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Study Rates Depression Drugs' Side Effect

May 17, 1999|THOMAS H. MAUGH II

The medications sertraline (Zoloft) and bupropion (Wellbutrin) are equally effective in treating depression, but sertraline causes significantly more sexual dysfunction, according to a team of researchers from around the country. In the study, sponsored by Glaxo-Wellcome, manufacturer of bupropion, 355 patients with depression received either sertraline, bupropion or a placebo.

The researchers report in the April issue of Clinical Therapeutics, published Saturday, that 41% of the patients taking sertraline reported orgasm dysfunction, compared to 15% taking bupropion and 8% taking the placebo.

Depression affects more than 17 million Americans each year and is one of the most treatable mental illnesses, says the American Psychiatric Assn. Because most drugs now used are effective at relieving symptoms, according to Dr. R. Taylor Segraves of Case Western Reserve University School of Medicine, factors such as side effects are an important consideration in selecting treatment.

Test Hints at Source of Mood Problems

An unusual insight into the origins of depression has been provided by French researchers who were implanting electrodes in the brain of a 65-year-old woman to control trembling caused by Parkinson's disease. While the team was testing the implanted electrodes, which can each be activated at four different sites, to determine which site was most effective at controlling trembling, they observed that electrical stimulation of the left substantia nigra--a part of the brain not usually associated with mood regulation--at a site 2 millimeters below the point that controls Parkinson's stimulated profound depression.

The team from Insitut National de la Sante et de la Recherche Medicale in Paris reported in Thursday's New England Journal of Medicine that, when the electrode was activated, the woman suddenly started to cry and told of feeling sad, guilty and useless.

"I no longer wish to live, to see anything, hear anything, feel anything," the woman told the doctors. Asked if she felt pain, she replied, "No, I'm fed up with life. I've had enough."

Ninety seconds after the current was turned off, her depression disappeared. With her permission, they repeated the procedure twice and, each time, observed a similar effect. The findings, according to Dr. Stuart C. Yudofsky of the Baylor College of Medicine, indicate that the neural circuitry controlling depression, and perhaps other emotions as well, is "hard wired" into the brain. This finding could lead to new ways to treat some mood problems.

More Folic Acid May Reduce Heart Disease

The government-ordered fortification of flour, rice and other grain products with folic acid, begun in January 1998 to help protect against spina bifida and related birth defects, may also have a salutary effect on heart disease, Boston researchers reported in Thursday's New England Journal of Medicine.

Studying a group of mostly white, middle-aged residents of Framingham, Mass., a team from Tufts University found that average blood levels of folic acid doubled after the fortification went into effect. The percentage of residents with a folic acid deficiency dropped from 22% to less than 2%.

The study also found that blood levels of homocysteine, a naturally occurring amino acid produced during the digestion of proteins, fell by 7%, while the number of people with unusually high homocysteine levels fell from 19% to 10%.

High levels of homocysteine have been associated with an increased risk of heart disease, but it has not yet been demonstrated that lowering homocysteine levels reduces that risk, the American Heart Assn. said in a statement.

Abnormal Brain Scan, Premature Birth Linked

Adolescents who were more than five weeks premature at birth are much more likely to have abnormal brain scans than those born after a normal gestation, according to researchers from University College London.

Dr. Ann Stewart and her colleagues performed magnetic resonance imaging studies on 72 adolescents who were premature and 15 who were born at the normal time. They reported in Saturday's Lancet that 40 of the premature group had abnormal scans, compared to only one in the control group. The abnormalities were mostly in the white matter, which is involved in carrying signals between different parts of the brain and between the brain and the spinal cord.

The subjects in the premature group were also twice as likely to have abnormal results on conventional verbal and written neurological tests, and were much more likely to have behavioral problems, difficulties in school and lower reading scores.

Most Don't Admit Using Herbal Supplements

Patients who take herbal supplements or large doses of vitamins often do not report their consumption to physicians, thereby increasing the risk of adverse drug interactions, according to a team from the Mayo Clinic in Rochester, Minn.

Surveying 200 randomly selected subjects undergoing regular health exams at the clinic, the Mayo researchers found that only 30% voluntarily reported use of such products to their doctors, but that 61% were actually using them. The results were reported in the May issue of the Mayo Clinic Proceedings. Most who did not report their use of the supplements said they simply did not consider it important.

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Medical writer Thomas H. Maugh II can be reached at thomas.maugh@latimes.com.

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