This will otherwise be known as “WTF are you doing, Journal of Medical Hypotheses”.
Sci likes Lithium.
(Lithium burns red. Sci thinks this could have applications for lightsabers if applied correctly)
It’s a cool element, interesting in that we’ve used it over the ages for stuff like gout (which, I hear, is making a comeback), prevention of migraine, blocking the effects of excessive anti-diuretic hormone, and of course for bipolar disorder. But what’s really interesting? We don’t know how it works. Not a clue. It may raise serotonin levels over time, it may decrease or increase other monoamine neurotransmitter levels (such as dopamine and norepinephrine). But we have no idea HOW this occurs. In this, as with other psychiatric drugs (such as Ritalin, which increases dopamine and norepinephrine and improves attention, or with selective serotonin reuptake inhibitors, which increase extracellular serotonin and alleviate depression), we don’t know HOW they work. We just know they WORK (though we’re working on that).
And THAT they work is what matters. When you’re dealing with someone who is potentially suicidal, or unable to function successfully due to severe psychiatric disorders, you’ll take what works and isn’t otherwise “bad” for you (that you can tell), and figure out the mechanism later. And some of these drugs, like Lithium, are very old indeed. Lithium has been used to treat mania and depression since the 1870s, and is still used today as one of the most effective treatments for bipolar disorder (a topic which I SWEAR I will cover someday). It goes a long way toward reducing suicide in those with severe bipolar, and can help with mood stabilization as well.
So if it’s been used that long, it must be good right? This means it might do everyone some good, right? Like, you could put it in the water, and it’d be fine?
Terao, et al. “Even very low but sustained lithium intake can prevent suicide in the general population?” Medical Hypotheses, 2009.
This will otherwise be known as “WTF are you doing, Journal of Medical Hypotheses”.
Ok, the serotonin theory of depression may not be wrong. But it is definitely incomplete. One might ask why we use serotonergic drugs to treat depression if the theory behind it is wrong. A good question, but to this I say: because it worked.
(I love the Zoloft depressed marshmallow. He’s so cute!)
This is post four of my series on depression. For previous posts on the etiology of depression, the pharmacotherapies for depression, and how depression is evaulated in the lab, please play link hopscotch! I’ve also got a very recent post on the serotonin system which can give you some more background.
The original antidepressants, the monoamine oxidase inhibitors and tricyclic antidepressants, were originally used to treat other diseases, such as tuberculosis and psychosis, and found to be effective for depression as a sideline. Did people know how they worked? Nope, but they appeared to work (though only in a subset of the population), and so they came into use. Some people might get up in arms about this, and yell about how we shouldn’t use drugs unless we know how they work. But if we spent our lives doing that, no one would have ever made asprin. Or morphine. Heck, no one would have patented Ritalin. We know THAT Ritalin works, and we know what Ritalin does in the brain, but do we know why Ritalin calms down people with ADHD when it’s really a stimulant? Not really, no. But it’s still out there, because it works.
And the serotonin-based antidepressants do work in some people. Only in about 60% of patients at best, and at their best, they only perform 30% better than placebo. But the modern selective serotonin reuptake inhibitors (SSRIs) still work in a set of depressed patients, and they do so with far fewer side effects than pre-existing drugs. And what can I say, we haven’t really got anything better yet. Except cocaine. That’s a GREAT antidepressant, but it obviously has some issues.
So where did this serotonin theory of depression come from? And why is it flawed?
Sci’s going to go ahead and admit, the last few weeks have been a little…brutal. Ok, maybe a LOT brutal. Grad school can be tough at times, and involve days that leave Scicurious wiped. But the posts must go on! And so, today your tough little grad student (YTLGS) is fortifying herself with the best cures imaginable, moose munch and liquor, to bring you today’s post.
(By the way, being poor, Sci accepts gifts to her blogging muse in the form of Moose Munch, dark chocolate of any kind, and liquor of all varieties except NightTrain. Contact her for details).
Todays post brought to you by sugar and…fermented sugars. Also the letter S. And the Journal Club that Sci has to give…soon. Very, very soon.
Landen, et al. “Short onset of action of a serotonin reuptake inhbitior when used to reduce premenstrual irritability.” Neuropsychopharmacology, 2009.
