“GSK has reached agreement to settle certain cases involving the use of Paxil during pregnancy. The details of those settlements are confidential,” spokeswoman Claire Brough said in an e-mailed statement.

“Other cases remain pending. Three cases are scheduled for trial in Philadelphia in September,” she added.

“GSK considers options for every case, including settlement when it makes sense. The company has agreed to these settlements, despite its litigation defenses, in order to avoid the costs, burdens and uncertainties of ongoing litigation.”

Bloomberg News, citing people familiar with the settlements, earlier said the drugmaker had agreed to pay more than $1 billion to resolve more than 800 birth-defect cases related to Paxil.

News of the Paxil settlements comes after British-based Glaxo said last week it was taking a 1.57 billion-pound ($2.4 billion) legal charge to cover litigation related to Paxil, as well as to its diabetes pill Avandia and a former factory in Puerto Rico.

In the case of Paxil, the company said on July 15 that it had settled the “vast majority” of product liability cases.

Glaxo is due to report second-quarter financial results at 1100 GMT on Wednesday,

($1=.6583 pounds)

(Reporting by Ben Hirschler; Editing by Greg Mahlich)

Technorati Tags: GlaxoSmithKline, Paxil, Paxil antidepressant, Paxil during pregnancy

“Stress? Dude my clothes are falling off me (because of weight loss). The level of stress here is tremendous. My husband has aged 10 years in two months,” Arnesen said on Friday as she loaded possessions into a van outside her trailer home in Venice.

Fears are growing of an increase in stress-related illness and mental health problems from the BP Plc spill. Anecdotal evidence abounds but mental health officials say they lack data about the scale and scope of suffering.

Arnesen recently set up the Wives of Commercial Fishermen network to respond to pressures in the community. Two days ago, a friend told her he was so upset about his failure to get hired by BP’s cleanup program he was considering suicide.

Arnesen has her own worries. Her husband cannot work as a shrimper because authorities have closed swathes of Gulf waters to fishing and her children and other relatives have fallen sick from what she believes are airborne toxins from the leak.

“The mental health impact here … (and) the level of uncertainty is taking a toll on people and that’s a huge, huge concern,” Arnesen said. She declined to say where she and her two children would settle but said her husband would stay behind to work for BP on the cleanup.

Thousands of Gulf Coast fishermen face financial ruin because of the spill. Some say the stress is worse than after Hurricane Katrina hit the Gulf Coast in 2005.

Then it was possible to get back to work despite the destruction. Now it is impossible to say when waters will reopen especially since oil continues to gush into the Gulf.

At the same time, many fishermen now rely on BP’s cleanup program as a financial lifeline and while that has provided a windfall for a few, others have yet to find employment.

FINANCIAL STRAIN

“We hear it over and over again,” said environmental scientist Wilma Subra of the Louisiana Environmental Action Network, a nonprofit group with deep community roots. “It is the stress because of the possibility of not being able to earn a living and pay their bills.”

Some experts caution it is possible to falsely perceive an uptick in a health phenomenon just by looking for it. But crisis counseling teams working with Gulf fishermen say anecdotal reports point to increased anger and anxiety and “a lot of marital discord,” said Acquanetta Knight, director of policy and planning at the Alabama Department of Mental Health.

Data on the problems should be available in the next two weeks, she told reporters on Friday.

Residents suffering mental distress may hesitate to seek help because of a fiercely individualistic culture and strong ethic of self-reliance on the Gulf, where many earn their living working long hours alone on the water.

“This is sometimes a population that’s not so accustomed to utilizing traditional services,” said Pamela Hyde, administrator of the Substance Abuse and Mental Health Services Administration.

Hyde said her agency, part of the Department of Health and Human Services, is looking at national suicide and domestic violence hotlines and state mental health agency reports to find data.

Louisiana, Alabama, and Mississippi state mental health agencies have requested millions of dollars from BP to help pay for expanded mental health monitoring and services.

In a June 28 letter to the energy company, the Louisiana Department of Health and Hospitals asked for $10 million and warned that health effects from the spill will be an “ongoing challenge.”

The department first requested funds for mental health care on May 28. BP has not yet responded to the request.

(Additional reporting by Emma Ashburn in Washington; Editing by Bill Trott)

Technorati Tags: Gulf spill, mental health

Researchers at Eastern Virginia Medical School, publishing an analysis of 43 past studies in the Journal of the American Medical Association on Tuesday, report that up to 10% of fathers may experience postpartum depression (PPD) after the birth of a child. That figure comes as a surprise, even to the authors, who had been studying paternal PPD for several years, especially because it doubles the average risk of depression found in the male population in general - which is only about 5%. “It is surprising and novel that the rate is much higher than most people would guess or expect,” says study author James Paulson. “This is a condition that is not recognized by many folks. Postpartum in men is an alien concept to most people.” (See a story on postpartum-depression signals during pregnancy.)

