Healthcare, medicine & pharmaceuticals

Why antidepressants are depressing

In Britain, 46 million prescriptions for antidepressants were dispensed last year, mostly to women. The effects of these drugs are more far reaching than it seems. They tend to blunt many different emotional reactions to life, not just the uncomfortable feelings. Sometimes they have the same side effects as the symptoms they were designed to relieve – no energy, disconnection - and they damage libido, all of which affect relationships. This certainly is depressing.

The experts claim women are more susceptible to depression. As well as their “monthly traumas of mood destabilisation”, when middle aged, they suffer “a series of losses: their children, their sexual attractiveness, their libido and fertility”. The writer of this article was even accused of having a “hysterical” reaction to this information.

With opinions like this bandied around, no wonder women are depressed.

The head of the Medicine and Healthcare Products Regulatory Agency says NHS patients are over-medicated and nearly a quarter of women have to wait more than a year for a review of their medication. Moreover, if they are not served, they can get the most common form of tranquillisers on the black market, whether the internet, Italy or Spain.

Damian Thompson, who wrote The Fix, believes we are growing dependent on mood-altering drugs. If you stop to think about your friends, how many of them are on this type of medication? The results are frightening, if not tragic. We think this is as much to do with the influence of pharmaceutical companies on GPs, as it is to do with women (or is it their men?) enduring so-called “monthly traumas”.

Turn on the wireless for drug delivery

Wireless control is going to transform medicine because of its ability to target living cells finely and remotely. It is a new branch of medicine, variously called wireless bioengineering or electromagnetic pharmacology (because it uses magnetic fields). The aim is to take control of living cells using radiowaves so you might, in the future, be able to activate a drug in your system with a mobile phone app.

Treatments, such as immunotherapy, gene therapy or stem cells, can potentially be turned off or on with a switch. This compares favourably to conventional medicine, which can take a long time to act and then remains for a while in the body.

The US has already approved a technique called transcranial magnetic stimulation (TMS) that treats depression by creating local electric currents in the brain. But now scientists are using magnetically sensitive bacteria, such as nematodes, to create pathways for drug delivery. A team at Rockefeller University has developed a way to control the production of insulin using radiowaves. With diabetes becoming the number one public health problem in the world, this will be transformative.

A team at Harvard found cells use physical tweaks and tugs to communicate so they were able to alter patterns of gene activity by stretching cells in different ways. They did this using magnetic nanobeads bound to integrins (proteins in the outer membrane of cells). Researchers could kill a cell this way, or deform a stem cell to see what type of tissue it would become. In another experiment, they were able to trigger the release of histamine using magnetic fields, which affects blood-vessel dilation, muscle contraction and gastric acid secretion.

The drawback of this system is security – someone at McAfee found he could use wireless signals to detect insulin pumps carried by diabetics. The same is true of pacemakers or defibrillators. Wireless medicine will transform our health system but, like all computer systems, provide mindless entertainment for hackers if not protected.

Catching early signs of autism

Movies like The Black Balloon have made autism more visible and there is more information about autism than ever before. Parents who think their baby may be autistic are urged to seek therapy straightaway as, the earlier this begins, the better are the child’s chances in life.

To this end, researchers at University of Minnesota are using Microsoft’s gaming sensor, Kinect, with computer-vision algorithms, to help detect abnormalities in young children. Researchers fitted a nursery with five Kinect depth-sensing cameras to watch the movements of children, aged 3-5, as they play. Each child was identified by shape and the colour of their clothing. Three PCs logged their activity, even of each limb, to see how it compared with the room average. Children with autism are usually hyperactive or uncommonly still. This software does not provide a diagnosis, it merely gives an early warning as to possible autism.

This study combines with another one containing video footage of children talking to a psychiatrist and uses computer-vision algorithms to identify markers on the Autism Observation Scale for Infants. It looks for particular behaviour, such as whether a child follows an object as it goes past their eyes.

Both studies focus on early diagnosis. Diagnosis is not as easy as it sounds, because early symptoms may be subtle. Parents are urged to watch their children carefully as they are the ones with the time and knowledge to notice these signals. The problem with that is they will feel painfully responsible if autism is diagnosed late – or they could overreact to every sign of poor social skills.

Social jet lag on the rise

Do you ever get the sense that everybody around you is tired? If Professor Till Rosenneberg is right, they probably are. They could be suffering from social jet lag, which means they are living permanently out of time. Social jet lag sufferers take to smoking, caffeine and often have mood swings and trouble concentrating at work. They are also more likely to be obese, which the professor believes is caused by living against the body clock.

The body clock responds to the light of the sun but our relationship with the sun is becoming weaker. With train travel, and then air travel, we outwit the sun by changing time zones. But we also work at night on computers and iPhones and interrupt sleep to get up and catch planes. At the same time, many of us sit at desks in artificial light all day. This means we “don’t get enough light to tell us it is daytime, and the nights are not dark enough to send us to sleep”.

One researcher took students into a sleep laboratory, when they were supposed to be at school, and found many of them had symptoms of narcolepsy. They fell asleep and entered quickly into REM sleep, which is more typical of the time before waking up. She believed they had not yet really woken up, even though they had walked into the lab. Rosenneberg wants students to start school later, because he believes their body clocks are adjusted to waking later.

In the battle between the body clock and the social clock, nobody wins. Our society tends to undervalue sleep and even to override it with drugs and distractions. The trend for taking artificial stimulants is a direct result of trying to stay awake when the body wants to sleep. Do we think this attitude to sleep will change? Dream on.

The Age of Anxiety

The NHS in Britain paid for 7 million tranquilliser prescriptions last year to meet growing demand for drugs to ease the debilitating effects of anxiety. In five years, the number of outpatients being treated in hospitals for anxiety has quadrupled. This is a tragic state of affairs for a wealthy western country.

One clinical psychologist, Dr Linda Blair, says that technology is exacerbating any economic concerns because it causes people to be on a permanent state of alert. When someone is bombarded with messages from the time they awake to the time they fall asleep (if they can), they cannot relax or switch off. This leads to chronic anxiety about what might happen next.

Another theory is that people are continually faced with images of what they ought to achieve and what is expected of them to be successful human beings. This sets out a sense of being unable to live up to it. We seem to have become less tolerant of adversity, real or imagined, and need drugs to help deal with our anxiety about it.

Frank Furedi, a sociologist, takes a contrary view. He says our culture feeds anxiety and encourages sufferers to wear it with pride. It has become fashionable to discuss anxiety at dinner parties and, if you are not anxious, then there is something wrong with you. He says even children “medicalise the everyday” and learn how to speak the jargon of stress and anxiety, even while the government is pushing for everyone’s happiness.

When “generalised anxiety disorder” was first entered into the manual of mental disorders, it was not known what effect this would have. But Dr Robert Spitzer, who introduced it, now believes his criteria were too broad and could cover up to 30% of the population. He may be right about the 30%. For each person on tranquillisers, anecdotal evidence suggests, there is probably somebody else anxious about whether they should take them too.