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Right now, about half of all people who take medicine for an anxiety disorder don’t get much help from it. And doctors have no definitive way to predict who will, and who won’t, benefit from each anti anxiety prescription they write.
But a University of Michigan Medical School researcher and his team are working to bring more certainty to how doctors and patients choose anxiety treatments, by probing the connection between brain activity, genetics and medication.
In a paper last month in the Journal of Neuroscience, K. Luan Phan, M.D., and his former University of Chicago colleagues reported intriguing findings from a brain imaging study in occasional, non-dependent, marijuana users.
In a placebo controlled design, they made the findings after giving the volunteers delta 9 tetrahydrocannabinol (THC), the active ingredient in marijuana, and exposing them to photographs of emotional faces, which served as signals of social communication. The study results, which showed that THC reduces the response to threat in a brain region called the amygdala, allowed the researchers to zero in on an area of the brain that might serve as a good target for new anti-anxiety drugs.
Now, with a new clinical trial that is currently seeking participants, Phan is searching for more clues as to how anxiety treatment could be tailored to the individual patient, to give the best chance that a treatment will work for him or her.
The new study will test a generic form of the drug Zoloft (sertraline), a selective serotonin reuptake inhibitor (SSRI) approved by the U.S. Food and Drug Administration for social anxiety disorder and other anxiety disorders. Both people with social anxiety disorder and a comparison group of people without anxiety are needed for brain scanning and genetic testing.
The idea is to see whether variations in the genes for certain brain receptors and transporters are linked with variations in how a person’s brain reacts to pictures of emotional faces, and variations in how they respond to the anti-anxiety drug. This information could lead to an individualized or personalized approach to medical care.
"These two studies are trying to get to the same goal: to find better treatments for anxiety disorders that affect millions of Americans and seriously interfere with their functioning," says Phan, an assistant professor of psychiatry at U-M and the VA Ann Arbor Healthcare System. "The cannabis study highlights a new avenue that we need to explore further as we try to develop novel medications, while the sertraline study will try to find out if we can tell which patients might or might not respond well, and by what mechanism, to an already existing medication known to have some efficacy in treating anxiety disorders."
Phan led the cannabis study at the University of Chicago, collaborating with Harriet deWit, Ph.D., the director of the Human Behavioral Pharmacology Laboratory in the Department of Psychiatry there. Their results are based on brain scans of 16 recreational marijuana users who agreed to undergo functional magnetic resonance imaging, or fMRI.
The researchers chose fMRI because it allows them to see in real time which areas of the brain are most active while a volunteer is performing a certain task for example, viewing a picture of a human face that is expressing anger or fear, or performing a decision-making exercise.
That same approach will be used in the new sertraline study, with two different scans before and after anxiety patients are prescribed the medication. The healthy volunteers in the study will also have fMRI scans, though they will not receive the drug. All study participants must between 18 and 55 years old, and those with anxiety disorders must not be taking any other medication that could be affecting the brain in order to qualify to enter the study.
The cannabis study used THC, and a placebo caplet that looked exactly like the THC caplet. The researchers found that when the marijuana users received THC, their brain’s response to "threatening" faces was less than it was when they received a placebo.
The difference in response was seen in an area of the brain called the amygdala, which is a hub for the brain’s ability to process signs of danger or warning, and to decide how to respond. But there were no differences between THC and placebo in the areas of the brain that process non-emotional visual signals or govern body movement suggesting that THC had a specific effect on a specific brain region and on a specific task of processing fear. Other researchers have shown this to be a region that’s rich in a receptor called CB1, part of the brain’s "cannabinoid" system.
The human brain produces compounds called endocannabinoids that act on these receptors, and are involved in anxiety and fear-learning, or the learning of which threats to be afraid of. But little has been known about the effect of THC, an exogenous cannabinoid, on the brain’s own system.
For ethical reasons, the researchers did not give THC to non-marijuana users, and the study was small. But the findings in the study volunteers suggest that THC and other compounds that act on the CB1 receptors in the amygdala could be fruitful targets for new anti-anxiety medicines. Phan notes that rimonabant, a smoking-cessation and weight-loss drug not yet available in the United States for clinical use, also acts on the CB1 receptor.
generico cialis in linea comrare Understanding how drugs such as marijuana affect the brain may also help reveal more about why people become addicted to illicit drugs or abuse certain prescription drugs, Phan notes. Some individuals may be using illicit drugs and misusing prescribed drugs to alleviate their anxiety. He hopes to investigate this issue further by studying people who have used prescription pain drugs recreationally (such as oxycodone), using new funding from the National Institutes of Health.
