Trial, Meet Error: The Story of a Pharmacy Regular

“Why isn’t this medication working?” me in 2002.

“Why isn’t this medication working?” me in 2018.

When the university nurse first prodded me to consider medication, I hesitated before eventually relenting. My reasoning: While this little white pill may not be my salvation, it surely can’t hurt.

Or can it?

Over the past 16 years, my medication history is longer than a typical Catholic wedding. A is for Abilify, B is for Buspar, C is for Clonazepam…and, well, you get the idea.

Medication, I naively hoped, would be a cure-all — a foolproof remedy for intrusive, tormenting thoughts. And while medication has, at times, lowered the volume on my depressive radio, it has come with its own set of challenges.  

Speaking from firsthand experience — now 16 years and counting, medications have potent and, at times, debilitating side effects. From complaining about grogginess to bouts of irritability to general apathy, my panicked emails to my dedicated health care team bear this out. Pinpointing the right medication is trial and error — in my case, a 16-year trial replete with lots of errors (and lethargy and grogginess and irritability).

When I first accepted the shiny white pill, at the university nurse’s gentle insistence, I had no idea I had just signed up for a 16-year medication joyride. In my naïveté, there was an implicit assumption — “just give the medication six weeks and life will suddenly become unicorns, rainbows, and free Beyonce concerts.”

Forget unicorns and a resplendent Beyonce sashaying in her yellow dress, I will take six weeks without a panic-stricken email to my dedicated health care provider (thank you, Dr. Neumaier, for your endless patience).

More than lamenting my own trials and tribulations, though, this article is intended for “Prozac Nation” — the millions of Americans seeking magic in a pill bottle as we shuffle from one supposed elixir to another. I understand the frustration — even despair — because I have lived it: the dry mouth, the racing heartbeat, the mental grogginess.  

After 16 years wandering in the (medication) desert, I believe I am inching closer to a long(er)-term solution. Knock on proverbial wood — or that Bartell’s counter that I have visited all too frequently. While Wellbutrin is far from perfect — and, yes, my mood vacillates more than Tesla stock — it is has provided a level of clarity and creativity. After years of medications numbing my mood, feelings, and, in some respects, life enjoyment, there is a level of comfort to know that there is a medication that, you know, actually works.

An estimated 40 million Americans now take a psychiatric drug; these drugs are as much of an American institution as the 9 to 5 and Thanksgiving family feuds. Despite prescription drugs’ ubiquity, however, their effects are deeply personal, even idiosyncratic (notwithstanding your health care professional’s calming reassurances that “you will feel better in no time”). For some, Prozac Nation may be an accurate title. For others, including yours truly, Wellbutrin World is a more fitting descriptor. One unmistakable lesson (and revelation) during my 16 years of medication cat and mouse: the best prescription may be, well, another prescription.  

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Breast Milk Best for Premature Babies’ Brain Development

Premature babies show better brain development when fed breast milk rather than formula, according to a new study.

Premature birth has been linked to an increased possibility of problems with learning and thinking skills in later life, which are thought to be linked to alterations in brain development, according to researchers at the University of Edinburgh.

Previous studies have shown that pre-term birth is associated with changes in the part of the brain’s structure that helps brain cells communicate with one another, known as white matter.

For their study, researchers studied MRI brain scans from 47 babies from a study group known as the Theirworld Edinburgh Birth Cohort.

The babies were born before 33 weeks gestation. Scans took place when they reached term-equivalent age, an average of 40 weeks from conception, the researchers reported.

The researchers also collected information about how the infants had been fed while in intensive care — either formula milk or breast milk from the mother or a donor.

The study found that babies who exclusively received breast milk for at least three-quarters of the days they spent in hospital showed improved brain connectivity.

The effects were greatest in babies who were fed breast milk for a greater proportion of their time spent in intensive care, the researchers discovered.

“Our findings suggest that brain development in the weeks after preterm birth is improved in babies who receive greater amounts of breast milk,” said Professor James Boardman, director of the Jennifer Brown Research Laboratory at the University of Edinburgh.

“This study highlights the need for more research to understand the role of early life nutrition for improving long-term outcomes for pre-term babies.”

“Mothers of pre-term babies should be supported to provide breast milk while their baby is in neonatal care — if they are able to and if their baby is well enough to receive milk — because this may give their children the best chance of healthy brain development,” he concluded.

The study was published in the journal NeuroImage.

Source: University of Edinburgh

Photo: The data suggest that brain connections in preterm babies are improved with greater amounts of breast milk in the weeks after birth. Credit: Jennifer Brown Research Laboratory, the University of Edinburgh.

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Regular Bedtime Can Help Keep Older Adults Healthy

A regular bedtime is not just for kids. A new study on sleep patterns suggests that a regular bedtime and wake time are just as important for heart and metabolic health among older adults.

In a study of 1,978 older adults, researchers at Duke Health and the Duke Clinical Research Institute found people with irregular sleep patterns weighed more, had higher blood sugar, higher blood pressure, and a higher projected risk of having a heart attack or stroke within 10 years than those who slept and woke at the same times every day.

Irregular sleepers were also more likely to report depression and stress than regular sleepers, both of which are tied to heart health, according to the researchers.

African-Americans had the most irregular sleep patterns compared to participants who were white, Chinese-American or Hispanic, the study’s findings showed.

The findings show an association — but not a cause-and-effect relationship — between sleep regularity and heart and metabolic health, according to the researchers.

“From our study, we can’t conclude that sleep irregularity results in health risks, or whether health conditions affect sleep,” said Jessica Lunsford-Avery, Ph.D., an assistant professor in psychiatry and behavioral sciences and the study’s lead author. “Perhaps all of these things are impacting each other.”

