A little red meat may help your depression

If you have depression, you are not depressed because there is a deficiency of antidepressants in your body...

...however...

...you may be depressed because you have some basic nutritional deficiencies. One mineral that is involved in numerous brain and nervous system functions, and that has been extensively studied with regards to its role in the development of depression, is zinc.

Various doses of zinc were recently shown to improve immobility time in rats. Immobility in a stressful situation is a common behavior in depression. (When you are not depressed, you have better decision making and response times when it comes to managing stressful situations.)

That's exactly what fluoxetine (Prozac), paroxetine (Paxil), imipramine (Tofranil), desipramine (Norpramin), and bupropion (Wellbutrin) do!

When zinc and antidepressants were administered together, immobility time was reduced by more than either therapy produced on its own.

Practically what that says is that:
(1) if you are at risk for, or have had a history of depression, emphasizing high-zinc dietary choices and/or zinc supplementation would be a smart strategy, and
(2) if you are on an antidepressant, supplementing with zinc would be important to be sure that you get enough medication to do the job without getting so much that you set yourself up for detrimental side effects.

In fact, it seems to me that it should be an automatic recommendation of any physician, when prescribing an antidepressant, to write "zinc supplement" in the script as well...

FYI, your best sources of zinc include: red meats, liver, and oyster. And, when the originating soil is in good condtion...wheat, sweet corn, lettuce, beans, nuts, almonds, whole grains, pumpkin seeds, sunflower seeds and blackcurrant. That's a lot of different options, something for practically everyone, meat eater or not!

Cunha MP, Machado DG, Bettio LE, Capra JC, Rodrigues AL. Interaction of zinc with antidepressants in the tail suspension test. Prog Neuropsychopharmacol Biol Psychiatry. 2008 Dec 12;32(8):1913-20. Epub 2008 Sep 11.

Being a banana brain just might be a good thing

Pyridoxine, a form of vitamin B6, is important for brain and nervous system function. It is needed for the chemical reactions that produce several neurotransmitters, including serotonin, dopamine, and norepinephrine. A recent study found that a therapeutic dose of pyridoxine administered to mice decreased their depressive-type behaviors. The response was similar to what was seen when these mice were given imipramine (Tofranil). When the two compounds were administered together, pyridoxine did NOT increase the effectiveness of imipramine.

Bottom line? Before meds, be sure your diet is balanced in the nutrients your brain needs to properly function.

The table below is from the National Institutes of Health, and it lists your best food sources of pyridoxine.

Table of Food Sources of Vitamin B6
Food Milligrams (mg) per serving % DV*
Ready-to-eat cereal, 100% fortified, ¾ c 2.00 100
Potato, Baked, flesh and skin, 1 medium 0.70 35
Banana, raw, 1 medium 0.68 34
Garbanzo beans, canned, ½ c 0.57 30
Chicken breast, meat only, cooked, ½ breast 0.52 25
Ready-to-eat cereal, 25% fortified, ¾ c 0.50 25
Oatmeal, instant, fortified, 1 packet 0.42 20
Pork loin, lean only, cooked, 3 oz 0.42 20
Roast beef, eye of round, cooked, 3 oz 0.32 15
Trout, rainbow, cooked, 3 oz 0.29 15
Sunflower seeds, kernels, dry roasted, 1 oz 0.23 10
Spinach, frozen, cooked, ½ c 0.14 8
Tomato juice, canned, 6 oz 0.20 10
Avocado, raw, sliced, ½ cup 0.20 10
Salmon, Sockeye, cooked, 3 oz 0.19 10
Tuna, canned in water, drained solids, 3 oz 0.18 10
Wheat bran, crude or unprocessed, ¼ c 0.18 10
Peanut butter, smooth, 2 Tbs. 0.15 8
Walnuts, English/Persian, 1 oz 0.15 8
Soybeans, green, boiled, drained, ½ c 0.05 2
Lima beans, frozen, cooked, drained, ½ c 0.10 6

* DV = Daily Value. DVs are reference numbers based on the Recommended Dietary Allowance (RDA). They were developed to help consumers determine if a food contains a lot or a little of a specific nutrient. The DV for vitamin B6 is 2.0 milligrams (mg). The percent DV (%DV) listed on the nutrition facts panel of food labels tells you what percentage of the DV is provided in one serving. Percent DVs are based on a 2,000 calorie diet. Your Daily Values may be higher or lower depending on your calorie needs. Foods that provide lower percentages of the DV also contribute to a healthful diet.

Amara RO, Aburawi SM. Pyridoxine effect on the antidepressant action of imipramine in albino mice. Saudi Med J. 2008 Nov;29(11):1554-7.

A Chinese herb with antidepressant activity

I love Chinese medicine and think there is a lot of potential with its options to treat conditions Western medicine simply doesn't manage very well. It's challenging to share this specialty in an evidence-based blog like this one, because much of the research that is reported, uses terminology that is not meaningful to a Western-trained practitioner like myself. So I was grateful that this group of Chinese researchers took the time to study an aspect of their practice, as well as report on it, in a way that is meaningful and potentially useful to their Western colleagues and friends.

