Research Discovers Pathways for Neurotransmitters

Depiction of a neurotransmitter.

New research showing that the neurotransmitter serotonin uses a special pathway to regulate biological functions could greatly affect future therapies for disorders such as depression and schizophrenia.

The Scripps Research Institute study published in the October 6, 2010 issue of the Journal of Neuroscience contends serotonin has significant influence over control of perception, cognition, sleep, appetite, pain, and mood.

"Our study shows that while both serotonin and hallucinogens act at the serotonin 2A receptor, serotonin utilizes a very specific pathway and its actions are independent of those produced by hallucinogens," says Laura Bohn, an associate professor on the Florida campus of The Scripps Research Institute. "Future drug discovery efforts to identify lead compounds for treatment of depression may consider focusing upon those that only engage that pathway. This work may also lend insight into the mechanisms that underlie the hallucinations that occur in schizophrenia."

This may be particularly important for the treatment of depression because traditional therapies ~ focusing on elevating serotonin levels ~ can sometimes produce serious side effects such as hallucinations, and is especially serious when antidepressants are mixed with monoamine oxidase inhibitors.

Click here for the complete PhysOrg.com article.

Grief is Next Target for Antidepressants

"Grief Out of Darkness into Light" by Jozef Israels (1834-1911)

Advocates of a pharmaceutically mediated society are making strides into yet another area of human experience ~ grief, especially following the loss of a loved one ~ they now consider suitable for treatment with antidepressants.

A recent article from National Public Radio describes the debate stemming from the new draft of psychiatry’s bible, the Diagnostic and Statistical Manual of Mental Disorders, that opens the door for grieving to be considered as major depression and treated accordingly.

On one side are the advocates for treating grief with drugs and therapy:

"I'd rather make the mistake of calling someone depressed who may not be depressed, than missing the diagnosis of depression, not treating it, and having that person kill themselves," says Dr. Sid Zisook, one of the psychiatrists who has argued for removal of the bereavement exclusion. "I mean, [pain] is a normal consequence of breaking a bone. But that doesn't mean that we don't treat the pain. We treat the pain vigorously."

Then there the opponents who see grief as a natural process:

Dr. Allen Frances, the famous psychiatrist and a former editor of the DSM, says that more and more, psychiatry is medicalizing our experiences. That is, it is turning emotions that are perfectly normal into something pathological.

"Over the course of time, we've become looser in applying the term 'mental disorder' to the expectable aches and pains and sufferings of everyday life," Frances says. "And always, we think about a medication treatment for each and every problem."

Advocates say that treating grieving people as depressed will affect about a third of the bereaved.

Click here for the complete NPR article.

Could Depression Be Beneficial?

Engraving entitled 'Melencolia' by Albrect Durer (1471-1528)

Statistics show that between 30 and 50 percent of people in the U.S. and other countries ~ at sometime in their lives ~ meet the psychiatric diagnostic criteria for major depression. The diagnosis has applied to me at times and many people I know, so I have no reason to doubt the statistic.

That’s why I’m interested in the way a few scientists are now approaching the concept of depression. They're considering that it's could be an evolutionary adaptation that has its dire costs, but also can provide benefits.

Here’s some of what Paul Andrews and J. Anderson Thomson say in a recent Scientific American article:

The symptoms of depression have been found in every culture which has been carefully examined, including small-scale societies, such as the Ache of Paraguay and the !Kung of southern Africa ~ societies where people are thought to live in environments similar to those that prevailed in our evolutionary past.

One reason to suspect that depression is an adaptation, not a malfunction, comes from research into a molecule in the brain known as the 5HT1A receptor. The 5HT1A receptor binds to serotonin, another brain molecule that is highly implicated in depression and is the target of most current antidepressant medications. Rodents lacking this receptor show fewer depressive symptoms in response to stress, which suggests that it is somehow involved in promoting depression. (Pharmaceutical companies, in fact, are designing the next generation of antidepressant medications to target this receptor.) When scientists have compared the composition of the functional part rat 5HT1A receptor to that of humans, it is 99 percent similar, which suggests that it is so important that natural selection has preserved it. The ability to “turn on” depression would seem to be important, then, not an accident.

