Depression

SEATTLE -- Increases in suicide rates in the first month of treatment for depression appear to be unrelated to the use of antidepressants, reported investigators here.

NEW YORK -- Showing evidence of a link between environmental factors and migraine, investigators here found that a higher family income may protect adolescents against migraine -- if they have no genetic predisposition to it.

Your Observations About the Man With the Tripod Sign

A 67-year-old woman arrived via ambulance in ventricular tachycardia. She had been experiencing crushing substernal chest pain and shortness of breath that had worsened over the past several hours. She received oxygen (by mask) and lidocaine (100 mg intravenously) en route to the emergency department (ED), but there was no change in the rhythm.

The diagnostic criteria for major depression are anhedonia, depressed mood, feelings of worthlessness or inappropriate guilt, inability to concentrate, fatigue, insomnia or hypersomnia, psychomotor agitation or retardation, significant weight loss or gain, and recurrent thoughts of death or suicide. Five or more of these symptoms must be present for at least 2 weeks, and one of them must be anhedonia or depressed mood. Conditions that can present with depression include dysthymia, bipolar disorder, cyclothymia, and adjustment disorder. Depression may also result from substance abuse or from the physiological conditions associated with a medical disorder, such as spinal or head injury, AIDS, or cancer.

LONDON -- A program of breathing and relaxation exercises known as the Papworth method eases the symptoms of asthma significantly -- largely without change in underlying lung function, researchers here said.

MINNEAPOLIS -- Selective serotonin reuptake inhibitors (SSRIs) have been linked to decreased bone density in older women and men, according to two related studies.

BOSTON -- Use of selective serotonin-reuptake inhibitors (SSRIs) during the first trimester of pregnancy did not significantly increase the risk of congenital heart defects overall, despite FDA and drug maker warnings to the contrary.

INDIANAPOLIS -- A pilot study suggests that patients with long-standing type 2 diabetes should be evaluated for sleep quality, and in those with sleep problems, pain should be assessed as a major contributor.

INDIANAPOLIS -- More than a third of U.S. adults report problems falling asleep or daytime sleepiness, and lack of sleep is linked to one in five serious motor vehicle accidents.

HONOLULU -- Medicare Part D formularies cover nearly all drug classes for treatment of hypertension, hyperlidemia, and depression, with generics accounting for most of the agents.

HOUSTON -- Psoriasis patients who had extended exposure to high-dose etanercept (Enbrel) responded without increased infections or other serious adverse effects, researchers reported.

CINCINNATI -- For treating the chronic pain and other symptoms of fibromyalgia, the anticonvulsant gabapentin (Neurontin) proved safe and effective, researchers here reported.

CHICAGO -- Mild cognitive impairment is more likely to develop in those who are beset by chronic mental distress than those who worry the least, concluded researchers here.

SEATTLE -- Women whose sexual desire diminishes during menopause are more likely to report disturbed sleep, night sweats, and depression, researchers here reported.

PHILADELPHIA -- Seven out of 10 patients with chronic insomnia never talk with their doctors about it. Instead, they self-medicate with over-the-counter medicines or alcohol.

AMSTERDAM, The Netherlands -- New users who took the street drug Ecstasy for a mean 1.6 months at low cumulative doses showed a decline in verbal recall and recognition.

BOSTON -- Suicidal tendencies that arise in some men who start on the antidepressant citalopram (Celexa) may be linked to genetic mutations, investigators in Boston and Dallas reported.

CHICAGO -- Unless cancer patients have major depression, antidepressants don't seem to do anything for them, Australian researchers have found.

PITTSBURGH -- Adding another drug when older patients don't respond well to an initial course of antidepressants may be of benefit, researchers here suggested.

I am an adult psychiatric nurse practitioner, and a significant part of my practice has been the treatment of subclinical hypothyroidism. Whenever a patient has depression and low energy, I measure free T4, free T3, and thyroid-stimulating hormone (TSH) levels. In most of the subclinical hypothyroidism I have detected, the TSH level is normal. In many cases, the only level that is low is the free T3. When liothyronine is prescribed for these patients, their symptoms of depression and tiredness decrease and their need for antidepressants has, in a few cases, been eliminated.

PHILADELPHIA -- Infrequent bowel movements are not the most common symptom in patients with constipation.

DALLAS -- Mice missing a single key gene in their brain tissue are smarter than the average mouse, researchers say.

PHILADELPHIA -- The most obvious clinical feature of obstructive sleep apnea may be weariness of mind, but this breathing disorder also slowly and silently wears down the heart, according to researchers.

SAN DIEGO -- Young suicide victims were significantly more likely to have SSRIs in their bloodstream than were young homicide or accident victims, investigators reported here.