Psychiatry News
Inflammation, Psychosis, and the Brain
When the solution to a clinical or scientific puzzle eludes us for more than a century, as with schizophrenia, we need new methods to examine the pathology. If we want to make an impact on the disease we must shift research paradigms and focus on the early detection, early intervention, and new avenues of treatment that address different symptoms of schizophrenia. Immunological and blood-brain barrier (BBB) abnormalities in patients with psychosis have been repeatedly noted. Hundreds of studies of schizophrenic illness in adults have documented immunological abnormalities in these patients, and an increasing number of studies have shown a link between S100b, a marker of BBB function, and schizophrenic illness
Depressive Symptoms Increases Risk of Dementia
Depression may be associated with an increased risk for dementia, although results from population-based samples have been inconsistent. This article examined the association between depressive symptoms and incident dementia over a 17-year follow-up period. During the 17-year follow-up period, 164 participants developed dementia; 136 of these cases were AD. A total of 21.6% of participants who were depressed at baseline developed dementia compared with 16.6% of those who were not depressed. Overall depressed participants had more than a 50% increased risk for dementia and AD.
Efficacy and Safety of Long-Term Fluoxetine Versus Lithium Monotherapy of Bipolar II Disorder
The authors examined the safety and efficacy of long-term fluoxetine monotherapy, lithium monotherapy, and placebo therapy in preventing relapse and recurrence of bipolar type II major depressive episode. Patients at least 18 years old who recovered from their major depressive episode during initial open-label fluoxetine monotherapy were randomly assigned to receive 50 weeks of double-blind monotherapy with fluoxetine at 10–40 mg/day, lithium at 300–1200 mg/day, or placebo. The mean time to relapse was 249.9 days for the fluoxetine group, 156.4 days for the lithium group, and 186.9 days for the placebo group. The hazard of relapse was significantly lower with fluoxetine compared with lithium, and the estimated hazard of relapse with lithium was 2.5 times greater than with fluoxetine suggesting that long-term fluoxetine monotherapy may provide superior relapse-prevention benefit relative to lithium monotherapy after recovery from bipolar II major depressive episode without an increase in hypomanic mood conversion episodes.
A randomised, double-blind, placebo-controlled trial of tropisetron in patients with schizophrenia
Cognitive deficits in schizophrenia are associated with psychosocial deficits that are primarily responsible for the poor long-term outcome of this disease. Auditory sensory gating P50 deficits are correlated with neuropsychological deficits in attention, one of the principal cognitive disturbances in schizophrenia. Our studies suggest that the alpha7 nicotinic acetylcholine receptor (alpha7 nAChR) agonist tropisetron might be a potential therapeutic drug for cognitive deficits in schizophrenia. A randomised, placebo-controlled trial of tropisetron in patients with schizophrenia was performed. A total of 40 patients with chronic schizophrenia who had taken risperidone (2 to 6 mg/day) were enrolled. Subjects were randomly assigned to a fixed titration of tropisetron (n = 20, 10 mg/day) or placebo (n = 20) in an 8-week double-blind trial. In all, 33 patients completed the trial. Tropisetron was well tolerated. Administration of tropisetron, but not placebo, significantly improved auditory sensory gating P50 deficits in non-smoking patients with schizophrenia.
An Aspirin A Day Keeps the Schizophrenia Away
Inflammatory processes may play a role in the pathophysiology of schizophrenia. The aim of this study was to determine the efficacy of adjuvant treatment with aspirin (acetylsalicylic acid) in schizophrenia spectrum disorders. It was shown that aspirin given as adjuvant therapy to regular antipsychotic treatment reduces the symptoms of schizophrenia spectrum disorders. The reduction is more pronounced in those with the more altered immune function. Inflammation may constitute a potential new target for antipsychotic drug development.
Anticonvulsant Medications and the Risk of Suicide, Attempted Suicide, or Violent Death
In 2008, the US Food and Drug Administration mandated warning labeling for anticonvulsant medications regarding the increased risk of suicidal thoughts and behaviors. The decision was based on a meta-analysis not sufficiently large to investigate individual drugs. In this weeks issue of JAMA a cohort study of the risk of suicidal acts and combined suicidal acts or violent death in patients beginning use of anticonvulsant medications compared with patients initiating a reference anticonvulsant drug was performed and suggests that the use of gabapentin, lamotrigine, oxcarbazepine, and tiagabine, compared with the use of topiramate, may be associated with an increased risk of suicidal acts or violent deaths.
Gene mutation may be key to schizophrenia: study
A genetic mutation linked to schizophrenia appears to rupture communication between the two areas of the brain believed to be responsible for memory and may be an underlying cause of the brain disorder, U.S. researchers suggested in a study published on Wednesday.
