Wednesday, January 28, 2009

Do we need a kindler, gentler football?

I'm going to let the New York Times do the talking today. I hate to see stories like this, because every time I do.....I wonder how we could use some simple nutritional therapies to minimize the chances of this kind of tragedy? I don't think it's all about nutrition, but I do think a good chunk of it might be.

Here's hoping some day, someone in a place to take action on that sentiment, has the money and the connections to actually do so.

Tuesday, January 27, 2009

Alzheimer's, sleep, and diabetes--three very interesting amigos

I didn't realize until reading this abstract that Alzheimer's disease affects sleep patterns as well as memory. It makes sense, since adequate sleep is necessary in order to retain memory of information gained during the day.

The medication reviewed in this article is galantamine (Reminyl), and the authors suggest that it is important to time medication administration in order to gain maximum effectiveness and sleep. And, that certain medications help (and interfere with) sleep more than others.

Disrupted sleep can worsen diabetes. Since many people with Alzheimer's also have diabetes--in fact, the two diseases are starting to be recognized as being very strongly linked to each other--this connection between sleep and medication can be very important to understand.

My guess is that if you are on this blog looking for information about Alzheimer's, it is a loved one, not you, that the information is for. Here is the bottom line:
1. If your loved one had problems with sleep before being recommended or placed on medication, it might be a good idea to check with the prescribing physician to be sure this was taken into account when choosing which Alzheimer's medication to prescribe.
2. If your loved one has developed changes in sleep habits since starting an Alzheimer's medication, be sure to let the prescribing physician know.
3. If your loved one's diabetes has become worse despite diligent attention to medications and food intake, consider the influence of sleep or lack thereof.
4. Be sure to ask your physician and/or pharmacist if there is a time of day your particular medication needs to be taken for maximum effectiveness.

Nieoullon A, Bentué-Ferrer D, Bordet R, Tsolaki M, Förstl H. Importance of circadian rhythmicity in the cholinergic treatment of Alzheimer's disease: focus on galantamine*. Curr Med Res Opin. 2008 Dec;24(12):3357-67.

Friday, January 16, 2009

Which came first...the hair or the hormones?

This abstract caught my eye because I also have a blog about polycystic ovary syndrome (PCOS) and finasteride is sometimes used to treat the hirsutism (hair growth in women) that this syndrome often causes. It has now been observed to have antipsychotic properties and is being proposed as a treatment for psychosis.

Antipsychotics are increasingly being used to treat depression, and at least 85% of women with PCOS have some kind of anxiety, depression, or other mood disorder associated with this diagnosis. If you have PCOS, please do not jump to the assumption that I am saying you are psychotic. What I am trying to point out here is that there is a huge mind-body connection in the syndrome that is often ignored. Physicians can be so compartmentalized with their treatments that they focus on the acne, the hair, the infertility...and completely ignore the moods, the mood swings, the associated disrupted eating patterns...and then they and their patients wonder why treatment is not successful.

I am posting this abstract to challenge anyone who treats PCOS to figure out what is going on in the brain of the woman with PCOS since it is, after all, the brain that controls hormones. Rather than mess with hormones and create even more problems, why aren't we going to the source and looking THERE for potential solutions? Let's make this the day we shift our thinking.

Bortolato M, Frau R, Orrù M, Bourov Y, Marrosu F, Mereu G, Devoto P, Gessa GL. Antipsychotic-like properties of 5-alpha-reductase inhibitors. Neuropsychopharmacology. 2008 Dec;33(13):3146-56. Epub 2008 Mar 19.

I chose the photo I did not to be funny, demeaning, or hurtful. I did it for the benefit of those who truly do not understand what many women go through because of their PCOS. Hair growth can be devastating and lead to horrible issues with self-image. Long ago it was often called "diabetes of the bearded ladies". If you can imagine what it's like to look in the mirror and feel as though you're losing your femininity, often at a time when you're trying to conceive and desiring to be attractive to your's a situation deserving of much more attention than it often gets by physicians.

Wednesday, January 14, 2009

Factors potentiating the risk of mirtazapine-associated restless legs syndrome.

Restless leg syndrome (RLS) is a very annoying condition. I know, because I get it when I'm under stress. It strikes when I'm relaxing; my legs begin to move on their own as if I am a puppet and they are attached to strings.

Restless legs is officially classified as a sleep disorder. Those involuntary movements interfere with restful sleep. You can see the vicious cycle that can get started, as poor sleep can make a day more stressful, which can exacerbate restless legs, etc., etc.

So this article about risk factors for restless legs syndrome caught my eye on a recent cruise through the National Library of Medicine database.

