Possible New Class of Antidepressants?

To give the reader some context in order to grasp the significance of the issue of a possible new class of antidepressant medications, I would offer the following points of information.

First, in spite of 30 years of hype and advertising by the pharmaceutical industry and especially the companies who have one by one introduced and advertised the so-called modern, or serotonin-based antidepressants, not much progress has been made in the actual efficacy of treating major depressive disorders with these medications. When the serotonin-based antidepressant medications started to emerge in the marketplace, the armamentarium of the psychiatrist and family physician, in the realm of novel pharmaceutical based advertising on Western television, the mode of action on a supposedly new neurotransmitter system was greatly hailed as a modern breakthrough. Serotonin actually is been known since the 1950s and the neuroscience circles in general.

Second, the only advance that was basically made was a reduction in the anticholinergic side effects of the previous generation of antidepressant medications. These the side effects are largely antihistamine. This means that they make nearly all mucous membranes and dry. This accounts for their marketed value in treating and controlling the symptoms of runny noses and watery eyes of viral colds and pollen allergies. These side effects present in the antihistamine medications and “try cyclic” antidepressant medications also cause decreased propulsion in the gastrointestinal tract, meaning the longer transit time for food and waste material through the small and large intestines. The longer that the foodstuffs and wastes stay especially in the large intestine, the more time there is for reabsorption of water from the stool. This makes for hard stool and consequently the long known constipation with all these medications. These same anticholinergic side effects can also affect heart rate and decrease blood pressure. The latter side effect is very problematic in the elderly and can cause lowered blood pressure upon standing and consequently falls in the elderly with alarming frequency and subsequent injuries such as hip fractures.

Continue reading

Advertisements

Diagnosing Us Via Our Emails?!

In a very well written, succinct article Dr. Alan Hofmann, an internist of Preventia Clinics in Saint Jerome, Canada, wrote relatively of recent but little-known efforts to use AI [Artificial Intelligence] to key in on mental illness flags in emails. As alarming as this might sound initially, the article surprises the reader by quickly informing that there have been well-intentioned efforts to help crisis clinics and services to identify potential high-risk contacts who might need urgent services.

I have to quote Dr. Hofmann’s definition of this phenomenon as he conveys the notion far better than I can: “A series of emojis, words, actions or even inactions can communicate how you feel at a given moment and when collected over time, comprise your “socionome” — a digital catalogue of your mental health that is similar to how your genome can provide a picture of your physical health.”

His article, “What happens when an algorithm labels you as mentally ill?,” appearing in this week’s WorldPost publication, a service of the Washington Post, discussed somewhat playfully [in my interpretation to be clear] extending this effort into the area of diagnosing anyone psychiatrically by running emails through an AI app or program that would flag designated codewords that could be associated with depression, suicide risk etc. Dr. Hofmann wrote that, lo and behold, this HAS been done on a larger scale than any of us would have thought…Microsoft Research and some crisis clinics have done some preliminary work trying to craft programs or apps to facilitate real-time identification of callers in distress.

The latter half of the article went on to discuss that the level of accuracy was only around 70% in associating certain words with depression. Interestingly, it emerged that even innocent words such as “ibuprofen”  could be linked with suicide or overdose risk on mental health hotlines. Seventy percent concordance sounds pretty impressive but the author helps the reader to learn that in the world of mental health, psychology and all, this does not constitute very good predictability at all, and is barely above “a coin toss.”

But I got to thinking about all this as my sneaky, weasel-like, conniving mind started inevitably whirling around the possibilities. In my personal deranged computing life, I suddenly remembered that my voice dictation software is always asking me to permit analysis of all my documents and emails! Egads! If I consented would it diagnose me? Likely not, but it certainly might gang up with my handy-dandy super trustworthy grammar correcting program and send me back to a freshman English composition course.

But this personal, in-my-computing-space reminder got me to thinking even more so about the implications.

