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  Tuesday, August 08, 2006

New Psychnotes

 A new Psychnotes is available

11:26:33 PM    comment []

  Friday, July 21, 2006

New PsychNotes

Coming soon,,,,

The New PsychNotes

11:05:28 PM    comment []

  Wednesday, January 04, 2006

World's Largest Online Drug Database

New Psychnotes.  A new Psychnotes is available

World's Largest Online Drug Database

Searching for credible information on various drugs can be a daunting task both for professionals and consumers. Web searches often bring up a confusing assortment of information generally inundated with sites that want to sell you something. Just released this month is DrugBank - the worlds largest online database from the University of Alberta, Departments of Computing Science, Biological Science and the Faculty of Pharmaceutical Sciences. It is described as an "interactive one-stop-shop" that offers detailed drug information for patients, researchers and health-care professionals.

The database began as teaching tool developed by Dr David Wishart for pharmacy students at the University of Alberta. Wanting to develop one source that offers a broad scope of information, Wishart and his team created DrugBank, the world's largest and most complete resource on drugs and drug targets. DrugBank contains detailed chemical, pharmaceutical, medical and molecular biological information on more than 3000 drug targets and 4100 approved or experimental drugs products.

The database allows pharmacists, physicians, drug researchers and the general public to find out just about everything they need to know about a drug or a drug target. It is the only database of its kind. DrugBank provides more than 80 data fields for each drug including brand names, chemical structures, protein and DNA sequences, links to relevant Internet sites, prescription information and detailed patient information.

As patients take more active roles in their own care, they can access detailed information without searching through scientific literature to find it. For example, a search for "acetaminophen," on the site, will reveal 197 brand names for products and 26 brand name mixtures that contain it.  DrugBank will also tell you how acetaminophen works, its side effects, how it's absorbed, how it's metabolized and how to take it.

For biologists and chemists, DrugBank supports a wide range of sophisticated searches and queries. Combined with DrugBank's 2D and 3D visualization software, these tools allow scientists to easily search for new drug targets, to compare drug structures, to study drug mechanisms and to discover new drug leads.

DrugBank is also the first database that brings the latest data from the Human Genome Project together with detailed chemical information about drugs and drug products. Much of this information was originaly only in books and journals which made the assembly of DrugBank difficult and time-consuming. More than a dozen textbooks, several hundred journal articles, nearly 30 different electronic databases and at least 20 in-house or web-based programs were individually searched, accessed, compared, written or run over the course of four years.

DrugBank is also playing an important role in another scientific endeavor--The Human Metabolome Project. As lead researcher on this Genome Canada effort, Wishart's goal is to guide the first group in the world to complete the human metabolome. That aim includes a database of all the metabolites in body fluids, such as urine and serum. In addition to the usual chemicals that the body makes (metabolites) many prescription drugs (xenobiotics) are also found in these body fluids. Understanding how drugs and their metabolites impact the body is crucial for future drug development.

DrugBank is available online as of January 1, 2006

10:54:52 PM    comment []

  Friday, December 30, 2005

Direct-to-Consumer Antidepressant Ads

The Public Library of Science (PLoS) presents an interesting article this month on the marketing of antidepressants to consumers. It is a curious view of the science, influence and shortcomings of the FDA in these highly successful direct-to-consumer advertising (DTCA) campaigns.

According to the authors, research has demonstrated that class-wide SSRI advertising has expanded the size of the antidepressant market, and SSRIs are now among the best-selling drugs in medical practice. In the US, the FDA monitors and regulates DTCA. The FDA requires that advertisements "cannot be false or misleading" and "must present information that is not inconsistent with the product label". Pharmaceutical companies that disseminate advertising incompatible with these requirements can receive warning letters and can be sanctioned. The FDA has reportedly sent only ten warning letters to antidepressant manufacturers since 1997 but has never cited a pharmaceutical company for the issues covered in this article.

Consumer Advertisements of Antidepressants

The authors state that contrary to what many people believe, the FDA does not require preapproval of advertisements. Instead, the FDA monitors the advertisements once they are in print or on the air. Misleading content is frequently found in various DTCA campaigns; hence, it is valuable to compare SSRI advertisements to the scientific evidence. These SSRI ads are widely promulgated; hundreds of millions of dollars have been spent disseminating these advertisements, and one study found that over 70% of surveyed patients reported exposure to antidepressant DTCA.


