Citalopram, an anti-depressant drug, could be used to slow the onset of Alzheimer’s disease, say scientists in the US.
Research into 23 people, and transgenic mice, found citalopram hampered a protein which helps to build destructive plaques in the brains of Alzheimer’s patients.
Scientists said they hoped the study could help prevent the disease.
Experts said the study was “interesting” and that using an approved drug could be beneficial.
Alzheimer’s disease is the most common cause of dementia.
Citalopram could be used to slow the onset of Alzheimer’s disease
It affects the brain through protein plaques and tangles which lead to the death of brain cells, and a shortage of chemicals important for transmitting messages.
Symptoms include loss of memory, mood changes, and problems with communication and reasoning.
Researchers at the University of Pennsylvania and Washington University School of Medicine carried out the study between 2012 and 2014.
They bred mice with Alzheimer’s disease and looked at the levels of the peptide – or protein component – amyloid beta (AB), in the brain.
AB clusters in plaques which, alongside the tau protein, are thought to trigger Alzheimer’s.
After giving the mice citalopram, the level of AB fell by 25%, compared to the control group, with no anti-depressant.
And after two months of anti-depressants, the growth of new plaques was reduced, and existing plaques did not grow any further, the study said.
But it noted the drug could not cause existing plaques to shrink, or decrease in number.
The 23 people used in the study were aged between 18 and 50 and were “healthy”, researchers said.
They were given a single dose of citalopram, and the levels of AB in their cerebrospinal fluid was monitored, according to the study.
Researchers said AB levels dropped by 38% in the 37-hour period after treatment, compared to a placebo test.
Lead author, Dr. Yvette Sheline, at the University of Pennsylvania, said the antidepressants worked by “clipping” the AB molecules so they were not able to function properly.
She said: “We had predicted the results, but they were very exciting.”
Dr. Yvette Sheline stressed the study was a “proof of concept” study, hence the small number of people without Alzheimer’s, and that if the results were successful, they could be used to slow the progression of the disease 10 to 15 years before it could typically become apparent.
She added: “I am eager to get on to the next study, where we will look at whether the effect can be sustained.”
Dr. Yvette Sheline said after that a “big study” spanning several years would look at the effectiveness of the drug in people compared to a placebo.
Prozac, an antidepressant introduced by Eli Lilly and Company more than 25 years ago, has entered the cultural lexicon and helped define how people think of mental illness.
In the 1990s Prozac achieved what few prescription drugs ever do. The drug, dubbed “happy pill”, was trendy.
It found fame among laymen, fuelled in part by Elizabeth Wurtzel’s bestselling book Prozac Nation. Now Prozac is part of the everyday lexicon.
Prozac was first introduced in Belgium in 1986 and in the US after two years. Since then, it has become a cipher for discussions about mental illness and whether it should be treated by the talking cure – therapy in which a patient works things out with the help of a professional – or with drugs.
“It was like bringing a meat cleaver down,” says British novelist Sarah Dunant, co-editor of an anthology of essays, The Age of Anxiety. She has a personal experience with antidepressants – saying they helped her through a tough time years ago.
Sarah Dunant believes Prozac has had far-reaching implications.
“Things are not the same now as they were before.”
However, not everybody is happy about that.
“What made Prozac good was not that it was potent, which it really was not, but that it had really good marketing,” says David Healy, a professor at Cardiff University and the author of Pharmageddon.
“They made us overcome the natural caution most of us have about pills and convince us that we absolutely had to have these things,” he said.
Prozac, an antidepressant introduced by Eli Lilly and Company more than 25 years ago, has entered the cultural lexicon and helped define how people think of mental illness
Prozac’s success key was the marketing plan.
Eli Lilly picked a name created by Interbrand that aimed to distance the drug “from everything typically associated with anti-depressants – strong chemicals, side effects”.
Prozac – as both a drug and a concept – caught on. Prozac Nation had a cult following. It was reissued in 2002, pegged to a movie starring Christina Ricci and sold more than 120,000 copies that year, according to Publishers Weekly.
Through books and movies, Prozac gave an almost chic gloss to mental illness in some people’s eyes.
After Prozac Nation was published, Elizabeth Wurtzel “went home with a different man every night and did heroin every day”, she wrote recently in New York Magazine.
Prozac, which now acts almost as shorthand for all anti-depressants, appears in the Oxford English Dictionary. People can have a “Prozac moment”, which means fleeting happiness – or forgetfulness. They can also have a Prozac shot (sambuca and schnapps).
