Two Antidepressants No Better Than One Megan Brooks Authors and .doc by xiaoshuogu

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									Two Antidepressants No Better Than One?
Megan Brooks

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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

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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

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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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