Anti-depressants likely do more harm than good, study suggests

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Commonly prescribed anti-depressants appear to be doing patients more harm than good, say researchers who have published a paper examining the impact of the medications on the entire body. See Also: Health & Medicine Pharmacology Birth Defects Mental Health Research Mind & Brain Depression Disorders and Syndromes Psychiatry Reference COX-2 inhibitor Psychoactive drug Seasonal affective disorder Anti-obesity drug "We need to be much more cautious about the widespread use of these drugs," says Paul Andrews, an evolutionary biologist at McMaster University and lead author of the article, published recently in the online journal Frontiers in Psychology. "It's important because millions of people are prescribed anti-depressants each year, and the conventional wisdom about these drugs is that they're safe and effective." Andrews and his colleagues examined previous patient studies into the effects of anti-depressants and determined that the benefits of most anti-depressants, even taken at their best, compare poorly to the risks, which include premature death in elderly patients. Anti-depressants are designed to relieve the symptoms of depression by increasing the levels of serotonin in the brain, where it regulates mood. The vast majority of serotonin that the body produces, though, is used for other purposes, including digestion, forming blood clots at wound sites, reproduction and development. What the researchers found is that anti-depressants have negative health effects on all processes normally regulated by serotonin. The findings include these elevated risks: developmental problems in infants problems with sexual stimulation and function and sperm development in adults digestive problems such as diarrhea, constipation, indigestion and bloating abnormal bleeding and stroke in the elderly The authors reviewed three recent studies showing that elderly anti-depressant users are more likely to die than non-users, even after taking other important variables into account. The higher death rates indicate that the overall effect of these drugs on the body is more harmful than beneficial. "Serotonin is an ancient chemical. It's intimately regulating many different processes, and when you interfere with these things you can expect, from an evolutionary perspective, that it's going to cause some harm," Andrews says. Millions of people are prescribed anti-depressants every year, and while the conclusions may seem surprising, Andrews says much of the evidence has long been apparent and available. "The thing that's been missing in the debates about anti-depressants is an overall assessment of all these negative effects relative to their potential beneficial effects," he says. "Most of this evidence has been out there for years and nobody has been looking at this basic issue." In previous research, Andrews and his colleagues had questioned the effectiveness of anti-depressants even for their prescribed function, finding that patients were more likely to suffer relapse after going off their medications as their brains worked to re-establish equilibrium. With even the intended function of anti-depressants in question, Andrews says it is important to look critically at their continuing use. "It could change the way we think about such major pharmaceutical drugs," he says. "You've got a minimal benefit, a laundry list of negative effects -- some small, some rare and some not so rare. The issue is: does the list of negative effects outweigh the minimal benefit?"

