For very a decade, the public has heeded warnings of suicidal behavior related to antidepressant use in kids and adolescents. However, the use of antidepressants in this population is still increasing. Initially, selective serotonin reuptake inhibitors (SSRIs), the most common class of antidepressants prescribed for kids, were the only drugs associated with the increase in suicidal behavior. Now, a huge cohort study published in a recent issue of Pediatrics reports that there is no difference in the risk of suicidal behavior among different SSRIs or difference classes of antidepressants.
The United States Food and Drug Administration (FDA) issued a public warning in October 2004 that cautioned about an increase in suicidal thoughts and behaviors in kids and adolescents taking SSRIs. Later, the FDA necessary a “black box warning” — the most serious type of warning obtainable — be placed on the labeling of SSRIs detailing the increased suicidal risks. The warning came after a 2007 study in the Journal of the American Medical Association found that the risk of suicidal thoughts and attempts in young patients taking SSRIs was once the rate of patients taking placebo.
However, plenty of patients, parents and prescribers were skeptical of the results and the use of SSRIs in kids and adolescents has continued to increase over the past several years. Several studies and reviews since the issuance of the FDA’s warning have not duplicated the increased suicidal behavior, and plenty of clinicians and patients feel that the benefits of antidepressant therapy outweigh the risks. A landmark study funded by the National Institute of Mental Health, the Treatment for Adolescents with Depression Study (TADS), concluded that a combination of fluoxetine (an SSRI) and psychotherapy is the most effective treatment for depression in young patients.
Several studies have also analyzed the relationship between antidepressant use in adults and suicide risk, but have yielded conflicting results. Further, several huge studies found no increase in suicidal behavior in young people, either. One study even reported that SSRI use was associated with decreased suicidal behavior in kids and adolescents.
Tuesday, June 15, 2010
Antidepressants Carry Equal Risks
For very a decade, the public has heeded warnings of suicidal behavior related to antidepressant use in kids and adolescents. However, the use of antidepressants in this population is still increasing. Initially, selective serotonin reuptake inhibitors (SSRIs), the most common class of antidepressants prescribed for kids, were the only drugs associated with the increase in suicidal behavior. Now, a huge cohort study published in a recent issue of Pediatrics reports that there is no difference in the risk of suicidal behavior among different SSRIs or difference classes of antidepressants.
The United States Food and Drug Administration (FDA) issued a public warning in October 2004 that cautioned about an increase in suicidal thoughts and behaviors in kids and adolescents taking SSRIs. Later, the FDA necessary a “black box warning” — the most serious type of warning obtainable — be placed on the labeling of SSRIs detailing the increased suicidal risks. The warning came after a 2007 study in the Journal of the American Medical Association found that the risk of suicidal thoughts and attempts in young patients taking SSRIs was once the rate of patients taking placebo.
However, plenty of patients, parents and prescribers were skeptical of the results and the use of SSRIs in kids and adolescents has continued to increase over the past several years. Several studies and reviews since the issuance of the FDA’s warning have not duplicated the increased suicidal behavior, and plenty of clinicians and patients feel that the benefits of antidepressant therapy outweigh the risks. A landmark study funded by the National Institute of Mental Health, the Treatment for Adolescents with Depression Study (TADS), concluded that a combination of fluoxetine (an SSRI) and psychotherapy is the most effective treatment for depression in young patients.
Several studies have also analyzed the relationship between antidepressant use in adults and suicide risk, but have yielded conflicting results. Further, several huge studies found no increase in suicidal behavior in young people, either. One study even reported that SSRI use was associated with decreased suicidal behavior in kids and adolescents.
The United States Food and Drug Administration (FDA) issued a public warning in October 2004 that cautioned about an increase in suicidal thoughts and behaviors in kids and adolescents taking SSRIs. Later, the FDA necessary a “black box warning” — the most serious type of warning obtainable — be placed on the labeling of SSRIs detailing the increased suicidal risks. The warning came after a 2007 study in the Journal of the American Medical Association found that the risk of suicidal thoughts and attempts in young patients taking SSRIs was once the rate of patients taking placebo.
