Mar
01
2005

Magnetic Therapy For Depression

Depression is a psychiatric condition, which is experienced by a lot of people. It is more than just a transient feeling of the “blues”. Depression can be a chronic and disabling disease, and in severe cases there is the risk of suicide. Great advances have been made from removing the social stigma from psychiatric illness, and cognitive therapy and effective medications can help most the patients to lead full and productive lives.
For a few patients however, depression can be drug-resistant and as a result, effective therapy will be much more difficult.
According to research by Dr. Gary Hasey at Mc Master University in Hamilton, Canada, magnets may have a future role in the treatment of mood disorders. TMS (standing for transcranial magnetic stimulation) has shown promising results in the treatment of some types of depression. A so far unpublished study found that 27% of 50 patients with drug -resistant depression achieved full response with TMS.

Simulated treatment in a control group did not produce this result in any of the patients. MRI scans have shown that depressed people have below-average brain activity in the frontal cortex of the brain. A magnetic field, which is created by passing an electric current through a hand-held magnetic coil, is aimed at the patient’s pre-frontal cortex, which stimulates the brain activity in this area. This treatment is vastly different from the well-known electro-shock treatment (ECT), where the patient needs sedation and close observation in a hospital setting. Contrary to this, TMS can be done without sedation.

Magnetic Therapy For Depression

Magnetic Therapy For Depression

The patient is conscious and can resume his normal activities after the treatment. The therapy was first discovered in the 1980’s, but a lot of research had been necessary before treatment could be made available. Other trials are also running in Great Britain, and promising results have been published in the medical paper “The Lancet”. Dr. Hasey cautions that there are still some details that have to be worked out. In the meantime Health Canada has approved TMS as treatment for drug-resistant depression.

More information about depression: http://nethealthbook.com/mental-illness-mental-disorders/mood-disorders/depression/

Reference: The Medical Post, February 1,2005, page 28

Last edited October 27, 2014

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Mar
01
2005

Metabolic Syndrome Threatens Mental Functioning

It used to be called syndrome of hyperinsulinism or syndrome X, but in the meantime the term Metabolic Syndrome stands for a derailment of the metabolism, which manifests itself in excessive weight, type 2 diabetes, high blood pressure and inflammatory processes in the body. The condition, which is largely preventable by healthy lifestyle choices, also paves the way for heart disease, stroke, arthritis and some cancers.
A study from the University of California at San Francisco by Dr. Kristine Yaffe points to yet another health problem that results from the metabolic syndrome and which mars the “golden years” of a large number of seniors: lack of cognitive function, short term memory loss, and forms of dementia.
The study was based on 2632 participants with an average age of 74 years. The likelihood to develop cognitive impairment was 20% higher in those participants of the study who had metabolic syndrome. Things were getting worse, if patients had metabolic syndrome and laboratory tests showed high inflammation with elevated blood levels of interleukin 6 and the C- reactive protein test: the likelihood to develop cognitive impairment rose to 66%.

Metabolic Syndrome Threatens Mental Functioning

Metabolic Syndrome Threatens Mental Functioning

So much for the bad news. The good news, however, is that lifestyle can be a powerful armor in the prevention of disability and disease.

Reference: The Medical Post, January 25,2005, page 45

Last edited October 27, 2014

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Dec
01
2004

Alzheimers Now Detected Early

A combined American and Swedish Research team has described the compound “Pittsburgh compound-C” (for short PIB), that glues itself onto amyloid plaques in the brains of Alzheimer’ patients. This gluey substance is responsible for the symptoms of dementia that plague the patients. These plaques can be detected by positron emission tomography, a test that is known as PET scan.
This may sound very high tech, but the significance of this is great: it allows researchers to look how Alzheimers begins, shows the progression and also demonstrates how effective drugs are at slowing down or reversing the disease. Dr. Klunk and his colleagues who share the research, note that it is possible to identify patients at high risk of early onset as much as ten years before symptoms of the disease show up. This is now even more critical as several new treatments for Alzheimers are being tested. Also as future medicines become available that work by preventing amyloid deposition, these early testing methods will be of utmost importance.