Opiates Killed 8 Americans In Afghanistan, Army Records Show

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Eight American soldiers died of overdoses involving heroin, morphine or other opiates during deployments in Afghanistan in 2010 and 2011, according to U.S. Army investigative reports. The overdoses were revealed in documents detailing how the Army investigated a total of 56 soldiers, including the eight who fell victim to overdoses, on suspicion of possessing, using or distributing heroin and other opiates. At the same time, heroin use apparently is on the rise in the Army overall, as military statistics show that the number of soldiers testing positive for heroin has grown from 10 instances in fiscal year 2002 to 116 in fiscal year 2010. Army officials didn't respond to repeated requests for comment on Saturday. But records from the service's Criminal Investigation Command, obtained by the conservative legal group Judicial Watch, provided glimpses into how soldiers bought drugs from Afghan juveniles, an Afghan interpreter and in one case, an employee of a Defense Department contractor, who was eventually fired. The drug use is occurring in a country that is estimated to supply more than 90% of the world's opium, and the Taliban insurgency is believed to be stockpiling the drug to finance their activities, according to a 2009 U.N. study. While the records show some soldiers using heroin, much of the opiate abuse by U.S. soldiers in Afghanistan involves prescription drugs such Percocet, the Army documents show. Judicial Watch obtained the documents under the Freedom of Information of Act and provided them to CNN. Spokesman Col. Gary Kolb of the International Security Assistance Force, the NATO-led command in Afghanistan, verified the documents to CNN on Saturday. One fatal overdose occurred in June 2010 at Forward Operating Base Blessing, after a soldier asked another soldier to buy black tar opium from a local Afghan outside the base's entry control point. The first soldier died after consuming the opium like chewing tobacco and smoking pieces of it in a cigarette, the documents show. The reports even show soldier lingo for the drug -- calling it "Afghani dip" in one case where three soldiers were accused of using the opiate, the Army investigative reports show. The United States has 89,000 troops in Afghanistan. The U.S. death toll since the September 11, 2001, attacks that triggered the war has risen to more than 1,850, including 82 this year, according to the U.S. Department of Defense and U.S. Central Command. Tom Fitton, president of Judicial Watch, said his group was interested in soldiers' drug use partly because the risk was present during the Vietnam War. "You never want to see news of soldiers dying of drug use in Afghanistan," Fitton said. "Our concern is, will the military treat this as the problem that it is, and are the families of the soldiers aware of the added risk in this drug-infested country? "There is a dotted line between the uses. Prescription abuse can easily veer into heroin drug use," Fitton added. "Afghanistan is the capital of this opiate production and the temptation is great there and the opportunity for drug use all the more." The group is concerned that "there hasn't been enough public discussion, and we would encourage the leadership to discuss or talk about this issue more openly," Fitton said. In one case, a soldier bought heroin and the anti-anxiety drug Xanax from five "local national juveniles at multiple locations on Camp Phoenix, Afghanistan, and consumed them," one report states. Soldiers also distributed heroin, Percocet and other drugs among themselves, according to the reports. Another soldier fatally overdosed in December 2010 after taking several drugs, including morphine and codeine, though the drugs were not prescribed for him, the Army documents show. One female soldier broke into the Brigade Medical Supply Office at Forward Operating Base Shank and stole expired prescription narcotics including morphine, Percocet, Valium, fentanyl and lorazepam, the documents show. The investigative reports show soldiers using other drugs, including steroids and marijuana, and even hashish that was sold to U.S. servicemen by the Afghan National Army and Afghan National Police personnel, the reports state.

3 arrests, 1 ticket so far in Boulder 4/20 protest; commercialism harshes vibe of marijuana rally in Denver

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The scene at Civic Center on Friday afternoon shortly before 4:20 p.m. (Hyoung Chang, The Denver Post)

  

A marijuana activist holds up a sign as police keep the CU-Boulder campus closed off to the general public today, April 20, 2012. (Joe Amon, The Denver Post)

 

 

University of Colorado police have so far arrested three people — apparently students — and ticketed another in a crackdown on the annual pro-marijuana gathering known as 4/20.

The arrests came around 1:30 p.m. today, when a trio of people crossed the police tape surrounding the university's Norlin Quad and sat down in the grass. Witnesses said the three made statements in support of marijuana legalization and against the university's efforts to stop 4/20 gatherings on campus.

CU police spokesman Ryan Huff said the three were arrested for trespass, a misdemeanor carrying a possible 6-month jail term and a $750 fine.

"Our officers were very cordial," CU police spokesman Ryan Huff said. The protesters, he said, "were even allowed to sit on the grass for a few minutes and say their message."

Huff said officers have also written one ticket for marijuana possession today. The four actions are the only major events so far on a day when CU officials have taken the extraordinary step of closing the campus to outsiders and closing Norlin Quad entirely to squelch 4/20, which in years past has drawn 10,000 people to campus for a mass marijuana smoke-up that commences at 4:20 p.m.

But that has not meant the day has been uneventful for CU students, who appear split over whether the crackdown — and the police presence that enforces it — is a good thing.

"We're getting no shortage of feedback," CU spokesman Bronson Hilliard said.

Some students complained about having to show their school identification to be allowed onto campus and about the uncomfortable atmosphere so many police officers on campus creates. Others said they are enjoying the commotion.

CU student Boston Cleek took advantage of the moment by creating a poster-sized copy of his student ID and carrying it around.