However, plenty of patients, parents and prescribers were skeptical of the results and the use of SSRIs in kids and adolescents has continued to increase over the past several years. Several studies and reviews since the issuance of the FDA’s warning have not duplicated the increased suicidal behavior, and plenty of clinicians and patients feel that the benefits of antidepressant therapy outweigh the risks. A landmark study funded by the National Institute of Mental Health, the Treatment for Adolescents with Depression Study (TADS), concluded that a combination of fluoxetine (an SSRI) and psychotherapy is the most effective treatment for depression in young patients.
Several studies have also analyzed the relationship between antidepressant use in adults and suicide risk, but have yielded conflicting results. Further, several huge studies found no increase in suicidal behavior in young people, either. One study even reported that SSRI use was associated with decreased suicidal behavior in kids and adolescents.
Take Two of These… And You Still Might Have Pain
Migraines are severe, often debilitating, headaches that may be accompanied by visual symptoms, as well as nausea and vomiting. Migraines may last up to 24 hours. The exact cause of migraine is unknown, and most treatment focuses on acute pain relief once the migraine begins. For many migraine sufferers, acute pain relief is often ineffective at relieving the migraine symptoms. But, a new analysis published in the Cochrane Database of Systemic Reviews reveals that a single dose of aspirin is effective for more than half of migraine sufferers.
The exact cause of migraines is unknown, and frequent, severe migraines significantly decrease quality of life for the patient and, often, his or her family. As many as 12% of people in Western countries experience migraine headaches, and women are 3 times as likely as men to be migraine sufferers. Migraines most commonly occur between the ages of 30 and 50. Additional risk factors for migraines include medication overuse, temporomandibular disorders, obstructive sleep apnea and obesity. Nearly all migraine sufferers treat the pain associated with migraine with medications for acute pain relief. Most often, these include over-the-counter remedies such as aspirin, ibuprofen, acetaminophen, and caffeine. Many patients still do not find relief, and several prescription options for migraine pain relief have been developed in recent years.
The new analysis of 13 studies included more than 4000 patients; it analyzed the effectiveness of aspirin for acute pain relief related to migraine. Overall, a single dose of 900 or 1000 mg of aspirin was more effective at reducing pain, nausea and vomiting, and sensitivity to light and sound compared to placebo. Aspirin exhibited similar efficacy compared to common prescription migraine remedies, including sumatriptan. A single dose of aspirin reduced moderate to severe pain to no pain in 2 hours in 24% of patients, compared to 11% of patients receiving placebo; aspirin reduced moderate to severe pain to no worse than mild pain in 52% of patients, compared to 32% of patients receiving placebo.
Migraine treatments can be very expensive, and many patients attempt to treat migraines with over-the-counter remedies whenever possible. However, according to the new study, aspirin still leaves nearly half of migraine sufferers with pain. Plus, aspirin is well-known to cause side effects, including gastrointestinal toxicity and bleeding disorders, and interacts with many prescription and over-the-counter medications.
So what is a migraine sufferer to do? While the exact cause of migraine headaches is unclear, many patients can identify individual triggers, such as food, drinks, activities or hormonal fluctuations, that provoke migraine attacks. Avoiding the triggers is the best way to prevent the disability and pain associated with migraines. When this is not possible, patients need accessible, effective, inexpensive relief from pain. New preventive treatments, including anticonvulsant drugs, onabotulinum toxin, muscle relaxants, nerve blocks, and neural stimulation, are being investigated, but are yet unavailable for widespread migraine relief.
Migraine headaches warrant additional research to determine the cause and treatment options to effectively eliminate this debilitating condition. Health care providers should be aware of the risk factors for migraine and aid patients in identifying migraine triggers
The exact cause of migraines is unknown, and frequent, severe migraines significantly decrease quality of life for the patient and, often, his or her family. As many as 12% of people in Western countries experience migraine headaches, and women are 3 times as likely as men to be migraine sufferers. Migraines most commonly occur between the ages of 30 and 50. Additional risk factors for migraines include medication overuse, temporomandibular disorders, obstructive sleep apnea and obesity. Nearly all migraine sufferers treat the pain associated with migraine with medications for acute pain relief. Most often, these include over-the-counter remedies such as aspirin, ibuprofen, acetaminophen, and caffeine. Many patients still do not find relief, and several prescription options for migraine pain relief have been developed in recent years.
