Many older adults with depression don’t respond to their first antidepressant, so doctors will switch them to another one to see if that does the trick. Now, new research suggests that the best strategy for these folks may instead be to add the antipsychotic drug Abilify (aripiprazole) to the original antidepressant. “This is good news for older adults with difficult-to-treat depression,” said study author Dr. Eric Lenze, head of the department of psychiatry at Washington University School of Medicine in St. Louis. “Adding a second medication produces improvements in psychological well-being [e.g., positive mood, life satisfaction] and, often, remission from depression, and these improvements are greater than switching medications.” The two-part study included 742 people aged 60 and older with depression who had not responded to at least two antidepressants. In the first part, 619 people who were taking an antidepressant were randomly divided into three groups. Some remained on their original medication and added aripiprazole, others continued taking their antidepressant but added the antidepressants Wellbutrin or Zyban (bupropion), and a third group tapered off their original antidepressant and switched to bupropion. The patients were followed for 10 weeks, and their medications were adjusted accordingly. Nearly 30% of people who continued with their original antidepressant but added aripiprazole showed improvements in symptoms of depression, compared with 20% of those who were switched to bupropion alone,…  read on >  read on >

The annual shift to daylight saving time is a challenge for many parents, whose children may struggle with the change. A pediatrics sleep medicine expert offers some tips for making springing forward a little easier for all ages. “Whether it be jet lag, spring break or daylight saving time, a break in sleep structure can make things challenging. But we have ways to cope with that,” said Dr. Sonal Malhotra. She is an assistant professor of pulmonary and sleep medicine services at Baylor College of Medicine, in Houston. Children tend to fall into three sleep categories depending on age, Malhotra said — infants under 6 months; toddlers and young children who have a natural inclination to wake early; and older kids and teens who struggle with morning wake-up times. The time change isn’t typically an issue for the youngest group, Malhotra said. “At this age, children are still building their circadian rhythms,” she said. “Although their sleep schedules are fragmented by naps throughout the day and night, there is still structure that ensures they get enough sleep.” The spring change is easier for the second age group than turning the clocks back in fall. It can be beneficial for parents to let them stay up later and sleep in more, Malhotra said. For kids over 6 months of age who struggle to wake up in…  read on >  read on >

Tossing and turning, waking up frequently or lying awake for hours is no laughing matter. According to the National Sleep Foundation, the average adult should aim for seven to nine hours of sleep each night. Why? The Cleveland Clinic explains that lack of sleep can lead to: impaired memory relationship stress decreased quality of life increased risk of a car accident Chronic lack of sleep, or insomnia, can also lead to serious health issues including: high blood pressure diabetes cardiac issues obesity So, if you are asking yourself why can’t I sleep, here are some tips on getting better shut-eye: Try sleep restriction therapy According to Dr. Sanjeev Kothare of Northwell Medical in New Hyde Park, N.Y., “insomnia from an unknown cause or underlying anxiety or depression” is one of the more common sleep disorders. The American Academy of Sleep Medicine says that approximately 35% of adults experience insomnia at some point. One potential solution is sleep restriction therapy. The basis for this therapy is that time spent in bed and not sleeping can increase anxiety and worsen insomnia. For example: If you usually go to bed for seven hours but only sleep for five hours, then you would limit your time in bed to five hours. Once your sleep improves, slowly increase your time in bed by 15 to 30 minute increments. Initially, sleep…  read on >  read on >

Ongoing shortages of a medication that hospitals and emergency rooms rely upon to treat breathing problems are likely to worsen in coming days and weeks, experts warn. That’s because one of the two major U.S. suppliers of liquid albuterol, Akorn Pharmaceuticals, abruptly laid off its entire workforce and closed plants in New Jersey, New York and Illinois in late February. “We’re down to just one plant that’s supplying liquid albuterol to all patients in the United States,” said Dr. Juanita Mora, a Chicago allergist/immunologist and volunteer spokesperson for the American Lung Association. That remaining supplier of liquid albuterol, Nephron Pharmaceuticals, has had manufacturing issues of its own, exacerbating the situation even more, said Bayli Larson, a strategic initiatives associate with the American Society of Health-System Pharmacists (ASHP). “Another phenomenon that could be at play is institutions, anticipating the shortage, may have increased their orders to ensure they had enough on hand,” Larson added. “ASHP discourages hoarding as a countermeasure to medication supply disruptions; however, some institutions feel they have to do it to avoid jeopardizing patient care.” The shortage comes at an extremely inopportune time, Mora said. “We are about to enter allergic asthma season, where pollen levels are going to begin to rise all throughout the United States,” Mora said. “And we know so many kids and adults suffer from allergic asthma symptoms and…  read on >  read on >