The THC study links three key domains of human behavior: a specific region of the brain, the function of that area, and a neurochemical agent (THC) that appears to act on them. The new sertraline study will take it one step further, by looking at genetics too. Specifically, Phan and his colleagues will look for variations ("functional polymorphisms") among several genes in individual subjects. Key among them is the gene (5-HTTLPR) that encodes the serotonin transporter protein that transports the neurotransmitter serotonin in and out of brain cells. Serotonin has long been known to be involved in depression and anxiety, and indeed most modern antidepressant and anti-anxiety drugs (such as SSRIs) work on this transporter.
Reference: Journal of Neuroscience, March 5, 2008, Vol. 28, No. 10, 2313-2319
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The Institute for Progressive Medicine (IPM), a revolutionary medical clinic that emphasizes safe, natural and alternative treatments in combination with traditional medical techniques, announced the clinic’s IV Therapies, including one of their most popular therapies - the Stress Drip. The Stress Drip is a variation of the Immune Drip - a popular drip that contains high doses of superior quality vitamin C and B vitamins, magnesium, trace minerals and the antioxidant glutathione, all of which are administered intravenously for superior assimilation. The Stress Drip includes all the elements of the Immune Drip but adds two additional ingredients, tryptophan and inositol, which can induce calming and relaxation. With the sluggish economy and depression rates on the rise, the Stress Drip can provide immunity support and energy, along with relief from anxiety and emotional discomfort.
Intravenous therapies can offer enormous health benefits. The Institute for Progressive Medicine has a newly renovated intravenous therapy department where IV treatments are administered in a comfortable and relaxing setting by certified nurses with many years of experience. IPM’s practice has administered over 20,000 infusions to patients with diverse health problems. Treatment times range from ten minutes for simple IV pushes to a few hours for specialized IV therapies. Immune Drips, specifically, are used to support individuals with: viral infections, respiratory infections, Mononucleosis, fatigue and fibromyalgia, cancer (including individuals undergoing radiation or chemotherapy), as well as for many other ailments.
"The Stress Drip is specially formulated to help those with extreme stress in their lives. Individuals facing a particularly difficult undertaking or feeling upset or incapable of handling a tough situation, anything from marital stress to parenthood, tax season or an operation, are ideal candidates for this calming therapy," explains Dr. Allan E. Sosin, M.D., founder and medical director of the Institute for Progressive Medicine. "The Stress Drip can help people relax, sleep better, has no common side effects and may be repeated as frequently as needed."
Patients receiving IV nutritional infusions often tolerate ailments much better than they would otherwise. It is believed that nutritional IV infusions can enhance the effect of conventional therapies.
Other IV therapies available from the clinic include chelation therapy for removal of heavy metals as well as drips to support patients with diabetes, vascular disease, asthma, liver disease and hepatitis, inflammation, macular degeneration, learning and cognitive disabilities, depression and other chronic conditions.
About Institute for Progressive Medicine
The Institute for Progressive Medicine is a revolutionary medical clinic that leans towards a natural and alternative medical routine. Buy generic cipro Started by Allan E. Sosin, M.D., a renowned physician who is board certified in Internal Medicine and Nephrology, IFPM supports the patient’s physical, mental and spiritual well-being using the most natural, safe and effective methods available. IFPM’s mission is to respect patient’s rights and look for the most natural and preventive path towards overall health. Dr. Sosin earned the title, Physician of the Year Award in 2000 from the National Health Federation.
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St. Jude Medical, Inc. (NYSE:STJ) announced the first patient implants in a clinical study that is investigating whether deep brain stimulation (DBS) therapy will help people who suffer from major depressive disorder, a severe form of depression. The patients, a 59-year-old woman and a 42-year-old man, were implanted at Alexian Brothers Behavioral Health Hospital in Chicago, with the St. Jude Medical Libra® Deep Brain Stimulation System, an investigational device.
The study, called BROADEN™ (BROdmann Area 25 DEep brain Neuromodulation), is a controlled, multi-site, blinded study that is evaluating the safety and effectiveness of DBS in patients with depression for whom currently available treatments are not effective.
