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You are here: Home / Science & Technology / New Treatment for Psychotic Depression?

New Treatment for Psychotic Depression?

by Anne Laurie|  August 23, 201011:22 am| 17 Comments

This post is in: Science & Technology, The War on Your Neighbor, aka the War on Drugs, Vagina Outrage, World's Best Healthcare (If You Can Afford It)

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The temptation is to make a joke about timeliness, but too many of us know how crippling (sometimes fatal) a disease depression can be. Or perhaps that knowledge is why we make such jokes. From ABC News, “Controversial RU-486 Studied For Treatment of Psychotic Depression”:

… The drug, a synthetic steroid compound known as mifepristone, is known as RU-486 in Europe, and marketed as Mifeprex in the United States. In combination with misoprostol, the drug was used in 161,000 medical abortions in the United States last year, according to the Guttmacher Institute.
__
But in clinical trials over the last decade, researchers have been using the drug to treat psychotic depression, a terrifying form of depression that carries a high suicide risk, and for which there are few sure-fire cures. They say the drug acts on the brain’s receptors for cortisol, the so-called “stress hormone.”
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The Food and Drug Administration will review an application for use as a treatment for psychotic depression at the end of the year.
[…] __
“When people are stressed, we know that there is an increase in inflammation and cortisol,” said Kenneth Robbins, medical director of psychiatry at Stoughton Hospital and professor of psychiatry at the University of Wisconsin. “I think this hypothesis is really interesting, and has to do with inflammation and cortisol metabolism, and treating inflammation somehow improves mood.”
[…] __
As for the potential for RU-486, which is so highly regulated that the distributor — Danco Laboratories — has offices in a secret location so they are not hounded by anti-abortion protesters, Robbins said, “I think we have to keep an open mind.”
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What interests Robbins is how steroids, which are used to decrease an inflammatory reaction, play a role in depression. And RU-486 is known to decrease the body’s steroid system.

The raw scientific information here is literally half the story. I’ve left out the personal saga that actually headlined the article: “Woman Buys Abortion Drug Illegally to Stop Psychotic Depression”. Mifepristone is a Schedule 1 drug here in the United States, put in the most tightly controlled class because of what in another drug would be treated as “an unfortunate side effect”. The American profiled in this piece is “uninsurable except in an expensive high-risk pool” ; she travels overseas to spend an estimated $15,000 – $20,000 every year to buy the drugs illicitly which enable her to function well enough to afford her medication. Just another statistic in our neverending War on Some Drugs. But at least we’re getting an FDA review!

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Reader Interactions

17Comments

  1. 1.

    Daddy-O

    August 23, 2010 at 11:25 am

    Hard to believe these wingers want to control real medicine for real problems, just because somebody might take it for an abortion. Same for the HPV vaccine.

    Now THAT’S a control freak for ya. And nothing says ‘control freak’ like religious insanity.

  2. 2.

    Zifnab

    August 23, 2010 at 11:26 am

    But at least we’re getting an FDA review!

    You say that like it’s nothing. Just bare in mind a previous President would have made banning RU-486 a campaign platform if it polled right among snake handlers and Christian psychics.

  3. 3.

    wilfred

    August 23, 2010 at 11:26 am

    More tempting to pun on the name: RU-486?

  4. 4.

    someguy

    August 23, 2010 at 11:30 am

    It’s outrageous that the FDA demands that drugs be evaluated for safety and efficacy in off-label uses.

    Well, except when off-label uses result in harm to people, in which case it’s outrageous that the FDA doesn’t do more to ensure that people who want to use drugs in a manner they weren’t designed for can safely do so.

    Those bastards!

  5. 5.

    Zifnab

    August 23, 2010 at 11:31 am

    @Daddy-O:

    Same for the HPV vaccine.

    Texas’s Governor Perry actually tried to make the HPV vaccine mandatory for high school students (and got a nice fat contribution from the pharmaceutical lobby for his troubles), but the nutters in the state shut him down because they thought it would cause Texas girls to turn into giant nympho super sluts (too late on that one, Texas – check your teenage pregnancy rate).

    But yeah, it’s kinda been a sore spot between corporate Republicans and their social gremlin allies.

  6. 6.

    aimai

    August 23, 2010 at 11:34 am

    Well, for god’s sake, they’ve *always* been willing to control “real medicine” to prevent sex and/or abortions. The entire Catholic war on condoms has been predicated on the notion that it were better for women to suffer and die from unwanted pregnancies than to enjoy protected, safe, sex. And when you threw AIDS into the mix, in the African context specifically where recreational heterosexual polygamy (for men) meant that AIDS was very much a disease of a mobile heterosexual male population and its wives and lovers, the Catholic opposition to the condom was a straight up death sentence for women.

    aimai

  7. 7.

