A nasal spray containing a ketamine derivative appears to beat one of the standard drugs used for people with difficult-to-treat depression, a new clinical trial has found. The trial, of nearly 700 people with treatment-resistant depression, found that esketamine nasal spray was more effective at sending patients into remission than a standard oral drug called quetiapine (Seroquel). After eight weeks, 27% of esketamine patients were in remission, versus 18% of those given quetiapine. By week 32, half of esketamine patients were faring that well, compared with one-third of those on quetiapine. Experts said the findings, published in the Oct. 5 issue of the New England Journal of Medicine, strengthen the case that esketamine is a good option for people with treatment-resistant depression. The condition, which plagues up to 30% of people with depression, is generally diagnosed when a person’s symptoms have failed to yield to at least two standard antidepressants. It’s a situation that places people at increased risk of hospitalization and suicide. There are a few medications approved in the United States as an “augmentation” therapy for treatment-resistant depression — meaning they are used along with a standard antidepressant. Quetiapine is one of them, and so is esketamine nasal spray, which has been available since 2019 under the brand-name Spravato. That approval was based on research testing esketamine against a placebo nasal spray. The…  read on >  read on >

In the United States, “conversion therapy” for LGBTQ people has been widely condemned by major medical associations. Not only that, nearly half of the country has now banned the practice for minors. But a new review of 16 investigations across six nations suggests conversion therapy is hardly a thing of the past. On average, nearly one of every 10 LGBTQ individuals around the world say they have been exposed to the highly problematic practice at some point in their lives, researchers found. Such practices “include organized attempts to deter someone from adopting or expressing an LGBTQ identity or a gender identity that differs from [their] sex assigned at birth,” explained study lead author Travis Salway. He is an assistant professor with the Simon Fraser University Centre for Gender and Sexual Health Equity, in Canada. But “the vast majority of research on conversion practices to date demonstrates limited to no effectiveness, and substantial risk of harm, including depression, anxiety and, in some cases, suicide,” Salway added. Nevertheless, after reviewing studies conducted in the United States, the United Kingdom, Australia, Canada, Colombia and South Korea, Salway’s team found “conversion practices remain prevalent, with approximately 8% of LGBTQ people having been exposed in their lifetime.” That figure did vary considerably from country to country, rising to 13% in the United States, while falling to 7% across Canada. On…  read on >  read on >

More than 80% of eligible Americans did not get a COVID-19 booster shot last fall. Now, a new study reveals the reasons for the hesitation. Nearly 40% of survey participants said a prior COVID-19 infection factored into their decision to not get the booster. Another 31.5% were worried about side effects. And an additional 28% didn’t think a booster would provide extra protection, while 23% said it wouldn’t protect from the new coronavirus. “Our results indicate that we have a lot more work to do in terms of educating the public and health care providers about the importance of staying up to date on COVID-19 boosters,” said first study author Elizabeth Jacobs. She is a professor of epidemiology at the Zuckerman College of Public Health at the University of Arizona Health Sciences, in Tucson. This research was done through Arizona CoVHORT, which began in May 2020 to track the effect of COVID infection on Arizonans. Researchers hope the results, published in the Oct. 6 issue of the journal Vaccine, will help encourage interventions to get more people vaccinated. A variety of strategies may be needed to improve vaccination rates, as age, ethnicity and education affected reasons for hesitation, according to the study. “Our results indicate that many people don’t know that a booster provides additional protection even if they have already been infected or that…  read on >  read on >

New research has discovered 12 gene variants that may be tied to an increased risk of attempting suicide. These genes also may have links with physical and mental health woes, including chronic pain, attention-deficit/hyperactivity disorder (ADHD), lung conditions and heart disease. The researchers hope this finding, published online Oct. 1 in the American Journal of Psychiatry, will lead to better understanding of the biological causes of suicide. “Many people who die from suicide have significant health conditions associated with that risk,” said study corresponding author Anna Docherty, an associate professor of psychiatry at the Huntsman Mental Health Institute (HMHI) at the University of Utah. “If we can use genetic information to characterize the health risks of those who attempt suicide, we can better identify those patients who need contact with the mental health care system.” For the study, the investigators analyzed data from 22 different populations, including people of diverse ethnic backgrounds. What they found wasn’t one single gene influencing risk, but the cumulative effect of different genes. “In psychiatry, we have many tiny genetic effects, but when we account for all of them together, we start to see a real genetic risk signal,” Docherty explained in a university news release. To assess that risk, the team broke down data from the Million Veteran Program and the International Suicide Genetics Consortium. That data included nearly…  read on >  read on >