The new analysis of 13 studies included more than 4000 patients; it analyzed the effectiveness of aspirin for acute pain relief related to migraine. Overall, a single dose of 900 or 1000 mg of aspirin was more effective at reducing pain, nausea and vomiting, and sensitivity to light and sound compared to placebo. Aspirin exhibited similar efficacy compared to common prescription migraine remedies, including sumatriptan. A single dose of aspirin reduced moderate to severe pain to no pain in 2 hours in 24% of patients, compared to 11% of patients receiving placebo; aspirin reduced moderate to severe pain to no worse than mild pain in 52% of patients, compared to 32% of patients receiving placebo.
Migraine treatments can be very expensive, and many patients attempt to treat migraines with over-the-counter remedies whenever possible. However, according to the new study, aspirin still leaves nearly half of migraine sufferers with pain. Plus, aspirin is well-known to cause side effects, including gastrointestinal toxicity and bleeding disorders, and interacts with many prescription and over-the-counter medications.
So what is a migraine sufferer to do? While the exact cause of migraine headaches is unclear, many patients can identify individual triggers, such as food, drinks, activities or hormonal fluctuations, that provoke migraine attacks. Avoiding the triggers is the best way to prevent the disability and pain associated with migraines. When this is not possible, patients need accessible, effective, inexpensive relief from pain. New preventive treatments, including anticonvulsant drugs, onabotulinum toxin, muscle relaxants, nerve blocks, and neural stimulation, are being investigated, but are yet unavailable for widespread migraine relief.
Migraine headaches warrant additional research to determine the cause and treatment options to effectively eliminate this debilitating condition. Health care providers should be aware of the risk factors for migraine and aid patients in identifying migraine triggers
Take Two of These… And You Still Might Have Pain
Migraines are severe, often debilitating, headaches that may be accompanied by visual symptoms, as well as nausea and vomiting. Migraines may last up to 24 hours. The exact cause of migraine is unknown, and most treatment focuses on acute pain relief once the migraine begins. For many migraine sufferers, acute pain relief is often ineffective at relieving the migraine symptoms. But, a new analysis published in the Cochrane Database of Systemic Reviews reveals that a single dose of aspirin is effective for more than half of migraine sufferers.
The exact cause of migraines is unknown, and frequent, severe migraines significantly decrease quality of life for the patient and, often, his or her family. As many as 12% of people in Western countries experience migraine headaches, and women are 3 times as likely as men to be migraine sufferers. Migraines most commonly occur between the ages of 30 and 50. Additional risk factors for migraines include medication overuse, temporomandibular disorders, obstructive sleep apnea and obesity. Nearly all migraine sufferers treat the pain associated with migraine with medications for acute pain relief. Most often, these include over-the-counter remedies such as aspirin, ibuprofen, acetaminophen, and caffeine. Many patients still do not find relief, and several prescription options for migraine pain relief have been developed in recent years.
The new analysis of 13 studies included more than 4000 patients; it analyzed the effectiveness of aspirin for acute pain relief related to migraine. Overall, a single dose of 900 or 1000 mg of aspirin was more effective at reducing pain, nausea and vomiting, and sensitivity to light and sound compared to placebo. Aspirin exhibited similar efficacy compared to common prescription migraine remedies, including sumatriptan. A single dose of aspirin reduced moderate to severe pain to no pain in 2 hours in 24% of patients, compared to 11% of patients receiving placebo; aspirin reduced moderate to severe pain to no worse than mild pain in 52% of patients, compared to 32% of patients receiving placebo.
Migraine treatments can be very expensive, and many patients attempt to treat migraines with over-the-counter remedies whenever possible. However, according to the new study, aspirin still leaves nearly half of migraine sufferers with pain. Plus, aspirin is well-known to cause side effects, including gastrointestinal toxicity and bleeding disorders, and interacts with many prescription and over-the-counter medications.
