Depression Needs To Be Treated

Depression is not something you can just ignore and hope it will go away on its own or think that you will just “snap out it”.  Depression is a serious medical condition and needs to be taken seriously.  It is caused by chemical changes or imbalances in the brain coupled with other different factors. Read more

Types of Mood Disorders

There are two categories of mood disorders recognized by the psychiatric community: unipolar and bipolar disorder. Both are a type of depression with the difference being those who suffer bipolar disorder, also known as manic depression, also experience extreme mood swings between depression and episodes of extreme mania or high energy.

The unipolar, or depression, type of mood disorder can further be broken down into the different types of depression which include: Read more

How To Control The Symptoms Of Panic Attacks

The Symptoms

Panic attacks are not uncommon, and are examples of what the medical professional call ‘anxiety disorders’. Would you be able to recognize the symptoms of a panic attack? No? Then let’s have a look at them so you may be able to recognize them.  Mind you, people with some of these symptoms may not necessarily be suffering from panic attacks, so be careful and use your head. Read more

Depression - Symptoms, Causes and Treatment options

Depression is a complex of psychological and physical symptoms. Low mood level or sadness is often the most prominent symptom. The common property of these symptoms is a decreased activity level in parts of the brain.

THE SYMPTOMS OF DEPRESSION

Depression may give one or more of these symptoms: Read more

Depakote, Lithium Shown Effective in Childhood Bipolar

Researchers reported today that a study has shown that Depakote and lithium are effective in helping alleviate bipolar disorder symptoms in children.

In the study, one of the largest of its kind, researchers randomly assigned 153 children to receive a placebo, lithium or divalproex sodium, also known more commonly by its brand name, Depakote.

The results were presented from data obtained after eight weeks from the Pediatric Bipolar Collaborative Mood Stabilizer Trial, which also included a second, 16-week phase. The investigation is the first controlled trial to test and compare lithium and divalproex versus placebo for six months, the largest trial of lithium and divalproex to date and first to demonstrate efficacy for divalproex in children aged 7 to 17 years, diagnosed with bipolar I disorder, mixed or manic, based on standardized criteria.

Many psychiatric medications prescribed for children and adolescents have not been indicated by the FDA for pediatric use. Making sure these drugs are effective and safe has been an important goal of pediatric psychiatry researchers as well as gaining FDA indications for appropriate use in children.

“Divalproex and lithium are the most widely used mood stabilizers for children and adolescents diagnosed with bipolar disorder,” said Robert A. Kowatch, M.D., Ph.D., a child and adolescent psychiatrist specializing in bipolar and other mood disorders at Cincinnati Children’s. “Our study now proves that these agents definitely work, which may give clinicians and families peace of mind.”

At the end of an eight-week treatment phase, patients receiving divalproex significantly decreased their average scores on the study’s primary outcome measure for manic symptom severity, the Young Mania Rating Scale (YMRS).

Fifty-six percent of patients in the divalproex group, 41 percent of those in the lithium group and 30 percent of the placebo group experienced a more than 50 percent
decrease in their YMRS scores.

Also, the response rates on the study’s other primary outcome measure, the Clinical Global Impressions Ratings (CGI) — improvement score, indicated that 54 percent of the divalproex group, 42 percent of the lithium group and 29 percent of the placebo group improved their CGI scores by one or two points.

The National Institute of Mental Health supported the Pediatric Bipolar Collaborative Mood Stabilizer Trial via a five-year grant. In addition to Cincinnati Children’s, other sites involved were Wisconsin Children’s Hospital and Case Western Reserve University.

Neither the investigators nor patients knew to which treatment group the patients were assigned at the end of the eight week treatment phase. Those patients who responded to treatment could continue in the double-blind testing for another 16 weeks.

The classic form of the bipolar illness, also know as bipolar I disorder, is thought to occur in children 6 to 17 years, although its occurrence in children has been the subject of recent controversy within the field.

The estimated annual number of for U.S. youths aged 19 years and younger receiving a diagnosis of bipolar disorder is about 1 percent, based on a 2007 NIH-funded analysis finding bipolar diagnoses occurring during 1,003 physician office-based visits by this age group per 100,000 population.

Symptoms of bipolar disorder include severe, explosive mood swings, euphoria, irritable mood, decreased need for sleep without daytime fatigue, pressured speech that is difficult to interrupt, racing thoughts, distractibility that varies with mood, increased goal-directed activity, hypersexuality and, in some cases, hallucinations. Children with the illness are at increased risk of attempting suicide. Bipolar disorder, like epilepsy, tends to be a lifelong medical condition that can be managed with medication, psychotherapy and lifestyle changes such as stress reduction, regular sleep, accommodations at school and avoidance of caffeine, alcohol and drugs of abuse.

The study was presented today at the annual meeting of the American Academy of Child and Adolescent Psychiatry in Boston.

Miscommunication Challenges ADHD Care

A new study finds that parents of children with attention deficit hyperactivity disorder are concerned with behaviors such as aggression and defiance, while pediatric psychiatrists focus on associated mental health conditions including depression, bipolar and learning disabilities.