But it shouldn’t be, he says, since fathers are just as susceptible to factors that tend to trigger PPD in mothers - especially in first-time parents. In new moms, postpartum depression typically stems from feelings of stress and anxiety associated with fatigue, lack of sleep, changes in the marital relationship and concerns about finances and work. Fathers experience the same stresses and the same overwhelming emotions that accompany the life-changing event of becoming a parent, Paulson notes. While his analysis does not isolate the specific factors that were responsible for the feelings of depression in the studies’ fathers, he theorizes that they mirrored known risk factors in new mothers and probably even included others that were unique to dads. “A lot of changes are going on with fathers too, so it’s reasonable to expect that they might not recognize depression when they experience it,” he says. (Comments on this story.)

In the report, which involved an analysis of data on 28,004 men around the world, new fathers were most likely to score high for depressive symptoms between the third and sixth months after birth (that was also found to be true for mothers) and least likely to have depressive symptoms in the first three months postpartum. Interestingly, the authors also found that symptoms of PPD were more common among American men than their international counterparts, a disparity that Paulson speculates may reflect cultural differences and varying paternity-leave policies in the workplace. (See how to prevent illness at any age.)

The mothers included in some of the studies showed patterns of PPD similar to the men, but Paulson says it isn’t clear whose depression came first or whether one caused the other. “Our study found a clear, consistent moderate correlation between Mom’s depression and Dad’s depression, but what the study doesn’t say is what direction the causality might be,” he says. “There’s no clear pattern in the research we have so far.”

It’s worth noting that most of the studies did not track cases of clinical depression diagnosed by a physician, but instead recorded the incidence of depressive symptoms through questionnaires or interviews. Some experts believe these measures tend to overestimate the actual rate of depression; others believe they are often a useful harbinger of underlying, undiagnosed illness.

Dr. Paul Ramchandani, a consultant in child and adolescent psychiatry at Warneford Hospital in Oxford, England, who conducted one of the previous studies on the subject, says Paulson’s findings warrant a greater awareness and need for depression screening in new fathers, particularly since a person’s well-being can have a profound effect on their loved ones. “Depressive symptoms have an impact on the [fathers] and also potentially on their developing babies,” he says. (See a story on migraines and depression.)

Also critical is early awareness. Studies of PPD in new mothers show that the greatest predictor of postpartum depression is previous depression - either during pregnancy or before - not giving birth itself. But if depression often goes undiagnosed and untreated in women during pregnancy, it goes doubly so for fathers, who are not often asked about their mental state during pre- or postnatal visits. If more physicians and new parents could be educated about potential problems, however - hopefully leading to more open conversations among couples - it may very well help parents cope better with the new addition to their family, Paulson says. “Awareness of this issue needs to be increased,” he says.

Along with greater awareness, Paulson and his colleagues seek better data that will help them understand the factors that may drive paternal PPD as well as the best ways to identify and address it. “Of course, there is little point in screening unless there are services to provide treatment and support for fathers and their families, so this is a critical part of the picture,” says Ramchandani.

Technorati Tags: clinical depression, Depression, depressive symptoms, Postpartum depression

Their 14-week study of 170 patients found that 54 percent of those who received the combined treatment were able to stop drinking, compared with 21 to 28 percent for patients who received a placebo, Zoloft only, or naltrexone only.

The patients who received the combined treatment also went for a longer period of time before they started drinking again — 61 days compared with 15 days for patients in the other groups.

The findings may prove an important advance in the treatment of patients with alcohol dependence and depression, said the University of Pennsylvania researchers.

“When depression and alcohol dependence occur together, each condition has a negative influence on the outcome of the other, so not only does this pairing of illnesses affect a lot of patients, it also makes the individual disorders worse,” study author Helen Pettinati said in a news release. “Combining sertraline and naltrexone could be a practical approach for these patients because both have (U.S. Food and Drug Adminstration) approval.”

The study was published March 15 in the The American Journal of Psychiatry.

Technorati Tags: Combination Treatment, depression and alcohol dependence, naltrexone, sertraline, stop drinking, zoloft

But less well known is depression during pregnancy — a common problem as well, and one that also can be risky for the unborn baby, experts now know.

A depressed woman, for instance, is more likely to give birth early, increasing health risks for the baby.

Depression during pregnancy is more common than most people believe, agree Dr. De-Kun Li, a reproductive perinatal epidemiologist in the research division at Kaiser Permanente in Oakland, Calif., and Dr. Diana Dell, a psychiatrist and obstetrician-gynecologist at Duke University Medical Center in Durham, N.C.

One or two of every 10 pregnant women have symptoms of major depression, according to the March of Dimes. Those who have had a bout of depression before are more likely to get it again. And Li said that others might have depressive symptoms — short of clinical depression but still bothersome and unhealthy.

In his recent study of 791 pregnant women, Li found that 44 percent had depressive symptoms, about half of them severe, during pregnancy. “It wasn’t necessarily clinical depression,” he said, but a mood noticeably low.

Li tracked the women through delivery and found that those with depressive symptoms had nearly twice the risk of delivering a baby early, before 37 weeks.

Early delivery, by itself, is associated with health risks, he said. “Premature delivery is the No. 1 cause of infant mortality,” he said. His findings were published in the January 2009 issue of Human Reproduction.

“We don’t know the mechanism” of why depression and early delivery are linked, Li said. But what’s certain is that “depression is not a benign condition,” he said. “It can be harmful to your baby.”

