Exercise May Improve Memory

February 7, 2018 · Posted in Potential Treatments · Comment 

exerciseA recent study suggests that exercising vigorously 20 minutes per day may improve “interference memory,” a type of memory that involves reconciling new learning with information one already knows. (Sometimes older information “interferes” with new learning.) In a 2017 article in the Journal of Cognitive Neuroscience, researcher Jennifer Heisz and colleagues report that performance on a high-interference memory task improved when participants engaged in 20-minute daily sessions of interval training for six weeks.

Heisz and colleagues compared three groups of students: one did interval training, another did both interval training and cognitive training, and a control group did no special training. Both exercise groups performed better on the high-interference memory task than the control group. Those who exercised also had higher levels of brain-derived neurotrophic factor (BDNF), which promotes the growth of new synapses and is crucial for long-term memory.

The researchers suggest that this finding could be useful to seniors facing memory deficits, since only six weeks of exercise improved memory performance. Interference memory tends to decline with age.

Previous research has linked aerobic exercise to better academic performance.

In Rats, Weight-Loss Drug Lorcaserin Reduces Opiate Use

February 5, 2018 · Posted in Potential Treatments · Comment 

rat investigating pills

The serotonin 5HT-2c agonist drug lorcaserin (Belviq) was approved by the US Food and Drug Administration in 2012 for the treatment of obesity and weight-related conditions (such as high blood pressure, type 2 diabetes, or high cholesterol) in adults. A 2017 article by researcher Harshini Neelakantan and colleagues in the journal ACS Chemical Neuroscience reports that in rats, lorcaserin may also reduce opiate use.

The rats had been self-administering the opiate oxycodone. After receiving lorcaserin, the rats were less likely to consume oxycodone and less likely to seek it out. The rats were also less responsive to cues that had previously led them to consume oxycodone, such as lights or sounds that occurred when oxycodone was available.

Serotonin 5HT-2c receptors both regulate psychostimulant reward in the brain and play a role in reactivity to cues like the lights and sounds the rats associated with oxycodone. Lorcaserin’s effect on these serotonin receptors explains how it could reduce the rats’ drug use.

Clinical trials are expected to examine whether lorcaserin can reduce opiate use in humans in addition to assisting with weight loss.

Grape Extract May Improve Cognition

January 31, 2018 · Posted in Potential Treatments · Comment 

Polyphenolic compounds in colored fruits and vegetables are thought to improve memory and cognition. Extracts from Vitis vinifera, the grape species that includes almost all well-known varieties of wine, have been found to have many beneficial effects: antioxidant, antibacterial, anti-inflammatory, anticancer, antidiabetic effects, in addition to protective effects on skin, the heart, the liver, and neurons.

For about a decade, researchers have known that polyphenolic compounds from grapes could improve cognitive impairment and reduce neuropathological lesions in the brain in animals with a model of Alzheimer’s disease. New research suggests that the same compounds that protect the plant against damage, fungus, or UV rays may also protect the human brain against damage.

Researchers led by Gioacchino Calapai tested a trademarked nutritional supplement called Cognigrape, which includes extracts from Vitis vinifera, in healthy adults between the ages of 55 and 75 in Italy. One group of 57 participants received 250mg of Cognigrape per day while the other group of 54 received placebo once a day for twelve weeks. Several weeks after the supplementation period, the group taking Cognigrape showed significant improvement in cognitive function compared to baseline and compared to the group taking placebo. The Cognigrape group also showed significant reductions in depression symptoms, improvements in somatic symptoms, and improvements in attention, language, immediate memory, and delayed memory. This is the first study to find an improvement in cognitive performance in humans after supplementation with a Vitis vinifera extract.

The study by Calapai and colleagues was published in the journal Frontiers in Pharmacology in 2017.

A New Treatment for Disruptive Mood Dysregulation

December 26, 2017 · Posted in Potential Treatments · Comment 

disruptive boy

The 2013 update to the Diagnostic and Statistical Manual of Mental Disorders, or the DSM-5, included a new diagnosis of disruptive mood dysregulation disorder. Children with persistent, severe temper outbursts and irritable or angry moods that are out of proportion to circumstances may be diagnosed with the disorder. However, there is not much specificity to the diagnosis and few treatment studies have been done to help clinicians and parents determine how to manage symptoms of the disorder.

