Health
Long-term antidepressant medication use may not help patients over the long haul, study says
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After a time period, antidepressant use in people with despair was not related to higher health-related high quality of life, (HRQoL), in comparison with these with despair who didn’t take medicines, a brand new research printed within the open-access journal PLOS ONE urged.
“It’s usually well-known that despair dysfunction has a big influence on the health-related high quality of life (HRQoL) of sufferers. Whereas research have proven the efficacy of antidepressant medicines for therapy of despair dysfunction, these medicines’ impact on sufferers’ total well-being and HRQoL stays controversial,” research creator Omar Almohammed, PhD, who’s an Assistant professor of scientific pharmacy at King Saud College, in Saudi Arabia, and his colleagues stated in a information launch about their analysis research.
The researchers analyzed knowledge from the 2005-2015 United States’ Medical Expenditures Panel Survey (MEPS), a kind of longitudinal research that tracks the well being companies Individuals use. Throughout the time of the research, the authors discovered that 17.47 million grownup sufferers have been recognized with despair every year with two years of follow-up and 57.6% of these have been handled with antidepressant medicines.
The investigators appeared on the outcomes of the psychological element of the SF-12, a survey that tracks health-related high quality of life. The discharge acknowledged that they famous a constructive change with the usage of antidepressants nevertheless, the change in high quality of life reported amongst these on the medicine for over two years, was not considerably completely different from that reported amongst these not handled with antidepressants.
The researchers stated within the printed report that the first objective of utilizing antidepressant medicines or psychotherapy is to enhance outcomes together with the affected person’s health-related high quality of life and stated within the launch, “Though we nonetheless want our sufferers with despair to proceed utilizing their antidepressant medicines, long-term research evaluating the precise influence for pharmacological and non-pharmacological interventions on these sufferers’ high quality of life is required. With that being stated, the position of cognitive and behavioral interventions on the lengthy term-management of despair must be additional evaluated in an effort to enhance the final word aim of look after these sufferers; enhancing their total high quality of life.”
Dr. Lynn Bufka, PhD, ABPP, is a board licensed licensed psychologist and Affiliate Chief, Apply Transformation on the American Psychological Affiliation. Bufka was not concerned with the research, however advised Fox Information in an interview that this report raises consciousness that well being professionals ought to be taking a look at high quality of life as a affected person end result. She stated extra research are wanted concerning this challenge.
Bufka additionally advised Fox Information that in therapy for despair, there are usually two objectives {that a} skilled is involved in: the signs and the issues that prompted the person to hunt the therapy. She additional defined that there’s an acute section of despair the place medicine could also be helpful after which a upkeep section the place the medicine dosage could must be adjusted and mixed with different interventions comparable to psychotherapy, train, and food plan to assist enhance a person’s high quality of life.
The psychologist advised Fox Information, “There are a lot of folks for whom medicine is nice and for others that medicine can present sufficient of a dent in despair that they will interact in psychotherapy.”
Bufka additionally advised Fox Information, “Individuals ought to be snug that medicines may be helpful however they don’t reply every little thing. You’re going to get some modifications, however medicines alone received’t offer you an incredible high quality of life – it simply provides us a glimpse.” Bufka defined that medicine could be a device, however will not be an ideal device and he or she confused the significance of the affected person discussing with their therapist their desired end result relating to their therapy.
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Bufka additionally added that medicine and psychotherapy have completely different results on the physique and it’s important to know which is extra vital to make use of at that individual second. “Psychotherapy’s aim is to present the instruments to deal with the challenges shifting ahead the place medicine helps to change the biochemistry which can provide you a distinct perspective and completely different strategy,” the psychologist defined.
Bufka additionally famous that research present that a good portion of prescribers of antidepressants are the affected person’s main care doctor and never a psychiatrist, who focuses on medicines and acceptable dosing in numerous phases of psychiatric situations, together with despair. She stated this fairly probably might play a task within the research’s findings.
Dr. Scott Krakower, DO, DFAACAP, is an attending Psychiatrist at Northwell Well being Zucker Hillside Hospital and advised Fox Information, “It’s exhausting to interpret the findings of this research and this ought to be interpreted with warning. Antidepressants do assist with the therapy of despair. This has been demonstrated with a plethora of research. Whereas there was concern with a big placebo impact of those brokers, there does look like enchancment to some extent with temper and different measurable outcomes.”
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The psychiatrist defined that in extreme instances of despair, medicine could also be warranted together with different interventions however in instances of gentle despair, particular person remedy could also be tried alone to mitigate potential unwanted effects of medicines. Krakower additionally advised Fox Information, “It has additionally been reported that medicine could assist to alleviate the period of time being spent in remedy, to permit sufferers to stay extra productive lives. Subsequently, medicine can also be thought-about an choice.”
Krakower additionally stated the most effective therapy for despair stays with medicine and particular person remedy.
