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Psychiatry Newsletter - Science Summaries
Hopkins BrainWise Fall 2009
Date: November 2, 2009
A Cut Above for Methadone Therapy
Patients on methadone therapy often struggle with other drug use and psychiatric disorders. But routine treatment combining methadone with monthly counseling brings too-slow results for the most poorly responding patients. A study led by Karin Neufeld rated Community Access Specialized Treatment, a network of Baltimore clinics with common access to short sessions of a new, “top drawer” program for patients who need more help. CAST, which includes on-site psychiatric care and tailored substance abuse services, proved much better on key outcomes measures than the single-clinic system.
An Alzheimer's Biomarker?
Microglia, the nervous system’s resident immune cells, release a brew of inflammatory molecules—cytokines—when they’re active. Alzheimer’s disease researchers know that the signature substance in AD-affected cells, amyloid-ß, potently stimulates microglia.
Paul Rosenberg hopes to tap into all this to develop a marker for Alzheimer’s disease.
By sampling key blood cells for cytokine levels, he’s found that what AD patients release is in proportion to poorer cognitive performance.
Huntington's in the Pipeline
Two already FDA-approved drugs—one for epilepsy, the other an antidepressant—recently inspired optimism as they moved up the investigational pipeline for Huntington’s disease.
Christopher Ross reports on studies with Wenzhen Duan in using a respected mouse model of Huntington’s he’d developed earlier. Tiagabine (Gabatril) extended survival, improved movement and lessened brain atrophy in the animals.
Sertraline (Zoloft) had similar effects while it increased the protective BDNF growth factor. Both drugs worked at dosages in sync with human therapy.
Depression's (Epidemiologically) Bumpy Road
Built-in biases—like looking only at clinic patients—skew studies on the nature of depression, says Peter Zandi. Recently, however, his Hopkins team focused on data from the Baltimore Epidemiologic Catchment Area, an ongoing survey of mental illness in communities.
Women showed a higher risk for a first depression, with longer episodes and tendency for it to recur. About 15 percent of the first-timers had depressions they couldn’t shake, even after 23 years.
Roughly half, though, recovered and had no repeats.
Closeness Counts for Alzheimer's Care
Closeness counts, says Constantine Lyketsos, on results of a study, with Hopkins and Utah State colleagues, on patient-caregiver relationships and progression of Alzheimer’s disease.
Patients whose caregivers felt emotionally close, especially a spouse, saw a beneficial cognitive effect on a par with some drugs used to treat AD.
“It may mean the difference between staying home and going into care,” he says.
Now, he adds, comes the search for the reason why.
Bupropion for Smoking
Almost all women who are illicit drug users keep smoking even though they’re pregnant, says Margaret Chisolm.
But there’s a bright spot: Given bupropion for their depression, pregnant, drug-dependent women in Chisolm’s study also cut at least six cigarettes from daily use.
That’s far better than results with one of two other antidepressants or with no therapy at all. Bupropion has a good safety profile during pregnancy.