Antidepressants

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  • A large new study has found a link between taking antidepressants and a 5% increase in body weight.
  • Some antidepressants were associated with a larger risk than others.
  • Other factors like age and sex didn’t affect the results.
  • The authors said it is important people don’t stop taking their medication if they are worrying about the side effects.
  • They added that alternative treatments such as group cognitive behavioural therapy may be preferable for people with milder depression.

Scientific studies have shown how being obese can increase the risk of developing depression, and how depression can be a predictor for developing obesity.

People who are obese are about 25% more likely to experience a mood disorder like depression than the rest of the population – with poor self image, low self esteem and social isolation all likely to be factors.

According to a new study published in The BMJ, the use of antidepressants could form another link between depression and obesity.

The National Health Service lists some of the common side effects of antidepressants on its website, which include headaches, bad sleep, nausea, and weight gain. Several studies have examined the association between taking antidepressants and gaining weight, but some have had relatively small sample sizes, and others insufficient reliable information.

In the new study, a UK based research team, led by Rafael Gafoor at King’s College London, analysed the body weight and body mass measurements of about 300,000 adults. Their body mass index (BMI) had been recorded at least three times by a doctor between 2004 and 2014.

Then, the team grouped participants according to their BMI, from normal weight to severely obese, and whether or not they were on antidepressants. They monitored them over the next 10 years, while accounting for other factors like age, diseases, and whether they smoked or took drugs, which could all affect weight gain.

Results showed that participants who were prescribed antidepressants during the first year were 21% more likely to have a 5% increase in weight over the next 10 years. The greatest risk appeared to be in the second and third years of antidepressant treatment, and remained higher for six years after first taking the drugs.

The absolute risk for weight gain with antidepressant use was 9.8 per 100 person years, meaning for every 59 people taking antidepressants, one extra person would gain at least 5% of their original body weight over the course of the study, compared to the rest of the population.

Factors like age, sex, and whether participants had health problems like diabetes or cancer didn’t have much of an impact on the results.

Some antidepressant drugs were more associated with weight gain than others. For example, mirtazapine and citalopram had a 50% and 26% higher risk of gaining 5% more weight respectively.

Despite having a large sample size, there are some caveats to the study. As it was observational, it cannot be said that antidepressants definitely cause weight gain. Also, people who had chronic illnesses may go to the doctor more often, meaning their BMI data could be more consistent. Additionally, there’s no guarantee people were taking their antidepressant medication as directed.

Depression in itself can also cause weight gain because people sometimes aren’t as motivated to exercise or eat well.

The researchers concluded that the widespread use of antidepressants “may be contributing to long term increased weight gain at a population level,” and this should be considered when people start taking them. It’s better to be aware of the risks than to stop taking your medication as a result of undesirable side effects.

“It’s important to stress that no patients should stop taking their medication and that if they have any concerns they should speak with their doctor or pharmacist,” Gafoor said.

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  • Popular text-based therapy platform Talkspace is planning a massive expansion.
  • The company is bringing on psychiatrists to prescribe medications to patients through the app using its video chat tool.
  • The app is also partnering with fraternity Delta Tau Delta to offer its 9,000 members free access.

I began my first therapy session on a crisp spring night in 2015, in the middle of a crowd near Manhattan’s Union Square. I was on my way to the subway when my phone buzzed with a new text from an app called Talkspace, a text-message-based therapy platform.

“Hi Erin, it’s nice to meet you,” the message said. “Can you tell me a little bit more about yourself? I’m glad you are here.”

Following that initial message, I used Talkspace for a week.

The app is designed to replace or supplement traditional in-person therapy. And nearly three years and some 1 million additional users after I tried it out, the platform is planning a major expansion.

The biggest change is that Talkspace plans to start prescribing users medications for conditions like anxiety and depression.

Roni Frank, Talkspace’s co-founder and head of clinical services, told Business Insider that the decision to expand into prescription drugs comes alongside the company’s recent appointment of its first chief medical officer. Neil Leibowitz, Talkspace’s pick for the role, was previously senior medical director at UnitedHealth.

In addition, Talkspace is announcing a round of new partnerships in the coming weeks, one of which involves free access for brothers in the 9,000-member college fraternity Delta Tau Delta.

Prescribing drugs through the Talkspace app

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The Talkspace platform is built as a way to confront the reality that traditional therapy – which involves pairing a licensed therapist or social worker with an individual or couple – is failing to meet a large and growing need for mental health services.

Of the roughly 20% of Americans who have a mental illness, close to two-thirds are estimated to have gone at least a year without treatment.