So what is a migraine sufferer to do? While the exact cause of migraine headaches is unclear, many patients can identify individual triggers, such as food, drinks, activities or hormonal fluctuations, that provoke migraine attacks. Avoiding the triggers is the best way to prevent the disability and pain associated with migraines. When this is not possible, patients need accessible, effective, inexpensive relief from pain. New preventive treatments, including anticonvulsant drugs, onabotulinum toxin, muscle relaxants, nerve blocks, and neural stimulation, are being investigated, but are yet unavailable for widespread migraine relief.
Migraine headaches warrant additional research to determine the cause and treatment options to effectively eliminate this debilitating condition. Health care providers should be aware of the risk factors for migraine and aid patients in identifying migraine triggers
The exact cause of migraines is unknown, and frequent, severe migraines significantly decrease quality of life for the patient and, often, his or her family. As many as 12% of people in Western countries experience migraine headaches, and women are 3 times as likely as men to be migraine sufferers. Migraines most commonly occur between the ages of 30 and 50. Additional risk factors for migraines include medication overuse, temporomandibular disorders, obstructive sleep apnea and obesity. Nearly all migraine sufferers treat the pain associated with migraine with medications for acute pain relief. Most often, these include over-the-counter remedies such as aspirin, ibuprofen, acetaminophen, and caffeine. Many patients still do not find relief, and several prescription options for migraine pain relief have been developed in recent years.
The new analysis of 13 studies included more than 4000 patients; it analyzed the effectiveness of aspirin for acute pain relief related to migraine. Overall, a single dose of 900 or 1000 mg of aspirin was more effective at reducing pain, nausea and vomiting, and sensitivity to light and sound compared to placebo. Aspirin exhibited similar efficacy compared to common prescription migraine remedies, including sumatriptan. A single dose of aspirin reduced moderate to severe pain to no pain in 2 hours in 24% of patients, compared to 11% of patients receiving placebo; aspirin reduced moderate to severe pain to no worse than mild pain in 52% of patients, compared to 32% of patients receiving placebo.
Migraine treatments can be very expensive, and many patients attempt to treat migraines with over-the-counter remedies whenever possible. However, according to the new study, aspirin still leaves nearly half of migraine sufferers with pain. Plus, aspirin is well-known to cause side effects, including gastrointestinal toxicity and bleeding disorders, and interacts with many prescription and over-the-counter medications.
So what is a migraine sufferer to do? While the exact cause of migraine headaches is unclear, many patients can identify individual triggers, such as food, drinks, activities or hormonal fluctuations, that provoke migraine attacks. Avoiding the triggers is the best way to prevent the disability and pain associated with migraines. When this is not possible, patients need accessible, effective, inexpensive relief from pain. New preventive treatments, including anticonvulsant drugs, onabotulinum toxin, muscle relaxants, nerve blocks, and neural stimulation, are being investigated, but are yet unavailable for widespread migraine relief.
Migraine headaches warrant additional research to determine the cause and treatment options to effectively eliminate this debilitating condition. Health care providers should be aware of the risk factors for migraine and aid patients in identifying migraine triggers
Good Health Equals Good Sex
Sexuality is an important component of overall health and quality of life. An active sex life can reduce stress, strengthen the immune system, improve cardiovascular health and promote longevity. Not only does sex lead to health benefits, but good health leads to improved sexuality. A recent British Medical Journal (BMJ) report concluded that the better one’s health, the more sex he or she can look forward to later in life.
Sexual health is important throughout a person’s life, and older age is no exception. Unfortunately, sexual activity and function declines with age in both men and women owing to a combination of biological, psychological, and cultural factors. Approximately half of sexually active middle-aged and elderly adults in the United States report at least one bothersome sexual problem; one-third of this population reports at least two problems. The most prevalent problem for women is low desire, while men complain most often of erectile dysfunction.