As all y’all know by now, I’m an experienced caffeine junkie. Currently, I’m trying to forgo it again (this Diet Coke right here is merely an aberration, do not look at the caffeine behind the curtain…). But really, it’s everywhere around us. Somehow I don’t think it was QUITE so prevalent until the age of Starbucks. but it seems like now you can’t go anywhere without running into a coffee shop or three. In some cities there is literally one on every street corner. And with the crazy lives we all appear to be living these days, shouldn’t we take whatever legal cognitive enhancement we can get our hands on?
And heck, with a Starbucks on every streetcorner, what’s a poor lady who is…*ahem*…increasing (for those not familiar with the Victorian term, it means preggers), to do? Some of us spend our lives pretty well addicted, but when a women in the US finds out she is pregnant, she is immediately to drop to no more than one caffeinated beverage a day. And 70% of expectant mothers apparently don’t even do that. So the big question is: is our children caffeinated?
Bjorklund et al. “Perinatal Caffeine, Acting on Maternal Adenosine A1 Receptors, Causes Long-Lasting Behavioral Changes in Mouse Offspring” PLoS ONE, 2008.
I’m BACK! Finally, a return to wireless. Granted, I’m sitting in an airport, but that’s long enough to bang out a post, right? The real work can wait, my brain is still on vacation.
I hope you all got what you wanted for the holidays, and that Santa left PhDs in your stockings, or tenure, or the latest in lab equipment. Or whatever.
Did I mention how much I LOVE getting free books in the mail? Seriously, it makes Sci so happy. This one looked promising right from the start. Freaks of Nature: What Anomalies Tell Us About Development and Evolution, by Mark Blumberg.
And for good measure, here’s the cover:
WARNING: spoilers ahead. Though considering it’s a book review, there SHOULD be spoilers ahead. Otherwise one would have to question whether or not I had read the book at all.
So I’ve been thinking of ways to make some of my more science-y blogging come across to those with less in the way of science backgroud. There was a suggestion that I try categorizing the posts into easy, intermediate, and difficult, but I wouldn’t want people to give up on something they may potentially find really cool just because it’s labelled “hard”, you know?
One way I thought of to help with this would be a series of really easy background posts on many of the topics that I write about. These would be things like different neurotransmitters and brain areas, as well as a couple of diseases that I happen to think are really cool. Thus, when I write the deeper, more science-y posts that contain these topics, I can link back to them, and you will know what I’m talking about. It’s like wikipedia, only better because all of these things relate specifically to ME. And cannot be edited by people who may just want to change things for fun. These will, of course, be interspersed with other posts (I’ve got something awesome brewing on Aristotle, stay tuned).
So, without further ado, the first one of the things that I happen to like blogging about background posts…DIABETES.
Before I do anything else, I want to let you know that Not Exactly Rocket Science has posted a really cool article on a robotic starfish! It can adapt to injury and self-assess. And it’s so cute! Anyone want to get me a robotic starfish? Anyone…?
And on a sad note: Tetrapod Zoology reports on strange giraffe deaths. This makes me so sad! The giraffe, in all it’s tall, necky, awkwardly graceful and nervous glory, is my totem! Though Coturnix also identifies with our favorite ungainly giant. Coturnix, watch out for trees.
ACK! Cool stuff keeps happening before I can finish this post! Tangled Bank is up over at Evolved and Rational, and yours truly is featured, tho’ we are misspelled are ‘Neutropia”. It’s almost the same, right?
Scienceblogs Book Club is back, with “Autism’s False Prophets” as it’s current book. I REALLY want this book. I think I might have to make it a special gift to me, since I’m so awesome.
Finally, and in keeping with today’s paper: Zooillogix has found fat dolphins. Regardless, I think they’re awfully cute. The second pic of the chubby one on the bottom is particularly so.
But really, I had something real to write about today (though I think I’ve spent the entire day writing so far…). As I’m sure most of you are aware, doctors are very worried about an obesity epidemic in the United States and other countries. There are lots of possible causes, lack of activity due to sedentary lifestyles, genetic components, crappy food, etc. It’s not that doctors are worried about people being obese per se (though there is probably some societal vanity at work), it’s that there are strong correlations between obesity and several tough health problems, such as diabetes, cardiovascular problems, and cancer. A new essay out in PLoS Biology predicts that it may not be your actual size that counts, but what you do with the fat you have.
Virtue, S, Vidal-Puig, A. “It’s not how fat you are, it’s what you do with it that counts”. PLoS Biology, 6(9), Sept. 2008.