Reference: National Review Of Medicine, November 15,2004, page 15

Alzheimers Now Detected Early

Alzheimers Now Detected Early

See also the following links regarding Alzheimers:

1. Diagnosis of Alzheimer’s: http://nethealthbook.com/neurology-neurological-disease/alzheimers-dementia-and-delirium/alzheimers-disease-diagnosis/

2. Link About the Pittsburgh compound and PET scanning

Last edited October 27, 2014

Feb
01
2004

Low Testosterone Linked To Alzheimers

A recent publication in the medical journal Neurology by Dr. Susan Resnick revealed a surprise link between a lack of testosterone and Alzheimer’s disease.

574 men from the Baltimore Longitudinal Study of Aging who had been followed for about 19 years were analyzed with respect to hormonal factors and their neurological status was also observed. Of these men who ranged in age from 32 to 87 years initially 54 were diagnosed with Alzheimers disease.

When the researchers looked at the hormone status of the men whose mental functioning stayed stable versus those who developed Alzheimers, it was clear that the height of the free testosterone level in the blood (expressed by dividing testosterone by the sex hormone-binding globulin) was a significant predictor for not getting Alzheimers. In other words, if men could maintain a stable level of free testosterone with aging they were significantly protected from Alzheimers disease. The effect was so marked that the blood test could predict 10-years in advance whether a man would develop Alzheimers in future or not. There was a 26% reduction in the risk of Alzheimers with each 10-unit increase in free testosterone.

The same edition of Neurology contains a second report by Dr. Gian Benedetto Melis and coworkers (University of Cagliari, Italy) where around 100 patients (males and females) with Alzheimers were compared with a similar number of patients without Alzheimers. All of their body mass index was in the normal range (20 to 22). These researchers found that the Alzheimers group (both male and female) had an extremely high sex hormone-binding globulin.

Low Testosterone Linked To Alzheimers

Low Testosterone Linked To Alzheimers

The testicles in males and the adrenal glands in males and females can produce testosterone. Dr. Resnick remarked that free testosterone can enter the brain tissue (via the blood brain barrier) easily and act directly on the brain or can be converted to estrogen. Estrogen has been shown in other studies to have a protective effect against Alzheimers. Dr. Resnick cautioned that another study where males with low testosterone levels are getting testosterone supplementation has to be done first before a male should be advised to get treated with testosterone for prevention of Alzheimers disease.

This article is based on a publication by Dr. Resnick et al. in Neurology 2004;62:188-193,301-303.

Comments: It is interesting to note that the “old fashioned” remedies such as weight loss, exercise (particularly anaerobic exercises such as weight training) and a low glycemic diet will naturally increase testosterone levels and vitality in both sexes. A comprehensive program such as the zone diet (by Dr. Barry Sears) or a similar such low glycemic program when combined with exercise will automatically make you lose weight down to a normal body mass index and allow you to maintain it without hunger pangs. It will also normalize hormones in most people on its own as previously elevated insulin levels normalize and the sex hormone-binding globulin will normalize as well. This will make the necessary hormones available to you whether female or male, will prevent osteoporosis (from exercise) and provide enough hormones before and after menopause or andropause to most people. Only a minority of patients will need to get blood tests from their doctors depending on symptoms and those need to seek medical advice to see whether they might benefit from bioidentical hormone replacement therapy.

Further information can be found here: bioidentical hormone replacement.

Last edited October 26, 2014

Oct
02
2003

Schizophrenia Gene Discovered

In the not too distant future new tests and new anti-psychotic drugs (“designer drugs” rather than “trial and error drugs”) for schizophrenia will likely be developed in the US because of the following new findings.

At the 19th International Congress of Genetics in Melbourne/Australia (July 2003) the Nobel Prize laureate Dr. Susumu Tonegawa, who had won the 1987 Nobel Prize for Medicine, reported about his new discovery of a gene that controls schizophrenia. This has already been studied extensively in mice by the research team that he is heading (from the Howard Hughes Medical Institute of Technology (MIT) in Cambridge/Mass).

