In the October 2008 American Journal of Psychiatry Podcast there is a new reader. There is a very interesting discussion of treating depression in people with breast cancer. Tamoxifen which is used for oestrogen positive tumours, is processed by Cyt P450 2D6 and antidepressants which minimally interact with this enzyme include citalopram and venlafaxine. In cases where there is no response to these medications then other management options are discussed. There is another study looking at Olanzapine v Placebo in people with anorexia. The Olanzapine group had a significant reduction in obsessive symptoms compared to the placebo group, no change in depression scores but were significantly more likely to obtain weight goals compared to the placebo group. Another study compares a group of people with hoarding plus or minus obsessive compulsive disorder and looks at the differences and similarities between the groups. There is a further discussion of OCD in the editorial. There is an association with brain injury and areas that have been implicated include the right orbitofrontal cortex, anterior cingulate cortex, right medial prefrontal cortex. The aripiprazole augmentation study in mania was discussed. There was also a discussion of the motor vehicle related PTSD study in children using a specific diagnostic algorithm.
In the science podcast of the 10th October 2008, there is a discussion of a new method of generating stem cells without the use of viral vectors. Stem cells could be used in Alzheimer’s Disease. The testing of drugs in the states is becoming more expensive due to enrolling large numbers of people, people needing to meet specific criteria (even as many as 30 criteria), having up to 100 procedures per person per trial and having longer trials. There is now an emerging move towards simplifying trials and reducing costs. There is discussion of another study finding that white american adults who were reluctant to ask questions about race in a game of Guess Who? when paired with other people were more likely to score lower on a colour matching test. There was also a finding that talking about race was less likely in children aged 10 compared to children aged 8, confirming previous research showing that relevant social rules in this area are internalised at around age 10.
In the Nature podcast of 9th October 2008, the completion of sequencing of the genome of falciparum vivax. There is also some confirmation of Francis Crick’s theory about the functioning of the reticular nucleus in the thalamus. Crick proposed some 25 years ago that this nucleus was a gatekeeper for information leaving the thalamus and entering the cortex. The evidence now suggests that neurons in the reticular nucleus are differentially activated depending on where attention is focused.
In the Nature Neuropod Podcast of October 2008 there is a discussion of a paper looking at CBT versus antidepressants. A speculative model is discussed in which it is thought that the amygdala and prefrontal cortex are areas affected in depression, that antidepressants target the amgydala and cognitive therapy targets the prefrontal cortex. There is discussion of the research in which motor feedback was found to play a role in speech production in people with cochlear implants which were turned off during testing and which was covered previously (albeit briefly) in this blog. There is also a discussion of the credit crunch and in particular the effects of emotions on decision making as well as the need to incorporate this into standard economic models. This presumably fits into the emerging area of ‘neuroeconomics’ and may be expected to inform government policy particularly where intervention is required.
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