Posts Tagged ‘natural cures for depression’

Major depression may lead to Cardiovascular disease in older adults

Sunday, December 4th, 2011

Major depressive disorder (MDD) may lead to cardiovascular disease (CVD) in older adults, new research suggests.

Omega3 EPA is effective to treat medium to severe depression as well as that it offers unique cardio protective benefits

In secondary analysis of the Mechanisms and Outcomes of Silent Myocardial Ischemia (MOSMI) study, which included almost 900 participants with a mean age of 60 years, those with MDD showed a significantly slower short-term heart rate recovery time after exercising than their nondepressed counterparts.

According to the investigators, this delayed ability to return to a normal heart rate can be a powerful tool for predicting CV events and mortality.

“The delayed rate indicates a dysfunctional biological stress system, or a dysfunctional ‘flight or fight response,’ and we believe this can contribute to an increased risk for heart disease,” senior author Simon Bacon, PhD, codirector of the Montreal Behavioral Medicine Center and associate professor in the Department of Exercise Science at Concordia University, Montreal, Quebec, Canada,

The researchers note that the study’s results reinforce findings from previous research suggesting that those who suffer from MDD should be tested for CVD.

“Both of these health issues should be treated to minimize risk of severe consequences,” said Dr. Bacon.

The study was published in the November issue of Psychophysiology.

Dysfunctional Fight or Flight Response

According to the investigators, previous studies suggest that individuals suffering from depression may be twice as likely to suffer a heart attack as those who are not depressed.

In addition, a recent study reported  found that depression and previous suicide attempts were significant predictors of heart disease mortality in young adults.

“There have been 2 competing theories as to why depression is linked to CVD,” said lead author Jennifer Gordon, PhD candidate from the Psychology Department at McGill University in Montreal, in a release.

“Depressed people may have poorer health behaviors, which in turn lead to heart problems. The other possibility is physiological: a problem with the fight or flight response.”

In other words, it may be that people with depression have an autonomic nervous system (ANS) imbalance. The investigators note that heart rate variability is often used as a measure of ANS dysfunction.

“Our study is the first to examine the role of a dysfunctional fight or flight response in depression in a large population,” said Dr. Gordon.

The MOSMI trial was created to examine risk factors for silent ischemia and its effect on CV outcomes. For this analysis, the investigators evaluated data on 886 MOSMI participants (68.8% men; mean age, 60 years) who underwent a 2-day exercise stress test using a treadmill and a single photon emission computed tomography imaging protocol.

While at rest, at peak exercise point, and at 1 and 5 minutes postexercise, the participants had their heart rate and systolic and diastolic blood pressures measured.

The Primary Care Evaluation of Mental Disorders and Beck Depression Inventory II (BDI-II) were also administered to all patients, along with a questionnaire on sociodemographic data and medical history, including depressive symptoms and medication usage.

Slower Heart Rate Recovery

Overall, 5.8% of the participants were found to have MDD. These patients had a significantly slower heart rate recovery time at the 1-minute postexercise checkpoint compared with those who were not depressed (adjusted difference, 3.7 beats per minute; P = .026).

However, there were no significant differences between the 2 groups in heart rate recovery time at the 5-minute postexercise checkpoint.

“The classic fight or flight response is very adaptive over time. This means the system is easily activated but can also quickly shut itself off after a stress is removed. So it wasn’t surprising to see that the depressed patients’ heart rates were still quite elevated at the earlier mark, and not at the later mark,” Dr. Bacon said.

There were no significant between-group differences in either systolic or diastolic blood pressure recovery at either time.

In addition, BDI-II scores were found to not be predictive of CV recovery, suggesting that “subclinical levels of depression are not as reliably associated with ANS dysfunction,” write the researchers.

“This may explain some of the variance in previous studies examining the relation between depression and exercise recovery.”

Dr. Bacon said that overall, he would recommend that mental health clinicians who see patients with MDD should think about how the disorder affects other physical elements, and that cardiologists should consider asking about the mental health status in their heart patients.

“The key element here is to make sure these different disciplines have a little more awareness of what’s happening with the patient. Ultimately, what we want to do is make people’s lives better.”

Screening Essential

“There’s been a long-term interest in whether the autonomic dysregulation that people have found with depression could be the cause of both the development of heart disease and a worse prognosis in those with comorbid depression and heart disease,” Wayne Katon, MD, professor and vice chair in the Department of Psychiatry and Behavioral Sciences at the University of Washington Medical School in Seattle, told Medscape Medical News.