"I just thought it would make people laugh," he said, "because people are complaining so much" about having

A large crowd gathered Friday, April 20, 2012, during Denver's 420 Rally in Civic Center. (RJ Sangosti, The Denver Post)

to show ID.

 

Members of the CU chapter of Students for Sensible Drug Policy are staging a small protest near Norlin Quad to decry the university's crackdown and speak out against the war on drugs. Law student Laura Schneider said she was upset that the crackdown caused a visiting lecturer who was to speak at one of her classes today to cancel.

"For me, that is a direct loss," she said. "The smokers, the pot heads, they didn't cause class to close. The school caused class to close."

But CU economics student Chris Anderson said the annual marijuana smoke-up, which has received national attention, gives the university a bad image that reflects on all its graduates and said the university is justified in its actions. Anderson was one of several students who wore a suit and tie to campus today, part of a "Stay Classy, CU" counter-4/20 demonstration.

"I don't want to be going into a job interview and have someone asking me if I smoke weed," Anderson said.

Asked what he would be doing at 4:20 p.m., Anderson — who completed his sartorial statement with a pair of Ray-Ban-style sunglasses — smiled.

"Mostly, staying classy," he said.

Several thousand people have gathered in Denver's Civic Center where a haze has already started to rise from the massive crowd. Music could be heard as early as 8 a.m. — by noon several hundred people had already gathered.

John Chotia, 43, said he attends the smokeout every year.

"I don't want see all drugs legalized, just marijuana," Chotia said. "It's a great event because people can come out and freely use their medicine. The vibe at the event is one of the best parts."

A number of vendors in the park are selling everything from bongs and pipes to lemonade and hot dogs. Chotia said the vendors have changed the feel of the smokeout during the years.

"The real drag is, back in the day you didn't have the commercialism," Chotia said. "You didn't come here to make money off of it."

As of 3:30 p.m., police officers had issued a handful of citations for illegal possession, said Raquel Lopez, spokeswoman for the Denver Police Department. The majority of officers are monitoring the event from the edge of the park.

"From the numbers(citations) we are receiving, opposed to the number of people there, it sounds like people are being pretty respectful," Lopez said.

Jay Berino took two hits from a thick joint before he passed it to his group of friends sitting in the park. The 24-year-old said he felt comfortable smoking marijuana and is not worried about getting a ticket. "It's nice to smoke in the park, no pressure."

Supporters of the 4/20 gathering say the event is a show of civil disobedience against what they say are unjust marijuana laws.

In Boulder, opponents say the event clogs campus walkways and disrupts classes, CU officials say. Carly Robinson, one of CU's student-government leaders, said the event drew numerous students who just wanted to watch, making it more of a spectacle than a demonstration. For that reason, Robinson said, the student government decided to stage a free concert by Wyclef Jean at the Coors Events Center, across campus from Norlin Quad. The doors close at 4 p.m., meaning attendees won't be able also to attend whatever pro-marijuana demonstration may occur at 4:20 this afternoon.

"It was something that was very disruptive to our campus," Robinson said of 4/20. "We thought the concert would be something that wasn't disruptive."

The student governmentis spending $150,000to stage the event.

Huff said police expect to spend more than $100,000 on campus security for the 4/20 crackdown.

CU student Kate Boyles wasn't impressed with those numbers.

"That's a lot of money just to get kids off the lawn at 4:20," she said.

The university also deployed a more pungent weapon against 4/20. Early this morning, crews began spraying a fish-based fertilizer on Norlin Quad — part of an annual lawn-care regimen that the university this year timed to keep 4/20 participants off the greenspace.

The fertilizer — which Hilliard says is organic and made from deep-sea fish that feed on deep-sea plankton — gives the lawn the aroma of a zoo's penguin enclosure. One student walking by the quad this morning sniffed the fertilizer — and began running.

What cannabis actually does to your brain

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Archaeologists recently found a 2,700-year-old pot stash, so we know humans have been smoking weed for thousands of years. But it was only about 20 years ago that neuroscientists began to understand how it affects our brains.