Dozens of other startups are also attempting to solve this problem, including AI-powered app Woebot and chatroom platforms like Better Help and 7 Cups of Tea. None of those currently offers patients access to medication, however.

With that in mind, Talkspace is bringing on a team of licensed psychiatrists who will serve as independent contractors and work directly with Talkspace’s therapists to determine appropriate prescriptions for medications.

With Leibowitz on board as CMO, Talkspace would be the first mental health app to provide this service, which Frank said they would be piloting in a region of the US beginning in October 2018.

“Many patients can’t access medication and it’s very expensive,” she said. “This collaboration is key for better clinical outcomes and better results.”

Users won’t completely forego an in-person consultation, though – Talkspace said that would take place via video chat.

Talkspace is increasingly moving into offices and universities

In addition to expanding into the prescription drug space, Talkspace is also bringing its platform to offices and universities – first by offering its services through employer assistance programs, and second by teaming up with fraternities on college campuses.

As part of the new arrangement with Delta Tau Delta, the fraternity’s members will get free access to Talkspace by using a special code. Talkspace views the initiative as an opportunity to provide young people greater access to mental health services, according to Lynn Hamilton, Talkspace’s chief commercial officer.

“I think millennials today are more open about their mental health and their desire to get services but the flipside of that is that the universities are challenged to keep up with the students’ demand to access care,” Hamilton said.

The company announced a similar partnership with Alpha Tau Omega in 2016, after a member of that fraternity heard about Talkspace in an advertisement and reached out to the company.

The company is also in talks with several sororities and has been mulling the decision to work directly with on-campus mental health services at universities across the US.

“I don’t view this as a fraternity-only partnership,” Hamilton said.

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  • In January, an author wrote a series of stories in outlets including The Guardian and Huffington Post claiming that antidepressants don’t work.
  • A large new review of studies backs up what scientists have been saying for years: that in fact, the drugs do help.
  • The study was written by a team of 18 specialists and looked at more than 500 trials comprising more than 100,000 people. All 21 of the drugs they studied were more effective than a placebo at reducing the symptoms of depression.

Coffee causes cancer. Eggs give you high cholesterol. Lexapro is a scam.

Just kidding.

Health advice these days feels like a game of ping-pong, and the accepted wisdom on antidepressants like Lexapro – one of the most popular drugs used to treat depression – is no exception to that mixed messaging.

In January, writer Johann Hari published a series of personal stories in outlets like The Guardian and the Huffington Post in which he claimed that antidepressant medications didn’t help him because “the whole idea that depression is caused by a ‘chemically imbalanced’ brain is wrong.”

Fortunately, a large new review of 500 studies comprising more than 100,000 people and published this week in the medical journal The Lancet, backs up what many experts in the fields of psychiatry and neuroscience have been saying for decades: antidepressants do work.

The review found that the drugs can be powerful tools in the fight against depression, which today remains the leading cause of disability and a major cause of suicide worldwide.

Written by a team of 18 medical doctors and specialists in Europe and England and funded by the UK’s Department of Health, the review concluded that all of the 21 antidepressant drugs they studied worked better at treating depression than a placebo.

In direct comparisons of some of the drugs, small differences in the results appeared, with the research suggesting that some medicines like escitalopram (frequently sold under brand-name Lexapro) worked slightly better than drugs like fluoxetine (sold under brand-name Prozac).

pill placebo pills clinical trial drugs prozac

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Still, antidepressants are not magic tricks.

Evidence suggests that for as many as 78% of people, simply taking a pill does not completely erase depression’s most insidious symptoms, which can include things like isolating oneself, having disturbing impulses to self-harm, or being so self-critical that it interferes with daily life.

A smaller percentage of people don’t respond to medications at all, a troublesome phenomenon known as treatment-resistant depression that remains one of the hardest types of the illness to address.

But for those whose symptoms do subside on antidepressants, they can be a powerful component of a larger treatment plan that might include things like therapy, group counseling, and exercise.

These other parts of treatment plans should not be discounted, as some studies suggest that the right forms may be just as powerful, if not more so, than medications. Unfortunately, therapy also tends to be expensive and time consuming, which makes it inaccessible to people who are working multiple jobs or can’t afford it.

Also, while most antidepressants work better than a placebo, it’s still somewhat unclear how much better than a placebo they function. For the latest review, the researchers found evidence that some medications ranged from being roughly a third more effective to more than twice as effective as a placebo – a fairly wide range. This means that some people’s symptoms may dramatically clear after a few weeks on the right drug while other people get only slight relief.

However, the main takeaway from the latest paper appears to be that for many people, antidepressants can be a helpful part of a broader approach to treatment – and in some cases, they provide powerful relief that isn’t available otherwise.