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Judge agrees with executive’s antidepressant defense

November 30, 2006

TAMPA, Fla. — A federal judge agreed with a Tampa executive’s claim that the antidepressant Paxil prompted him to embezzle $1.8 million from a former employer.
U.S. District Judge James Moody Jr. sentenced Patrick Henry Stewart, 42, to a year of home confinement and five years’ probation.
Moody granted the reduced sentence Nov. 20 in part because defense lawyers produced studies and experts that said Paxil sometimes triggers arrogant and uncontrollable behavior in people with bipolar disorder. Stewart was recently diagnosed with bipolar disorder.
Prosecutors had recommended at least 3 1/2 years in prison as part of a plea agreement.
“We believe the wrong message was sent to our employees, our shareholders and the public with this sentence,” said Beth Walters, a spokeswoman for Stewart’s former employer, Jabil Circuit, a contract manufacturer of printed circuit boards. “We will move on knowing that Pat Stewart is a convicted felon.”
Stewart agreed in August to plead guilty to wire fraud charges in exchange for a lighter sentence. His lawyers asked for more lenience based on the Paxil evidence.
Stewart declined to comment after the Nov. 20 hearing.
“It’s a good day at our house,” said his wife, Leslie.
Paxil’s box carries a warning that anyone using the drug should be monitored for signs of agitation, irritability, suicidal thoughts or other unusual changes in behavior. It also warns that any psychoactive drug may impair judgment or thinking. Paxil is manufactured by GlaxoSmithKline (NYSE: GSK).

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THE LEGACY OF A CRIME (Part 2 of 2): No more appeals

November 27, 2006

Benjamin Garris said he has no more appeals left; he has spent more than a decade serving a life sentence plus 50 years for the 1995 murder of Sharon Edwards at a psychiatric treatment center in Baltimore County.

“The only thing I could ever really hope for is to have my sentence modified,” he said recently in the visiting room of the Jessup Correctional Institution.

Garris plans to file in 2007 to have his sentence reduced.

He says he has had no infractions in prison, that he represents his cell block as a liaison to prison staff.

“It’s a waiting game,” he said. “People want to see what your pattern of behavior is.”

Whether the outside world believes Garris can one day walk free is still undecided.

“I take wholehearted responsibility for what was done,” he said. “I don’t expect anything miraculous … but I would like a little bit of light at the end of the tunnel.

“I don’t know how long will be long enough for the rest of the world.”

Garris has appealed his sentence before. The Maryland Court of Special Appeals affirmed his conviction in September 1996. On Oct. 14, 1998, he petitioned for post-conviction relief to have a new trial. The petition’s arguments centered on his use of Prozac.

Benjamin Garris had decided to die.

Everything was so different since he had run away with his friends to New York City and Boston in November 1994, when he left a note for his father simply stating “Dad — I’m sorry, but I have to go. Love, Ben.”

After years of teenage rebellion — sex, drugs, acting out in class, vandalism, shoplifting — following his parents’ divorce when he was 10, Garris was diagnosed with depression in the spring of 1994 at Suburban Hospital in Bethesda. Between his running away and January 1995, he went to a group home in Sykesville.

Back in Frederick, Garris saw a counselor and was put on 30 milligrams of Prozac a day for his depression.

But he felt himself slipping away, both academically and personally. He failed to keep a B average, and his girlfriend broke up with him.

Methodically, Garris planned his suicide. He started hoarding pills and researching through a computer encyclopedia what medicines could be lethal.

On the night of March 8, 1995, Garris consumed a bottle of cough syrup with codeine, Ambien, Sominex, NyQuil and whiskey.

If the family dog hadn’t found him and barked, the 15-year-old might have slipped away.

II

On March 10, 1995, at 3:42 p.m., two days after Garris’ suicide attempt, Sheppard and Enoch Pratt Health System took in medical record No. 89532-6 and admission No. 78018, diagnosed with “major depression, severe, recurrent (with suicide attempt).”

