Americans prefer drugs to talk therapy for depression, with nearly 80 percent taking a pill for the condition, Consumer Reports said on Tuesday.

The most popular class of drugs remain the so-called SSRIs such as Prozac, the group found. People found newer, pricier antidepressants less desirable because of side-effects.

Patients benefited just as much from therapy — almost any kind of therapy, the consumer group found in its survey of 1,500 readers.

Those surveyed said they improved just as much after seven or more sessions of talk therapy as if they took drugs and it did not matter if the therapist was a psychiatrist, psychologist or social worker.

Nearly 80 percent of people who had been diagnosed with depression or anxiety were prescribed antidepressants.

Patients were happiest with the selective serotonin reuptake inhibitors or SSRIs, a class that includes Eli Lilly and Co’s Prozac or its generic equivalent fluoxetine;, Pfizer Inc’s Zoloft or sertraline, and Celexa or citalopram and Lexapro or escitalopram from Forest Laboratories Inc.

People complained of more side-effects from serotonin-norepinephrine reuptake inhibitors or SNRIs, a newer, often more expensive class of antidepressants, the survey found.

These include venlafaxine, made by Pfizer-owned Wyeth under the Effexor brand name and Lilly’s duloxetine, sold as Cymbalta.

The survey found a range of side-effects, but the most common one — loss of sexual interest or ability — was less common than in past surveys, the consumer group said.

Source: Reuters

Popularity: 4% [?]

Although antidepressants are effective in children, they are known to increase suicidal behavior. That increase, however, is not dependent on the specific drug, researchers reported on Monday.

Examining a wide range of antidepressants — including fluoxetine (Prozac), sertraline (Zoloft) and paroxetine (Paxil) — they found similar rates of suicide and suicide attempts in more than 20,000 Canadian youth.

“The main finding is essentially a non-finding, meaning that there is no difference in risk for a suicide between different drugs,” said Dr. Sebastian Schneeweiss of Harvard Medical School, who led the research, published in the journal Pediatrics.

“That is extremely important to know, because then you can focus only on the effectiveness of antidepressant drugs,” he added.

The US Food and Drug Administration currently requires a “black box” warning on antidepressant labels that draws attention to the increased risk of suicidal thoughts and behaviors in kids and young adults who take the drugs.

What hasn’t been clear, however, is whether some drugs are safer than others.

Schneeweiss and colleagues found three suicides and 266 unsuccessful suicide attempts among 10- to 18-year-old Canadians who had taken antidepressants for a year. Considering how long each person had been on antidepressants, that corresponds to about 3 suicides per year if 10,000 are treated.

While this rate is about five times the rate in the general population of teens in British Columbia, where the data was collected, the suicide risk was similar for different types of antidepressants. These included selective serotonin reuptake inhibitors (SSRIs) — the most commonly used drugs such as Prozac — and older drugs.

“The new study includes a far wider range of antidepressants than were included in earlier studies,” psychiatrist Dr. Mark Olfson of Columbia University, who was not involved in the study, told Reuters Health in an e-mail.

He added that the results suggest doctors and patients shouldn’t worry as much about safety when comparing antidepressants. Instead, he said, they should concentrate on how well the drugs work.

Because of the increased suicide risk in children and adolescents, it is still important to keep a close eye on young patients, said Dr. Thomas Laughren, director of the FDA’s Division of Psychiatry Products. But, he added, “being vigilant is different than being afraid.”

“The fact is, most people treated with these drugs get better,” he told Reuters Health.

SOURCE: Pediatrics, online April 12, 2010.

Popularity: 6% [?]

The debate over patents in India continues. India has been struggling to bring its intellectual property laws up to a standard that will invite multinational companies to do business there. But public opinion is strongly in favor of domestic companies, putting Big Pharma in a tough spot. Drugmakers want to sell their branded drugs at a branded drug price–which might be lower in India than in, say, the U.S. But thanks to a strong local drugs business, Indians have enjoyed cheap meds for years.