The differing perceptions over a child’s most concerning behaviors often lead to miscommunication and a less than ideal situation for patients, parents and medical professionals.

“We found that among the psychiatrists and parents studied, 78 percent provided different responses when asked about the patient’s ‘most concerning behavior,’” said Robert Findling, M.D., lead author and professor of psychiatry at Case Western Reserve University.

“There was a notable incidence of psychiatrist/parent misalignment regarding the patients’ most concerning behaviors, including aggression and defiance.”

The study, designed to capture naturally occurring conversations between psychiatrists, patients with ADHD and their parents, consisted of eleven psychiatrists, thirty-two child and adolescent ADHD patients and their parents.

Half of the patients were younger than 13 years old, and the majority fulfilled the criteria of “complicated ADHD,” which was defined in the study as a patient “having or suspected to have one or more psychiatric comorbidities.”

Physicians classified 81 percent of patients as having one or more psychiatric comorbidities/learning disabilities.

The most common comorbidities greater than 20 percent included: depression (46 percent), oppositional defiant disorder (42 percent), anxiety (38 percent), learning disabilities (35 percent) and bipolar disorder (23 percent).

In post-visit interviews, parents most often reported concern about aggression and defiance; however, these behaviors that parents reported as “most concerning” post-visit were unaddressed in one-third of the visits.

“These results indicate psychiatrists can adopt several techniques to improve in-office communication about complicated ADHD, including structuring visits, so that all voices are heard, discussing comorbidities using language that is more comprehensible to parents, and eliciting parents’ expectations at the initiation of treatment,” said Dr. Findling.

“By focusing on how time is spent and what types of questions are asked of parents and patients, this can lead to successful expectation-setting with both parents and patients. As a result, psychiatrists can have better in-office discussions about ADHD as well as improved treatment of patients suffering from complicated ADHD.”

Source: Porter Novelli

When Someone You Love Has a Mental Disorder

IT STARTED as a typical weekday morning for the Johnsons. The family of four was up and dressed for the day’s activities. Gail reminded her 14-year-old son, Matt, that it was past time to catch the school bus. What followed was completely unexpected. Within half an hour, Matt spray-painted a bedroom wall, tried to set fire to the garage, and attempted to hang himself in the attic. Read more

See? Sleep deprivation is not good: look at this picture

Evidence implicating sleep deprivation as one of the central ingredients in bipolar mood problems just keeps racking up. Thanks to Nancy and John for sending me a link with a remarkable picture I hope many readers here will take a moment to view.

Sleep deprivation increases activity in the amygdala, a brain region associated with strong emotions such as fear and agitation. In some ways, this is no surprise: getting more emotional, less able to control one's expressions of anger or sadness, is a familiar consequence of getting too little sleep. But if you want to see a dramatic demonstration of the brain basis of this phenomenon, see a brief explanation of this new research on my webpage about sleep and the biological clock, part of the Biological Basis of Bipolar Disorder series. Or see Dr. Walker's press release.

Dr. Phelps

Delayed-Release Valproic Acid Capsule, Stavzor, One Step Closer to Approval

A new type of delayed-release valproic acid capsule is one step closer to receiving final approval for sale in the U.S. by the Food and Drug Administration (FDA). The new drug will be marketed under the brand name Stavzor by Noven Pharmaceuticals.

The delayed release valproic acid capsules, when they receive final approval, will be available in 125mg, 250mg and 500mg strengths. The FDA approval is for the use of Stavzor in the treatment of manic episodes associated with bipolar disorder, adjunctive therapy in multiple seizure types (including epilepsy), and prophylaxis of migraine headaches.

The FDA states in the letter that it has completed its review of the Stavzor new drug application and that it is approvable. The FDA has requested certain non-clinical information, including additional in vitro dissolution data, as a condition to final approval. The FDA has not requested additional human studies or clinical data.

Noven expects to receive Stavzor’s final FDA approval by the end of July 2008.

Stavzor was developed using Banner’s patent-pending EnteriCare enteric soft gelatin capsule delivery system. Noven acquired a license to market and sell Stavzor in the U.S. as part of Noven’s acquisition of JDS Pharmaceuticals in August 2007. Stavzor will be a branded product; it is not expected to be AB-rated to or generically substitutable for Depakote, nor will Depakote or any Depakote generics be substitutable for Stavzor.

“We are very pleased to announce that the FDA has issued an approvable letter for Stavzor, and we offer our congratulations to the Banner and JDS teams for this successful result,” said Robert C. Strauss, Noven’s President, CEO & Chairman. “We are now working with Banner to satisfy the conditions to final approval as expeditiously as possible. Banner has advised that it expects to respond to the FDA’s requests in the coming weeks. Concurrently, the Noven/JDS team has begun launch and production planning in anticipation of a 2008 launch of Stavzor.”

Anxiety Attack - Five Top Questions

Do you every feel numb, nauseous or dizzy? Does your breathing speed up so much that you feel you are hyperventilating? Do you have intense feelings of being afraid or so stressed that your body freezes up? If so, you may be undergoing an anxiety attack. Read more

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