Troubling new research finds that rates of type 1 and type 2 diabetes are continuing to increase in children and young adults. Asian or Pacific Islander, Black and Hispanic children had higher rates, the study found. “Our research suggests a growing population of young adults with diabetes who are at risk of developing complications from the disease,” said lead researcher Lynne Wagenknecht, a professor and director of public health sciences at Wake Forest University in Winston-Salem, N.C. “It’s a troubling trend in young people whose health care needs will exceed those of their peers,” she said in a university news release. The findings are from the final report of the large SEARCH For Diabetes in Youth study, launched in 2000 with support from the U.S. Centers for Disease Control and Prevention and the U.S. National Institutes of Health. Wake Forest School of Medicine was coordinating center for the study, which included five U.S. medical centers. It identified more than 18,000 young people age 19 and under who were diagnosed with type 1 diabetes and 5,200 10- to 19-year-old diagnosed with type 2 diabetes between 2002 and 2018. The annual incidence of type 1 diabetes was 22.2 per 100,000 in 2017-2018 and 17.9 per 100,000 for type 2 diabetes. “In our 17-year analysis, we found that the incidence of type 1 diabetes increased by 2% per…  read on >  read on >

In yet another example of the mind-body connection, people with depression symptoms may face an increased risk of having a stroke, as well as a worse recovery afterwards. A new international study, published online March 8 in the journal Neurology, found about 18% of those who had a stroke had symptoms of depression, compared to 14% of those who did not have a stroke. After adjusting for other contributing factors, researchers determined that people with symptoms of depression before stroke had an overall 46% increased risk of stroke compared to those with no symptoms of depression. As the symptoms increased, so did the higher risk of stroke. “Depression affects people around the world and can have a wide range of impacts across a person’s life,” said study author Dr. Robert Murphy, of the University of Galway in Ireland. “Our study provides a broad picture of depression and its link to risk of stroke by looking at a number of factors including participants’ symptoms, life choices and antidepressant use,” Murphy said in a journal news release. “Our results show depressive symptoms were linked to increased stroke risk and the risk was similar across different age groups and around the world.” The researchers used data from more than 26,000 adults in the INTERSTROKE study, which included 32 countries across Europe, Asia, North and South America, the Middle…  read on >  read on >

A new review of 137 studies from around the world has found that, despite dramatic stories about COVID-19’s impact on mental health, the psychological fallout from the pandemic has been less intense than thought. “Mental health in COVID-19 is much more nuanced than people have made it out to be,” said senior study author Brett Thombs, a Canada Research Chair and professor in the Department of Psychiatry at McGill University in Montreal. “Claims that the mental health of most people has deteriorated significantly during the pandemic have been based primarily on individual studies that are ‘snapshots’ of a particular situation, in a particular place, at a particular time,” Thombs said in a university news release. “They typically don’t involve any long-term comparison with what had existed before or came after.” About 75% of study participants in the studies reviewed were adults and 25% were children and adolescents between the ages of 10 and 19. The mental health changes were minimal, researchers found, whether the studies covered the mental health of the population as a whole or that of specific groups. “This is by far the most comprehensive study on COVID-19 mental health in the world, and it shows that, in general, people have been much more resilient than many have assumed,” said study first author Ying Sun, a research coordinator from the Lady Davis Institute…  read on >  read on >

A new poll on sleep and mental health has found that more than 90% of adults who reported they get good sleep were also free of depressive symptoms. In its annual poll, the nonprofit National Sleep Foundation (NSF) focused this year on the impact of sleep on mental health because of the current mental health crisis in the United States. “In the day-to-day execution of our sleep health mission, we give lots of simple, evidence-based and consensus-driven tips and tools to help people get enough of the quality sleep they need. For this year’s poll, we were compelled to look again at the connection between sleep health and mental health conditions like depression,” NSF CEO John Lopos said in a foundation news release. The Sleep in America poll also found that about 65% of adults who were dissatisfied with their sleep experience had mild or greater levels of depressive symptoms. Those who reported difficulties falling or staying asleep just two nights a week had higher levels of depressive symptoms than those without sleep difficulties. About 50% of all adults who sleep less than the recommended seven to nine hours nightly experienced mild or greater levels of depressive symptoms. “One unique aspect of this year’s research was how we combined NSF’s multiple validated measures of the population’s sleep health with an established measure of depressive symptoms,…  read on >  read on >