Scientists have known for a while that the active ingredient in cannabis was a chemical called delta-9-tetrahydrocannabinol, or THC for short. Ingesting or smoking THC has a wide range of effects, from the psychoactive "getting high" to the physiological relief of pain and swelling. It also acts as both a stimulant and depressant. How could one substance do all that?

Meet the cannabinoid receptor

In the 1980s and 90s, researchers identified cannabinoid receptors, long, ropy proteins that weave themselves into the surfaces of our cells and process THC. They also process other chemicals, many of them naturally occurring in our bodies. Once we'd discovered these receptors, we knew exactly where THC was being processed in our bodies and brains, as well as what physical systems it was affecting. Scattered throughout the body, cannabinoid receptors come in two varieties, called CB1 and CB2 - most of your CB1 receptors are in your brain, and are responsible for that "high" feeling when you smoke pot. CB2 receptors, often associated with the immune system, are found all over the body. THC interacts with both, which is why the drug gives you the giggles and also (when interacting with the immune system) reduces swelling and pain.

 

Cannabinoid receptors evolved in sea squirts about 500 million years ago; humans and many other creatures inherited ours from a distant ancestor we share with these simple sea creatures. THC binds to receptors in animals as well as humans, with similar effects.

Tasty, tasty, tasty

Cannabis notoriously makes people hungry - even cancer patients who had lost all desire to eat.One study showed that cancer patients who thought food smelled and tasted awful suddenly regained an ability to appreciate food odors after ingesting a THC compound. There are CB1 receptors in your hypothalamus, a part of your brain known to regulate appetite, and your body's own cannabinoids usually send the "I'm hungry" message to them. But when you ingest THC, you artificially boost the amount of cannabinoids sending that message to your hypothalamus, which is why you get the munchies.

Understanding this process has actually led to a new body of research into safe diet drugs that would block those cannabinoid receptors. That way, your hypothalamus wouldn't receive signals from your body telling it to eat, and would reduce hunger cravings in dieters.

What you're forgetting

What's happening in your brain when smoking pot makes you forget what you're saying in the middle of saying it? According to the book Marijuana and Medicine (National Academies Press):

One of the primary effects of marijuana in humans is disruption of short-term memory. That is consistent with the abundance of CB1 receptors in the hippocampus, the brain region most closely associated with memory. The effects of THC resemble a temporary hippocampal lesion.

That's right - smoking a joint creates the effect of temporary brain damage.

What happens is that THC shuts down a lot of the normal neuroprocessing that goes on in your hippocampus, slowing down the memory process. So memories while stoned are often jumpy, as if parts are missing. That's because parts literally are missing: Basically you are saving a lot less information to your memory. It's not that you've quickly forgotten what's happened. You never remembered it at all.

A bit of the old timey wimey

Cannabis also distorts your sense of time. THC affects your brain's dopamine system, creating a stimulant effect. People who are stoned often report feeling excited, anxious, or energetic as a result. Like other stimulants, this affects people's sense of time. Things seem to pass quickly because the brain's clock is sped up. At the same time, as we discussed earlier (if you can remember), the drug slows down your ability to remember things. That's because it interferes with the brain's acetylcholine system, which is part of what helps you store those memories in your hippocampus. You can see that system's pathway through the brain in red in the illustration at left.

In an article io9 published last year about the neuroscience of time, we noted:

The interesting thing about smoking pot is that marijuana is one of those rare drugs that seems to interact with both the dopamine and the acetylcholine system, speeding up the former and slowing down the latter. That's why when you get stoned, your heart races but your memory sucks.

It's almost as if time is speeding up and slowing down at the same time.

Addiction and medicine

Some experts call cannabis a public health menace that's addictive and destroys lives by robbing people of ambition. Other experts call it a cure for everything from insomnia to glaucoma, and advocate its use as a medicine. The former want it to be illegal; the latter want it prescribed by doctors. Still other groups think it should be treated like other intoxicants such as alcohol and coffee - bad if you become dependent on it, but useful and just plain fun in other situations.