The article concludes that the impact of the widespread promotion of the serotonin hypothesis should not be underestimated. Antidepressant advertisements are ubiquitous in American media, and there is emerging evidence that these advertisements have the potential to confound the doctor-patient relationship. A recent study by Kravitz et al. found that pseudopatients (actors who were trained to behave as patients) presenting with symptoms of adjustment disorder (a condition for which antidepressants are not usually prescribed) were frequently prescribed the specific brand of SSRI that they requested and the authors conclude that "such enquiries from actual patients could be prompted by DTCA."

The article suggests that "what remains unmeasured, is how many patients seek help from their doctor because antidepressant advertisements have convinced them that they are suffering from a serotonin deficiency. These advertisements present a seductive concept, and the fact that patients are now presenting with a self-described "chemical imbalance" shows that the DTCA is having its intended effect: the medical marketplace is being shaped in a way that is advantageous to the pharmaceutical companies. Recently, it has been alleged that the FDA is more responsive to the concerns of the pharmaceutical industry than to their mission of protecting US consumers, and that enforcement efforts are being relaxed. Patients who are convinced they are suffering from a neurotransmitter defect are likely to request a prescription for antidepressants, and may be skeptical of physicians who suggest other interventions, such as cognitive-behavioral therapy, evidence-based or not. Like other vulnerable populations, anxious and depressed patients are perhaps more susceptible to the controlling influence of advertisements."

The authors conclude by stating that "in 1998, at the dawn of consumer advertising of SSRIs, Professor Emeritus of Neuroscience Elliot Valenstein summarized the scientific data by concluding, "what physicians and the public are reading about mental illness is by no means a neutral reflection of all the information that is available." The current state of affairs has only confirmed the veracity of this conclusion. The incongruence between the scientific literature and the claims made in FDA-regulated SSRI advertisements is remarkable, and possibly unparalleled.

Lacasse JR, Leo J. Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature. PLOS Volume 2, Issue 12,DECEMBER 2005

1:36:28 PM    comment []

  Friday, December 16, 2005

Remember The Kids When Parents Are Ill

This is a time of year when holidays can bring out an increased concern for others and a generous spirit in many people. Organizations often collect toys and other gifts and give them to needy children or to underpriviledged families. There is an interesting commentary in this month's Current Psychiatry by William Campbell entitled "Remember the kids when parents are ill." He reminds us that in families where a psychiatric disorder can cause functional impairment in a parent, their ability to care for dependent children can also be somewhat compromised.

While his article is short and leaves the reader wishing that he had developed his ideas more, the message is an important one that can help make a difference in a child's life.  Often information about the children of mentally ill parents is anecdotal but there is a research base that serves to highlight some of the needs of these kids.

A paper from Finland, examines the coping mechanisms and resilience of children of a mentally ill parent and a Swedish study that states there is an urgent need for psychiatric services to initiate parental issues in programs for treatment and rehabilitation to ensure that the specific needs of minor children are met.  A study from Clark Insititute in Toronto, Canada, suggests that "children of the mentally ill constitute a group neglected by mental health care providers." Another study from a Toronto group last month suggests that we need to rethink our attitudes and approaches to these children. That we should think of them not as "passive, developing, 'unfinished' persons" but as "complex young persons who have competencies as well as vulnerabilities linked to their developmental stages."

A recent article from the American Journal of Orthopsychiatry published on Medscape discusses the SMILES group program for children with mentally ill parents or siblings. The Simplifying Mental Illness + Life Enhancement Skills program, is for children with a mentally ill parent or sibling. It is a 3-day program that aims to increase children's knowledge of mental illness and to better equip them with life skills considered beneficial for coping in their family.

11:03:17 AM    comment []

  Wednesday, November 23, 2005

Laughter: The Cure and the Disease

An upcoming study in the Quarterly Review of Biology, describes the evolutionary origins of two distinct types of laughter. Biologists from Binghamton University delineate laughter which is stimulus-driven and laughter which is self-generated and strategic.

Laughter that occurs during everyday social interaction in response to banal comments and humorless conversation is now being studied. How this type of humor relates to other types of humor is the object of study. Using empirical evidence from across disciplines, including theory and data from work on mirror neurons, evolutionary psychology, and multilevel selection theory, the researchers detail the evolutionary trajectory of laughter over the last 7 million years.