“This study is better than some of the other past studies because it measured major depression (not just depressive symptoms) and both long- and short-term return to normal heart rate. And they controlled for exercise capacity,” said Dr. Katon, who was not involved with this research.

He noted that most people with MDD have less exercise capacity, probably because the disorder is associated with an increased sedentary lifestyle.

“Many people with depression have inadequate treadmill tests. But this study used a type of test that was set up for people who were older and more sedentary. So they probably didn’t have to deal so much with people giving up and quitting before a good read could be recorded,” said Dr. Katon.

“Of course the study findings will need to be replicated, but it does suggest that depression is associated with at least short-term decreased ability of the heart to return to a normal rate.”

The main takeaway of this study, said Dr. Katon, is that patients with CVD should be screened for depression.

“We routinely screen for diabetes and other medical conditions because they worsen prognosis. Because there’s excellent evidence that depression also worsens prognosis, we should be screening for it,” he said.

“We’re also finding a bidirectionality between depression and chronic medical illness. So certainly screening our aging population for depression in general is important. And treating it better is essential.”

The study was supported by grants from the Heart and Stroke Foundation of Quebec and the Canadian Institutes of Health Research, and from the Canadian Hypertension Society

A study of the safety and harms of antidepressant drugs for older people: a cohort study using a large primary care database

Thursday, October 20th, 2011

he aim of this study was to establish the relative safety and balance of risks for antidepressant treatment in older people.

The cohort study included 60,746 patients aged 65 years and over diagnosed with depression. The study was based in 570 general practices in the UK supplying data to the QResearch database.

The study objectives were to:

* determine relative and absolute risks of predefined adverse events in older people with depression, comparing classes of antidepressant drugs:
o tricyclic and related antidepressants (TCAs)
o selective serotonin reuptake inhibitors (SSRIs)
o monoamine oxidase inhibitors (MAOIs)
o other antidepressants
o commonly prescribed individual drugs with non-use of antidepressant drugs
* directly compare the risk of adverse events for SSRIs with TCAs;
* determine associations with dose and duration of antidepressant medication;
* describe patterns of antidepressant use in older people with depression; and
* estimate costs of antidepressant medication and primary care visits.

There were 13 predefined outcome measures:

* all-cause mortality
* sudden cardiac death
* suicide
* attempted suicide/self-harm
* myocardial infarction
* stroke/transient ischaemic attack (TIA)
* falls
* fractures
* upper gastrointestinal bleeding
* epilepsy/seizures
* road traffic accidents
* adverse drug reactions
* hyponatraemia

Here’s what the study found:

* The associations with the adverse outcomes were significantly different between the classes of antidepressant drugs for seven outcomes
* SSRIs were associated with the highest adjusted hazard ratios (HRs) for falls [1.66, 95% confidence interval (CI) 1.58 to 1.73] and hyponatraemia (1.52, 95% CI 1.33 to 1.75)
* The group of other antidepressants was associated with the highest HRs for all-cause mortality (1.66, 95% CI 1.56 to 1.77), attempted suicide/self-harm (5.16, 95% CI 3.90 to 6.83), stroke/TIA (1.37, 95% CI 1.22 to 1.55), fracture (1.63, 95% CI 1.45 to 1.83) and epilepsy/seizures (2.24, 95% CI 1.60 to 3.15) compared with when antidepressants were not being used
* TCAs did not have the highest HR for any of the outcomes
* There were also significantly different associations between the individual drugs for seven outcomes, with trazodone, mirtazapine and venlafaxine associated with the highest rates for several of these outcomes
* The mean incremental cost (for all antidepressant prescriptions) ranged between £51.58 (amitriptyline) and £641.18 (venlafaxine) over the 5-year post-diagnosis period.

The authors concluded:

This study found associations between use of antidepressant drugs and a number of adverse events in older people.

There was no evidence that SSRIs or drugs in the group of other antidepressants were associated with a reduced risk of any of the adverse outcomes compared with TCAs; however, they may be associated with an increased risk for certain outcomes. Among individual drugs trazodone, mirtazapine and venlafaxine were associated with the highest rates for some outcomes. Indication bias and residual confounding may explain some of the study findings.

The risks of prescribing antidepressants need to be weighed against the potential benefits of these drugs.