We all take for granted that the NSA and all the mind-boggling spy networks analyze our phone calls and emails for “bad words” that have to do with the War on Terror. These words I imagine are things like bomb, blow up, kill the Infidel, and so on. When I was a kid during the Cold War, words/phrases like dirty Capitalist pig, Molotov cocktail, bourgeois and such would have brought the attention of the FBI and CIA to “Commies” and student radicals in the 1960’s and 1970’s.

Closer to home for those who are on Facebook™ [I no longer am for many reasons which I will rant about here] ‘consent’ to having posts analyzed for use by advertisers for targeting ads constantly to one’s views of posts, photos etc.

Twitter may do much the same thing, I am not sure. Tweets seem to me, in general, to be more unrestrained and loose-lipped with more gutter language and “F-bombs” than anywhere I go on the Internet. What if the ‘mental health diagnosing’ apps were set loose on twitter by enterprising wags, or hackers, or smear artists, “trolls” in today’s lingo for blackmail purposes. Or by ill-tempered political types in an effort to smear tweeters with whom they disagreed politically?

Granted this kind of idea seems ludicrous to me and bourne of ‘hair on fire’ kind of media exaggeration/hysteria that could emerge from any Right or Leftist fringe territory. Then again I thought this could be a “good thing” if we could have our own personal mental health screener app. One would purchase and install it in your browser. You could then program it yourself to screen for words or code phrases that you found distasteful or not in line with your political or social-cultural views and tag those tweets for exclusion.

But then one would further aggravate the silo’ing that we face in only reading and contemplating views consistent with our own preferences. And that is NOT a good thing in my view. It only reinforces echo chamber based discourse, further dividing us politically and “every which-a-way” from engaging and ‘building bridges’ of understanding, if that is still possible.

Or given the mudslinging, insult-driven tenor of our times, one could use such “linguistic” grading of tweets to label the posted sentiments of others as “unbalanced,” or “mentally ill” according to one’s own prejudicial scoring system. I can see it now, a genre of tweet replies along the lines of “well my app shows you score 84% on the skreptomaniac scale!”

And the cycle of anger, flame wars as they were called in the early days of “Bulletin Boards” would continue and do our national no good whatsoever.

And lastly, I am sure that opponents of our President would run their mental health scoring apps on Trump’s all too over the top tweets and move armchair, unethical, misplaced psychiatric diagnosing into new stratospheric levels of absurdity worthy of publication in my long-time favorite past journal of satire, The Wormrunner’s Digest from Dr. James V. McConnell of the University of Michigan in the days of Mort Sahl and the Golden Age of Satire.

 

 

 

Marijuana and Sesame Street?

No, this is not some tell all that the entire staff of Sesame Street, that most beloved of tv childhood icons (certainly in my family with about three sets of kids have learned from it!), were all stoned. So not like our most famous space saga franchise in which some of the major players spent their filming days stoned etc., which was a bit disillusioning to learn…oh well.

I have for a period of time followed a superb blog on the history of drugs and substance abuse. It appeals to the history bug/buff/geek/triiva-guy in me for one thing. But it is also fascinating beyond words. It has set me ‘aright’ on a number of misconceptions I had in my lifetime before and after my medical education. The blog is “Points: The Blog of the Alcohol and Drugs History Society.” Yes, there is such a society, it was news to me too.

The post that caught my eye this date, August 16, 2018, is “Hidden Figures of Drug History: Joan Ganz Cooney.” Who, you might ask is Joan Ganz Cooney? I had forgotten who she was, but I did remember her name. Only when I started reading the post did her personage come back to me.

Ms. Cooney was the founder, innovator, and driver behind The Children’s Television Workshop and Sesame Street. As a child psychiatrist-developmentalist and parent, I have to state my disclaimer that I have admired Sesame Street for decades and cannot say enough good about it. As much as Head Start and other similar early childhood educational movements, it has benefitted our preschoolers beyond measure for generations. (Even more than Barney…).  Her storied accomplishments are highlighted and recounted in the article. I was dutifully reminded of how important this woman was to America.