What's the truth? Scientists have proven that cannabis does have medical usefulness, and the more we learn the more intriguing these discoveries become. Since the early 1980s, medical researchers have published about how cannabis relieves pressure in the eye, thus easing the symptoms of glaucoma, a disease that causes blindness. THC is also "neuroprotective," meaning in essence that it prevents brain damage. Some studies have suggested that cannabis could mitigate the effects of Alzheimer's for this reason.

At the same time, we know that THC interferes with memory, and it's still uncertain what kinds of long-term effects the drug could have on memory functioning. No one has been able to prove definitively that it does or does not erode memory strength over time. Obviously, smoking it could cause lung damage. And, like the legal intoxicant alcohol, cannabis can become addictive.

Should cannabis be illegal, while alcohol flows? Unfortunately that's not the kind of question that science can answer. Let's leave the moral questions to courts, policymakers and shamans. I'll be off to the side, smoking a joint, thinking about my acetylcholine system and the many uses of the hippocampus.

28 million Americans have sleep apnea,

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Joseph A. Golish, M.D.A new C.P.A.P. device has two small plugs that create just enough air pressure to keep the airways open at night.

Surf Air: Can an all-you-can-fly airline possibly work?

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SURF AIR, a Californian start-up, has a novel business model: for a monthly fee you can fly with the airline as much as you want. Is buffet-style air travel the wave of the future? JetBlue and Sun Country Airlines have both already tried offering all-you-can-fly passes, but so far no carrier has built its business model exclusively on a buffet plan. The idea isn't bad, but some scepticism is warranted. At $790 a month, Surf Air's flying plan will probably only appeal to business travellers who often go to the same places and rich Californians in long-distance relationships. Will that customer base allow Surf Air to make a profit? Maybe: 20m frequent flyers jetted between San Francisco and Los Angeles in 2011, according to the company's numbers. The airline plans to launch with service between Palo Alto, Monterey, Santa Barbara and Los Angeles, but it still needs to secure regulatory approval, according to a company press release. Frequent flyers make up a huge portion of the business-traveller population, and almost every airline relies on business travellers to get (and stay) in the black. There is surely some group of private-jet-sharing business travellers who might be attracted to an all-you-can-jet airline as a cheaper alternative. A lot will depend on how many flights and how much convenience Surf Air can offer, and how quickly it can expand service. The company's promises certainly seem attractive: [Surf Air will offer] its members 30-second booking and cancellations, travel to and from uncongested regional airports, and an easy arrive-and-fly process with no hassle, no lines and no extra fees. It's easy to make promises, though. It's much harder to run a profitable airline. As Gulliver often notes, the American airline sector overall has never really made any money—in fact, total earnings over the entire history of the industry are minus $33 billion. That, of course, suggests that existing airlines might be doing it wrong. Maybe all-you-can-fly really is the way to go. It's at least worth a shot. I'll be eager to see what people think of the final product—assuming regulators give the go-ahead.

Worrying is good for you and reflects higher IQ

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It evolved in humans along with intelligence to make them more adept at avoiding danger. A study of 42 people found the worst sufferers of a common anxiety disorder had a higher IQ than those whose symptoms were less severe. Scientists say their findings published in Frontiers in Evolutionary Neuroscience, suggest worrying has developed as a beneficial trait. Psychiatrist Professor Jeremy Coplan, of SUNY Downstate Medical Centre in New York, and colleagues found high intelligence and worry are linked with brain activity measured by the depletion of the nutrient choline in the white matter of the brain. He said: "While excessive worry is generally seen as a negative trait and high intelligence as a positive one, worry may cause our species to avoid dangerous situations, regardless of how remote a possibility they may be. "In essence, worry may make people 'take no chances,' and such people may have higher survival rates. Thus, like intelligence, worry may confer a benefit upon the species." The researchers made the discovery by monitoring activity in the brains of twenty six patients with generalized anxiety disorder (GAD) and eighteen healthy volunteers to assess the relationship between IQ, worry and the metabolism of choline. In the control group high IQ was associated with a lower degree of worry, but in those diagnosed with GAD it was linked with more. The correlation between IQ and worry was significant in both the GAD group and the healthy control group. But in the former it was positive and in the latter negative. Previous studies have indicated excessive worry tends to exist both in people with higher and lower intelligence, and less so in people of moderate intelligence. It has been suggested people with lower intelligence suffer more anxiety because they achieve less success in life. Worrying has also been shown to lessen the effect of depression by countering brain activity that heightens the condition.