CAC Coupland, P Dhiman, G Barton, R Morriss, A Arthur, T Sach and J Hippisley-Cox. A study of the safety and harms of antidepressant drugs for older people: a cohort study using a large primary care database (PDF). Health Technology Assessment 2011; Vol. 15: No. 28.

Biological mechanism of antidepressant effect of omega-3 fatty acids: how does fish oil act as a ‘mind-body interface’? Neurosignals.

Thursday, August 18th, 2011

Biological mechanism of antidepressant effect of omega-3 fatty acids: how does fish oil act as a ‘mind-body interface’? Neurosignals. 2009;17(2):144-52.
The unsatisfactory results of monoamine-based antidepressant therapy and the high occurrence of somatic symptoms and physical illness in patients with depression imply that the serotonin hypothesis is insufficient to approach the aetiology of depression. Depressive disorders with somatic presentation are the most common form of depression. Somatization, the bodily symptoms without organic explanation, is similar to cytokine-induced sickness behaviour.

Based on recent evidence, omega-3 polyunsaturated fatty acids (n-3 PUFAs, or n-3 fatty acids) are enlightening a promising path to discover the unsolved of depression, sickness behaviour and to link the connection of mind and body.

The PUFAs are classified into n-3 (or omega-3) and n-6 (or omega-6) groups. Eicosapentaenoic acid and docosahexaenoic acid, the major bioactive components of n-3 PUFAs, are not efficiently synthesized in humans and should therefore be obtained directly from the diet, particularly by consuming fish.
Eicosapentaenoic acid is important in balancing the immune function and physical health by reducing membrane arachidonic acid (an n-6 PUFA) and prostaglandin E(2) synthesis, which might be linked to the somatic manifestations and physical comorbidity in depression.
The role of n-3 PUFAs in immunity and mood function supports the promising hypothesis of psychoneuroimmunology of depression and provides an excellent interface between body and mind.

This review is to provide an overview of the evidence about the role of n-3 PUFAs in depression and its common comorbid physical conditions and to propose mechanisms by which they may modulate molecular and cellular functions.
(Synapses and inflammatory/anti-inflam ratios)

Deficiency of Omega 3 fish oil in the diet may explain high rates of depression

Friday, July 15th, 2011

Deficiency of Dietary Omega-3 May Explain Depressive Behaviors
— How maternal essential fatty acid deficiency impact on its progeny is poorly understood. Dietary insufficiency in omega-3 fatty acid has been implicated in many disorders. Researchers from Inserm and INRA and their collaborators in Spain collaboration, have studied mice fed on a diet low in omega-3 fatty acid. They discovered that reduced levels of omega-3 had deleterious consequences on synaptic functions and emotional behaviours.

TakeOmega has the highest levels of EPA per capsule available globally , EPA has been found to be as effective as Prozac in the treatment of medium to severe depression . It is manufactured entirely in the UK and each capsules has over 950mg Omega 3 , other brands are as low as 15% in active ingredients.
Details of this work are available in the online version of the journal Nature Neuroscience.
In industrialized nations, diets have been impoverished in essential fatty acids since the beginning of the 20th century. The dietary ratio between omega-6 polyunsaturated fatty acid and omega-3 polyunsaturated fatty acid omega-3 increased continuously over the course of the 20th century. These fatty acids are “essential” lipids because the body cannot synthesize them from new. They must therefore be provided through food and their dietary balance is essential to maintain optimal brain functions.
Olivier Manzoni (Head of Research Inserm Unit 862, “Neurocentre Magendie,” in Bordeaux and Unit 901 “Institut de Neurobiologie de la Méditerranée” in Marseille), and Sophie Layé (Head of Research at INRA Unit 1286, “Nutrition et Neurobiologie Intégrative” in Bordeaux) and their co-workers hypothesized that chronic malnutrition during intra-uterine development, may later influence synaptic activity involved in emotional behaviour (e.g. depression, anxiety) in adulthood.
To verify their hypotheses, the researchers studied mice fed a life-long diet imbalanced in omega-3 and omega-6 fatty acids. They found that omega-3 deficiency disturbed neuronal communication specifically. The researchers observed that only the cannabinoid receptors, which play a strategic role in neurotransmission, suffer a complete loss of function. This neuronal dysfunction was accompanied by depressive behaviours among the malnourished mice.
Among omega-3 deficient mice, the usual effects produced by cannabinoid receptor activation, on both the synaptic and behavioural levels, no longer appear. Thus, the CB1R receptors lose their synaptic activity and the antioxidant effect of the cannabinoids disappears.
Consequently, the researchers discovered that among mice subjected to an omega-3 deficient dietary regime, synaptic plasticity, which is dependent on the CB1R cannabinoid receptors, is disturbed in at least two structures involved with reward, motivation and emotional regulation: the prefrontal cortex and the nucleus accumbens. These parts of the brain contain a large number of CB1R cannabinoid receptors and have important functional connections with each other.
“Our results can now corroborate clinical and epidemiological studies which have revealed associations between an omega-3/omega-6 imbalance and mood disorders,” explain Olivier Manzoni and Sophie Layé

