Antidepressants 'work instantly'

Antidepressants get to work immediately to lift mood, contrary to current belief, UK researchers say.

Although patients may not notice the effects until months into the therapy, the team say they work subconsciously.

The action is rapid, beginning within hours of taking the drugs, and changes negative thoughts, according to the Oxford University researchers.

These subtle, positive cues may add up over time to lift the depression, the American Journal of Psychiatry reports.

It may also explain why talking therapies designed to break negative thought cycles can also help.

“ We found the antidepressants target the negative thoughts before the patient is aware of any change in feeling subjectively ”
Lead researcher Dr Harmer

Psychiatrist Dr Catherine Harmer and her team at Oxford University closely studied the reactions of 33 depressed patients and 31 healthy controls given either an antidepressant or a dummy drug.

The depressed patients who took the active drug showed positive improvements in three specific measures within three hours of taking them.

These patients were more likely to think about themselves in a positive light, rather than dwelling on their bad points, the researchers said.

They were also more likely to see the positive in others.

For example, if they saw a grumpy person they no longer internalised this to think that they must have done something wrong to upset the person.

New drugs

This was despite feeling no improvement in mood or anxiety.

Dr Harmer said: "We found the antidepressants target the negative thoughts before the patient is aware of any change in feeling subjectively.

"Over time, this will affect our mood and how we feel because we are receiving more positive information."

She said the findings could help scientists looking for new drugs to treat depression.

Dr Michael Thase, a psychiatrist from the University of Pennsylvania, said the findings challenged conventional wisdoms and were potentially "paradigm-changing".

But he said much more research was needed.

"The highest research priority is to confirm that the rapid effects observed in this study are predictive of eventual clinical benefit."

He said it was possible that switching off the negative thoughts was a crucial part of the therapy.

Alternatively, it might merely be a sign that the drug was beginning to work at the cell level in the brain.

Paul Farmer, chief executive of Mind, said: "This research may contribute to our understanding of how our bodies respond to antidepressants, but the changes recorded can't always be felt by patients and it can be some weeks before they begin to feel the symptoms of depression easing.

"We must also remember that the side-effects of medication can often be felt straight away long before the benefits really kick in, and this will always affect people's experiences in the initial stages of treatment."

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/8304782.stm

Published: 2009/10/26 00:37:16 GMT

Virtual reality tackles 'shell shock' By Fergus Walsh

A virtual reality computer programme is being used to treat Iraq war veterans in the US.

The soldiers are able to relive the sights, the sounds and even the smells of warfare.

In a small windowless room a US marine puts on a 3D headset and picks up a dummy rifle.

Sergeant Robert Butler has been a marine for nearly 20 years and done two tours of Iraq.

After his last stint he returned with post traumatic stress disorder - what was once called shell shock.

Now he can finally deal with painful memories of the horrors of war.

Sergeant Butler believes his psychological problems stem from a patrol in 2005 where he witnessed the death of a father and his teenaged son who were killed after being caught up in a fire fight.

His son was about the same age as the boy who died.

Recluse

"When I first came back I was just a complete recluse and avoided outside contact," he said.

Initially he was reluctant to join the virtual Iraq programme.

"I thought PTSD was something the doctors dreamed up for job security," he said.

“ Our different senses are very powerful cues to our memory ”
Commander Scott Johnston Clinical psychologist

"But I'd hit the point in my life where I felt I had zero control and was about to lose the one thing in my life that meant the most which was my family, so I was prepared to try anything."

Sergeant Butler demonstrates the computer scenario which was used to help him.

On a computer screen I can see the same image projected onto Sergeant Butler's visor.

He is in the front seat of a Humvee armed vehicle patrolling the streets of Iraq; each time he turns his head, the viewpoint on the screen changes.

Sights, sounds and smells

An explosion ahead cracks the front windscreen and you see that the virtual soldier sitting alongside him is wounded, blood streaming down his arm.

The platform, on which Sergeant Butler is sitting, vibrates, to add to the sense of reality.

And there are not just the sights, sounds and vibrations of war, there are also the smells.

These come from a machine which can release the scent of burning rubber, Middle Eastern spices, cordite, diesel fuel - even body odour.

Commander Scott Johnston, a clinical psychologist, runs the programme at the Naval Medical Center San Diego.

He said: "Our different senses are very powerful cues to our memory.

"Instead of allowing the person to continue to avoid these memories and haunt them, if we bring them out into the daylight and really face them we can decrease the negative effects on the individual."

Unlocking thoughts

This begins to explain how the programme is supposed to work.

The theory is that by repeatedly running the computer scenario it enables soldiers with PTSD to unlock and then discuss troubling wartime experiences which have been buried away.

After each thirty minute session on the computer, the soldiers have an hour of talking therapy with a psychologist.

"I'm a completely changed person", says Sergeant Butler.

"Am I 100%? No, because PTSD will always be part of my life; those memories never go away.

"But it definitely has helped me to take steps and file that information.

"It does come up, it gets processed like any other memory and I'm able to do the things a lot more now than before the war."

Commander Johnston says the preliminary results are exciting.

"We found that 30 out of 40 of our subjects were able to return to full duty so we are now starting to implement it across the different services for our returning warriors."

Many British as well as American troops have suffered psychiatric problems after serving in the Middle East.

But the Ministry of Defence in London has yet to be convinced by the virtual Iraq programme.

It says for some years it's been exploring the possible uses of virtual reality in treating mental health conditions, but this is still very much "work-in-progress".

Colleges See Rise In Mental Health Issues

October 19, 2009

They may not tell their roommates or even close friends, but on college campuses all across the United States, more students than ever before are seeking psychiatric help, according to recent national surveys of campus therapists.

And it's not just for homesickness and relationship problems, says the University of Michigan's Daniel Eisenberg. He directs the Healthy Minds Study, a multicenter study that queries primarily students, but also a sampling of college counselors, about mental health issues, including the prevalence of clinical depression, anxiety and eating disorders on campus. Eisenberg says his findings dovetail with those of a large national survey of counseling center directors, led by the University of Pittsburgh's Robert Gallagher.

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