Together with other colleagues from other Centers (Duke University, Rockefeller University and Columbia University College of Physicians and Surgeons) they have developed an animal model, a “schizophrenic mouse”, that is defective for the schizophrenia gene. Researchers had found that an enzyme called “calcineurin” was missing in schizophrenic families where genetic defects could be located in one particular gene. Subsequently this type of gene was also shown to be important for the normal brain metabolism in mice. The detection of a mouse model for schizophrenia has made it much easier to do ground-breaking research in the field of schizophrenia. Dr. Tonegawa said that the existing drugs for schizophrenia were developed by trial and error. In some patients these drugs do not work, in many others they have serious side-effects. He stated further that in future there will be a new class of anti-psychotic drugs with minimal side-effects as they will specifically normalize the calcineurin production.

Schizophrenia Gene Discovered

Anti-psychotic designer drugs

This in turn will normalize the derailed brain metabolism. In schizophrenics it is in this area where the psychotic behavior originates due to a lack of normal calcineurin production. This enzyme is found not only in brain tissue, but also in immune cells such as the T lymphocytes throughout the body. Because of this connection a future modern treatment for schizophrenia will likely normalize the brain metabolism, but also have beneficial effects on the entire immune system.

Here is a link to a review of schizophrenic disorders

Last edited October 26, 2014

 

Jul
01
2003

Food And Mood

“Food affects your mood” is the heading of an article by Dr.Susan Biali (practising family physician with a degree in dietetics) in the June 24, 2003 edition of The Medical Post (page 24). According to her there is good evidence in the medical literature to indicate that a number of biologically active brain hormones depend on what we eat. There are 5 major items that she pointed out, which I summarized below in tabular form.

The medical literature points to the importance of these various food factors to allow us to have a balanced brain metabolism. When these ingredients are present our mood is more likely to be normal with more resilience to depression.

The literature centers around various population groups in comparison with the North American population. For instance, in an article of the Dec. 2000 issue of Psychiatric Clinics of North America a study was reported that found that Taiwanese and Chinese people consume a lot more omega-3 fatty acid rich foods such as fish than North Americans.

In the same study the rate of major depression was found to be 10-times more frequent in North Americans and the investigators felt that this was so because of the brain hormone stabilizing effect of the omega-3 fatty acids. Other researchers suggest that chronic stress might lead to a depletion of omega-3 fatty acids in the brain through an oxydation process, which eventually results in depression.

Food And Mood

Food And Mood

Several nutritional factors appear to have caused deficiency states of essential brain nutrients, one being the junk foods like candy bars, French fries, hamburgers etc. leading to a dysbalance of the omega-6 fatty acid to omega-3 fatty acid ratio. Another factor is the increase of consumption of highly refined carbohydrates (sugar and starch), often also called high glycemic foods. This is known to lead to the metabolic syndrome, also called syndrome of insulin resistance. Finally many people still have too much fat in their diets with a high amount of hydrogenated vegetable oils (see link). It is also important to note that folate, Vit. B6 and Vit.B12 are required for prevention of hardening of the arteries by lowering homocysteine levels.

Brain food components that affect your mood
Food item: Comments:
omega-3-fatty acids Chinese and Taiwanese eat much more of these and have 10 times less depression than North Americans
DHA, a long-chain omega-3-fatty acid our daily intake is 100mg less per day than 50 years ago due to our diet being based on commercial livestock; lack of DHA leads to depression
too much
omega-6-arachidonic acid in “junk foods”
ratio of
omega-6 to omega-3 arachidonic acid has increased from fast food consumption; this
leads to depression
folate and Vit.B12 deficiency associated with depression
tryptophan
an essential amino acid that is needed to make serotonin, a brain hormone without
which we experience depression

So what is “brain food” ? Dr. Biali pointed out in her article that it is always best to start with a low fat, well balanced food plan where junk foods are avoided and where vegetables and fruit provide the low to medium glycemic index carbohydrates. Fish should be eaten at least three times per week to provide the brain with the essential omega-3 fatty acids.

It is probably not recommendable to take tryptophan as a supplement: in 1989 several fatalities occurred from impurities in commercial tryptophan and many researchers are concerned about dysbalancing the network of brain hormones by giving an overdose of only one amino acid, but not giving enough of the others. It is much safer to simply eat enough protein (meat, soy protein, milk products) and the body can pick and choose what it needs in terms of amino acids including tryptophan. With folates one needs to be careful not to exceed 0.8 mg per day as with mega-doses of folate in the 15 mg range toxic symptoms of vivid dreams, disturbed sleep patterns and even occasional seizures developped. A good multivitamin supplement will not only provide the right folate dose, but also Vit. B12, which is also needed to prevent depression.