Medical records from March to September 1995 show fluctuations in mood and progress. Doctors and nurses charted a cycle: Garris appears to improve and then promptly reverts back to anger, silen
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ce and depression.

In the records, Garris’ parents often talk about how frustrating the treatment was, how he never seemed to improve.

Following months of Garris showing little or no emotion — putting a safety pin through his eyebrow and clothes pins on his nipples, cutting his arm and reporting a 13-pill overdose of the anti-convulsion and manic depression medication Depakote — doctors at the hospital began to recognize that he needed long-term residential treatment.

“He continues to verbalize suicidal and homicidal thoughts when angry,” Dr. Meenakshi Vimalananda wrote July 18. “He continues to invest his primary energies into dysfunctional relationships with peers, particularly females. He continues to engage in splitting staff as he does his family.”

Garris’ insurance provider granted him an additional 90 days at Sheppard-Pratt in August 1995 until he could be placed in a long-term center.

But there something else was wrong, too — something Garris and his parents attribute to his medication, specifically Prozac.

When he entered the hospital, Garris had been taking 30 milligrams of the antidepressant every morning; the dosage was increased incrementally to 60 milligrams in his first three weeks at Sheppard-Pratt, lowered temporarily to 40 milligrams on June 2, and then raised back to 60 milligrams two weeks later.

This was eventually combined daily with 1,000 milligrams of Depakote.

“He was just blank,” Garris’ father, Steve Garris, said. “Within three months (of treatment), he was a completely changed person.”

Garris became very placid and cooperative, said John Lee, his stepfather, but would flare up in anger and hurt himself.

“It was like a ‘Stepford child,’” Mr. Lee said. “We had no idea what was really going through his head.”

Also troubling was the violence in Garris’ mind — bloody images that came in flashes, like lightning storms in his head.

He wondered aloud to his mother, Tina Lee, what another patient would look like without hands or feet, trussed up like a pig with an apple in his mouth. He describe to his father a vision of the Lees chained down to a burning bed. He asked hospital staff about bomb ingredients.

Garris’ parents asked if the hospital staff could search his room, in case he was planning to run away again; they were told no, that would invade his privacy.

“I didn’t think violent thoughts (before). That’s not a part of who I am,” Garris said. “It was like I was in the back seat and someone else was driving.”

He said his mind cleared in prison, once he stopped taking medication.

III

Garris’ petition for post-conviction relief, sent to Baltimore County Circuit Court in October 1998, relied heavily on a report about his medical treatment written by Dr. Peter Breggin.

Dr. Breggin, a psychiatrist, is highly critical of Prozac. In his 1994 book, “Talking Back to Prozac,” he describes how his independent research into the U.S. Food and Drug Administration approval of Prozac revealed a high dropout rate that resulted in only 286 patients making it all the way through the 17 studies before the drug’s approval. Even then the data still did not show any effectiveness greater than antidepressants already on the market, Dr. Breggin wrote.

The basis for the new trial request was that Garris had insufficient counsel. The arguments of his lawyer, Howard Cardin, rested on lack of premeditation rather than being not criminally responsible — i.e., whether Garris was under the influence of drugs and therefore could not be held responsible for the murder.

Dr. Breggin argued that 60 milligrams a day of Prozac, three times the recommended adult dose at a time when the drug was not approved for children and adolescents, increased Garris’ potential for violent action.

During FDA trials, Dr. Breggin wrote in his report, slightly more than 1 percent of Prozac users experienced medication-induced psychosis, and documented reports in scientific literature, such as The Journal of the American Academy of Child and Adolescent Psychology, show how at-risk patients comparable to Garris are more in danger of succumbing to adverse affects.

“Ben was psychotic at the time of the offenses and Prozac, without question, can cause or exacerbate psychosis,” Dr. Breggin’s report states.

The court, however, did not believe Garris’ petition necessitated a new trial.

In a May 1999 opinion, Judge Dana M. Levitz wrote that Mr. Cardin’s argument of a lack of premeditation was a strategic decision that did not meet the criteria for insufficient counsel.