Fortunately, older adults who wish to remain sexually active have an armamentarium of products and medications to treat sexual dysfunction. Additionally, being in good overall health improves sex and prolongs sexual life expectancy. The BMJ study analyzed two cohorts of more than 3000 adults each and assessed the anticipated number of years remaining of sexually active life for different gender and age groups. Overall, men were more likely to report being sexually active, enjoying a good quality sex life, and having an interest in sex in all age groups. In the study populations, 39% of men and 17% of women were still sexually active at age 75 to 85 years old. Of those who were sexually active, nearly 71% of men and 51% of women reported a good quality sex life, and 41% of men and 11% of women were interested in sex. For all age groups, both men and women in self-reported “very good” or “excellent” health were nearly twice as likely as their unhealthier peers to be sexually active. Good health was also associated with increased frequency of sex, as well as sexual desire.
The good news for healthy, younger adults is that they can look forward to many years of a sexually active life. The average sexually active life expectancy for a 30-year-old today is nearly 35 years for a man and 31 years for a woman. A 55-year-old man today can still anticipate 15 more years of a sex life, while a woman can expect a little more than 10 years. At age 55, men in very good or excellent health can expect an additional 5 to 7 years of sexually active life, compared to their peers in fair or poor health; women in very good or excellent health can expect 3 to 6 additional years of an active sex life.
The good news from the BMJ study for older adults is that if they are already enjoying a healthy sex life, there are many more years of sexual activity ahead. But, if they are not enjoying a healthy sex life, there is hope: make sexual health a part of overall health. Identifying factors that contribute to good health, and good sexual health, are important for physicians to discuss with patients. A minority of middle-aged and elderly patients report discussing sexual health or function with a physician since the age of 50, despite advances in treating sexual dysfunction in both men and women. Similarly, maintaining cardiovascular health, controlling diabetes, or treating depression can improve sex — all components of overall health that physicians should be addressing anyway. Good health leads to good sex, and good sex leads to good health. That is a cycle that most adults can support.
Sexual health is important throughout a person’s life, and older age is no exception. Unfortunately, sexual activity and function declines with age in both men and women owing to a combination of biological, psychological, and cultural factors. Approximately half of sexually active middle-aged and elderly adults in the United States report at least one bothersome sexual problem; one-third of this population reports at least two problems. The most prevalent problem for women is low desire, while men complain most often of erectile dysfunction.
Fortunately, older adults who wish to remain sexually active have an armamentarium of products and medications to treat sexual dysfunction. Additionally, being in good overall health improves sex and prolongs sexual life expectancy. The BMJ study analyzed two cohorts of more than 3000 adults each and assessed the anticipated number of years remaining of sexually active life for different gender and age groups. Overall, men were more likely to report being sexually active, enjoying a good quality sex life, and having an interest in sex in all age groups. In the study populations, 39% of men and 17% of women were still sexually active at age 75 to 85 years old. Of those who were sexually active, nearly 71% of men and 51% of women reported a good quality sex life, and 41% of men and 11% of women were interested in sex. For all age groups, both men and women in self-reported “very good” or “excellent” health were nearly twice as likely as their unhealthier peers to be sexually active. Good health was also associated with increased frequency of sex, as well as sexual desire.
The good news for healthy, younger adults is that they can look forward to many years of a sexually active life. The average sexually active life expectancy for a 30-year-old today is nearly 35 years for a man and 31 years for a woman. A 55-year-old man today can still anticipate 15 more years of a sex life, while a woman can expect a little more than 10 years. At age 55, men in very good or excellent health can expect an additional 5 to 7 years of sexually active life, compared to their peers in fair or poor health; women in very good or excellent health can expect 3 to 6 additional years of an active sex life.
The good news from the BMJ study for older adults is that if they are already enjoying a healthy sex life, there are many more years of sexual activity ahead. But, if they are not enjoying a healthy sex life, there is hope: make sexual health a part of overall health. Identifying factors that contribute to good health, and good sexual health, are important for physicians to discuss with patients. A minority of middle-aged and elderly patients report discussing sexual health or function with a physician since the age of 50, despite advances in treating sexual dysfunction in both men and women. Similarly, maintaining cardiovascular health, controlling diabetes, or treating depression can improve sex — all components of overall health that physicians should be addressing anyway. Good health leads to good sex, and good sex leads to good health. That is a cycle that most adults can support.
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