And a bit later:

So what could be so useful about depression? Depressed people often think intensely about their problems. These thoughts are called ruminations; they are persistent and depressed people have difficulty thinking about anything else. Numerous studies have also shown that this thinking style is often highly analytical. They dwell on a complex problem, breaking it down into smaller components, which are considered one at a time.

This analytical style of thought, of course, can be very productive. Each component is not as difficult, so the problem becomes more tractable. Indeed, when you are faced with a difficult problem, such as a math problem, feeling depressed is often a useful response that may help you analyze and solve it. For instance, in some of our research, we have found evidence that people who get more depressed while they are working on complex problems in an intelligence test tend to score higher on the test.

Indeed, they may be on to something. The important thing, it seems to me, is that this offers a new way of looking at the serious situation ~ deserving of further study ~ other than simply administering drugs to dull the mind into stupefaction.

Click here for the Scientific American article.

Meditation Improves Depression Therapy

Using a therapy based on mindfulness meditation techniques, researchers at Oxford University were able to improve the mental condition of people who had suffered major depression and suicidal thoughts.

“We are on the brink of discovering really important things about how people can learn to stay well after depression,” Mark Williams, a professor in Oxford’s Department of Psychiatry, told ScienceDaily. “Our aim is to help people to find long-term freedom from the daily battle with their moods.”

Twenty-eight people currently suffering from depression ~ and with thoughts of suicide ~ were randomly assigned into two groups. One received Mindfulness-based Cognitive Therapy (MBCT) in addition to treatment as usual, while the other received only regular treatment. Treatment with MBCT reduced the number of patients with major depression, while it remained the same in the other group.

The Oxford researchers are carrying out a larger study to compare MBCT with a group form of cognitive therapy to pinpoint which elements of meditation or talking therapies can help which people.

Click here for the ScienceDaily article.

Sleeping Pill Use Soars Among Young

Use of prescription sleep aids has tripled among young adults between 1998 and 2006. A new Thomson Reuters study of medical and drug use has found a 50-percent increase in use of the drugs among all adults under 45, who also appear to be using the sleep aids for a longer period of time to help them fall asleep.

"I find it very worrisome that young people who should have a very strong and healthy sleep system are now finding they are turning to medication to help them get to sleep," Donna Arand, a sleep specialist at Kettering Hospital Sleep Disorder Center in Dayton, Ohio, told Reuters News.

Two-thirds of those in this study population were taking non-benzodiazepine hypnotics ~ such as Sanofi-Aventis' Ambien CR and Sepracor Inc's Lunesta. These newer sleep aids in rare cases can cause sleep walking.

Click here for the complete Reuters article.

Depression/Religion Link Puzzles Researchers

Old Woman at Prayer, by Dutch master Nicholaes Maes, 1656.

In an unexpected twist, a study evaluating health matters in relation to religious activity found that people with higher levels of “religious well-being” also had higher levels of depression.

Then the researchers realized the puzzling finding was likely related to the fact that depressed people often cling tighter to religion, relating more often to God and praying more often than less depressed people.

The study ~ conducted by Harvard and Brown University medical schools as well as the National Institutes of Mental Health and the Society for the Scientific Study of Religion ~ characterized the religiosity of 918 study participants in terms of three domains of religiosity:

• Religious service attendance, referring to being involved with a church.
• Religious well-being, referring to the quality of a person's relationship with a higher power.
• Existential well-being, referring to a person's sense of meaning and their purpose in life.

Researchers were surprised to find that the group with higher levels of religious well-being were 1.5 times more likely to have had depression than those with lower levels of religious well-being.

Researchers also theorize this is because people with depression tend to use religion as a coping mechanism. As a result, they're more closely relating to God and praying more.

"People with high levels of existential well-being tend to have a good base, which makes them very centered emotionally," lead researcher Joanna Maselko told Science Daily. "People who don't have those things are at greater risk for depression, and those same people might also turn to religion to cope."

Maselko admits that researchers have yet to determine which comes first for the depressed people: the depression or being religious.

Click here for the Science Daily article.