Not surprisingly, Prozac has also become a source of material for film directors. In Steven Soderbergh’s psychological thriller Side Effects, a New Yorker takes pills for depression – and Prozac is inevitably mentioned.
Prozac has seeped into pop culture, and also the lives of ordinary people. Today, Europeans and Americans take antidepressants at roughly the same rate. In 2010, one in 10 people in Europe had taken them, according to the Institute for the Study of Labour in Bonn. In the US, 11% of people over the age of 12 take antidepressants, according to the US Centers for Disease Control research.
It’s easy to conclude that the public image of Prozac has helped fuel social acceptance of antidepressant use.
But plenty of those who have prescribed drugs can be critical of the way they have been used.
“There was this whole idea that Prozac made you better – well, I wasn’t sure,” says Joanna Moncrieff, now a senior clinical lecturer in neuroscience at University College London and author of forthcoming book The Bitterest Pills.
Joanna Moncrieff worked for years with patients in a 22-bed ward at a Brentwood mental hospital.
“I spent a lot of time in the ward reducing medication,” she said.
“The staff called me The Slasher.”
Not everybody should be taking medication, Joanna Moncrieff said.
“A hundred years ago if you didn’t feel good, you wouldn’t have expected it to be eliminated.”
Still, she knows people will continue to take antidepressants. Just as Viagra has changed lives – and provided fodder for late-night comedy skits – Prozac has altered the national discourse about mental illness.
Many experts believe antidepressants are useful. Manchester University’s Ian Anderson, a professor of psychiatry, said that people should not take a dogmatic approach to the drugs.
“In the end it’s about getting on with your life,” said Prof. Ian Anderson.
“I’ve seen enough people just struggling along with depression. That doesn’t seem fair.”
Sarah Dunant said antidepressants once got her through a bad breakup. She said she wished the drugs were around when her father, a manager in the airline industry, suffered a breakdown in the 1970s. He had to undergo electroshock therapy.
“It would have helped him through the most terrifying fall through the darkness,” she said.
Many people feel better when they are on the drugs. But the precise mechanism is still not apparent. Antidepressants have an effect on serotonin levels in the brain, which seem to be related to emotional well-being. Yet the relationship between serotonin and happiness remains unclear.
“We’re a bit blind about this,” said Stafford Lightman from University of Bristol.
Researchers do not have an animal model to study the effects of the drugs.
“There is no such thing as a depressed mouse.”
“Consequently, there are leaps of faith when you take these drugs,” he said.
Cognitive Behavioral Therapy (CBT) can reduce symptoms of depression in people who fail to respond to drug treatment, found a new study in the Lancet.
CBT, a type of psychotherapy, was found to benefit nearly half of the 234 patients who received it combined with normal care from their GP.
Up to two-thirds of people with depression do not respond to anti-depressants.
Patients should have access to a range of treatments, the charity Mind said.
CBT is a form of talking psychotherapy to help people with depression change the way they think to improve how they feel and alter their behavior.
The study followed 469 patients with treatment-resistant depression picked from GP practices in Bristol, Exeter and Glasgow over 12 months.
One group of patients continued with their usual care from their GP, which could include anti-depressant medication, while the second group was also treated with CBT.
After six months, researchers found 46% of those who had received CBT reported at least a 50% reduction in their symptoms.
This compared with 22% experiencing the same reduction in the other group.
CBT is a form of talking psychotherapy to help people with depression change the way they think to improve how they feel and alter their behavior
The study concluded CBT was effective in reducing symptoms and improving patients’ quality of life. The improvements had been maintained for a period of 12 months, it added.
The patients who did benefit from cognitive behavioral therapy spent one hour a week with a clinical psychologist learning skills to help change the way they think.
Chris Williams, professor of psychosocial psychiatry at the University of Glasgow, and part of the research team, said: “The research used a CBT intervention alongside treatment with anti-depressants. It confirms how these approaches – the psychological and physical – can complement each other.
“It was also encouraging because we found the approach worked to good effect across a wide range of people of different ages and living in a variety of settings.”
WHAT IS CBT?
Cognitive Behavioral Therapy is:
- a way of talking about how you think about yourself, the world and other people
- how what you do affects your thoughts and feelings
CBT can help you to change how you think (cognitive) and what you do (behavior).
Unlike some other talking treatments, it focuses on the “here and now” instead of the causes of distress or past symptoms.