Omega 3 Fish Oil EPA and DHA reduce anxiety and inflammation in healthy students

Thursday, July 14th, 2011

Omega-3 Reduces Anxiety and Inflammation in Healthy Students,
A new study gauging the impact of consuming more fish oil showed a marked reduction both in inflammation and, surprisingly, in anxiety among a cohort of healthy young people.

The findings suggest that if young participants can get such improvements from specific dietary supplements, then the elderly and people at high risk for certain diseases might benefit even more.
The findings by a team of researchers at Ohio State University were just published in the journal Brain, Behavior and Immunity. It is the latest from more than three decades of research into links between psychological stress and immunity.
Omega-3 polyunsaturated fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have long been considered as positive additives to the diet. Earlier research suggested that the compounds might play a role in reducing the level of cytokines in the body, compounds that promote inflammation, and perhaps even reduce depression.
Psychological stress has repeatedly been shown to increase cytokine production so the researchers wondered if increasing omega-3 might mitigate that process, reducing inflammation.
To test their theory, they turned to a familiar group of research subjects — medical students. Some of the earliest work these scientists did showed that stress from important medical school tests lowered students’ immune status.
“We hypothesized that giving some students omega-3 supplements would decrease their production of proinflammatory cytokines, compared to other students who only received a placebo,” explained Janice Kiecolt-Glaser, professor of psychology and psychiatry.
“We thought the omega-3 would reduce the stress-induced increase in cytokines that normally arose from nervousness over the tests.”
The team assembled a field of 68 first- and second-year medical students who volunteered for the clinical trial. The students were randomly divided into six groups, all of which were interviewed six times during the study. At each visit, blood samples were drawn from the students who also completed a battery of psychological surveys intended to gauge their levels of stress, anxiety or depression. The students also completed questionnaires about their diets during the previous weeks.
Half the students received omega-3 supplements while the other half were given placebo pills.
“The supplement was probably about four or five times the amount of fish oil you’d get from a daily serving of salmon, for example,” explained Martha Belury, professor of human nutrition and co-author in the study.
Part of the study, however, didn’t go according to plans.
Changes in the medical curriculum and the distribution of major tests throughout the year, rather than during a tense three-day period as was done in the past, removed much of the stress that medical students had shown in past studies.
“These students were not anxious. They weren’t really stressed. They were actually sleeping well throughout this period, so we didn’t get the stress effect we had expected,” Kiecolt-Glaser said.
But the psychological surveys clearly showed an important change in anxiety among the students: Those receiving the omega-3 showed a 20 percent reduction in anxiety compared to the placebo group.
An analysis of the of the blood samples from the medical students showed similar important results.
“We took measurements of the cytokines in the blood serum, as well as measured the productivity of cells that produced two important cytokines, interleukin-6 (IL-6) and tumor necrosis factor alpha (TNFa),” said Ron Glaser, professor of molecular virology, immunology & medical genetics and director of the Institute for Behavioral Medicine Research.
“We saw a 14 percent reduction in the amounts of IL-6 among the students receiving the omega-3.” Since the cytokines foster inflammation, “anything we can do to reduce cytokines is a big plus in dealing with the overall health of people at risk for many diseases,” he said.
While inflammation is a natural immune response that helps the body heal, it also can play a harmful role in a host of diseases ranging from arthritis to heart disease to cancer.