"We are excited to be part of the first double-blind study of Deep Brain Stimulation for depression and remain hopeful that this therapy may prove beneficial for this seriously ill patient population," said Anthony D’Agostino, M.D., medical director of Alexian Brothers Behavioral Health Hospital and the principal investigator at the study site. "The study is an important contribution to the advancement of treatment options for severely depressed patients."
This study is researching a specific area in the brain called Brodmann Area 25 that is thought to be involved in depression. The first research of DBS for depression was conducted in Toronto, Canada, by neurologist Helen S. Mayberg, M.D., and neurosurgeon Andres Lozano, M.D., in 2003. They published their findings in Neuron in March 2005, reporting that brain imaging studies indicate that Brodmann Area 25 appears to be overactive in profoundly sad and depressed people.
St. Jude Medical owns the intellectual property rights, and has various patents issued and pending, for the use of neurostimulation at Brodmann Area 25. The Libra Deep Brain Stimulation System provides mild pulses of current from a device implanted near the collarbone and connected to small electrical leads placed at specific targets in the brain.
"This depression study represents a continuation of our commitment to provide solutions for those who are suffering and in need of additional therapy options," said Chris Chavez, president of the St. Jude Medical ANS Division. "The Brodmann Area 25 study is an important step in bringing physicians and their patients a neuromodulation therapy that, if successful, will treat this debilitating form of depression."
The National Institute of Mental Health estimates that more than 21 million U.S. adults suffer from some kind of depressive disorder. Current therapies are effective for about 80 percent of this patient population according to the National Advisory Mental Health Council. That means approximately 4 million adult Americans live with depression that doesn’t respond to medications, psychotherapy or electroconvulsive therapy.
To be eligible for this study, participants must:
- Currently be diagnosed with major depressive disorder
- Be between 21 and 70 years old, with onset of first episode before age 45
- Have tried at least four treatments in their current episode, such as different medications, various combinations of medications or electroconvulsive therapy
- Have been depressed for at least one year
For more information about this study, call toll-free at 866-787-4332, visit
Sponsored by St. Jude Medical, the BROADEN study is being conducted under a U.S. Food and Drug Administration (FDA) investigational device exemption (IDE). Initial study centers are located in Chicago, Dallas and New York City. This clinical study was preceded by a smaller pilot study of 20 patients at three sites in Canada which found that six months after the procedure, 56 percent of the patients experienced at least a 40 percent decrease in depressive symptoms. At last follow-up, 78 percent of the patients were responders, and eight of the patients have re-engaged in life activities such as work, school, travel and relationships, and three of the study patients are considered to be in remission. Patients’ symptoms were measured using the Hamilton Rating Scale for Depression.
About St. Jude Medical
St. Jude Medical develops medical technology and services that focus on putting more control into the hands of those who treat cardiac, neurological and chronic pain patients worldwide. The company is dedicated to advancing the practice of medicine by reducing risk wherever possible and contributing to successful outcomes for every patient. Headquartered in St. Paul, Minn., St. Jude Medical employs more than 12,000 people worldwide and has five major focus areas that include: cardiac rhythm management, atrial fibrillation, cardiac surgery, cardiology and neuromodulation. For more information, please visit
About the ANS Division of St. Jude Medical
The ANS Division (Advanced Neuromodulation Systems) became a part of St. Jude Medical in 2005. The ANS Division is an innovative technology leader dedicated to the design, development, manufacturing and marketing of implantable neuromodulation systems to improve the quality of life for people suffering from disabling chronic pain and other nervous system disorders ().
Forward-Looking Statements
This news release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 that involve risks and uncertainties. Such forward-looking statements include the expectations, plans and prospects for the Company, including potential clinical successes, anticipated regulatory approvals and future product launches, and projected revenues, margins, earnings, and market shares. The statements made by the Company are based upon management’s current expectations and are subject to certain risks and uncertainties that could cause actual results to differ materially from those described in the forward-looking statements. Buy levitra without prescription These risks and uncertainties include market conditions and other factors beyond the Company’s control and the risk factors and other cautionary statements described in the Company’s filings with the SEC, including those described in the Risk Factors and Cautionary Statements sections of the Company’s Annual Report on Form 10-K filed on February 27, 2008. The Company does not intend to update these statements and undertakes no duty to any person to provide any such update under any circumstance.
ANS Division of St. Jude Medical
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