According to the authors, laughter can arise from non-serious social incongruity promoted by community play which evolved from ape play-panting sometime between 4 million years ago and 2 million years ago during fleeting periods of safety. Such non-serious social incongruity, it is argued, is the evolutionary precursor to humor as we know it.

However, neuropsychological and behavioral studies have shown that laughter can be more than just a spontaneous response to such stimuli. Around 2 million years ago, human ancestors evolved the capacity for willful control over facial motor systems. As a result, laughter was co-opted for a number of novel functions, including strategically punctuating conversation, and conveying feelings or ideas such as embarrassment and derision.

This study looks at different types of humor and how it has related in social situations. Humans have a range of ways that humor can affect their lives, moods and attitudes and can voluntarily access laughter and utilize it for their own ends, including smoothing conversational interaction, appeasing others, inducing favorable stances in them, or laughing at individuals who are not liked.

Another recent study in the Journal of Early Human Development, attempts to differentiate spontaneous smiles from spontaneous laughs (smiles accompanied by vocal sounds) in infants. The goal was to try to understand the early beginnings of laughter. 

Cure vs Disease

Interestingly enough, looking at laughter in the literature produces both the idea of humor as a cure and as a disease. In the area of humor as cure, a number of studies deal with the use of humor as a adjunct to treatment. In a recent article in Oncologist, humor is described as a way to help to ease the pain and show the human side of the health care team.  It can help the patient, support caregivers and encourage the healing process in cancer patients. Whether the patient uses humor to lighten the mood of a difficult consultation with their physician, or health care workers use it to help cheer each other through the day, humor and laughter can be valuable tools. Humor can soften the isolation experienced by both patients and staff. When used sensitively, respecting the gravity of the situation, humor can build the connection among the caregiver, patient, and family. However, it is pointed out that insensitive joking is offensive and distressing.

On the pathology side, a case report in last month's Movement Disorders Journal described acute pathological laughter. Pseudobulbar affect is a condition characterized by uncontrollable episodes of inappropriate laughing or crying that are disproportionate and discordant to the situation at hand. The article describes a 16-year-old woman presenting with acute pathological laughter in the context of CNS demyelinating disease. Brain MRI scans obtained before and after the onset of this symptom demonstrated acute gadolinium-enhancing lesions in the cerebral peduncles. The etiology of this condition remains theoretical; however, the results here provide further insights into the pathways of emotional control.

Research this month from Stanford University used event-related functional MRI to evaluate humor in the personality dimensions, introversion-extroversion and emotional stability-neuroticism. The goal was to look at putative neural and behavioral associations between humor appreciation and these personality dimensions.

The analysis showed extroversion to positively correlate with humor-driven blood oxygenation level-dependent signal in discrete regions of the right orbital frontal cortex, ventrolateral prefrontal cortex, and bilateral temporal cortices. Introversion correlated with increased activation in several regions, most prominently the bilateral amygdala. Although neuroticism did not positively correlate with any whole-brain activation, emotional stability (i.e., the inverse of neuroticism) correlated with increased activation in the mesocortical-mesolimbic reward circuitry encompassing the right orbital frontal cortex, caudate, and nucleus accumbens. 
These findings tie together existing neurobiological studies of humor appreciation and are compatible with the notion that personality style plays a fundamental role in the neurobiological systems subserving humor appreciation. For these characteristics, the study shows that personality can predict activity in reward and emotional regions associated with humor.

Unfortunately. the medical literature contains a dearth of information on humor, and very little research has been conducted on this common aspect of human communication.

Some quotes on Humor

There's no trick to being a humorist when you have the whole government working for you.
Will Rogers

Humor is the only test of gravity, and gravity of humor; for a subject which will not bear raillery is suspicious, and a jest which will not bear serious examination is false wit.

Humor is just another defense against the universe.
Mel Brooks

Humor is by far the most significant activity of the human brain.
Edward De Bono

Humor is also a way of saying something serious.
T. S. Eliot

Humor is a rubber sword - it allows you to make a point without drawing blood.
Mary Hirsch

Humor is the great thing, the saving thing. The minute it crops up, all our irritations and resentments slip away and a sunny spirit takes their place.
Mark Twain

Our five senses are incomplete without the sixth - a sense of humor.
Author Unknown

Imagination was given to man to compensate for what he is not, and a sense of humor to console him for what he is.
Author Unknown

Good humor is a paradox. The unexpected juxtaposition of the reasonable next to the unreasonable.