Last edited December 9, 2012

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Jun
01
2003

Genetic Link Found For Bipolar Disorder

A staff psychiatrist at the Dalhousie Medical School in Halifax (Novia Scotia, Canada) has gathered 1100 DNA samples and psychiatric histories from patients with bipolar disorder and family members who do not have this psychiatric disease. Dr. Martin Alda, The Medical Post reports on page 46 of the May 20, 2003 edition, and his medical team were able to identify 4 areas of interest on chromosomes 15, 7, 6 and 21 where molecular markers for bipolar disease were located.

Two additional tools, namely responders to lithium (common bipolar disease stabilizer) and certain ethnic group differences, are being utilized as well. Dr. Alda has already found that unstable genes can be stabilized in the presence of lithium. By studying the genes involved in the expression of bipolar disorder and defining what triggers a depressive response and what triggers a manic episode, the researchers hope to unravel the mysteries that still surround this intriguing disease. Dr. Alda is also studying the connection of diabetes and biploar disease. Patients with biploar disease are 3 times more prone to diabetes than the general population. As these patients (bipolar patients with diabetes) are poor responders to lithium, there is a suggestion that perhaps the newly defined genetic loci are blocked in some way by the hormone changes in diabetics. Further investigations in this direction are planned by the research group.

Genetic Link Found For Bipolar Disorder

Genetic Link Found For Bipolar Disorder

Link to bipolar disorder: http://nethealthbook.com/mental-illness-mental-disorders/mood-disorders/bipolar-disorder/

Link to diabetes:

http://www.nethealthbook.com/articles/hormonalproblems_diabetesmellitus.php

Last edited October 26, 2014

May
01
2003

Bipolar Disorder In Children And Teens Different From Adults

Bipolar disorder used to be called “manic-depressive illness” in the past, now it is termed “bipolar disorder”. It is a multifaceted mental illness where subtle changes in the mix of brain hormones can lead to periods when the patient is euphoric, manic or even psychotic (manic episode), but at other times it seems that someone “pulled the plug”, so to speak, and the patient is depressed, lethargic and perhaps even suicidal.

To complicate matters even further,and this was the subject of a recent seminar at the Child and Health Resource Institute in London/Ontario, symptoms in children and teens are often completely different from symptoms in adults. This can be very misleading to the healthcare workers and the immediate family members. It can also delay the diagnosis and appropriate treatment of bipolar disorder. The Medical Post in its April 1, 2003 edition (page 54) published a review of this topic, based on a presentation by Dr. Margaret Steele at this seminar in London/Ont. Dr. Steele is a child psychiatrist of the University of Western Ontario.

Dr. Steele explained that bipolar disorder is relatively rare in children and adolescents. About 0.5% or less of children in pre-puberty and about 1% of adolescents are affected. But these children/adolescents usually have a family history of either bipolar disorder or depression. 20% of adults with bipolar disease experienced their first episodes of the disease during the teen years.

Bipolar Disorder In Children And Teens Different From Adults

Bipolar Disorder In Children And Teens Different From Adults

Below is a summary of her findings with regard to depressive symptoms in children/teens when compared to adults in tabular form.

Comparison Of Symptoms Of Depression In Bipolar Disorder Patients Depending On Age
Adult Symptoms:
Symptom Presentation In Children/Teens:
depressed mood irritability is more common; normally easy-going, but suddenly being oppositional and grouchy
anhedonia (difficulty to think positive and enjoy living) “I am bored” may be the only comment, retreating into a shell
sleep disturbance, mostly insomnia (problems sleeping) they may have the opposite, namely hypersomnia (sleeping too much and too long); this may cause problems when they sleep in during the week or they fall asleep in school
appetite disturbance (usually associated with weight loss) young children fail to grow and gain weight; adolescence may crave junk foods (sugar and starch) and overeat
lethargy in children a decrease in concentration may only become evident as a decrease in school performance (slipping marks)
psychomotor agitation or retardation these symptoms are similar in both adults and children, may be evident as pacing, fighting (agitation) and as “laziness”, moving slowly (retardation)
Suicidal thoughts
or behavior
similar in adults and children, but could be more concealed at a younger age (see below)
hopelessness when asked “what do you see in the future?” an answer like “I see nothing at all, I have no goals” could indicate hidden suicidal thoughts
masked depressive symptoms younger children may have temper tantrums, which would be out of character from their normal behavior; adolescents may “act out”
somatic complaints adolescents present with headaches and other physical symptoms (e.g. abdominal pain etc.) meaning a “screen of mood” should be done

