Depression drugs ‘causing falls’

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19 January 2012 Last updated at 01:21 GMT Falls are the leading cause of accidental death in the over-65s Elderly people with dementia are more likely to suffer falls if they are given anti-depressants by care home staff, a study claims.

Many dementia patients also suffer from depression and drugs known as selective serotonin uptake inhibitors (SSRIs) are frequently prescribed.

But the British Journal of Clinical Pharmacology reports that the risk of injuries from falls was tripled.

The Alzheimer's Society called for more research into alternative treatments.

The risk of falls following treatment with older anti-depressants is well established, as the medication can cause side effects such as dizziness and unsteadiness.

It had been hoped that a move to newer SSRI-type drugs would reduce this problems, but the latest research, from the Erasmus University Medical Center in Rotterdam, appears to show the reverse.

'Worrying'

Dr Carolyn Sterke recorded the daily drug use and records of falls in 248 nursing home residents over a two-year period.

The average age of the residents was 82, and the records suggested that 152 of them had suffered a total of 683 falls.

The consequences of falls were relatively high, with 220 resulting in injuries including hip fractures and other broken bones - and one resident died following a fall.

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More research is now needed to understand why this anti-depressant is having this effect on people with dementia and if there is an alternative treatment for depression that they could be prescribed”

End Quote Professor Clive Ballard Alzheimer's Society The risk of having an injury-causing fall was three times higher in residents taking SSRIs compared with those not taking the drug, and this risk rose further if the patient was being given sedative drugs as well.

Dr Sterke said that these risks needed to be taken into account when assessing whether anti-depressants were required.

She said: "Physicians should be cautious in prescribing SSRIs to older people with dementia, even at low doses."

Professor Clive Ballard, from the Alzheimer's Society, said it was "worrying" that such a commonly prescribed anti-depressant was causing increased risk.

He said: "It is important to highlight any aspect of care that might be causing risk to a person with dementia. We want to ensure that people with the condition are always receiving the best care possible.

"More research is now needed to understand why this anti-depressant is having this effect on people with dementia and if there is an alternative treatment for depression that they could be prescribed.

"One in three people over 65 will die with dementia yet research into the condition continues to be drastically underfunded. We must invest now.'

Source BBC

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WHO: Number of people with TB falls for 1st time

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LONDON (AP) — The World Health Organization says the number of people with tuberculosis has fallen for the first time.

In a report issued Tuesday, WHO estimated 8.8 million people fell ill last year, dropping from a peak of about 9 million in 2005. Officials said fewer people are now dying from the disease, but that a third of cases worldwide are probably not reported.

The small decline in reported cases is partly due to increased availability of medical treatment for TB, WHO said. The U.N. health agency also said estimates are now more accurate because countries have better surveillance of tuberculosis patients.

The TB death rate is expected to be reduced by half by 2015 everywhere except Africa, where the AIDS epidemic has also fueled a spike in tuberculosis. India and China account for about 40 percent of the world's tuberculosis cases.

In recent years, health experts have also warned of the increasing threat of drug-resistant tuberculosis, a signal that many people with TB aren't being treated properly.

Last month, officials warned that drug-resistant tuberculosis is spreading fast in Europe and that there are few drugs left to treat it. WHO estimated countries need another $1 billion to fund tuberculosis programs in 2012.

In the report, officials said they didn't have enough data to know whether the global outbreak of drug-resistant tuberculosis is increasing, decreasing or stable.

Last year, a new rapid test for drug-resistant TB was unveiled in more than two dozen countries, allowing patients to be treated sooner and stopping the disease's spread.

"But the promise of testing more people must be matched with the commitment to treat all detected," Mario Raviglione, the director of WHO's TB department, said in a statement. "It would be a scandal to leave diagnosed patients without treatment."

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Heroin and crack treatment falls

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6 October 2011 Last updated at 11:50 GMT An increasing number of drug users are also said to be recovering from addiction The number of heroin and crack cocaine users needing treatment in England has fallen by 10,000 in two years.

The National Treatment Agency for Substance Abuse said the number of adults that began treatment for the class A drugs fell from 62,963 in 2008/09 to 52,933 in 2010/11.

The steepest decline was in the under-30 age group.

The number of people accessing treatment for all drugs also fell for the second year running.

The latest figures also show an increase in the number of drug users "recovering" from addiction - people who no longer need treatment.

Some 27,969 users were classed as recovering in 2010/11, a rise of 18% on the previous year and 150% higher than 11,208 in 2005/06.

The figures showed that, of the 255,556 people who entered a drugs treatment programme since April 2005 for the first time, 28% (71,887) had successfully completed the course and did not need further treatment.

Paul Hayes, the NTA's chief executive, said the figures showed that "recovery is now becoming a reality for more individuals each year".

"More drug users are recovering from addiction, fewer need treatment, and more are getting over their addiction quickly," he said.

'Not complacent'

Mr Hayes went on to say he thought the figures showed England had "probably passed the high watermark of the impact of epidemic of the late '80s and early '90s and that younger groups of people were reluctant to begin patterns of behaviour... that they've seen cause damage to their older siblings, people in their community, sometimes, sadly their mums and dads."

"They realise the consequences of heroin and crack use and they're turning their backs on that," he said.

