- Depression in the news
- Home Remedy Service (including some advice on depression)
Depression in the news
Section titled “Depression in the news”Prozac in the Headlines
Section titled “Prozac in the Headlines”In today's New York Times you'll find the headline "Antidepressants lift clouds, but lose 'Miracle-Drug' label." In case the New York Times article isn't available to you, I'll give you a summary. For about a third to a half of patients, antidepressants are effective. For the rest, they produce only side-effects or, at best, nothing. Whereas years ago we believed that depression was due to lowered levels of the neurotransmitter serotonin, it is clear today that much more is involved. Brain structure can change, stress hormones play a part, and each of us has a different response to similar environmental situations. What the article does not discuss is that for many of us, life's choices, problems, and our response to those challenges also play a role in depression. Nutritional deficiencies and other subtle functional disturbances are less common but important to be aware of. Studies show, too, that meditation and participation in organized religion reduce the incidence of depression. Despite these omissions, this article gives a fair, informative and accurate portrayal of the situation. Here is a less inspiring story...
More Headlines
Section titled “More Headlines”A few months ago you may have noticed headlines in the major newspapers and newsmagazines reading "St John's wort found to be ineffective for depression." A few journalists had a more accurate headline- "St John's wort ineffective for severe depression." In both cases they were referring to a study published in the Journal of the American Medical Association on April 10, 2002.
The Real Story
Section titled “The Real Story”Few journalists told the real story, which is that in this study, severely-depressed patients were treated for eight weeks with St John's wort, sertraline (available as ZoloftÆ), or placebo. I quote from the abstract: "On the 2 primary outcome measures, neither sertraline nor H perforatum (the botanical name for St John's wort) was significantly different from placebo."
What's that again?
Section titled “What's that again?”Neither St John's wort nor Zoloft helped these patients? Looking at the average patient, that seemed to be the case. A few sentences later, the authors conclude "This study fails to support the efficacy of H perforatum in moderately severe major depression." Wait a minute! What about the fact that the ZoloftÆ didn't work either? After all, it is approved by the FDA as effective for depression. But in the space of a few short sentences in the abstract, these researchers seem to have entirely forgotten about that fact.
Any wonder the major news media got it wrong, too?
The Facts of Life
Section titled “The Facts of Life”The lead author, Jonathan Davidson, holds stock in and has consulted for Pfizer, the manufacturer of ZoloftÆ. He has received lecture fees from both Pfizer and Lichtwer, the manufacturer of the St John's wort used in the study. In the same issue of the Journal of the AMA, David Kupfer and Ellen Frank write an editorial on the importance of placebos in clinical trials. They discuss this study and present points in favor of ZoloftÆ but none in favor of St John's wort. David Kupfer has worked as a consultant for Pfizer and Ellen Frank as a management scientist for Pfizer. Do they put forth any falsehoods in what they write? No, they don't appear to. Maybe they even are making the correct call. But do you want an umpire behind the plate who has stock in one of the baseball teams?
Other studies on St John's wort
Section titled “Other studies on St John's wort”There is only one other head-to-head comparison of St John's wort and ZoloftÆ. That study in Clinical Therapeutics, April 2000, looked at people with mild-to-moderate depression. They concluded "The hypericum (an active substance in St John's wort) extract was at least as effective as ZoloftÆ in the treatment of mild to moderate depression in a small group of outpatients."
In summary, the facts that you should have been given instead of the misleading headlines: St John's wort and ZoloftÆ both appear to be effective in mild to moderate depression, and neither appears effective for most people with severe depression.
Help with depression
Section titled “Help with depression”So now you know that neither St John's wort, ZoloftÆ, nor any other antidepressant helps every individual with depression. Emotions are a part of being human, and span the scale between an occasional case of the "blahs" to suicidal despair. For most people, a candid look at how they are living their lives is more likely to bring relief than is medication. However, when those blues are so severe that we cannot sleep nor concentrate, lose interest in sex and eating, and have difficulty with work, then the depression is influencing our physiology. In that case, we are more likely to benefit from medical help.
See below for our new Home Remedy advice for "the blues."
Yours for good health!
Douwe Rienstra, MD
Coming in future issues
Section titled “Coming in future issues”- We'll review my favorite books on medical care and self-care.
- We'll answer your questions.
- No Cure - No Pay treatment for ear wax, toenail fungus, and warts.
Our new Home Remedy Service
Section titled “Our new Home Remedy Service”About a hundred years ago, most people who had a headache did not take aspirin. It had been developed, but wasn't widely used. Now we all know that aspirin relieves most headaches. It may be the world's best home remedy.
Today there are many home remedies that are are as unknown and underused as aspirin was all those years ago.
Our Home Remedy Service helps you discover these effective home remedies for minor complaints.
To use this service, just come to our office and tell our receptionist which condition you'd like information on. She will ask you to sign an acknowledgement that we are not taking responsibility for your diagnosis and care. She will give you one or more information sheets. These sheets will give you one or more suggested home remedies for your condition. It's that simple.
We can give you Home Remedy help with these conditions.
Section titled “We can give you Home Remedy help with these conditions.”Acne
Acne rosacea
Allergic rhinitis
Allergies
Arthritis pain
Asthma
Back pain
Bruises
Carpal tunnel syndrome
Chronic fatigue
Cigarette addiction
Colds and Flu
Constipation
Daily multiple vitamin supplements
Depression, mild
Digestive discomfort
Dry skin
Eczema
Esophageal reflux
Fatigue in women having menses
Fibromyalgia
Flu - early treatment
Flu prevention
Food allergy
General health maintenance - daily vitamins
Hay fever
Heartburn
Hemorrhoids
High cholesterol
Hot flashes
Immune Support
Knee pain
Liver cleanse
Memory disorders
Menopausal symptoms
Mouth ulcers
Premenstrual syndrome
Prevention, general
Prostate problems
Rosacea
Runny nose
Seasonal affective disorder
Sinus congestion simple
Skin dryness
Sleep disorders
Sore throat
Sugar craving
Urinary tract infection prevention
Varicose veins
Winter "blahs"
See the updated list on our office bulletin board.
Here is a summary.
Section titled “Here is a summary.”- This service is for Dr Rienstra's and Mary Flick's patients only.
- This service is available only by personal visit to the office.
- We will ask you to sign an agreement.
We will add to this list as time goes on. If there are conditions you'd like us to add, let us know. If we know a good home remedy, we'll include it in our list.
CJK 8/21/06