Mental Health- Low Omega 3 fatty acid EPA, High ARA Linked to Neuroticism in Healthy Adults

Sunday, July 10th, 2011

The involvement of long-chain polyunsaturated fatty acids (LC-PUFAs) in psychological and psychiatric conditions has attracted considerable attention in the past several years. This is partly because patients with various personality and mental disorders have been reported to have low concentrations of LC-PUFAs, especially those of the omega-3 (n-3) family than people without such conditions, and because treatment with n-3 LC-PUFAs has improved symptoms in several studies. Others have reported associations between low concentrations of n-3 LC-PUFAs in red blood cells or plasma lipids and increased anger, anxiety hostiity and risk of suicide

TakeOmega3 offers 750mg EPA AND 50mg DHA and is the highest concentration of EPA currently available , it is uniquely manufactured in MHRA facilities in the UK and offers the highest concentrations at 85%. This makes this supplement the first choice for health professionals in the treatment of various mental health conditions. www.takeomega3.co.uk.Associations between n-3 LC-PUFAs and mental disorders have been more widely reported than links with n-6 PUFAs, mainly linoleic or arachidonic acids. Thus, it is unclear whether dietary intake or tissue concentrations of n-6 PUFAs are associated with the development of mental disorders or whether they simply reflect the effects of low intakes of n-3 LC-PUFAs. Because arachidonic acid (ARA) and docosahexaenoic acid (DHA) sometimes have opposite effects, imbalances between these LC-PUFAs may contribute to risk.
In the cross-sectional study described here, Sarah Conklin and colleagues at the University of Pittsburgh School of Medicine, USA, determined whether a relationship existed between serum fatty acid concentrations and assessments of depression and neuroticism in 116 healthy volunteers recruited from the community. Participants were between the ages of 30 and 55 years (mean age 45 years) and 43% were male. Study participants were free of clinically apparent chronic diseases, psychotropic, cardiovascular or diabetic medications, fish or flax seed oil supplements and diagnosed mental disorders. All completed the neuroticism NEO Personality Inventory and Beck Depression Inventory assessments to provide information about personality characteristics and depressive symptoms. The investigators focused on neuroticism—the enduring tendency to experience negative emotional states—because its presence increases the risk of depression. Facets of neuroticism include anxiety, angry hostility, depression, self-consciousness, impulsivity and vulnerability. Fatty acids were analyzed in serum phospholipids.

Scores for the Beck Depression Inventory were severely skewed, so the investigators grouped the scores into 2 groups, those with no or minimal symptoms (scores ranging from 0 to 9) and those with mild to moderate symptoms (scores 10-17). The n-3 LC-PUFAs were not normally distributed, so values for eicosapentaenoic acid (EPA) and DHA were transformed logarithmically. Data for ARA and the NEO Inventory were normally distributed. The relationships between phospholipid fatty acid concentrations and scores for the components of neuroticism were analyzed by linear regression, controlling for age, race and gender. Depression scores were analyzed by logistic regression.

In a healthy population, higher EPA concentrations in serum phospholipids were linked to lower to neuroticism scores, a condition predisposing a person to depression. This finding supports other studies linking EPA status to depression and other mood disturbances, mainly in patient populations. However, few studies have assessed neuroticism itself, but have singled out its components, such as depression, anger and anxiety. It is noteworthy that significant associations between low EPA concentrations and 4 of the 6 facets of neuroticism were observed. The positive association between negative mood traits and mild to moderate depressive symptoms with ARA has been observed previously, but less frequently, and metabolites of the ARA cascade are thought to be involved in negative mood disorders.

A higher ratio of ARA to EPA was reported in this study and others, but alterations in both PUFAs could contribute to changes in the ratio, complicating the interpretation of such data. Western diets that provide high intakes of n-6 PUFAs, but relatively small amounts of n-3 PUFAs, especially n-3 LC-PUFAs, would foster higher ratios of ARA to EPA because the denominator is small. For several reasons, ratios of n-6 to n-3 fatty acids are not useful concepts.

Other studies of mood and mental disorders have reported that EPA may be more effective than DHA in treating patients with these conditions. The observation here that serum DHA concentrations were unrelated to neuroticism or depressive symptoms lends indirect credence to these reports. However, without a more detailed understanding of the mechanisms involved in these disorders, it would be premature to conclude that only derangements of EPA metabolism were involved. This point is especially important as DHA and ARA are the primary PUFAs in neuronal membranes and significant DHA deficits in the brains of patients with major depression have been observed.

Conklin SM, Manuck SB, Yao JK, Flory JD, Hibbeln JR, Muldoon MF. High ω-6 and low ω-3 fatty acids are associated with depressive symptoms and neuroticism. Psychosom Med

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