during pregnancy.
Yet prior evidence indicates that 25% to 50% of women report drinking alcohol while pregnant, with low income level, partner’s drinking behavior, and mother’s pre-pregnancy alcohol use all contributing risk factors.
The present population-based study, led by Dr. Kim Stene-Larsen from the Norwegian Institute of Public Health in Oslo, Norway, used data from 66,111 pregnant women and their partners who were part of the Norwegian Mother and Child Cohort Study (MoBa). Mothers filled out surveys related to alcohol use at 17 and 30 weeks of gestation.
The Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) was used in the present study to measure
- light alcohol use (0.5 to 2 units, 1-4 times per month) and
- binge drinking (intake of 5 alcohol units or more in a single drinking episode).
In Norway one unit of alcohol is equivalent to
- one glass (1/3 liter or ≈11 oz) of beer,
- one sherry glass of fortified wine, or
- one snaps (shot) glass of spirit or liqueur.”
Negative affectivity was assessed in gestational weeks 17 and 30 using the Hopkins Symptom Checklist, which measures anxiety and depression. Medical evidence has established that measures of anxiety and depression symptoms are comparable to negative affectivity measures.
Findings indicate that with each unit increase in maternal negative affectivity, the odds for light alcohol increased in the first and second trimester, 27% and 28%, respectively.
The odds for binge drinking were much higher at 55% in the first trimester and 114% in the second trimester for each unit increase of negative affectivity in the mother.
“Our findings clearly show a link between a mother’s negative emotions, such as depression and anxiety, and light alcohol use and binge drinking during pregnancy,” concludes Dr. Stene-Larsen. “Further study is needed to understand why women continue to drink alcohol while pregnant despite health warnings.”
“Our findings clearly show a link between a mother’s negative emotions,
such as depression and anxiety, and light alcohol use and binge drinking during pregnancy”
October is national depression screening month.
Screening for Mental Health offers National Depression Screening Day programs for the military, colleges and universities, community-based organizations and businesses.
Held annually during Mental Illness Awareness Week in October, National Depression Screening Day (NDSD) raises awareness and screens people for depression and related mood and anxiety disorders.
NDSD is the nation’s oldest voluntary, community-based screening program that provides referral information for treatment. Through the program, more than half a million people each year have been screened for depression since 1991. Take an anonymous depression screening at www.HelpYourselfHelpOthers.org
In a recent Finnish study, subjects with the worst health habits were also the most depressed. Perhaps not surprising, lifestyle evaluations in countries with well established public health services provide a baseline for intervention and corrective action.
Health is our birthright. Health care should also be part of any society’s organizing principles if for no other reason than it works.
Background: The Lapinlahti 2005 study was carried out to explore cardiovascular disease risk factors, lifestyle and quality of life in Lapinlahti residents in eastern Finland. Our aim was to study the association between lifestyle and health-related quality of life (HRQoL) in the community.
Subjects and methods: The present study is based on the baseline data of the followed up (2005–2010) population-based cohort (N = 376, n of males = 184). A trained research nurse measured weight, height, waist circumference and blood pressure. Self-reported HRQoL was measured using a 15D questionnaire. A BDI-21 inventory was used to assess the presence of self-reported depressive symptoms.
Lifestyle factors (nutrition, exercise, smoking and alcohol use) were examined with a structured questionnaire. Each lifestyle item was valued as −1, 0 or 1, depending on how well it corresponded to the recommendations. Based on the index the participants were divided into three lifestyle sum tertiles: I = unhealthy, II = neutral and III = healthy. The age- and sex-adjusted linear trend between the tertiles was tested.
Results: The 15D score had a positive linear relationship with the lifestyle tertiles (P = .0048 for linearity, age- and sex-adjusted). Respectively, self-reported depressive symptoms were less frequent among subjects with a healthier lifestyle (P = .038).
Conclusions: People who are expected to strive most to change their lifestyle have the lowest quality of life and psychological welfare, which should be taken into account in both clinical work and health promotion.
Scand J Public Health 1403494813504837, first published on September 18, 2013 as doi:10.1177/1403494813504837.