The research authors did notice within the launch that they weren’t capable of individually analyze any subtypes or various severities of despair and did say that future research ought to examine the usage of non-pharmacological despair interventions utilized in mixture with antidepressants.
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Health
California fires and mental health toll: Celebrities and therapists offer tips
As Los Angeles battles the worst wildfires in the city’s history, thousands of people have been displaced or have seen their homes burn to the ground.
Around 130,000 people were ordered to evacuate and some 10,000 structures were destroyed, according to the Associated Press. At least 10 people have died as a result of the blazes.
The devastation of the fires has undoubtedly taken a grave toll on the psyches of those affected, experts agree.
STEVE GUTTENBERG CALLS LA WILDFIRES ‘GREAT EQUALIZER,’ URGES PEOPLE TO LEAN ON ONE ANOTHER
Fox News Digital spoke with celebrities and mental health experts, who offered the following guidance for the people impacted.
Recognize your feelings
For those who have experienced a loss from the fires, common reactions include shock, disbelief and confusion, according to David Kessler, a grief counselor in Los Angeles and founder of Grief.com.
“I call it grief brain,” he told Fox News Digital.
“Your mind is trying to comprehend what happened, and it’s a hard thing for it to do, because this is unimaginable that your house, your safety, is suddenly gone.”
Not all grief is related to death, Kessler noted, as there are many different types of losses.
“I always say grief is a change you didn’t want — and certainly a fire is a change we didn’t want,” he added.
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It’s important to “self-validate” the reality of the loss, he said.
“People might give you toxic positivity of, ‘well, at least no one died,’” he said. “And while that’s true, the reality is you still have lost your home. Don’t let anyone minimize that.”
“The loss of a home is devastating and it can take years to recover.”
“I think we’re going to deal with a lot of depression after this, a lot of sadness.”
Actor Steve Guttenberg, who lives in Pacific Palisades, California, where fires erupted on Tuesday, shared how the disaster has impacted his own mental health.
“I’ve seen so much tragedy the last three or four days that I’ve got to be careful to … keep a hold of my mind,” he said in an interview with Fox News Digital.
“And I think that we’re going to deal with a lot of depression after this, a lot of sadness. And it’s going to be really tough because this is like nothing you’ve ever seen.”
Gutenberg noted that while it’s “very normal” to be down, he is trying not to let himself “go down that hole.”
“But I’m pretty sad about this,” he added.
HOW TO COPE WITH ‘COLLECTIVE GRIEF’ WHEN MASS TRAGEDY STRIKES
Jonathan Alpert, a psychotherapist in Manhattan and Washington, D.C., noted that the grief following the Los Angeles fires is “profound.”
“It’s not just about the physical loss of homes or belongings — it’s also about the sense of safety and normalcy that has been lost,” he told Fox News Digital.
“It’s important for people to feel emotions and not ignore them. This is a normal reaction to such overwhelming loss and tragedy.”
Reach out for support
Guttenberg emphasized the importance of maintaining connections with others and drawing support from the community during a disaster of this magnitude.
“We’re social animals — we need people,” he said. “So I’m reaching out to my friends. There’s no way to meet right now because it’s so dangerous — so the best thing you cn do … is call and reach out and maybe you can drive somewhere.”
Most of the people in town have evacuated, he pointed out. “There’s probably 10% of the population left here. Or less.”
Kessler reiterated that connection is critical after this type of trauma. “We need to be taken care of. We need other people around us. People equal safety,” he said.
“We need other people around us. People equal safety.”
Pastor Jesse Bradley of Grace Community Church outside Seattle, Washington, agreed that it’s essential to avoid isolating yourself after a loss.
“We need God and we need each other. Community is vital,” he told Fox News Digital.
“Family, friends and neighbors care about you. God sends His love through these people. Reject isolation. Don’t shut down and don’t shut people out.”
Take action
“In times of crisis such as this, regaining even small amounts of control can be grounding,” Alpert said.
He recommends creating a plan for what’s next, whether it’s finding temporary housing, accessing local resources or starting the process of rebuilding.
“Taking action — no matter how small — can help you move forward.”
Kessler agreed, noting that people who are in the area but did not experience loss may feel a sense of relief mixed with guilt.
“If you do have survivor’s guilt, I always say the best thing is to take action,” he advised.
In the longer term, advocacy efforts can be a powerful tool in dealing with trauma, Alpert noted.
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“Working to improve fire prevention policies, supporting relief efforts or helping neighbors rebuild can provide a sense of purpose and empowerment during this difficult time,” he said.
Some people may be angry about the systems that failed to prevent the fires in the first place, Alpert acknowledged, and this anger can be a “powerful motivator.”
“Taking action — no matter how small — can help you move forward.”
“Use that energy to demand better, but don’t get stuck on the anger,” he advised.
“By holding leaders accountable for the policies — or lack thereof — that contributed to this devastation, and by asking the right questions and demanding answers, you might start to feel better.”