A poster presented at the 2017 Psych Congress reported that a medication protocol consisting of an anticonvulsant drug to stabilize moods and temper outbursts and a dopamine agonist to reduce irritability, impulsivity, and concentration problems reduced rates of re-hospitalization. The retrospective study by researchers D. Matthews and G. Matthews included 91 children and adolescents who were prescribed the anticonvulsant oxcarbazepine and the dopamine agonist amantadine following hospitalization for severe aggression, mood instability, and impulsivity. Those who stuck to the regimen with minimal changes for one year had an 8% re-hospitalization rate compared to a 26% re-hospitalization rate among those who discontinued the regimen or substituted other drugs.

Editor’s Note: Oxcarbazepine has a long-acting preparation, Oxtellar, that can be given all at night.

Amantadine (Symmetrel) not only is a dopamine agonist used for Parkinson’s disease, but is also an antiviral and a blocker of glutamate NMDA channels. It stabilizes the closed state of the NMDA channel.

Simvastatin Looks Promising in Treatment of Negative Symptoms of Schizophrenia

December 20, 2017 · Posted in Potential Treatments · Comment 

simvastatin

The statin drug simvastatin (Zocor) enhances the effects of risperidone on negative symptoms of schizophrenia, according to a 2017 article by Soode Tajik-Esmaeeli and colleagues in the journal International Clinical Psychopharmacology.

In the 8-week study, 40 mg/day of simvastatin enhanced the effects of 4–6 mg/day of the antipsychotic risperidone on negative symptoms of schizophrenia, such as apathy and withdrawal, but not positive symptoms such as hallucinations or delusions.

Other statins, lovastatin and pravastatin, have not had a similar effect, possibly because they do not cross the blood-brain barrier as easily as simvastatin does.

Simvastatin has other benefits as well. Like all statins it decreases lipid levels, reducing cardiovascular disease. People with schizophrenia and bipolar disorder are at especially high risk for cardiovascular disease.

Simvastatin also decreases inflammation (lowering IL-1 alpha and TNF-beta levels) and may be neuroprotective, as it increases brain-derived neurotrophic factor (BDNF), a protein that protects neurons and is important for learning and memory. Inflammation is increasingly implicated in schizophrenia and bipolar disorder.

There is also some evidence that statins can prevent depressions over long-term follow-up. Studies in women without depression and men who had recently had heart attacks both showed that those taking statins had a lower rate of future depression than those not taking statins.

Editor’s Note: These findings suggest a potential 5-fold benefit to simvastatin: 1) It reduces negative symptoms in schizophrenia. 2) It reduces inflammation. 3) It increases BDNF. 4) It decreases cardiovascular disease risk by lowering lipid levels. 5) It may prevent future depressions.

Other approaches to augmenting schizophrenia treatment include nutritional supplements vitamin D3 and folate. Patients with psychosis often have vitamin D deficits. Folate supplements can reduce homocysteine, which has been linked to cognitive deficits in schizophrenia.

Liraglutide Decreased Body Weight, Improved Glucose Tolerance and Cardio Health in Schizophrenia

December 18, 2017 · Posted in Potential Treatments · Comment 

weightA 2017 article by Julie R. Larsen and colleagues in the journal Archives of General Psychiatry reported that the drug liraglutide, a treatment for type 2 diabetes, improved certain health measures in people with schizophrenia who were overweight and prediabetic and being treated with the atypical antipsychotics olanzepine or clozapine.

In the 16-week trial, patients received a daily 2 mg injection of liraglutide under the skin or placebo. Liraglutide decreased body weight, improved glucose tolerance, and improved cardio-metabolic measures. Weight decreased by more than 10 pounds on average compared to placebo.

Liraglutide is derived from a human metabolic hormone. It binds to the same receptors as does the metabolic hormone GLP-1, which stimulates insulin secretion.

Augmentation Strategies for Negative Symptoms of Schizophrenia

December 13, 2017 · Posted in Potential Treatments · Comment 

 teen

In a 2017 article in the journal JAMA Psychiatry, Christoph U. Correll and colleagues reviewed 42 secondary strategies to treat schizophrenia when the primary antipsychotic treatment has an incomplete effect. Many people with schizophrenia show only a limited response to antipsychotic drugs, so additional treatments are often necessary, but currently there are no US Food and Drug Administration guidelines for combination treatment.