The data suggest tracking sleep regularity could help identify people at risk of disease, and where health disparities may impact specific groups, such as African Americans, she noted.

“Heart disease and diabetes are extremely common in the United States, are extremely costly, and also are leading causes of death in this country,” she said. “To the extent we can predict individuals at risk for these diseases, we may be able to prevent or delay their onset.”

For the study, participants used devices that tracked sleep schedules down to the minute so researchers could learn whether even subtle changes — going to bed at 10:10 p.m. instead of the usual 10 p.m. — were linked to the health of participants.

Study participants ranged in age from 54 to 93. People with diagnosed sleep disorders, such as sleep apnea, were not included in the study, she noted.

The study also tracked the duration of participants’ sleep and whether someone turned in early or was a night owl. According to these measures, people with hypertension tended to sleep more hours, and people with obesity tended to stay up later, the study discovered.

Of all three measures, however, regularity was the best at predicting someone’s heart and metabolic disease risk, the researchers found.

As one might expect, irregular sleepers experienced more sleepiness during the day and were less active, perhaps because they were tired, Lunsford-Avery said.

The study was published in the journal Scientific Reports.

Source: Duke University Medical Center

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Bosses Who Procrastinate May Breed Contempt in Their Staffs

A new study reveals that managers who procrastinate when making decisions and carrying out tasks not only leave employees feeling less committed to the business, but also more likely to display abnormal and unpleasant behavior.

Most alarmingly, this can escalate beyond taking unnecessary sick days to becoming abusive to colleagues and stealing office supplies, according to an international research team led by Drs. Alison Legood and Allan Lee from the University of Exeter in the U.K.

“We have found procrastination from managers can be really detrimental to their staff, and companies need to take action to ensure there are better relationships between bosses and employees,” said Lee, a senior lecturer in organization studies and management at the University of Exeter’s Business School.

“When bosses fail to do their work, knowing this will cause problems for others, it causes their staff to become frustrated and leaves them less committed to their employer.”

For the study, the researchers collected data from 290 employees on the impact of their leaders procrastinating, and measured how much managers procrastinated based on questions such as “my manager delays making decisions until it’s too late.”

The researchers also collected further information from 250 workers, and their 23 supervisors, in a Chinese textile manufacturing company in Zhejiang Province.

Employees were asked to rate their relationships with their bosses, while managers were asked to rate whether staff were deviant and how committed they seemed to the company, the researchers report.

The results show that when leaders procrastinate, this leads to “deviant behavior” from their staff.

The researchers, also from SOAS University of London and Deakin University in Australia, suggest that staff should try to discover why their managers are prone to procrastination, and also take part in any decision making to help combat the issue.

Companies also could deliver training to try to encourage better relationships between staff and managers, the researchers advised.

“We found employees are less likely to be frustrated by their leaders’ procrastination if they had a good relationship with that leader,” Lee noted. “Encouraging feedback sessions, such as 360-degree feedback, may help leaders to become more aware of their own behavior, and sharing leadership could reduce the effect of a procrastinating leader.”

The study was published in the Journal of Occupational and Organizational Psychology.

Source: University of Exeter

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Mediterranean Diet May Reduce Stroke Risk in Middle-Aged Women

A new U.K. study finds that adhering to a Mediterranean-style diet can significantly lower the risk of stroke in women over the age of 40, regardless of menopausal status or hormone replacement therapy.

A traditional Mediterranean-style diet includes a high intake of fish, fruits, nuts, vegetables, cereal foods and potatoes and reduced meat and dairy consumption.

The research, published in the journal Stroke, is one of the largest and longest-running efforts to evaluate the potential benefits of the Mediterranean-style diet in lowering risk of stroke.

Over a 17-year period, researchers from the Universities of East Anglia, Aberdeen and Cambridge examined 23,232 participants’ diets and compared stroke risk among four groups ranked highest to lowest by how closely they adhered to a Mediterranean style diet.

Study participants (Caucasian, ages 40 to 77) were from the EPIC-Norfolk study, the United Kingdom Norfolk arm of the multicenter European Prospective Investigation into Cancer study.

In participants who most closely followed a Mediterranean-style diet, the reduced onset of stroke was:

  • 17 percent in all adults;
  • 22 percent in women; and
  • 6 percent in men (which researchers said could have been due to chance).

“It is unclear why we found differences between women and men, but it could be that components of the diet may influence men differently than women,” said Ailsa A. Welch, Ph.D., study lead author and professor of nutritional epidemiology at the University of East Anglia, United Kingdom.

“We are also aware that different sub-types of stroke may differ between genders. Our study was too small to test for this, but both possibilities deserve further study in the future.”

The researchers also found a 13 percent overall reduced risk of stroke in participants already at high risk of cardiovascular disease across all four groups of the Mediterranean-diet scores. However, this was driven primarily by women who showed a 20 percent reduced stroke risk. This benefit appeared to be extended to participants in the low risk group although the possibility of a chance finding cannot be ruled out completely.

“Our findings provide clinicians and the public with information regarding the potential benefit of eating a Mediterranean-style diet for stroke prevention, regardless of cardiovascular risk,” said Professor Phyo Myint, M.D., study co-author and former British Association of Stroke Physicians Executive Committee member, University of Aberdeen, Scotland.

“A healthy, balanced diet is important for everyone both young and old,” said Welch.

The study used seven-day diet diaries, which the researchers said had not been done before in such a large population. Seven-day diaries are more precise than food-frequency questionnaires and participants write down everything they eat and drink over the period of a week.

Research suggests that having a stroke can increase the risk of anxiety and/or depression. Depression affects between one- and two-thirds of stroke survivors, according to the American Stroke Association.

Source: American Heart Association

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