Depression Can Be a More Serious Matter for Men Than Women, Reports the Harvard Mental Health Letter

10/31/2006 10:37:00 AM

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To: National Desk, Health and Medical Reporter

Contact: Christine Junge of Harvard Health Publications, 617-432-4717, or Christine_Junge@hms.harvard.edu

BOSTON, Oct. 28 /U.S. Newswire/ — Depression is sometimes called the common cold of mental health, but it’s unlike the common cold in at least two important respects: It doesn’t go away in a week without treatment and it doesn’t affect men and women equally or in the same ways. Though depression seems to affect more women than men, it presents special problems for men, reports the November issue of the Harvard Mental Health Letter.

In the United States, about half as many men as women are diagnosed as being seriously depressed at some time in their lives. But this relatively low rate could be an illusion. Men often don’t like to admit that they are depressed, so they are more likely to withdraw into silent misery or hide depression under anger, irritability, alcoholism or drug abuse.

Depression can be an even more serious matter for men than for women. To begin with, it is a key risk factor for suicide and men commit suicide four times more often than women do. Another mortal concern for men with depression is cardiovascular disease. Depression affects blood pressure, blood clotting and the immune system. It’s a well-known risk factor for heart disease, heart attacks and stroke. Men are especially vulnerable because they develop these diseases at a higher rate and at an earlier age than women.

“The most important thing others can do for a man who shows signs of depression is to help him contact a physician or mental health professional,” says Michael Miller, editor in chief of the Harvard Mental Health Letter. “If necessary, accompany him to treatment and encourage him to continue until his symptoms improve.”

***Ephosting.com does not own the copyright to this report. This is a reprint of a press release. The source of this document: http://releases.usnewswire.com/GetRelease.asp?id=75364

Press Release
August 7, 2006

Contact: Susan Cahill
NIMH Press Office

301-443-4536
NIMHpress@nih.gov

Experimental Medication Kicks Depression in Hours Instead of Weeks

People with treatment-resistant depression experienced symptom relief in as little as two hours with a single intravenous dose of ketamine, a medication usually used in higher doses as an anesthetic in humans and animals, in a preliminary study. Current antidepressants routinely take eight weeks or more to exert their effect in treatment-resistant patients and four to six weeks in more responsive patients — a major drawback of these medications. Some participants in this study, who previously had tried an average of six medications without relief, continued to show benefits over the next seven days after just a single dose of the experimental treatment, according to researchers conducting the study at the National Institutes of Health’s National Institute of Mental Health.

This is among the first studies of humans to examine the effects of ketamine on depression, a debilitating illness that affects 14.8 million people in any given year. Used in very low doses, the medication is important for research, but is unlikely to become a widely used clinical treatment for depression because of potential side effects, including hallucinations and euphoria, at higher doses. However, scientists say this research could point the way toward development of a new class of faster- and -longer-acting medications. None of the patients in this study, all of whom received a low dose, had serious side effects. Study results were published in the August issue of the Archives of General Psychiatry.

“The public health implications of being able to treat major depression this quickly would be enormous,” said NIH Director Elias A. Zerhouni, M.D. “These new findings demonstrate the importance of developing new classes of antidepressants that are not simply variations of existing medications.”

For this study 18 treatment-resistant, depressed patients were randomly assigned to receive either a single intravenous dose of ketamine or a placebo (inactive compound). Depression improved within one day in 71 percent of all those who received ketamine, and 29 percent of these patients became nearly symptom-free within one day. Thirty-five percent of patients who received ketamine still showed benefits seven days later. Participants receiving a placebo infusion showed no improvement. One week later, participants were given the opposite treatment, unless the beneficial effects of the first treatment were still evident. This “crossover” study design strengthens the validity of the results.

“To my knowledge, this is the first report of any medication or other treatment that results in such a pronounced, rapid, prolonged response with a single dose. These were very treatment-resistant patients,” said NIMH Director Thomas R. Insel, M.D.

Ketamine blocks a brain protein called the N-methyl-D-aspartic acid (NMDA) receptor. Previous studies have shown that agents that block the NMDA receptor reduce depression-like behaviors in animals.

NMDA receptors are critical for receiving the signals of glutamate, a brain chemical that enhances the electrical flow among brain cells that is required for normal function. Studies indicate that dysregulation in glutamate could be among the culprits in depression. Using ketamine to block glutamate’s actions on the NMDA receptor appears to improve function of another brain receptor — the AMPA receptor — that also helps regulate brain cells’ electrical flow.

Scientists think the reason current antidepressant medications take weeks to work is that they act on targets close to the beginning of a series of biochemical reactions that regulate mood. The medications’ effects then have to trickle down through the rest of the reactions, which takes time. Scientists theorize that ketamine skips much of this route because its target, the NMDA receptor, is closer to the end of the series of reactions in question.

“This may be a key to developing medications that eliminate the weeks or months patients have to wait for antidepressant treatments to kick in,” said lead researcher Carlos A. Zarate Jr., of the NIMH Mood and Anxiety Disorders Program.

The researchers who conducted the study now are zeroing in on other areas of the glutamate system. Specifying which components of the system are affected by compounds such as ketamine may help scientists understand how and why depression occurs, reveal biological markers that may one day aid in diagnosis, and point the way to more precise targets for new medications.

Dr. Zarate was joined in this research by Husseini K. Manji, chief of the NIMH Mood and Anxiety Disorders Program, and colleagues Jaskaran B. Singh, Paul J. Carlson, Nancy E. Brutsche, Rezvan Ameli, David A. Luckenbaugh, and Dennis S. Charney.

******Ephosting.com does not own the copyright to this report. This is a reprint of a press release. The source of this document: http://www.nimh.nih.gov/press/ketamine.cfm