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Two Antidepressants No Better Than One? Megan Brooks Authors and Disclosures Rate This Article: Physician Rating: ( 12 Votes ) Print This Email this Share MEDSCAPE'S FREE MOBILE APP Experience the fastest, most comprehensive, FREE medical app used by physicians. Available for iPhone®, iPod touch®, iPad™, Android™, and BlackBerry® Learn more July 7, 2011 — Combination antidepressant treatment using 2 antidepressants appears to offer no advantage over monotherapy in patients with major depressive disorder (MDD) and may even do more harm than good, new research suggests. Overall results from the Combining Medications to Enhance Depression Outcomes (CO- MED) study, a large-scale trial, showed that when treatment in patients with MDD is initiated, a single antidepressant produced the same remission rate as 2 antidepressants and that therapy with 2 drugs may have more side effects than a single drug. "We found no clinical advantage over escitalopram-placebo from either combination of antidepressant medications in terms of either remission or response rates at either 12 weeks or 7 months," the investigators, led by John A. Rush, University of First Duke-National University of Singapore Graduate Medical School and the CO-MED team, write. The study was published in the July issue of the American Journal of Psychiatry. Mom's Antidepressant Use Linked to Autism Risk in Children Deborah Brauser Authors and Disclosures Rate This Article: Physician Rating: ( 24 Votes ) Print This Email this Share MEDSCAPE'S FREE MOBILE APP Experience the fastest, most comprehensive, FREE medical app used by physicians. Available for iPhone®, iPod touch®, iPad™, Android™, and BlackBerry® Learn more July 6, 2011 — Use of selective serotonin reuptake inhibitors (SSRIs) by pregnant women may increase the risk for autism spectrum disorder (ASD) in their offspring, new research suggests. In a study of more than 1800 children, investigators found an adjusted 2-fold increased risk for ASD among mothers who used an SSRI during the year before delivery and a 3-fold increased risk when SSRIs were ingested during the first trimester. "The potential association between use of antidepressants during pregnancy and risk of [ASDs] has never been investigated before," lead author Lisa A. Croen, PhD, senior research scientist and director of the Autism Research Program at Kaiser Permanente Northern California (KPNC) in Oakland, told Medscape Medical News. However, she noted that the results "should be interpreted with extreme caution" and that further studies are needed to determine if this association represents a causal connection. "At this point, we do not recommend that women make any changes to their treatment approach for depression and/or anxiety," said Dr. Croen. Instead, she recommends that those prescribed SSRIs during pregnancy discuss the issue with their doctors. Dr. Lisa A. Croen "We know that there are real risks to the woman and their children if mental health disorders in mom go untreated, and there are real benefits to appropriate treatment. So the potential risk of autism must be balanced with the real benefit of treatment," she said. The study was published online July 4 in the Archives of General Psychiatry. Autism Cases Increasing According to the study, autism cases have increased from 4 to 5 per 10,000 in 1966 to almost 100 per 10,000 today. "While at least some of this observed increase in prevalence can be attributed to changing diagnostic standards, availability of services, and greater public awareness, there is considerable scientific and public concern about environmental factors that may contribute to autism risk, most likely in interaction with genetic factors," write the investigators. "There is some literature suggesting a family history of mental health conditions among individuals with [ASDs], but no prior studies have been able to look at both the mental health condition and the treatment for the condition at the same time," said Dr. Croen. For this study, the investigators evaluated medical records of 298 children with ASD (82.9% male; 54.7% white, 13.4% Hispanic, 9.4% Asian, 9.1% black) and 1507 healthy controls (80.6% male; 46.4% white, 20.4% Hispanic, 9.9% Asian, 10% black) from the Childhood Autism Perinatal Study. All were born between January 1995 and June 1999 at a KPNC facility. Most Suicidal Patients Receive No Treatment, Global Study Shows Deborah Brauser Authors and Disclosures Rate This Article: Physician Rating: ( 5 Votes ) Print This Email this Share MEDSCAPE'S FREE MOBILE APP Experience the fastest, most comprehensive, FREE medical app used by physicians. Available for iPhone®, iPod touch®, iPad™, Android™, and BlackBerry® Learn more July 5, 2011 — Most people with suicidal intentions do not receive mental health treatment, in large part due to their attitudes toward help-seeking and not because of stigma or financial concerns, international research shows. After examining data on more than 55,000 adults from 21 countries, investigators found that only about 40% of the total suicidal respondents had received any treatment at all. "Clinicians, policy-makers, and healthcare planners should be aware of the significance of the degree of unmet need and the broad range of barriers that prevent suicidal people from seeking treatment," writes Ronny Bruffaerts, PhD, from the University Psychiatric Center at the Catholic University Leuven in Belgium and the University Hospital Gasthuisberg, and colleagues. The researchers also note that suicide prevention strategies should become regionally tailored. "Improving the receipt of treatment worldwide will have to take into account culture-specific factors that may influence the process of help-seeking [and] interventions may be needed to expand or reallocate treatment resources, especially in countries with lower access to treatment." The study is published in the July issue of the British Journal of Psychiatry.
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