Some quotes on laughter

The human race has one really effective weapon, and that is laughter.
Mark Twain
The most wasted of all days is one without laughter.
e e cummings
Laughter is the closest distance between two people.
Victor Borge
Laughter gives us distance. It allows us to step back from an event, deal with it and then move on.
Bob Newhart
You can't deny laughter; when it comes, it plops down in your favorite chair and stays as long as it wants.
Stephen King
Laughter is the sun that drives winter from the human face.
Victor Hugo

10:59:42 AM    comment []

  Monday, November 07, 2005

The Complexities and Eccentricities of Our Sensory System

Five senses; an incurably abstract intellect; a haphazardly selective memory; a set of preconceptions and assumptions so numerous that I can never examine more than a minority of them never become conscious of them all. How much of total reality can such an apparatus let through?
C.S. Lewis

The current issue of Neuron, features a special review of the sensory systems. Ten articles review the various leading edge aspects of sensory systems neurobiology.

As a general concept, the basic functions of all of the sensory modalities are the same, to respond to a specific peripheral stimulus (smell, taste, sound, light or touch) and translate that stimulus into neuronal signals that can be processed to create an internal representation of the external world. Each modality utilizes a special type of receptor cell that selectively responds to a particular stimulus. There are numerous studies over decades that have examined the dynamics of these cells and their complex interaction with our physiology. This issue of Neuron pulls together the latest science and uncovers some interesting and unusual aspects of our sensory perception.

Taste and Smell

It is all about understanding our interaction with our sensory apparatus and how the brain receives and interprets all the signals that we receive. A number of the reviews tackle various questions or seeming incongruities in our sensory system. For example, taste and smell are intimately intertwined. "While the olfactory system is remarkable for the sheer number of olfactory receptors (over a thousand), the gustatory system appears to be much simpler. Relatively fewer receptor types and even fewer taste modalities (five in humans) are required to encode the sense of taste."

Auditory and Visual

For all our senses, representations of the information of the external sensory world are ultimately encoded in the corresponding sensory cortex. How auditory signals are represented in the auditory cortex is an interesting question. There are many more neurons in the auditory cortex than there are in the auditory nerve, and similarly, in the visual system there many more cells in the visual cortex than in the retina, and a key question has been why this is so? A review by DeWeese and colleagues, explores the possibility that these 'extra' neurons are used to counteract the effects of noise that results from moving the sensory signal along the processing stream and to thereby assure a reliable representation of the peripheral signal.

The visual system hijacking the auditory system - ventriloquism

Looking at how auditory and visual signals are integrated in the context of space perception. It has been observed that vision usually dominates over auditory localization in our perception of space. An example used is ventriloquism, where the voice is perceived to be coming from the puppet's moving mouth rather than the puppeteer. Many experiments have shown that vision is capable of making plastic changes in the processing of auditory spatial information. It is suggested that such visual capture may occur because visual information is usually more reliable and precise and the brain has evolved to integrate information optimally, with a greater weighting toward the more statistically reliable information.

Autism and Cognition

Dakin and Frith examine the data that suggest that defects in visual perception play a role in the cognitive defects associated with autism spectrum disorder (ASD). They evaluate three classes of perceptual phenomena that have repeatedly been associated with ASD: superior processing of fine detail (local structure), either inferior processing of overall/global structure or an ability to ignore disruptive global/contextual information, and impaired motion perception. This review evaluates the quality of the evidence bearing on these three phenomena.

Synesthesia explored

Another review looks at seemingly crossed signals, for example. in synesthesia, a condition in which stimulation of one sensory pathway or system elicits experiences in a second, unstimulated pathway or system. So that individuals with grapheme-color synesthesia, viewing letters or numbers causes them to experience colors.

Some of the articles are complex but interesting reading. Neuron also supplements the current issue with several articles from previous issues that can help highlight various concepts about our sensory system. This collection of articles was chosen to complement the topics and talks presented at this year's Neuron satellite meeting on "Neurons and Sensory Systems" at the Society for Neuroscience meeting which takes place this week (November 10 & 11). The presenters are among the world's leading scientists and researchers including Linda Buck, a 2004 Nobel Prize winner in Physiology or Medicine.

These featured research articles will be freely accessible through the Neuron website until November 23rd.

Volume 48 Issue 3: November 3 , 2005

10:05:59 AM    comment []

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