He said officials were also seeing "significant declines in purity" which "suggests that attempts to restrict supply are having an impact".

"It's extremely likely, from where we sit, that the different aspects of the government's drugs strategy are coming together to have a positive effect," he added.

But he warned that addiction remained a "serious problem" for many communities, particularly the poorest ones.

"We need to remain vigilant, particularly in a tough economic climate.

"There's absolutely no inevitability that rising unemployment among young people will see a rise to '80s levels of heroin use, but we need to watch that situation very carefully," he said.

'Momentum'

Simon Antrobus, chief executive of Addaction, said it was "hugely encouraging" that young people were shunning heroin and crack cocaine.

He said underlying drug use still needed tackling, and it was important "not to let our guard down".

"While these figures suggest that fewer young people were turning to crack and heroin, Addaction is concerned that an older generation of long-term problem users remains; causing huge problems not only for themselves, but for their children.

"And we know that the children of this group are more likely to develop their own problems.

"So, while we hope today's figures prove to be a milestone in the tackling of the UK's drug problems, we certainly cannot be complacent."

Turning Point's director of substance misuse, John Mallalieu, said the figures were "promising" and the drug support charity had witnessed greater numbers of people recovering from drug addiction.

"This is made easier for them because as a nation, we are becoming more ambitious for drug users and giving them more opportunities to become part of society again.

"It is important that we ensure the right methodologies are kept in place to tackle the wide range of problems that contribute to a person's substance misuse such as mental health, unemployment, housing and physical health.

"The current momentum must be continued so that those 27,969 who are still in treatment have a better chance of turning their lives around too," he said.

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For women, risk of depression falls as coffee intake rises

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Some experts have speculated that the antioxidants in coffee may have health benefits.Some experts have speculated that the antioxidants in coffee may have health benefitsWomen who drink caffeinated coffee are less likely to become depressed, study saysThe study included more than 50,000 women between the ages of 30 and 55

(Health.com) -- A few cups of coffee a day may help keep the blues at bay. According to a large new study, women who drink caffeinated coffee are less likely to become depressed -- and the more they drink, the more their risk of depression goes down.

The study, which was published today in the Archives of Internal Medicine, included more than 50,000 women between the ages of 30 and 55 who periodically filled out surveys about their coffee consumption and health. None of the women had depression symptoms (or a history of depression) at the start of the study, but during the next 10 years roughly 5% received a depression diagnosis or began taking antidepressant medication.

Compared with women who drank little or no caffeinated coffee, those who averaged two to three cups per day were 15% less likely to develop depression, even after the researchers took into account a wide range of potentially mitigating factors including marital status, church or community participation, and various health measures. Drinking four cups a day was associated with a 20% lower risk of depression.

Health.com: The 10 most depressing states in the U.S.

The study doesn't prove cause and effect, so there's no reason to believe that drinking cup after cup will actually prevent depression, the researchers say.

"There's no need to start drinking coffee," says study co-author Alberto Ascherio, M.D., a professor of epidemiology and nutrition at the Harvard School of Public Health, in Boston. "The message is that coffee is safe to drink, with no adverse effects. That's really all that can be said."

Previous research, including a study published last year that was conducted among men in Finland, has linked caffeine consumption to a lower risk of depression and suicide.

"A couple of past studies found similar results," says Daniel Evatt, Ph.D., a psychiatry research fellow at the Johns Hopkins School of Medicine, in Baltimore, who was not involved in the new research. "This study validates the association, and it was done in the best possible way."

Health.com: Big perks: coffee's health benefits

It's not clear why coffee might protect against depression. Some experts have speculated that the antioxidants in coffee may have health benefits, but in the new study people who drank only decaf were no more or less likely to be depressed than women who drank no coffee at all.

The caffeine might be responsible, but the researchers weren't able to confirm or deny this theory because there wasn't enough data available to determine whether drinking caffeinated tea or sodas is linked to depression risk in the same way as coffee consumption. Eighty-two percent of the study participants drank coffee, while only 13% and 6% drank tea and soft drinks, respectively.

Evatt, who studies the psychological effects of caffeine, is "not terribly convinced" that caffeine can prevent depression. "There's a very strong indication that there is a real relationship there, but that doesn't mean that coffee will stop depression," he says. "We need to come up with a hypothesis for the mechanism at work, and then try to see what's really happening."

Health.com: 12 surprising sources of caffeine

Another possibility is that people who aren't depressed may simply be more drawn to coffee than their depression-prone peers. Non-depressed people tend to be more "behaviorally activated," and coffee drinking may therefore fit in better with their lifestyle, says Scott Bea, Psy.D., a psychologist at the Cleveland Clinic who was not involved in the study.

Similarly, Bea adds, some depressed people may steer clear of coffee because it can heighten anxiety, which often goes hand in hand with depression.

"We shouldn't rush to the conclusion that I should drink more coffee if I don't want to be depressed," Bea says.

Health.com: 12 nondrug remedies for depression

For his part, Evatt stresses that caffeine can have negative consequences for many people, whether they're experiencing depression symptoms or not.

"We shouldn't put caffeine in too positive a light," he says. "Some people have a relationship with caffeine that's similar to an addictive drug. I don't want to pin it as a public health problem, but people can become dependent on coffee and have troubling withdrawal symptoms."

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