Saturday, July 5, 2014

June 2014


Venlafaxine About as Effective as Estrogen for Menopausal Symptoms


Low-Dose Estradiol and the Serotonin-Norepinephrine Reuptake Inhibitor Venlafaxine for Vasomotor Symptoms


JAMA Internal Medicine

Abstract Conclusions
Low-dose oral estradiol and venlafaxine are effective treatments for VMS in women during midlife. While the efficacy of low-dose estradiol may be slightly superior to that of venlafaxine, the difference is small and of uncertain clinical relevance.


Study Identifies Decreased Dopamine Transmission in Cortex of Patients With Alcoholism


Decreased Prefrontal Cortical Dopamine Transmission in Alcoholism


The American Journal of Psychiatry

Abstract Conclusions  
The results of this study, for the first time, unambiguously demonstrate decreased dopamine transmission in the cortex in alcoholism. Further research is necessary to understand the clinical relevance of decreased cortical dopamine as to whether it is related to impaired executive function, relapse, and outcome in alcoholism.

Link: http://ajp.psychiatryonline.org/article.aspx?articleID=1877641


NIDA Summarizes Research on Negative Health Consequences of Marijuana Use


Adverse Health Effects of Marijuana Use


The New England Journal of Medicine

Conclusions
Marijuana use has been associated with substantial adverse effects, some of which have been determined with a high level of confidence.
Marijuana, like other drugs of abuse, can result in addiction. During intoxication, marijuana can interfere with cognitive function (e.g., memory and perception of time) and motor function (e.g., coordination), and these effects can have detrimental consequences (e.g., motor-vehicle accidents). Repeated marijuana use during adolescence may result in long-lasting changes in brain function that can jeopardize educational, professional, and social achievements. However, the effects of a drug (legal or illegal) on individual health are determined not only by its pharmacologic properties but also by its availability and social acceptability. In this respect, legal drugs (alcohol and tobacco) offer a sobering perspective, accounting for the greatest burden of disease associated with drugs77 not because they are more dangerous than illegal drugs but because their legal status allows for more widespread exposure. As policy shifts toward legalization of marijuana, it is reasonable and probably prudent to hypothesize that its use will increase and that, by extension, so will the number of persons for whom there will be negative health consequences.

Link: http://www.nejm.org/doi/full/10.1056/NEJMra1402309


Antidepressants May Have Role in Preventing Alzheimer's Disease


An Antidepressant Decreases CSF Aβ Production in Healthy Individuals and in Transgenic AD Mice


Science Translational Medicine

Abstract
Serotonin signaling suppresses generation of amyloid-β (Aβ) in vitro and in animal models of Alzheimer’s disease (AD). We show that in an aged transgenic AD mouse model (APP/PS1 plaque-bearing mice), the antidepressant citalopram, a selective serotonin reuptake inhibitor, decreased Aβ in brain interstitial fluid in a dose-dependent manner. Growth of individual amyloid plaques was assessed in plaque-bearing mice that were chronically administered citalopram. Citalopram arrested the growth of preexisting plaques and reduced the appearance of new plaques by 78%. In healthy human volunteers, citalopram’s effects on Aβ production and Aβ concentrations in cerebrospinal fluid (CSF) were measured prospectively using stable isotope labeling kinetics, with CSF sampling during acute dosing of citalopram. Aβ production in CSF was slowed by 37% in the citalopram group compared to placebo. This change was associated with a 38% decrease in total CSF Aβ concentrations in the drug-treated group. The ability to safely decrease Aβ concentrations is potentially important as a preventive strategy for AD. This study demonstrates key target engagement for future AD prevention trials.

Link: http://stm.sciencemag.org/content/6/236/236re4.abstract


Study Finds Differences Between Brain Activity in Youth and Adults With Bipolar Disorder


Developmental Meta-analyses of the Functional Neural Correlates of Bipolar Disorder


JAMA Psychiatry

Abstract Conclusions
Our data suggest that amygdala, prefrontal, and visual system hyperactivation is important in the emotional dysfunction present in BD-youths, as well as that anterior cingulate cortex hypoactivation is relevant to the cognitive deficits in BD-youths. Future studies are required to determine if the developmental fMRI differences between BD-youths and BD-adults identified by our ALE meta-analyses are useful as brain-based diagnostic or treatment markers of BD, including either longitudinal neuroimaging studies of BD-youths as they become adults or cross-sectional imaging studies directly comparing BD-youths with BD-adults.

Link: http://archpsyc.jamanetwork.com/article.aspx?articleid=1878925 



Depression Linked to Higher Risk for Cardiovascular Events In Younger Women with Coronary Artery Disease (CAD)


Sex and age differences in the association of depression with obstructive coronary artery disease and adverse cardiovascular events.
 

JAMA  

Abstract Conclusions  
Among patients with suspected or established coronary artery disease (CAD), depressive symptoms are associated with increased risk of death, particularly in young women. This group may be especially vulnerable to the adverse cardiovascular effects of depression.

Link: http://www.ncbi.nlm.nih.gov/pubmed/?term=ghasemzadeh+shah


Prenatal Exposure to Antidepressants Shows No Cardiac-associated Risk in Offspring, Study Finds


Antidepressant Use in Pregnancy and the Risk of Cardiac Defects


The New England Journal of Medicine

Abstract Conclusions
The results of this large, population-based cohort study suggested no substantial increase in the risk of cardiac malformations attributable to antidepressant use during the first trimester.

Link: http://www.nejm.org/doi/full/10.1056/NEJMoa1312828


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