Based on a recent survey, an estimated 27 million Americans use antidepressants. And according to a FDA survey, more than 80% of survey respondents were exposed to pharmaceutical advertising with antidepressants being one of the most heavily advertised class of medications.

Yet, given the heavy use and promotion of antidepressants our knowledge of them is surprisingly poor.

A new study published in the American Journal of Psychiatry, raises concerns that antidepressants may lead to increased stroke risk. The researchers examined stroke risk based on previous reports that antidepressants — particularly selective serotonin reuptake inhibitors — may induce bleeding complications in arteries of the brain.

The study analyzed data from 24,214 patients enrolled in the National Health Insurance Research Database in Taiwan from 1998 to 2007. Researchers compared rates of antidepressant use 7, 14, and 28 days before the onset of stroke.

Research Findings

• Antidepressant use in the 2 weeks before the stroke was associated with a 48% higher stroke risk.
• There was no association between stroke risk and the number of antidepressant prescriptions in the previous year.
• Patients who had more than 6 antidepressant prescriptions had a lower stroke risk and those who had 1 or 2 prescriptions had greater stroke risk.

Authors of the study concluded that the somewhat conflicting results indicated that short-term use of antidepressants increased the risk of stroke, but long-term use had beneficial effects on stroke risk.

Many physicians and researchers, however, agree with me that these contradictory results are confusing and require further studies.

But what is clear, is that

If you or your doctor is considering the use of antidepressants or if you are currently on antidepressants, please be aware of the more serious potential side effects. And make sure to follow up with your doctor about any side effects you may be experiencing, no matter how minor you may think it is.

As you recall from my earlier blog post, Fight Depression with Exercise, exercise has many great physical and mental benefits. One of the most important of those benefits is exercise’s ability to lift depressed moods.

Now a new study published in 2011 suggests that exercising outdoors may lead to greater mental and emotional benefits than indoor exercise. After examining 11 studies with 833 participating adults, the author’s concluded that when compared to indoor exercise, outdoor exercise led to

• Greater improvement in mental well-being
• Greater feelings of revitalization
• Increased energy and positive engagement
• Greater decreases in tension, confusion, anger and depression

Those who exercised outside also stated that when compared to working out indoors, they found greater enjoyment and satisfaction with outdoor activity and were more likely to continue with their outdoor workouts.

To get the most anti-depressive effects out of exercise:

• Engage in any form of exercise (mild activity is fine if you don’t want to over-exert yourself)
• Exercise in your spare time
• Exercise with someone or in a group
• Exercise outdoors!!

As the weather gets warmer, be sure to grab a friend and exercise outdoors!

Selecting medications for psychiatric disorders is typically a hit-or-miss process.

Over the years I’ve seen many patients come in who have tried one medication or combination of medications after another over months or even years with little success.

Unlike many other diseases, psychiatric disorders such as depression are vague collections of symptoms. And there are no objective medical tests to reveal their presence nor clearly defined physical signs of their resolution. This leaves many psychiatrists with only a trial-and-error approach to selecting medication.

If only there was a test to help psychiatrists predict more accurately which drug is likely to help their patients. The good news: THERE IS!

The referenced electroencephalogram, or rEEG, is a revolutionary test that helps guide medication selection. An EEG records the brain’s electrical activity. A patient’s brainwave patterns are then “referenced,” or compared, to a database of more than 20,000 medication trials. This information guides the physician in selecting medications that are more likely to work for you.

The EEG is painless, harmless, and noninvasive. The procedure involves placing about 20 small patches, or electrodes, on the scalp. A machine then records the brain’s electrical activity for 30 minutes to 1 hour.

Then, the patient’s EEG is entered into a database where it is matched with other similar brainwave patterns. The database produces a readout of medications which have helped patients with similar brainwave patterns.

Although the rEEG helps more accurately select medications, the rEEG can NOT diagnose particular illnesses; particular brainwave patterns do not correspond with specific diagnoses. The rEEG only indicates which drugs are likely to help a particular patient.

This revolutionary, yet simple, brain test enables psychiatrists to improve the traditional trial-and-error approach to medication selection.