Tuesday, March 30, 2010

Are Anti-depressant Drugs Effective?

Yes and no. A meta-analysis (study of studies) published in JAMA by Dr. Jay Fournier of the University of Pennsylvania found that anti-depressants were no better than placebo, except in severe cases of depression. When we measure neurotransmitter levels such as serotonin and dopamine in patients with being treated with these drugs for depression, we often find that levels are not raised as one would expect. You can raise these levels much more effectively by giving amino acids like 5 hydroxytryptophan. If depression is not severe, other methods, including herbs and nutrients, might be preferable to the drugs. In some cases, both can be used. An individualized approach is definitely called for.

See Family Practice News (click here), February 1, 2010, p. 5.

Wednesday, March 24, 2010

Study Shows the Value of Music Therapy in Brain Function

Dr. Gottfried Schlaug of Harvard reported to the annual meeting of the American Association for the Advancement of Science that patients with severe stroke on the left side of the brain who can no longer speak can sometimes be taught to communicate with singing. Similar results have been documented in autistic children who have regressed in their language development. Music therapy is a developing science that has great potential for difficult medical problems.

See Associated Press article in The Blade (click here), February 21, 2010, p. 11.

Tuesday, March 16, 2010

Getting the Best Value in Heart Surgeries

The Blade in Toledo congratulated the Cleveland Clinic in its editorial pages for signing an agreement with Lowe’s to do all of their employees’ heart surgeries with transportation costs thrown in and deductibles waived. The Clinic performed a record 4,128 such surgeries last year, and their complication rate is lower than the national average. This is probably better than sending patients to India for their cardiac surgery, but how about the idea of reducing the need for surgeries? With lifestyle changes and EDTA chelation therapy, we showed that the need for surgical intervention, and the incidence of heart attacks and premature deaths was much lower in patients treated with this non-surgical approach, and the much larger TACT trial is ongoing to confirm these findings.

See The Blade, February 19, 2010, p. 6 and Chappell LT, Shukla R, Yang J, Blaha R, et al. Subsequent cardiac and stroke events in patients with known vascular disease treated with EDTA chelation therapy: a retrospective study(click here). Evid Based Integrative Med 2005;2:27-35.

Tuesday, March 9, 2010

Evidence Supports Cold Remedies

The Prescriber’s Letter requires significant evidence to recommend therapies. It listed the following products that have some benefits to treat colds and flu: Nasal saline irrigation, zinc lozenges, vitamin D, echinacea, elderberry, probiotics, and possibly vitamin C. Most doctors ignore this evidence. Many recommend decongestants and other products that have no effect on the severity or length of viral infections, although they might help a patient feel better (at the risk of side effects). We are now offering 100,000 units of vitamin D or more by injection for acute viral infections.

See Prescriber’s Letter (click here), November, 2009, p. 65.

Thursday, March 4, 2010

Infants Need a Wider Variety of Foods

Frank Greer of the AAP’s Committee on Nutrition reports that rice cereal is a poor choice for introducing foods after breast feeding for the first 6 months of life. High protein and fiber foods should be included. Vegetables and fruits are also important to include not only directly to infants, but also indirectly by mother’s intake and then through breast milk. Babies exposed to a wide variety of foods either way are more likely to develop healthy eating patterns as they grow older.

See Family Practice News (click here), January, 2010, p. 70-1.

Tuesday, March 2, 2010

Alcohol and Breast Cancer

Marilyn Kwan of Kaiser Permanente in Oakland, CA found that women who were moderate to heavy drinkers had a higher incidence of breast cancer. Patients who already had breast cancer and continued to drink 3-4 times a week had a 1.3 times higher recurrence rate. Drinking a half a glass of wine or one beer daily appears to be the upper safe limit for cancer and also has some protective effect for coronary artery disease. It is a fine line between protection and increased risk.

See Family Practice News (click here), January, 2010, p. 46.