“Mr. Cardin was faced with the difficult task of representing a defendant in a brutal crime for which the State had overwhelming evidence of the Defendant’s guilt. Less experienced attorneys would have been at a loss to present any viable defense,” Judge Levitz wrote. “After reviewing the transcript, this Court is impressed with the professionalism and tenacity of the defense in this case. The defendant was entitled to competent legal representation; he was not entitled to a magician.”

IV

In “A Clockwork Orange,” the 1971 Stanley Kubrick adaptation of Anthony Burgess’ book, society is plagued by nihilistic teenagers who terrorize innocent people with beatings and rapes. A young man is arrested and trained like Pavlov’s dog to associate violence with physical sickness. That rehabilitation eventually fails.

In “Natural Born Killers,” a 1994 release conceived by Quentin Tarantino and directed by Oliver Stone, two lovers travel across the country on a murder spree, both feared and admired by the media before they incite a prison riot and escape.

Both films played a role in the public image of Garris when he escaped from Fordham Cottage at Sheppard-Pratt and eluded capture for about three weeks.

A day after Garris was charged with Sharon Edwards’ murder, an Oct. 10, 1995, article in a Frederick newspaper quoted Baltimore County Police Detective Sam Bowerman.

“Lt. Bowerman said friends of the youth have described him as manipulative, intelligent, well-read on violent crime and a chronic liar,” the article states.

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“He has been a fan of ‘A Clockwork Orange’ and may have recently been acting out scenes from movies or books, the officer said. ‘A Clockwork Orange’ is both a novel and film about violent youth.”

On Oct. 11, 1995, a Frederick newspaper published an interview with Sarah Scully, his ex-girlfriend.

Ms. Scully showed a reporter a photo of Garris “standing pensively by a tree, his head shaved, wearing sunglasses and looking like Woody Harrelson in the movie ‘Natural Born Killers,’” the article states.

According to the article, Ms. Scully said she watched the movie eight times with Garris.

The article continues: “Some time ago, said Miss Scully, Garris told her he planned to steal a Ford Bronco, steal guns and ‘we were just going to run’ like Mickey and Mallory in ‘Natural Born Killers,’ a movie about a couple’s crime spree.”

The same article mentions “A Clockwork Orange.”

“Garris also believes he is ‘Alex’ from ‘A Clockwork Orange’, a book and movie about a violent man a futuristic government attempts to rehabilitate, (Miss Scully) said.”

Defining the movies as obsessions is wrong, Garris said recently in Jessup. He never craved bloodshed or believed he was either of those characters — he simply wanted to run away from institutions that had imprisoned him.

“The whole thing was blown up out of proportion,” he said.

Public perception crystallized into rumors that Garris would come back to Frederick High School on Friday, Oct. 13, 1995, and explode a bomb. Plainclothes deputies began roaming the halls, and one math teacher locked the door to her classroom.

Those movies, Garris said, had nothing to do with his problems, which were manifested in his efforts to be a class clown and acting out like a rebellious teenager.

“I was an actor without a stage,” he said. “I always wanted to be in the spotlight.”

“A Clockwork Orange” was so dense, especially with its use of fictitious Russian slang, that Garris never even finished the film or book.

“I just saw something that was very cult and kitsch,” he said. “We couldn’t even watch the whole damn thing.”

Garris’ confession after the crime fueled the notion that he was consumed by violent fantasy by quoting “A Clockwork Orange.”

“Oh yes, brothers, it grew into a real horrorshow, with devotchkas kreeching their eyes out over unforgivable sinny winnys sins that your humble narrator was soon enough the catalyst of,” the confession states.

Garris said the confession shows how delusional he was at the time, and how separated he felt from his actions.

“Why I did it, I have no É clue,” he said recently. “I couldn’t understand that I wrote that.”

Public fascination with these two films, and the violence sometimes attributed to them, stems from their voyeuristic qualities according to Robert Thompson, founding director of the Center for the Study of Popular Television at Syracuse University and a trustee professor of Television and Popular Culture at the S.I. Newhouse School of Public Communications.

