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Five biotypes of depression - Input Junkie
May 12th, 2014
08:49 am

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Five biotypes of depression
A new study finds some evidence that there are (at least) five types of depression

Undermethylated Depression
This type of depression was found in 38 percent of patients in the study. The problem in these cases is low activity at serotonin receptors, apparently due to rapid reabsorbtion after serotonin is released into a synapse.

“It’s not serotonin deficiency, but an inability to keep serotonin in the synapse long enough. Most of these patients report excellent response to SSRI antidepressants, although they may experience nasty side effects,” Walsh said.

Pyrrole Depression
This type was found in 17 percent of the patients studied, and most of these patients also said that SSRI antidepressants helped them. These patients exhibited a combination of impaired serotonin production and extreme oxidative stress.

Copper Overload
Accounting for 15 percent of cases in the study, these patients cannot properly metabolize metals. Most of these people say that SSRIs do not have much of an effect—positive or negative—on them, but they report benefits from normalizing their copper levels through nutrient therapy. Most of these patients are women who are also estrogen intolerant.

“For them, it’s not a serotonin issue, but extreme blood and brain levels of copper that result in dopamine deficiency and norepinephrine overload,” Walsh explained. “This may be the primary cause of postpartum depression.”

Low-Folate Depression
These patients account for 20 percent of the cases studied, and many of them say that SSRIs worsened their symptoms, while folic acid and vitamin B12 supplements helped. Benzodiazepine medications may also help people with low-folate depression.

Walsh said that a study of 50 school shootings over the past five decades showed that most shooters probably had this type of depression, as SSRIs can cause suicidal or homicidal ideation in these patients.

Toxic Depression
This type of depression is caused by toxic-metal overload—usually lead poisoning. Over the years, this type accounted for 5 percent of depressed patients, but removing lead from gasoline and paint has lowered the frequency of these cases.


I really hope this pans out-- finding the right anti-depressant can be a miserable process.

I'll also note that the people ranting about school shootings and anti-depressants may well have been partly right.

I had no idea there might be a connection between copper and depression, though it's not totally news-- this discussion talks about a copper/zinc imbalance.

This entry was posted at http://nancylebov.dreamwidth.org/1048523.html. Comments are welcome here or there. comment count unavailable comments so far on that entry.

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From:vvalkyri
Date:May 12th, 2014 05:26 pm (UTC)
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i believe there is also a manner of genetic testing that can identify what drugs are likely to work
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From:redbird
Date:May 12th, 2014 05:43 pm (UTC)
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I'm skeptical here, partly because they assert "a study" but don't actually link to it. (This sort of press release normally has a link to at least an abstract, and usually the article, perhaps behind a paywall.) So, they assert "we have a study of n thousand people," but all they've published so far is this press release and pretty graph.

Since they haven't included all causes of depression in their graph—at minimum, they're omitting traumatic brain injury, PTSD, multiple sclerosis and and other diseases which can have depression as a symptom, and depression as an drug side effect—I really would want to see the paper. How did they screen their subjects? (Eliminating people with a known non-biochemical issue would be reasonable, but should be stated, if only because someone could have one of the chemical problems they're looking at and be on interferons or have a history of trauma.)

Also, poking around a little, "pyrrole disease" seems to be a discarded hypothesis, something that made sense fifty years ago but turned out not to be replicable. If so, what they're left with is "and 17% of patients had depression not from one of these other causes, and SSRIs helped them," which among other things could mean two or more different things that SSRIs helped.

They may be onto something useful here, but I'd want to see more data, ideally both the data from this study and follow-up work by other researchers.

[I'm leaving essentially the same comment, with perhaps slight differences in the last paragraph, here and on Dreamwidth, since I'm not sure where the discussion is going to happen.]
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From:rimrunner
Date:May 12th, 2014 08:30 pm (UTC)
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The press release appears to refer to a presentation made at the American Psychiatric Association conference. I don't know how it works in psychiatry, but in some fields conference presentations are of unpublished or not yet published research. It doesn't look like this year's program and abstracts are available online yet; I could only find last year's.

I don't have anywhere near the relevant knowledge to assess whether this research is any good, just offering a possible explanation for why there's no study link.
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From:pseudomonas
Date:May 13th, 2014 12:00 pm (UTC)
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The only thing I can find by the first author is a book called Nutrient Power: Heal Your Biochemistry and Heal Your Brain whose title sets off my quackdar, though I haven't looked at its content.
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From:redbird
Date:May 13th, 2014 03:16 pm (UTC)
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And mine, but if there had also been a link to a paper with the actual data I'd have given it a chance. It's possible (not likely, but possible) that he has a plausible approach to nutrition, and a publisher or marketing department handed him that dubious title with the argument "you need to get people's attention"
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From:pseudomonas
Date:May 13th, 2014 03:17 pm (UTC)
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Oh, yes, if there's actual published research we need to take it at its merits. But in this case, there doesn't seem to be any that I can find...
From:paulshandy
Date:May 13th, 2014 06:52 am (UTC)
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I once read that half the psychological meds being given to people are to counter the side effects of the meds they are already on. That's a disturbing thought in of itself.
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From:redbird
Date:May 13th, 2014 03:17 pm (UTC)
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Do you remember where, or is this from the Esteemed Journal of I Saw It Somewhere (which I also draw from, and am then frustrated when I can't remember/track down details)?
From:paulshandy
Date:May 14th, 2014 02:50 am (UTC)
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I'm afraid most of my knowledge is made up of the latter. It's probably why I write novels instead of textbooks.
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From:johnpalmer
Date:May 13th, 2014 09:41 pm (UTC)
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There's surely some of that, but it might be minor.

An antidepressant makes you buzzy so you can't sleep, so you get a sleep aid? Not a big deal.

Antidepressant makes you mildly manic so they add a mood stabilizer which makes you tired so they add a stimulant which makes you tic so they add... is the kind of thing that makes me nervous.
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From:adrian_turtle
Date:May 13th, 2014 09:41 pm (UTC)
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And some large fraction of anti-nausea meds are prescribed to counter the side effects of other meds. (Most famously, chemotherapy drugs, but some others as well.) Why do you find it disturbing that people now have options other than gritting their teeth and enduring side effects?
From:paulshandy
Date:May 14th, 2014 02:58 am (UTC)
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Because it suggests to me that we're messy around with something as delicate as brain chemistry with guesswork. And I've read articles about putting kids on meds for acting like kids, and I've had friends on meds for depression when I thought being sad was a pretty rational reaction to their life.

Then again, I've also had friends with chemical imbalances; one of them was so abused by her father her brain lost the ability to produce chemicals normal brains use to calm down from stress. So I know the issue complicated, but sometimes I think drugs are becoming the new alcoholism.
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From:en_ki
Date:May 14th, 2014 03:27 am (UTC)
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"Successive approximation" != "guesswork".
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From:supergee
Date:May 13th, 2014 11:31 am (UTC)
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Blogging this; thanx
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From:apostle_of_eris
Date:May 13th, 2014 05:17 pm (UTC)
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I'm willing to wait for more detail/corroboration, but I think that in a lot of murky areas (and selecting drugs for depression is certainly murky) it's just that we're lumping together different things with similar appearances because we can't tell them apart yet. So the structure of the list is completely consistent with what I expect.
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