Correll and colleagues compiled data from 29 meta-analyses covering 381 individual trials. They found that while the meta-analyses were well done, the quality of the data in the original studies was lacking.

Focusing on Negative Symptoms

However, since the negative symptoms of the illness such as apathy, withdrawal, and blunted emotional response are the hardest to treat, any amount of improvement in this area could be particularly helpful. Read more

Probiotics May Improve Depression As Well As IBS

December 11, 2017 · Posted in Potential Treatments · Comment 

vitamin DA pilot study of people with irritable bowel syndrome (IBS) suggests that taking a probiotic nutritional supplement can improve depression as well as gastrointestinal upset.
In the 2017 study published in the journal Gastroenterology, researcher Maria Pinto Sanchez and colleagues at the Farncombe Family Digestive Health Research Institute found that when those with IBS took a probiotic, their co-occurring depression improved more than it did in people with IBS who took a placebo.

Senior author Premysl Bercik suggested the study confirms that the microbiota environment in the gut affects what goes on in the brain, opening new avenues for the treatment of psychiatric diseases.

The study included 44 adults with IBS who also had mild to moderate anxiety and depression. For 10 weeks, half received a daily dose of the probiotic Bifidobacterium longum NCC3001, while the others received placebo.

After 6 weeks, 64% of the probiotic group saw improvement in their depression, compared to 32% of the placebo group. Functional magnetic resonance imaging (fMRI) showed brain changes associated with the improvement in mood.

The researchers are planning larger trials of probiotics.

TDCS Better Than Placebo But Not as Good as Escitalopram at Improving Unipolar Depression

December 8, 2017 · Posted in Potential Treatments · Comment 

An article by André R. Brunoni and colleagues in the New England Journal of Medicine reports that transcranial direct current stimulation (tDCS) can treat unipolar depression more effectively than placebo, but not quite as effectively as the selective serotonin reuptake inhibitor (SSRI) antidepressant escitalopram. TDCS consists of a constant, low direct current applied to the scalp via electrodes.

The study included 245 patients with moderate to severe depressive symptoms, many of whom also had anxiety disorders. To minimize the placebo effect, patients all participated in sessions wearing tDCS gear and received a daily pill. However, one group received real tDCS treatment but placebo pills, a second group received sham tDCS but real escitalopram pills, and the third group received both sham tDCS and placebo pills.

The real tDCS treatment consisted of 30-minute sessions of tDCS every day for 15 consecutive weekdays, then seven once-a-week treatments. The escitalopram dosage was 10 mg/day for three weeks, then 20 mg daily.

Ten weeks into treatment, those who received escitalopram showed the greatest improvement in depression. Those who received tDCS showed slightly less improvement, but still significantly more than those who received neither treatment. Cognitive performance either improved or stayed the same in all the groups.

In terms of side effects, those who received escitalopram were more likely to report sleepiness or severe constipation. Those who received tDCS reported more skin redness/tingling, itching, tinnitus, and nervousness. Two patients in the tDCS group had new-onset mania during treatment. There were no suicides, hospitalizations, or other serious side effects.

Botox for Depression

December 1, 2017 · Posted in Potential Treatments · Comment 

botox injectionSeveral recent clinical trials have suggested that Botox injections between the eyebrows may improve depression. The theory is that decreasing muscle tension could reduce feelings of depression, instead of depression causing muscle tension. In a phase 2 double blind multicenter trial of 258 women with depression, participants were randomized to receive 30 units of Botox, 50 units of Botox, or placebo. Those who received the 30-unit injections showed significantly greater improvement in depression at three weeks and nine weeks compared to those who received placebo. However, it was not superior to placebo at the primary endpoint of the study, six weeks, and the 50-unit dosage was not superior to placebo. Both doses were well tolerated.

Botox is derived from botulinum toxin, which can relax tense muscles. It is also being explored as a treatment for migraine headaches. The manufacturer, Allergan, expects to move forward with phase 3 trials of Botox for depression.

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