Mr. Thompson said the “you are what you watch” thesis whitewashes the complexity of human motivations, particularly with violence.

“To make that direct cause and effect (between actions and movies) … is a very dangerous thing to do,” he said. “There’s a big middle step that a lot of people ignore, and the problem is a lot of people include the general public.”

Offering a pop culture comparison is easy, Mr. Thompson said, but it distorts reality.

“That’s a common cultural thing people can understand,” he said. “That really brings a whole bunch of baggage to the story because you already have a narrative.”

During Garris’ trial, “A Clockwork Orange” was introduced into evidence. A jury’s objectivity is endangered when a defendant is crafted as an imitation of a pop culture figure, Mr. Thompson said.

“You’re not really trying Ben Garris. You’re trying Alex (from A Clockwork Orange).”

V

People who know Ben Garris best don’t recognize the image projected in the courts, newspapers and television shows. They remember a teenager everyone had called “Gentle Ben” since childhood.

“He was a normal kid. He had his ups and downs, just like any other kid,” John Lee said. “He was not this monster.

“(But) it’s easier for society to come up with a picture of what they think (a criminal) should be. It scares people to think ‘it could be my kid.’”

More than 10 years after the murder, Steve Garris doesn’t believe his son’s hometown understands who he is — a kid who, when he was 7, opened a bag holding his stuffed animals because he was afraid they wouldn’t have enough air.

“I wish they could know him for who he really was and not who he was made out to be,” Mr. Garris said.

For Tina Lee, Garris will always be her son, the one who chose Augustine as his confirmation name in the Catholic Church without knowing that her own confirmation name, Monica, was St. Augustine’s mother.

Garris’ room hasn’t been changed, she said, and it still bears a mural he painted before he went to Sheppard-Pratt, one that depicts his tortured emotions.

“When he gets out, we’ll paint over it together,” she said.

For now, Garris finds solace in painting in his cell.

Conversations about anything — the crime, Frederick, literature — inevitably lead back to the apologies he writes in brushstrokes.

“I wish I could say 10 years in prison helps you deal with it,” he said. “It doesn’t soften anything. It doesn’t soften the edges at all. And those memories are still here. I’m probably never going to let those things go.

“And I don’t want to.”

Garris doesn’t expect people to relate to his life. He doesn’t expect them to feel sorry for him. He said he only wants them to know he is trying to apologize.

“I don’t have sympathy (for other prisoners) É which makes me question who the hell will have sympathy for me.”

VI

If, one day, Garris leaves the Jessup Correctional Institution, his first stop won’t be his mother’s home in Frederick or his father’s in Lusby, Va.

If he ever gets into a car, it will take a right out of House of Corrections Road onto Md. 175.

The car will pass porch-lined houses, Jessup Elementary School, churches and a community center, and merge onto I-295 north toward Baltimore.

From there it will take exit 3A, and turn right on Md. 2 North. One last right turn will take the car onto Cedar Hill Lane, a small road edged by tall trees and modest houses that turns into a rutted, unpaved path leading through the two small brick pillars that mark the entrance to Mount Calvary Cemetery, where Sharon Edwards is buried.

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Europe OKs popular Lilly diabetes drug

November 22, 2006

Eli Lilly and Co.’s new diabetes drug Byetta, which became so popular that the company had trouble meeting demand this summer, is about to go international.

The drug, noted for its weight-loss benefits, has been approved for sale in 27 European countries, Lilly said Tuesday. It’s the first market outside the United States for the drug, which Lilly is counting on to become a key future source of revenue.
Lilly co-developed Byetta with Amylin Pharmaceuticals, a San Diego-based company.
Byetta is given to diabetic patients to help control their blood-sugar levels before they become insulin-dependent. Many patients and diabetic advocacy groups report that people who take Byetta often lose weight, in contrast with some other diabetes drugs, which often cause weight gain.
“The word-of-mouth feedback has been remarkably positive, more so than any diabetes drug I can remember being launched,” said Kelly L. Close, principal of the San Francisco diabetes and obesity-consulting firm Close Concerns.
Sales of Byetta have mushroomed since the drug was launched in June 2005. In the third quarter, sales were $126.4 million, up 28 percent from the previous quarter, putting it on a growth trajectory to become one of Lilly’s major products, said Dave Vondle, Lilly’s global brand development team leader for Byetta.