The latest skirmish involves 81 drug patents granted over the first four years of India’s new patent laws, 76 of which went to foreign pharma companies. One-third of them were divided among some of the top names in Big Pharma: Novartis, Eli Lilly and Pfizer.

The domestic industry now is questioning the validity of those patents, saying that they were issued in violation of two sections of the new law. These sections would deny patent protection to modified forms of long-ago-patented drugs and to new drugs that aren’t a big leap forward. An industry lobby demanded a review of these patents, and now the drugs in question–and some other related data–have been made public by a government agency.

The disputed patents include one granted to Eli Lilly for a combination of the antipsychotic drug Zyprexa (olanzipine) and the antidepressant Prozac (fluoxetine). Another, given to Novartis, covers a combo of blood pressure meds Norvasc (amlodipine) and Diovan (valsartan), with hydrochlorothiazide, a diuretic.

The industry lobby is fighting hard against these patents, calling for that controversial section of Indian patent law known as 3(d) to be strictly enforced. But others, including the U.S.-India Business Council, are calling for 3(d) to be abolished. It’s a hot-button issue on both sides, and the debate isn’t close to being resolved.

Source: FiercePharma

Popularity: 3% [?]

Some anti-depressant drugs are associated with an increased chance of developing cataracts, according to a new statistical study by researchers at the University of British Columbia, Vancouver Coastal Health Research Institute and McGill University.

The study, based on a database of more than 200,000 Quebec residents aged 65 and older, showed statistical relationships between a diagnosis of cataracts or cataract surgery and the class of drugs called selective serotonin reuptake inhibitors (SSRIs), as well as between cataracts and specific drugs within that class.

Published online today in the journal Ophthalmology, the study does not prove causation but only reveals an association between the use of SSRIs and the development of cataracts. The study could not account for the possibility of smoking – which is a risk factor for cataracts – and additional population-based studies are needed to confirm these findings, the researchers say.

This study of statistical relationships is the first to establish a link between this class of drugs and cataracts in humans. Previous studies in animal models had demonstrated that SSRIs could increase the likelihood of developing the condition.

“When you look at the trade-offs of these drugs, the benefits of treating depression – which can be life-threatening – still outweigh the risk of developing cataracts, which are treatable and relatively benign,” says Dr. Mahyar Etminan, lead author of the article, a scientist and clinical pharmacist at the Centre for Clinical Epidemiology at Vancouver Coastal Health Research Institute and an assistant professor in the Dept. of Medicine atUBC.

Researchers found patients taking SSRIs were overall 15 per cent more likely to be diagnosed with cataracts or to have cataract surgery.

The degree of risk among specific and different types of SSRIs varied considerably. Taking fluvoxamine (Luvox) led to a 51 per cent higher chance of having cataract surgery, and venlafaxine (Effexor) carried a 34 per cent higher risk. No connection could be made between fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft) and having cataract surgery.

Co-author Dr. Frederick S. Mikelberg, professor and head of the Dept. of Ophthalmology and Visual Sciences at UBC and head of the Dept. of Ophthalmology at Vancouver General Hospital, notes that the average time to develop cataracts while taking SSRIs was almost two years.

“While these results are surprising, and might inform the choices of psychiatrists when prescribing SSRIs for their patients, they should not be cause for alarm among people taking these medications,” Mikelberg says.

Source: University of British Columbia

Popularity: 10% [?]

Eli Lilly announced on Monday that the FDA granted expanded approval for Symbyax (olanzapine/fluoxetine) in the acute treatment of treatment-resistant depression (TRD). The new indication applies to adults with major depressive disorder who have twice experienced failure to respond to other antidepressants during their current episode, and the company said its combination product is the first drug to receive FDA approval for this use.

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The FDA also approved the use of its antipsychotic Zyprexa (olanzapine), in combination with Prozac (fluoxetine), in adults for the acute treatment of bipolar depression and for the acute treatment of TRD, the drugmaker said.

