Here’s a roundup of noteworthy items in the news, including:
New Guidance on Anti-Depressants.
Two Wyoming Bobsledders. Two Horrific Brain Injuries. One Survivor.
Evidence indicates women have a tougher time recovering from brain injuries.
New Guidance on Anti-Depressants
One of the advantages of having a national health service is the ability to more easily perform meta-analyses of patient outcomes and learn what’s working and what isn’t.
Such an analysis was performed in the UK with regard to anti-depressants, and here are the highlights of their new guidance:
Anti-depressants should only be prescribed AFTER equally effective behavioural interventions have failed.
By default, they should be used temporarily for a period of months before they are slowly reduced and eliminated. This is due in part to how severe the withdrawal symptoms can be when one takes the drugs for too long.
Patients should be given far clearer education on the risks of starting these drugs. They should also be given clearer guidance on the need to get off the drugs and how to go about that in a gradual way. They should start the prescription with the expectation that they will gradually get off the drugs within a year.
The general public and medical professionals need to be re-educated: Depression is not a “chemical imbalance”.
Patients need to know that slowly discontinuing the drugs comes with withdrawal symptoms, and these should not be mistaken as a return of their condition.
The Evening Standard podcast The Leader hosted an interview with Mark Horowitz from University College London on the matter. You can listen to that here:
University College London and the Royal Cornwall Hospitals NHS Trust have worked together on the review, looking into the role of antidepressants and how to help patients stop using them.
They have recommended that doctors should prescribe fewer antidepressants and for shorter periods of time, and also argued that long-term use for many is probably inappropriate.
Mark Horowitz is a clinical research fellow in psychiatry from University College London who worked on the review.
He discusses their recommendations for doctors, how patients should stop using the drugs, and the evidence around serotonin levels.
In the interview, Mr Horowitz said that women received 50% more medication than men, meaning that women receive far more prescriptions.
When post-concussion syndrome goes on for months, people can understandably fall into clinical depression, and it’s common for such people to be prescribed anti-depressants.
These findings seem to indicate that such a course of action should likely be seen (by doctor and patient) as a temporary measure, one that should only be undertaken after other equally effective measures fail.
Story About Two Wyoming Bobsledders in NY Times
There was yet another story about the suffering of athletes in the aftermath of concussions, this time in the sport of bobsledding, in the New York Times.
Two Wyoming Bobsledders. Two Horrific Brain Injuries. One Survivor.
I find such stories incredibly frustrating to read. Time and again, the people in a position to help the afflicted display near-total ignorance. And the reporters of these stories, not knowing any better, accept the ignorance without any further interrogation.
Only a few days prior to the publication of the NYT story, I posted this piece on Brainwave, which actually gets at the central question posited (but not answered) by the NYT piece.
Women seem to have a tougher time recovering from brain injuries
A new study involving female veterans with brain injuries indicates that women have a tougher time recovering from such injuries due in part to differences in male and female brains.
Odette Harris, MD, professor of neurosurgery and a brain trauma expert, led the study that began five years ago. She was wary of sharing her findings. “I was concerned that this information could be weaponized or misconstrued. We’re not saying women don’t do as well as men, or women aren’t as strong as men. That’s not it at all,” she said.
One of the takeaways: After a TBI, women seem to experience greater levels of cortical thinning than men.
Here’s a video about a case connected to the study.
Brainwave is an informational resource for people whose symptoms haven’t resolved after a concussion or mTBI. I endeavor to present this information in a clear and concise way, spelling out what’s backed by science and what remains unknown. Nothing here is meant as a substitute for professional medical advice, diagnosis, or treatment. I am not a physician or a healthcare practitioner of any kind; I’ve simply had a lot of sports-related concussions and had to learn this stuff the hard way. If you found this information helpful or know someone who might benefit from it, please share and subscribe to Brainwave.