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Currently, Byetta is still far behind such Lilly blockbusters as schizophrenia drug Zyprexa, which rang up $1.1 billion in the third quarter; cancer drug Gemzar ($355 million); antidepressant drug Cymbalta ($349 million); or osteoporosis drug Evista ($258 million).
“What makes Byetta different is that patients are asking for the drug,” said David Kliff, publisher of Diabetic Investor, a Chicago newsletter for investors in diabetes companies. “I think it has an outstanding future.”
So many patients were taking the drug that Lilly and Amylin ran into a shortage of injection-pen cartridges this summer, and asked doctors to hold off on putting new patients on the drug for several months.
Jim Reddoch, an analyst with Friedman Billings Ramsey & Co. in Arlington, Va., expects Byetta to hit at least $2 billion in annual sales by 2011, he wrote in a recent report.
Lilly plans a phased launch of Byetta in Europe starting in mid-2007, to give the company time to handle logistical issues.
Lilly co-markets the drug in the United States with Amylin, sharing the revenue evenly. But in Europe, Lilly will market the drug alone and book all the revenue, paying Amylin a royalty.

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Drug price wars intensifying: One-upmanship may hurt chains, MSU prof says

November 21, 2006

Target on Monday began selling 145 generic prescription meds for $4, becoming the fourth major retail chain in six months to hack away at the local price of certain time-worn medications.

The group of drugs includes the antibiotic amoxicillin, the steroid prednisone and the antidepressant nortriptyline.

In May, Kmart Corp. offered 90-day supplies of 184 generics for $15.

In October, Meijer Inc. started giving away seven generic antibiotics. Shortly afterward, Wal-Mart Stores Inc. were selling 143 generics for $4.

“If I was one of the CEOs, I’d say, ‘Fasten your seat belts because it’s going to be a bumpy ride,’ ” said Charles Ballard, an economics professor at Michigan State University.

Ballard likened the price-cutting frenzy to what happened in the airline industry in the late 1980s. American Airlines, he said, offered frequent-flyer miles - a great move until competitors followed. The deal was no longer special.

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Today’s one-upmanship is a sign the world of the hyper-marts is hyper competitive.

“I just don’t know where it will leave some of these companies,” Ballard said.

Certainly, small-time pharmacies are worried, said Andrea Rybicki, spokeswoman for the Michigan Pharmacists Association in Lansing. They can’t afford a price war.

Wal-Mart on Monday put an upbeat spin on Target’s headline grabber.

“We’re happy other companies are doing this,” said Nick Infante, Wal-Mart’s Lansing-area spokesman. “Everybody benefits.”

Officials at Target, which supports 1,287 pharmacies nationwide, did not return calls for this story.

Ballard said the discounted drugs appear to be a loss leader - something to draw customers with the hope they’ll shop for more than prescriptions.

“The biggest winner,” he said, “is the person who has lots of medications that he needs to buy but doesn’t buy much of anything else.”

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Ex-Jabil worker’s defense: Paxil made me do it

November 20, 2006

Patrick Henry Stewart, a mid level finance professional who stole $1.8-million from ex-employer Jabil Circuit and will be sentenced for wire fraud next week, is waging a last-minute bid to avoid prison time.

His angle? The Paxil made me do it.

Stewart, 42, pled guilty this fall to writing more than 100 company checks to himself and his creditors. In exchange for his cooperation, federal prosecutors agreed to recommend a reduction in the maximum prison term of 20 years.

But in motions filed this week, attorney Kevin Darken cited testimony from three psychiatrists who claim Stewart was suffering from an undiagnosed case of bipolar disorder when a doctor prescribed him the antidepressant Paxil in 2002. The interaction allegedly flipped a “manic switch” that caused Stewart to make bizarre and impulsive decisions throughout his two-year-long scam.