These researchers investigated the activity of xiaobuxin-tang (XBXT), which is a traditional Chinese herb that has been used as an antidepressant in China for centuries. Previously, these researchers discovered that XBXT improves the serotonin balance as well as the behavior of chronically stressed rats with depression. In this particular study, the researchers demonstrated that XBXT stimulates neuron development in the hippocampus, the brain's memory center. (Hippocampal neurons tend to degenerate and die in the throes of depression.) Levels of compounds associated with neuron formation, such as brain-derived neurotropic factor (BDNF), were also increased in the presence of XBXT.

The overall activity of XBXT was compared to that of the antidepressant imipramine.

This little guy here felt so good on XBXT he's still celebrating eight months into the year of the rat!

An L, Zhang YZ, Yu NJ, Liu XM, Zhao N, Yuan L, Chen HX, Li YF. The total flavonoids extracted from Xiaobuxin-Tang up-regulate the decreased hippocampal neurogenesis and neurotrophic molecules expression in chronically stressed rats. Prog Neuropsychopharmacol Biol Psychiatry. 2008 Aug 1;32(6):1484-90.

Now if I could just remember where I found this article...

If I were to be able to tally the time I've spent over a lifetime looking for lost things...especially my keys...there would probably be enough time there to pursue my Ph. D in neuroscience. And I'd likely find myself in a program conducting studies like this one, which looked at how stress affects the memory center (and why mine doesn't seem to ever register "last key location" in any functional part of my neurons).

Most researchers in the area of depression agree that a characteristic biological marker of depression is an elevated level of cortisol, a stress hormone. The researchers in this study decided to see just what cortisol does to the hippocampus, the brain's memory center, both short- and long-term.

Chronic exposure to cortisol decreased the ability of the hippocampus to regenerate neurons, and the volume of existing neurons decreased. These changes could be prevented with the administration of two different antidepressants, imipramine (Tofranil), and fluoxetine (Prozac).

Short-term exposure to stress brought out "depressed" behaviors in the rats. Long-term exposure seemed to create more of an anxious presentation.

The researchers concluded that the physically damaging effects of stress could be prevented with antidepressants.

I conclude that the next time I lose my keys, if I can remember to do so, I'm going to use that as an indicator that I may be trying to do too many things in too short a time. And that I need to do something to reduce my stress level. I really don't think I need to be taking an antidepressant to prevent memory loss!

Murray F, Smith DW, Hutson PH. Chronic low dose corticosterone exposure decreased hippocampal cell proliferation, volume and induced anxiety and depression like behaviours in mice. Eur J Pharmacol. 2008 Mar 31;583(1):115-27.

Caffeine and antidepressant medications

Over the short term (one day on meds), imipramine (Tofranil)and amitriptyline (Elavil) decreased, while fluoxetine (Prozac) accelerated the overall metabolism of caffeine. Nefazodone(Serzone) also stimulated metabolism, but through a more indirect pathway. To say it another way, the body more rapidly broke down and inactivated caffeine under the influence of these medications.

Fluoxetine given chronically increased an indirect pathway of caffeine metabolism. Sertraline (Zoloft) and mirtazapine (Remeron) enhanced the rates of all caffeine oxidation pathways.

I must qualify this study was done on rats, not humans, and I can't remember the last time I saw a rat in line chumming it up with the barista. Even so, it's not unreasonable to assume the same effects could be seen in humans.

So...if you're feeling like your Prozac may have reduced the effect of your double caf skinny no foam morning treat into a half caf regular cup of joe...it may not be your imagination!

Don't let that drug influence tempt you into buying a frequent flyer card at your local coffee haunt, though. Excess caffeine is associated with insulin resistance which can aggravate weight gain. Better to focus on better sleep habits (and less late night web sudoku)than on better productivity through chemical stimulation.

Kot M, Wójcikowski J, Daniel WA. Caffeine metabolism during prolonged treatment of rats with antidepressant drugs. Pharmacol Rep. 2007 Nov-Dec;59(6):727-33.

Antidepressants and risk of bone fracture

Are broken bones the price paid for a better attitude? Some researchers may think so. In a rather large study (124,655 fracture cases and 373,962 age and gender matched controls), relationships between fractures were seen with the following psychiatric medications:

Amitriptyline (Elavil), clomipramine (Anafranil), citalopram (Celexa), fluoxetine (Prozac), and sertraline (Zoloft) were all associated with an increased risk of fractures. Imipramine (Tofranil) and nortriptyline (Pamelor) did not demonstrate this association. Paroxetine (Paxil) showed a slight relationship but statistically it was insignificant.

No medication is perfect, ever. However, antidepressants are used for a wide variety of medical problems, and as you know if you read my blog, many of these uses are off-label. For anyone with a family history of osteoporosis, or in a demographic group at risk for osteoporosis, it is important to (1) weight the risks vs. benefits of your prescribed medication before taking it, and(2) consider consulting with a dietitian to enhance your diet and lifestyle choices to minimize the risk of bone-debilitating side effects.

Many of the lifestyle choices you are likely to be advised to adopt to prevent osteoporosis (more exercise, less soda, wider variety of foods) also enhance brain health. And what do you know--that may reduce your depressive symptoms as well.

(If you're getting tired of hearing that exercise, healthy food, adequate sleep, and less stress might be your answer...maybe that means you should try them...tee hee!!)

Vestergaard P, Rejnmark L, Mosekilde L. Selective Serotonin Reuptake Inhibitors and Other Antidepressants and Risk of Fracture. Calcif Tissue Int. 2008 Jan 25 [Epub ahead of print]