“Paranoia Strikes Deep”*: MMR Vaccine and Autism
On February 12, 2009, the US Court of Federal Claims issued a trio of long-awaited decisions in its Omnibus Autism Proceeding.1 The 3 were representative cases chosen from more than 5500 pending MMR/autism cases by the Plaintiffs’ Steering Committee. Each presented the theory that the measles-mumps-rubella (MMR) vaccine in combination with thimerosal, a mercury-based ingredient contained in some diphtheria-tetanus-pertussis (DTP), diphtheria-tetanus–acellular pertussis (DTaP), hepatitis B, and Haemophilus influenzae type B (Hib) vaccines, causes autism. In nearly 700 combined pages that reviewed the scientific and epidemiological evidence, all 3 opinions determined that the plaintiffs had not demonstrated a link between these vaccines and autism.
Decreased Hippocampal Volume in Healthy Girls at Risk of Depression
Researchers have documented that the hippocampus is smaller in individuals with depression than in those without. The temporal or causal association of this reduction in hippocampal volume in depression, however, is not known. A study out the Archives of General Psychiatry used magnetic resonance imaging to examine brain structure volume in individuals at high and low familial risk of depression. Compared with individuals at low familial risk of the development of depression, high-risk individuals have reduced hippocampal volume, indicating that neuroanatomic anomalies associated with depression may precede the onset of a depressive episode and influence the development and course of this disorder.
Association Between Cannabis Use and Psychosis
The early use of marijuana increases the risks for schizophrenia, delusions and hallucinations in young adulthood, according to a study published online March 1 in the Archives of General Psychiatry.
The Past, Present, and Future of Medical Marijuana in the United States
On October 19, 2009, the Office of the Deputy US Attorney General issued a memorandum, “
Investigations and Prosecutions in States Authorizing the Medical Use of Marijuana.”1 The memo announced a federal policy to abstain from investigating or prosecuting “individuals whose actions are in clear and unambiguous compliance with existing state laws providing for the medical use of marijuana.” The memo made clear, however, that it did not “legalize marijuana or provide a legal defense to a violation of federal law.” Rather, it was “intended solely as a guide to the exercise of investigative and prosecutorial discretion.”
This article seeks to place the attorney general’s action in historical, medical, and legal context.
Brain Dopamine Receptor Density Correlates With Social Status
People have typically viewed the benefits that accrue with social status primarily from the perspective of external rewards. A new paper in the February 1st issue of Biological Psychiatry, published by Elsevier suggests that there are internal rewards as well.
Long-Chain 
-3 Fatty Acids for Indicated Prevention of Psychotic Disorders
The use of antipsychotic medication for the prevention of psychotic disorders is controversial. Long-chain (omega-3) polyunsaturated fatty acids (PUFAs) may be beneficial in a range of psychiatric conditions, including schizophrenia. A Randomized, double-blind, placebo-controlled trial from the Archives of Psychiatry found that Long-chain -3 PUFAs reduce the risk of progression to psychotic disorder and may offer a safe and efficacious strategy for indicated prevention in young people with subthreshold psychotic states.
Bipolar diagnosis jumps in young children: study
BOSTON (Reuters) - The number of children aged 2 to 5 who have been diagnosed with bipolar disorder and prescribed powerful antipsychotic drugs has doubled over the past decade, according to research released on Friday.The research suggests that while it is still rare to prescribe powerful psychiatric drugs to 2-year-olds, the practice is becoming more frequent.
Cocaine changes how genes work in brain
Prolonged exposure to cocaine can cause permanent changes in the way genes are switched on and off in the brain, a finding that may lead to more effective treatments for many kinds of addiction, U.S. researchers said on Thursday.
Decreased Frontal Serotonin2A Receptor Binding in Antipsychotic-Naive Patients With First-Episode Schizophrenia
Postmortem investigations and the receptor affinity profile of atypical antipsychotics have implicated the participation of serotonin2A receptors in the pathophysiology of schizophrenia. To assess in vivo brain serotonin2A binding potentials in a large sample of antipsychotic-naive schizophrenic patients and matched healthy controls. It was shown schizophrenic patients had significantly lower serotonin2A binding in the frontal cortex than did control subjects suggesting that frontal cortical serotonin2A receptors are involved in the pathophysiology of schizophrenia.
Increased Mortality in Bulimia Nervosa and Other Eating Disorders
American Journal of Psychiatry
Anorexia nervosa has been consistently associated with increased mortality, but whether this is true for other types of eating disorders is unclear. The goal of this study was to determine whether anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified are associated with increased all-cause mortality or suicide. Crude mortality rates were 4.0% for anorexia nervosa, 3.9% for bulimia nervosa, and 5.2% for eating disorder not otherwise specified. All-cause standardized mortality ratios were significantly elevated for bulimia nervosa and eating disorder not otherwise specified; suicide standardized mortality ratios were elevated for bulimia nervosa and eating disorder not otherwise specified.
Doubts on suicide-anti-smoking drug Chantix
Despite earlier health agency warnings, there is no strong evidence that the anti-smoking drug Chantix raises the risk of suicidal thoughts or depression compared to other stop-smoking products, researchers reported Thursday in the British Medical Journal. Back in July of this year, U.S. health officials ordered strong "black box" warnings be added to Chantix (also called varenicline) as well as anti-smoking drug Zyban, following more than five thousand reports of depression, hostility and other behavioral changes possibly associated with use of these drugs.