In 181 records reviewed over a 3 1/2 year period, in individuals taking the antidepressant mirtazapine (Remeron), eight percent reported having RLS, tending to start within a few days of beginning mirtazapine therapy. This trend seemed to be more frequent if, in addition to mirtazapine, the individual was using tramadol and/or dopamine-blocking agents.

Be sure to let your physician know if you've noticed this syndrome developing. There are alternatives, pharmacological and non pharmacological, that won't steal your sleep in the name of making you feel better.

Kim SW, Shin IS, Kim JM, Park KH, Youn T, Yoon JS. Factors potentiating the risk of mirtazapine-associated restless legs syndrome. Hum Psychopharmacol. 2008 Oct;23(7):615-20.

Monday, January 12, 2009

Let's not play around with our adolescents!

Methylphenidate (Ritalin) is a very common, in fact the most common, choice for treating attention deficit-hyperactivity disorder (ADHD). One of its major effects is to interfere with social interaction so that people with ADHD are not overly intrusive or disrespectful of normal social boundaries with others. A recent study of methylphenidate in adolescent rats showed that not only did this medication accomplish that goal, it interfered with social and play behaviors considered to be normal for these rats at this developmental stage. In other words, methylphenidate somewhat overshot the mark when it came to inhibiting pre-medicated behaviors.

Of course, to a parent who is frustrated and tired from managing a child whose behaviors have not demonstrated appropriate boundaries, this can be a welcome change. However, social interactions and recreational activities are important for teaching skills important to a productive adult life. Chemically denying a child these learning opportunities may create more problems later in life, when that child does not have the social skills that promote successful relationships, careers, and stress management.

I of course believe there are many options to consider before medication, and they are discussed elsewhere in this blog. If you do believe methylphenidate is the only rational solution to your child's situation, I would at least recommend closely observing your child's social behavior. If s/he has become a wallflower and swung completely in the opposite direction, at least discuss this change with the prescribing caregiver. There ARE other medications and options that can help set your child up for a successful adulthood...which is one of the primary responsibilities of responsible parenthood.

Vanderschuren LJ, Trezza V, Griffioen-Roose S, Schiepers OJ, Van Leeuwen N, De Vries TJ, Schoffelmeer AN. Methylphenidate disrupts social play behavior in adolescent rats. Neuropsychopharmacology. 2008 Nov;33(12):2946-56. Epub 2008 Feb 27.

Friday, January 9, 2009

Sweet dreams for fewer migraines

If you've ever had a migraine, you know they're debilitating. I get them. When they come, my vision gets squirrely, my thinking gets fuzzy, and all I want to do is sleep. I'm completely useless for as long as one chooses to stick around.

I've tried the pharmaceutical options, and while they worked, I always wished that there was a natural solution. For me, that solution came with changing my work situation, moderating caffeine intake, stress management, and incorporating yoga into my activity routine. When I found this article, I realized that I've also been better to myself when it comes to sleep, and not cutting myself short in that department. Maybe that's part of the reason I rarely have migraines anymore.

The scientists in this study gave a 3 mg dose of melatonin to 22 children who complained of regular migraine or tension-type headaches. By the time the study was over, 3 months later, 2/3 of the subjects reported a decrease in headache frequency of 50%, and 4 subjects reported having no headaches at all.

Of course, you can go out and buy some melatonin. But what I'd recommend, first of all, is taking a good hard look at your sleep habits. Are you giving yourself at least 7 hours of sleep a night? Or are you hooked on late night TV? Are you sitting in bed with your laptop surfing the net when you should be dreaming?

It's an easy solution for a serious and unpleasant problem. Take care of your head--and your head won't have to hit you where it hurts to get your attention.

Miano S, Parisi P, Pelliccia A, Luchetti A, Paolino MC, Villa MP. Melatonin to prevent migraine or tension-type headache in children. Neurol Sci. 2008 Sep;29(4):285-7. Epub 2008 Sep 20.

Thursday, January 1, 2009

Thanks to all of you and Happy 2009!

Hello readers,

I had no idea whatsoever that my random posts about mental health would gain so much readership. In one short year this blog has grown from a reader here and there to 1300 readers from 112 countries, and 1600 page views per month.

Thank you so much for your interest!

I can tell by the comments you take the time to post, that you are all sincerely desiring to take control of your health. I understand the responsibility that goes with that kind of trust, given the diagnoses and medications I address when I write. I hope as 2009 progresses that I continue to write about meaningful topics that give you inspiration and tangible ideas for actions you can take in your respective lives.

Please do let me know how I can improve on this blog, and please comment where you see fit. This blog is a community effort, steered by the interests of you, the readers.

Happy New Year everyone!