- Jorma Savolainen1,2
- Hannu Kautiainen6
- Juhani Miettola1
- Leo Niskanen3,4
- Pekka Mäntyselkä5,6
1Institute of Public Health and Clinical Nutrition, Primary Health Care, School of Medicine, University of Eastern Finland, Kuopio, Finland
2Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
3University of Eastern Finland, Faculty of Health Sciences, School of Medicine, Kuopio, Finland
4Finnish Medicines Agency Fimea
5Institute of Clinical Medicine, General Practice, University of Turku, Finland
6Unit of Primary Health Care, Turku University Hospital, Turku, Finland
- Jorma Savolainen, Institute of Public Health and Clinical Nutrition, Primary Health Care, School of Medicine, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland. E-mail: firstname.lastname@example.org
One of the quickest ways to determine whether you are experiencing symptoms of mental health is to take a screening test. Here’s a short survey that’s completely anonymous and may alert you to symptoms of Bi-Polar Disorder, Depression, Anxiety or PSTD.
Check it out at Mental Health America.
Taking a screening test is one of the quickest and easiest ways to determine whether you are experiencing symptoms of a mental health condition. The M3 screening test on this site is completely anonymous and confidential.
The 3 Minute Test tests for Depression, Anxiety, Bipolar Disorder and PTSD. These are serious conditions that affect, not only your quality of life, but your physical health.
Did you know that having a mood disorder may increase your heart attack risk and decrease your ability to recover from other illnesses like stroke, diabetes, multiple sclerosis and cancer?
Your M3 score is a number that will help you and your doctor understand if you have a treatable mood disorder, like depression, anxiety, bipolar disorder, or post-traumatic stress disorder.
What’s my M3? Knowing can help you take control of your mental health, and you can discover yours in about three minutes with our free, confidential test.
– See more at: http://www.mentalhealthamerica.net/llw/depression_screen.cfm#sthash.M9Kh99Jk.dpuf
The widespread belief that dopamine regulates pleasure could go down in history with the latest research results on the role of this neurotransmitter. Researchers have proved that it regulates motivation, causing individuals to initiate and persevere to obtain something either positive or negative.
The neuroscience journal Neuron publishes an article by researchers at the Universitat Jaume I of Castellón that reviews the prevailing theory on dopamine and poses a major paradigm shift with applications in diseases related to lack of motivation and mental fatigue and depression, Parkinson’s, multiple sclerosis, fibromyalgia, etc. and diseases where there is excessive motivation and persistence as in the case of addictions.
“It was believed that dopamine regulated pleasure and reward and that we release it when we obtain something that satisfies us, but in fact the latest scientific evidence shows that this neurotransmitter acts before that, it actually encourages us to act. In other words, dopamine is released in order to achieve something good or to avoid something evil”, explains Mercè Correa.
Studies had shown that dopamine is released by pleasurable sensations but also by stress, pain or loss. These research results however had been skewed to only highlight the positive influence, according to Correa. The new article is a review of the paradigm based on the data from several investigations, including those conducted over the past two decades by the Castellón group in collaboration with the John Salamone of the University of Connecticut (USA), on the role of dopamine in the motivated behaviour in animals.
The level of dopamine depends on individuals, so some people are more persistent than others to achieve a goal. “Dopamine leads to maintain the level of activity to achieve what is intended. This in principle is positive, however, it will always depend on the stimuli that are sought: whether the goal is to be a good student or to abuse of drugs” says Correa. High levels of dopamine could also explain the behavior of the so-called sensation seekers as they are more motivated to act.
Application for depression and addiction
To know the neurobiological parameters that make people be motivated by something is important to many areas such as work, education or health. Dopamine is now seen as a core neurotransmitter to address symptoms such as the lack of energy that occurs in diseases such as depression. “Depressed people do not feel like doing anything and that’s because of low dopamine levels,” explains Correa. Lack of energy and motivation is also related to other syndromes with mental fatigue such as Parkinson’s, multiple sclerosis or fibromyalgia, among others.
In the opposite case, dopamine may be involved in addictive behaviour problems, leading to an attitude of compulsive perseverance. In this sense, Correa indicates that dopamine antagonists which have been applied so far in addiction problems probably have not worked because of inadequate treatments based on a misunderstanding of the function of dopamine.