What about antidepressant use during pregnancy?

“What I tell patients who see me in consultation [for depression] is that moms need to be well in pregnancy,” Dell said.

That may or may not mean taking antidepressants, she said. There have been no head-to-head comparisons of antidepressants during pregnancy to determine which are safest, she said, making it difficult to know, if medication is needed, which to choose.

In 2008, the American College of Obstetricians and Gynecologists updated its bulletin, “Use of Psychiatric Medications During Pregnancy and Lactation.” In it, the group notes that more than 500,000 pregnancies in the United States each year involve women who have psychiatric illnesses — depression, but other illnesses as well — that occurred before the pregnancy or emerge with it.

In the bulletin, the college experts offer a number of recommendations, including the suggestion that pregnant women avoid the antidepressant paroxetine (Paxil). In 2005, the U.S. Food and Drug Administration issued a warning about Paxil based on studies that found that it might increase the risk of birth defects.

Other reports have found that babies born to women who are taking a type of antidepressant known as an SSRI (selective serotonin reuptake inhibitor) could have breathing or feeding problems, according to the March of Dimes.

The bulletin recommends that treatment with antidepressants be individualized.

Antidepressants, though, aren’t the only option to treat depression during pregnancy, Dell said. Other options include talk or cognitive therapy. Some women might find help through a support group, according to the March of Dimes. And, if a woman has the type of depression known as seasonal affective disorder, which returns in the fall and winter when less light is available, light therapy might help, according to the March of Dimes.

What is crucially important, Li and Dell agree, is for a woman who is pregnant and thinks she is depressed to alert her physician. Together, they can weigh the pros and cons of treatment and decide what would be best for her and the baby.

Technorati Tags: antidepressants, Depression, depressive symptoms, pregnancy, treat depression during pregnancy

Of the four major categories of medications for psychiatric symptoms, only one will be covered in some detail here. This is one of two categories that correlate more closely to stress (the other category includes the anti-anxiety medications). And within this article they’ll simply be called “stress medicine” although this certainly isn’t a medical term.

Antidepressants:

As the name implies, these medications (meds) treat the symptoms of depression. This includes low mood, low energy, appetite problems, sleep problems, and poor concentration. They can also be effective for anxiety disorders such as panic disorder, obsessive compulsive disorder, and phobias. It may be 2, 3, 5, or even 8 weeks before the patient notices a change. And never stop taking a med without first talking to your doctor.

The newer generation of these medications for depression is called “serotonin selective reuptake inhibitors” (SSRIs). They tend to cause fewer side effects. SSRIs include Prozac, Zoloft, Serzone, Lexapro, and Luvox.

The brain chemistry of depression and anxiety is not fully understood. However, evidence supports the view that people with these disorders have an imbalance of the brain’s neurotransmitters. These are chemicals in the brain that allow nerve cells to communicate. One of the most commonly accepted theories suggests that two naturally occurring chemicals, serotonin and norepinephrine, are believed to affect core mood and pain symptoms of depression. An imbalance in these chemicals may be an important factor in the development of depression and anxiety.

These chemical messengers (neurotransmitters) aid communication between many areas of the brain and spinal cord that affect emotional aspects of a person’s nature. They are also important in “controlling the volume” of messages about pain between the body and the brain.

The SSRIs work in this way: Serotonin is released from one nerve cell and passed to the next. In the process, some of the serotonin released is reabsorbed by the first nerve cell. SSRIs block the re-absorption of serotonin into the first nerve cell. It is this blocking action that causes an increased amount of serotonin to become available at the next nerve cell and this is how SSRIs affect the balance of serotonin in the brain.

No two meds are exactly alike. And exactly what conditions a drug can be prescribed for vary as do the side effects for each drug or medication. Not everyone has side effects but the common ones include: Nausea, vomiting, excitement, agitation, headache, sexual problems, dry mouth, dizziness, sedation, weight gain, constipation, heart palpitations, cardiac abnormalities, insomnia, memory problems, over-stimulation, and hypertensive crisis.

Another sub-category of antidepressant stress medicine is called selective SNRIs (selective serotonin and norepinephrine reuptake inhibitor). They work on the same basic principle as the SSRIs but target other chemicals. This impacts which conditions they can be prescribed for. Cymbalta is a common med and some of the side effects are nausea, dry mouth, diarrhea, constipation, dizziness, fatigue, decreased appetite, increased sweating, and difficulty sleeping.

Wellbutrin on the other hand, helps balance the levels neurotransmitters called dopamine and norepinephrine. It’s another antidepressant. Some of the side effects are agitation, dry mouth, skin rash, loss of appetite, sweating, ringing in the ears, shakiness, stomach pain, insomnia, muscle pain, nausea, fast heartbeat, sore throat, urinating more often, constipation, headaches, and weight loss.

Talk to your doctor about any other medications you’re on BEFORE getting a prescription for one of these antidepressants sometimes called “stress medicine.” They interact with some other medications in very dangerous ways.

Technorati Tags: cymbalta, Depression, depression medications, lexapro, stress, stress medications, wellbutrin