Eating nuts can help stave off obesity, says study

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Dieters often dismiss them because of their high fat content, but research suggests that snacking on nuts can help keep you slim. A study found that those who consumed varieties such as almonds, cashews and pistachios demonstrated a lower body weight, body mass index (BMI) and waist circumference compared to non-consumers. They were also at lower risk of developing heart disease, type 2 diabetes and metabolic syndrome. Experts are now recommending a daily intake of 1.5 ounces, or three tablespoons of nuts as part of a healthy diet. Lead researcher Carol O'Neil, from Louisiana State University, said: 'One of the more interesting findings was the fact that tree nut consumers had lower body weight, as well as lower body mass index (BMI) and waist circumference compared to non-consumers. 'The mean weight, BMI, and waist circumference were 4.19 pounds, 0.9kg/m2 and 0.83 inches lower in consumers than non-consumers, respectively.' In the study, published in the Journal of the American College of Nutrition, researchers compared risk factors for heart disease, type 2 diabetes and metabolic syndrome of nut consumers versus those who did not consume nuts.

Britain's health secretary says Australia's lead on cigarette plain packaging has inspired the UK to develop similar laws of its own.

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While the Australian Government is preparing to do legal battle with cigarette companies over plain packaging, the UK is starting a consultation process aimed at stopping young people taking up smoking.

British health secretary Andrew Lansley says 5 per cent of 11 to 15-year-olds are regular smokers, adding to a habit that costs the country 100,000 lives each year.

Cancer Research UK tobacco control manager Robin Hewings says Australian Health Minister Nicola Roxon has had an important influence on UK.

"We know Andrew Lansley, our health secretary here, says that talking to Nicola Roxon was one of the things that inspired him to have a consultation on plain packaging," she said.

"The kind of strength that the Australian Government is showing in response to the current tobacco industry legal action and bullying and so on, I think has also helped us as well."

Cigarette companies in the UK are as stridently against seeing plain packaging laws introduced into the country.

Imperial Tobacco communications director Alex Parson says a packaging ban would simply fuel the counterfeit industry.

Tobacco companies in Australia raised the same issue before the Federal Parliament passed its plain packaging laws last November. The laws are due to come into effect in December this year.

The laws ban the use of company logos and require all cigarette packets to be a uniform dark green colour.

British American Tobacco has launched a High Court challenge against the laws in Australia, saying the Government is attempting to acquire valuable intellectual property used to identify tobacco brands without compensation.

Tobacco giant Philip Morris has also filed two challenges to the laws, saying they violate Australia's trade treaty with Hong Kong and are unconstitutional.

PHOTO: Australia's laws ban company logos and require all cigarettes be sold in dark green packets. (Supplied)

'No evidence'

Mr Parson denies there is any evidence children are attracted by cigarette packaging in the first place.

"The idea that children are going into their local shop to buy sweets and a comic and then are seeing coloured packs of cigarettes behind the retailer counter and are compelled to try and purchase cigarettes, is just ludicrous; there's just no evidence to support that at all," he said.

But Professor Linda Bald from the University of Stirling disagrees.

"The industry has put all its funding, almost all its advertising and marketing budget into creating innovate, brightly coloured packs," she said.

"We've seen an explosion of innovation on packaging in recent years and we know that those packs do appeal to children."

Her view is strongly supported by many British MPs, including Liberal Democrat Stephen Williams, who chairs a parliamentary committee on smoking.

Like many, he has a story of personal loss that fuels his anger against the tobacco industry.

"My father was a smoker but he died young; he died when he was 42 and one of the causes of his death was respiratory failure," he said.

"That's one of the main reasons why, as a politician, I am very much against smoking myself."

Mr Williams also says Australia is leading the way.

"What we have noticed in particular is how vociferously the tobacco companies fought the legislation in Australia, so we already know some of the tricks they're going to get up to and are well prepared for it," he said.