According to Darken, Stewart allegedly:

- Kept a parrot in his Jabil office even though it bit people; ate a bag of marijuana while in Amsterdam on a business trip; and drank so heavily at an Orlando conference for Jabil controllers that he cut his head open in the pool.

- Bought a 2.2-pound gold bar, a gold-plated Colt .45 pistol, mailboxes for seven of his Hunter’s Green neighbors, $100,000 worth of coins, a solo ticket for a trip down the Amazon River and a John Deere lawn mower that he drove home from the store. He also donated more than $25,000 to the Tampa Bay Performing Arts Center. Daily shoplifting ventures culminated with his arrest outside a Publix grocery store.

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“If this problem had been identified quickly and early … I have no doubt that Stewart would not have suffered from this manic behavior and would not find himself in his current legal predicament,” University of South Florida psychiatric research director David Sheehan said in a letter to the court. “This phenomenon of secondary mania has been well-documented in medical literature.”

Stewart called his check-writing scheme compulsive and risky during a 2005 psychiatric evaluation.

“I didn’t set up any shadow companies,” he reportedly told Sheehan. “I just processed the checks … (and) copied them on the copier in front of my colleagues and bosses.”

Stewart kept each check under $50,000 so that he wouldn’t need to obtain a second signature.

Stewart has repaid more than $1-million to Jabil. The federal government is reclaiming still more by seizing his home, cars and other assets.

Jabil spokeswoman Beth Walters said she was unaware of Stewart’s last-minute gambit.

“We’re confident the U.S. Attorneys’ office will address the purported ‘Paxil defense’ during Monday’s hearing,” she said.

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New research strives to understand how antidepressants may be associated with suicidality

November 14, 2006

The National Institute of Mental Health (NIMH), part of the National Institutes of Health, is funding five new research projects that will shed light on antidepressant medications, notably selective serotonin reuptake inhibitors (SSRIs), and their association with suicidal thoughts and actions (suicidality).

Studies have shown that most individuals suffering from moderate and severe depression, even those with suicidal thoughts, can substantially benefit from antidepressant medication treatment. However, use of SSRIs in children and adolescents has become controversial. In 2005, the U.S. Food and Drug Administration (FDA) adopted a “black box” warning–the most serious type of warning in prescription drug labeling–for all SSRIs. The notice alerts doctors and patients of the potential for SSRIs to prompt suicidal thinking in children and adolescents, and urges diligent clinical monitoring of individuals of all ages taking the medications. This can be particularly challenging because it is difficult for patients, their family members and practitioners to determine whether suicidal thoughts may be related to the depression, the medication, or both.

“These new, multi-year projects will clarify the connection between SSRI use and suicidality,” said NIMH Director Thomas Insel, M.D. “They will help determine why and how SSRIs may trigger suicidal thinking and behavior in some people but not others, and may lead to new tools that will help us screen for those who are most vulnerable,” he added.

The projects are listed below.

* Kelly Kelleher, M.D., of Columbus Children’s Hospital and the Ohio State University, and Joel Greenhouse, PhD, of Carnegie Mellon University, will build on data initially collected by the FDA to analyze antidepressant medication use and suicidal behavior among youth, adults and older adults. Dr. Kelleher will use new and more sensitive statistical approaches to integrate data from numerous other studies–both randomized and non-experimental–to paint a more complete picture of the relationship between antidepressant medication use and suicidal thoughts or actions.

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* Marcia Valenstein, M.D., of the University of Michigan, will examine the records of 994,000 individuals from the U.S. Department of Veterans Affairs National Registry for Depression, Medicare records and the National Death Index to determine what relationships exist between the use of antidepressants and suicide attempts and/or deaths, and use of any concurrent medications or treatments. The study will help determine the relative effectiveness of different depression treatments in reducing suicidal thoughts and actions.