Additionally, Eli Lilly reported that the company updated the labels for Zyprexa and Symbyax to include extra information on weight gain, hyperglycaemia and hyperlipidaemia in patients taking the drug. The move follows an FDA review of study data which the drugmaker submitted to the agency between August 2007 and July 2008.

Source: FirstWord

Popularity: 5% [?]

A class of antidepressants thought to raise the risk of suicide among teens may significantly reduce the risk in adults, a review suggests.

In Tuesday’s issue of the Canadian Medical Association Journal, researchers from Italy and the World Health Organization reviewed eight studies involving more than 200,000 patients with moderate or severe depression who took selective serotonin reuptake inhibitors (SSRIs).

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“Data from observational studies should reassure doctors that prescribing SSRIs to patients with major depression is safe,” Dr. Corrado Barbui of the University of Verona and colleagues concluded.

“However, children and adolescents should be followed very closely because of the possibility of increased risk of suicidal thoughts and suicide.”

SSRIs include Paxil or paroxetine and Prozac or fluoxetine.

Since 2003, regulators in Canada, the U.S. and Europe have sent out advisories warning that clinical trials suggest SSRIs are linked to an increased risk of suicidal thoughts and behaviour in children and teens.

In 2007, an analysis by the U.S. Food and Drug Administration concluded that SSRIs significantly increased suicide risk for adolescents, offered protection for the elderly and were neutral for adults.

“While the FDA found a neutral effect of SSRIs (or a promoting effect in adults aged 18-25), we found a strong protective effect associated with SSRI treatment in adults,” the study’s authors wrote.

A commentary accompanying the study called for randomized trials to determine the safety and effectiveness of depression treatments in young adults to help guide doctors.

Dr. John Mann of Columbia University and Dr. Robert Gibbons of the University of Illinois said it was alarming that “concerns about the risk of suicide in youth have led not only to fewer SSRI prescriptions without substitution of alternative medications or psychotherapies, but also to a decrease in predicted rates of diagnosis of mood disorders.”

Source: cbc.ca

Popularity: 6% [?]

Two antidepressants, Zoloft and Cipralex, work slightly better and are better tolerated compared with 10 other similar drugs for moderate to severe depression, a new review has found.

In Thursday’s online issue of the medical journal The Lancet, an international team of doctors looked at more than 100 previous studies on antidepressants involving nearly 26,000 patients from 1991 to 2007.

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They concluded that Zoloft, or sertraline, and Cipralex, or escitalopram, were the best options when considering benefits, side-effects, and cost.

Edronax was considered the least effective.

“Such findings have enormous implications,” wrote Dr. Sagar Parikh, a psychiatrist at the University of Toronto, in a commentary accompanying the study.

“Now a clinician can identify the four best treatments, identify individual side-effect profiles, explore costs and patients’ preferences and collaborate in identifying the best treatment.”

The study’s authors weighed the drugs based on whether it reduced depression scores on two standardized tests by at least half and if patients had not stopped taking the medication in the last two months.

All of the antidepressants helped and there were no major differences, said the study’s lead author, Dr. Andrea Cipriani of the University of Verona in Italy.

“If a patient is taking a drug and doing well, he should not stop and switch drugs,” Cipriani said.

The other drugs reviewed were:

• Celexa (citalopram)
• Cymbalta (duloxetine)
• Effexor (venlafaxine)
• Ixel (milnacipran)
• Luvox (fluvoxamine)
• Prozac (fluoxetine)
• Seroxat (paroxetine)
• Remeron (mirtazapine)
• Zyban (bupropion)

Side-effects for the various drugs include nausea, sleeplessness, and sexual dysfunction.

The findings may lead doctors to prescribe Zoloft and Cipralex more often, but psychiatrists should also consider alternatives such as behavioural therapy, said Irving Kirsch, a professor of psychology at Britain’s University of Hull.

The study was paid for by the authors’ academic institutions in Britain, Greece, Italy, and Japan.

Cipriani has not received any grants from pharmaceutical companies. Several of his co-authors reported receiving funding from various makers of antidepressants.

Source: cbc.ca

Popularity: 12% [?]