    Sad_Dem

    August 23, 2010 at 11:58 am

    It’s very simple: If it works against depression, they ban it, because people that aren’t slogging through life in a fog are dangerous to the status quo. If it sorta kinda works and has nasty side effects and can be patented so that drug companies can make lots of money off it, they push it on TV constantly.

  8. 8.

    CJ

    August 23, 2010 at 11:59 am

    Speaking as someone with a family member who suffers from this sort of depression, off-label use of RU-486 to treat it will almost certainly not be anything close to a miracle cure.

    But any kind of effectiveness would be nice.

  9. 9.

    mclaren

    August 23, 2010 at 1:08 pm

    There’s hope for General Crackpot Fake Name yet.

  10. 10.

    TooManyJens

    August 23, 2010 at 1:21 pm

    because of what in another drug would be treated as “an unfortunate side effect”

    I’m pretty sure that’s not true. Are there other drugs out there that reliably cause fetal death in pregnant women and are basically treated with a shrug and an “oh well”? I’m not aware of any.

  11. 11.

    gene108

    August 23, 2010 at 1:44 pm

    I wonder what other medications Cheryl had taken before seeking out RU-486. It seems she was under treatment before, but why those meds didn’t work and RU-486 does should be evaluated.

    High doses of anti-depressants and anti-psychotics have enough side effects, we do need to see what long term impacts a new anti-psychotic has because people who are really koo-koo end up on those doses.

    I don’t think anyone was really meant to be on max doses for meds for a long period of time, but it ends up happening because there isn’t any other way for them to control their problems.

  12. 12.

    gene108

    August 23, 2010 at 1:46 pm

    @wilfred: the only puns I can think of involve someone being max smart.

  13. 13.

    wenchacha

    August 23, 2010 at 2:20 pm

    I predict a 3-2-1 countdown for pharmacists with Godly minds claiming a “conscientious” reason for denying any woman this drug, regardless of the reason.

    I am all for studying drugs for off-label use; sometimes you find some other very helpful applications.

  14. 14.

    asiangrrlMN

    August 23, 2010 at 2:55 pm

    @Sad_Dem: You may be snarking on this, but I think you’re close to the truth. Plus, depression is still stigmatized and whatnot.

  15. 15.

    Aardvark Cheeselog

    August 23, 2010 at 4:21 pm

    “I have delayed telling my story for so many years, and the main reason is because I am risking my ability to get this drug for my own well-being,” she said. “It’s a federal offense. RU-486 is a schedule 1 drug, the most controlled we have.”

    No, Schedule I would be if it were prohibited like heroin. Mifepristone seems to be covered under a FDA regulation that is supposed to be used to ensure that drugs are as safe as the makers claim, but probably is being used here just to inconvenience women who want abortions.

  16. 16.

    gene108

    August 23, 2010 at 5:20 pm

    A better summary of the ABC News article

    http://susanfreinkel.com/_the_case_of_the_notorious_depression_drug__62273.htm

    From a 2007 article, which discusses Cheryl and the clinical trials for mifepristone, which was linked in the ABC article.

    What bothers me in both articles is the lack of reporting about anyone in Europe ever trying to use mifepristone as a cure for psychosis, even though a Dutch guy tried it and got good results, once, way back in the early 1980’s.

    The SF Mag article does a better job evaluating the clinical trial data, but unfortunately states people with psychosis can be cured by a placebo, because they think “happy thoughts”. From having trouble with psychosis, I find this hypothesis to be bullshit.

    I can sort of forgive the SF Mag 2007 article, because it’s about the doctor, trying to take a drug to market and has a lot of info about the doctor, the trials and criticism, but the ABC News article is awful. It’s just rehashing another article and leaves out the details.

    There’s so much I’d like to know, including, as I stated above what’s the history of mifepristone in Europe, has cortisol therapy been tried before and what are the results, and how is mifepristone different from other attempts at using cortisol therapy to treat psychosis.

    I’m sadly old enough to remember when ABC news meant better reporting than just rehashing a 3 year old article and leaving out some of the details.

    The advances in treatments for mental illness in the past 20 years have been awesome. It’d be interesting to read about possible new treatments.

  17. 17.

    Anne Laurie

    August 23, 2010 at 8:30 pm

    @TooManyJens:

    Are there other drugs out there that reliably cause fetal death in pregnant women and are basically treated with a shrug and an “oh well”? I’m not aware of any.

    There are plenty of widely-prescribed drugs that are “contraindicated” for pregnant women — including, IIRC, Accutane for the treatment of acne. (Women used to have to sign a form promising not to get pregnant while taking Accutane before they could get a prescription.) And, working from the other end of the equation, some of the newest anti-psychotics are so risky patients have to be tested for liver function every six months, but the alternative for patients who don’t respond to “safer” drugs is worse than the small but real chance of liver failure.

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