Seek professional help as needed
“The L.A. fires no doubt will not just leave physical scars, but deep emotional ones, too,” Alpert said.
“For many people, the fear, panic and helplessness experienced during the fires don’t just disappear — they linger, creating flashbacks, anxiety and difficulty functioning.”
In many cases, this can lead to post-traumatic stress disorder (PTSD). Symptoms of this condition can include vivid memories of the fires, nightmares, hypervigilance or avoidance of anything that reminds someone of the event, Alpert said.
“It’s important to see this not as weakness, but rather, the mind’s and body’s way of trying to cope with extreme stress.”
“While the fires were devastating, they don’t diminish your strength or character.”
As you seek help, it’s also important to understand that PTSD doesn’t define you, he added.
“It’s a part of your experience, not your identity. While the fires were devastating, they didn’t diminish your strength or character.”
Lean on your faith
For those who have experienced traumatic grief, Kessler emphasized the importance of faith and spirituality.
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“They help ground us in a world full of fear,” he said. “And when we’ve lost everything, it can feel like our faith is the one thing we have to hold onto.”
During a time of crisis, Guttenberg said it’s important to “rely on anything that you believe in.”
“If you believe in your mom and dad, you rely on them, your brothers and sisters, your friends, your family. God, the universe.”
Above all, he added, “Just remember, you’re not alone. God is always with you. Jesus is always with you. You’ve got to hang on to that.”
Find ways to exercise gratitude
During times of hardship, it’s important to recognize the good things that are still in your life, Pastor Bradley said.
“It’s easy to be consumed with what you no longer have,” he told Fox News Digital.
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“You need to be intentional to take inventory of the blessings in your life. For example, you might lose a home or business, but you still have family.”
This mindset will help you keep a healthy perspective and protect gratitude, Bradley added.
Health
Scientists May Be Able to Make Grapefruits Compatible With Medications They Currently Interfere With
You may be among the millions of people who have seen a surprisingly specific warning like this on the labels of drugs you take:
Avoid eating grapefruit or drinking grapefruit juice while using this medication.
Such warnings are issued for dozens of substances, including docetaxel, a cancer drug; erythromycin, an antibiotic; and some statins, the cholesterol-lowering drugs prescribed to more than a third of American adults over 40.
The problem is a set of molecules, furanocoumarins. High levels of furanocoumarins interfere with human liver enzymes, among other processes. In their presence, medications can build up to unhealthy levels in the body. And grapefruits and some related citrus fruits are full of them.
But there is no such warning for other kinds of citrus, such as mandarins and other oranges. Citrus researchers at the Volcani Center in Israel reported Wednesday in the journal The New Phytologist that, by crossing mandarins and grapefruit, they’ve uncovered genes that produce furanocoumarins in some citrus fruits. It’s a finding that opens the possibility of creating grapefruit that doesn’t require a warning label.
Scientists had worked out the compounds’ structures and pieced together a basic flowchart of how they are made years ago, said Yoram Eyal, a professor at the Volcani Center. But the precise identities of enzymes catalyzing the process — the proteins that snip off a branch here, or add a piece there — remained mysterious. He and his colleagues knew that one way to identify them was to breed citrus high in furanocoumarins with those without. If the offspring of such a cross had varying levels of the substances, it should be possible, by digging into their genetics, to pinpoint the genes for the proteins.
“We were afraid to approach it, because it’s very time-consuming and it takes many years,” he said, noting how involved it can be to grow new trees from seeds and assess their genetics. “But finally, we decided we have to dive in.”
When they examined the offspring of a mandarin and a grapefruit, the researchers saw something remarkable. Fifty percent of the young plants had high levels of furanocourmains, and 50 percent had none. That particular signature meant something very specific, in terms of how the ability to make these substances is inherited.
“We saw there was only one gene that could have controlled it,” said Livnat Goldenberg, a Volcani Center researcher who is the lead author of the new study.
The researchers soon identified the gene controlling the production of furanocoumarins in leaves and fruit, which produces an enzyme called 2-oxoglutarate-dependent dioxygenase, or 2OGD for short. Mandarins, it turns out, have a mutated form of this gene that keeps the enzyme from functioning properly. This version cropped up in all the mandarin and orange varieties the researchers checked, explaining why they do not cause the same problems as grapefruit in people taking prescription medications. In these plants, furanocoumarin production is paused.
With gene editing technology, it should be possible to alter the gene in grapefruit as well, Dr. Eyal suggests. The team at the Volcani Center is now exploring that project.
Looking at how widespread this mutated version is in mandarins and some other citrus, the scientists speculate that some gene nearby on the genome must play an important role in a highly prized trait. A long-ago citrus breeder, selecting for some unknown quality, must have unwittingly spread this furanocoumarin-busting version of the gene to an ancestor of modern varieties of mandarins and oranges.
All these years later, that person’s work is coming to light, under the gaze of geneticists, who may, someday, put grapefruit back on the menu.
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