* Wayne Goodman, M.D., of the University of Florida, will investigate if and how SSRIs may induce in some young people an “activation syndrome”–a set of symptoms such as irritability, agitation and mood swings that may lead to suicidal thoughts or actions. He will study this potential syndrome among pediatric patients diagnosed with obsessive compulsive disorder. By focusing on patients with a disorder that is less likely to be associated with suicidality, he will be able to better assess whether SSRIs are related to an actual activation syndrome, and whether suicidality is a component of the syndrome. The study will improve recognition and understanding of the syndrome, and help identify interventions that will reduce the risk of suicide.

* Sebastian Schneeweiss, M.D., of Brigham and Women’s Hospital, will assess critical issues surrounding the safety of antidepressant medication use by comparing several large datasets of SSRI users. He will measure rates of suicidality; identify social and demographic factors that may be associated with SSRI use and suicidality; and examine the impact of FDA actions on use of SSRIs. The study aims to develop and better target prescribing and risk management strategies.

* Prudence Winslow Fisher, PhD., of the New York State Psychiatric Institute, will develop better and more reliable ways of monitoring for adverse reactions to the use of antidepressant medication. The study’s long-term goal is to construct a standardized computer tool for adolescents and parents that could be used to screen for suicidality associated with the use of antidepressant medications.

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Easing Depression May Ease Bone Loss

November 1, 2006

Studies in mice are shedding light on how depression helps eat away at human bone.

Scientists have longed noted links between depression and lowered bone mass. In fact, the bone density of depressed people is up to 15 percent less than that of happier folk.

Now, researchers from Jerusalem and Hungary say they slowed bone loss in “depressed” mice by giving the rodents an antidepressant. Their study is providing clues to how depression weakens bones, as well as new ways to stop it.

The study is published in the Nov. 7 issue of the Proceedings of the National Academies of Science.

The findings may help in the fight against the osteoporosis, said one expert who’s done similar work.

“These results are a nice complement to our research,” said Ricardo Battaglino, assistant member of the staff in the department of cytokine biology at the Forsyth Institute in Boston.

In the study, a team led by Raz Yirmiya of Hebrew University of Jerusalem, first induced depression in mice by exposing them to chronic stress. They then gave them the antidepressant imipramine (Tofranil).

The drug improved both the rodents’ behavior and their bones, the researchers said.

Battaglino wasn’t surprised by the finding, since his own group had found that the antidepressant drug Prozac increased bone mass in adult mice.

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Battaglino said he tried the drug after noticing serotonin receptors on the surface of bone cells. Serotonin receptors regulate the entry of serotonin, a molecule that facilitates communication between brain cells and is implicated in anxiety and depression. Prozac is one of a group of drugs known as selective serotonin reuptake inhibitors (SSRIs) that act on this receptor.

Battaglino’s team decided to see if the Prozac could influence bone cells and bone mass. They found that it did. His team is publishing the results in the Journal of Cellular Biochemistry.

Yirmiya and his colleagues gave the mice imiprimaine and found that some responded by a reversal in bone loss. “Imipramine is a tricyclic antidepressant that acts on both the norepinephrine (also called noradrenaline) and serotonin reuptake systems,” Battaglino explained.

Yirmiya found that the animals’ bone loss was associated with an increase in the neurotransmitter norepinephrine. So, they decided to treat the animals with a drug known as a beta blocker, propranolol (Inderal), which works by inhibiting norepinephrine.

They found the drug reduced bone loss without affecting the rodents’ behavior.

“They found a new mediator for depression-induced bone loss, norepinephrine,” Battaglino said.

Bone remodeling is a constant process of new bone formation and bone degradation. If not enough new bone is made or too much existing bone is degraded, the net result is low bone mass.

Battaglino said his research, as well as the results of this new study, both suggest that depression most likely affects the bone-forming cells, the osteoblasts, rather than the bone-degrading cells, the osteoclasts.

While there is no immediate reward for patients stemming from the new research, Battaglino said, “I think it’s important to raise awareness that these drugs could potentially be used as drugs to increase bone formation.”

What is not yet known, he said, is whether the drugs would work better than the current bone-building drugs or if they should be used in combination with them.

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