The other part of the equation of bipolar disorder is mania. Different names are used for this hyperactive state of the mind depending on how severe it is: ‘hypomania’ for the lower end, ‘mania’ for an abnormally elevated and expansive mood lasting for at least 1 week. The most severe form of mania is a ‘manic psychosis’ where the person is “completely out of it” and needs to be hospitalized. Again there are some differences of how a manic episode is expressed in children/teens when compared to adults. Dr. Steele covered this in the seminar mentioned above as well and I have summarized the findings in tabular form again as follows.

Child psychiatrists are most familiar with assessing whether a child or adolescent has bipolar disorder. Apart from symptoms being quite variable as mentioned above, there are also lower-key versions of bipolar disorder.

A milder, scaled down version of a manic episode is called ‘hypomania’ as explained above and when expressed in bipolar disease this can lead to ‘bipolar II disorder’. In 60% of adolescents with bipolar disease a ‘mixed bipolar episode’ can be diagnosed. Typically, in these cases the teenager would have depressive symptoms in the morning (feeling low energy, feeling terrible etc.), but later in the day after school would get revved up having problems winding down at night. Often such behavior is very stressful for the parents, particularly as bipolar disorder is running in families and one of the parents may have established bipolar disorder that is being treated.

The reason for including this overview here is that many parents may recognize some symptoms in their offspring that warrant a closer look by a child psychiatrist. By diagnosing this condition early and treating it, these children and teens can have a normal life and prevent a lot of needless suffering and danger.

Click for links about bipolar disorder , depression and watch for suicide.

Manic symptoms in bipolar disorder patients depending on age
Manic symptoms in adults: Manic symptoms in children/teens:
inflated self-esteem elevated, irritable mood; it is beyond being giddy and silly, which many teens normally display; children may say that they are ‘Spiderman’, it can be difficult to separate from normal play, but on further questioning manic children have racing thoughts and hear voices (delusions), which normal children do not have
racing thoughts, often detected in conversation as ‘flight of ideas’ racing thoughts express themselves more as ‘distractibility’; a child might pick up a toy, drop it after a short time and suddely play with something else
pressured speech increased chattiness
excessive pursuit of activities that are potentially harmful (speeding in car, excessive drinking or drugs, risk taking in the stock market, etc.) risk taking expressed differently: kids might steal despite never having done this before; manic children may exhibit sexual behavior such as flirtatious behavior, etc.
medical conditions may mimic symptoms of mania (e.g. diabetes out of control) side-effect of oral corticosteroid therapy for asthma can lead to a psychosis and mimic a manic episode

Child psychiatrists are most familiar with assessing whether a child or adolescent has bipolar disorder. Apart from symptoms being quite variable as mentioned above, there are also lower-key versions of bipolar disorder.

A milder, scaled down version of a manic episode is called ‘hypomania’ as explained above and when expressed in bipolar disease this can lead to ‘bipolar II disorder’. In 60% of adolescents with bipolar disease a ‘mixed bipolar episode’ can be diagnosed. Typically, in these cases the teenager would have depressive symptoms in the morning (feeling low energy, feeling terrible etc.), but later in the day after school would get revved up having problems winding down at night. Often such behavior is very stressful for the parents, particularly as bipolar disorder is running in families and one of the parents may have established bipolar disorder that is being treated.

The reason for including this overview here is that many parents may recognize some symptoms in their offspring that warrant a closer look by a child psychiatrist. By diagnosing this condition early and treating it, these children and teens can have a normal life and prevent a lot of needless suffering and danger.

Click for links about bipolar disorder , depression and suicide prevention.

Last edited October 25, 2014