The post though has a different emphasis that was surprising beyond words.

Ms. Cooney’s service on the now largely forgotten “Shafer Commission” of the Nixon Presidency is highlighted. This article is worth reading for anyone interested in (drum roll please…): Nixon, legalization-decriminalization of pot, Watergate, the fate of federal reports that displease a President, and other fascinating tidbits one never would anticipate aforehand.

So no more spoilers, feel free to read this post, it is a true rare gem.

 

 

Mourning the Loss of The Aliens

DNA in space
“Life in Space”

Fairly recently some of our better known big shot thinkers like Elon Musk have begun to give voice to the growing idea that we should STOP looking for aliens in space.

The underrepresented public segment in the space and sci-fi communities read this sort of commentary in the esoteric scientific and sci-fi (there is less and less difference nowadays?) media in order to have an intellectual sort of escapism reading to be cognitively relieved of the relentless deluge of Trump-related news and vitriol from all sides of our so-called body politic. Other social demographically classified persons read of this burning issue such as space geeks, diehard Star Trek fans and their contentious Star Wars upstarts, and not to forget NASA government types who battle for funds for those oversized space radio receivers we tend to place in areas needing beer joints and economic development such as God-forsaken spaces in New Mexico and Australia.

The organizing idea seems to be that something called the “Fermi Paradox” has taken over space and alien related discussion sites, is that there is an increasing likelihood that there is likely no life OUT THERE. Other than us. And I thought this Fermi Paradox was all about the A-Bomb development in the Manhattan Project, that it was thought in those days, atomic power was nice and socially helpful and lo and behold turned out to be just another Defense Department awesomely scary military weapon.

Putting aside all the statistical and other abstract bases for the theorizing that there is no alien life virtually anywhere, I found myself mulling over the socio-cultural repercussions of this not quite cataclysmic news. This may not be as trivial as one might at first surmise. After all, why could the declaration of the NON-existence of something that has never been manifest in our world be such a Big Deal? It is akin to saying that purple bears do not exist in the unexplored areas of the Amazon. Or that Stanley no longer needs to search for Livingston’s never born twin. I mean, saying that something that has not existed does not need any further searching is not earth-shattering news.

I found myself further considering that this whole seemingly waste of time and billions of dollars of research, was not a waste but a “good thing,” because what if the great classical discoverers of modern times had decided there was “no sich-a thang as ‘lectricity” and not tried to shock themselves with lightning bolts or ignored getting shocked after scooting across a wool rug. We would be still locked in the ages of campfires and polluting coal furnaces in every room and have no egad, computers or tv!! We would have been spared bad movies about listening to outer space and watching Jodie Foster try to make a bad flick entertaining…At least we won’t spend billions looking for purple Russian bears I suppose.

There are though definite quarters for whom this apparently issue now deemed without importance is important. For instance, just to name a few, all the NASA scientifist and alien searching agenices and their funding, tin foil hat types, Area 51 devotees (now reclassified in the category of ‘there is no there there;), alien genre movie scriptwriters and so on. Some of those sectors command huge budgets. Those folks may lose jobs. And they and their families might be destitute. I can see the new class of highway handout folks now, “Space Scientist Willing to Tutor New Math Homework to Your School Child.”

The cinematic industry will take a huge hit. A category that previously sucked in scare seeking teenagers wishing to sneak a hug in the dark protective anti-chaperone theaters will disappear. Summer alien mongering movie revenues will dip. Democratic political office seekers will have to reduce by a corresponding percentage the L.A. based PAC donations they count on every two years.

Back to Elon Musk for a moment. This public figure is drumming up support for funding from the government, meaning US, for his idea to Colonize Far Reaches of Space. His argument is that we are trashing the Earth so badly that we have to move to a new Cosmic Neighborhood that has better water and air.

But he has an inherent conflict of interest. He is plugging his Space X venture. He is generataing free publicity so that us Earth Bound Rubes will sign up for trips and generate revenue. Sir Richard Branson is doing much the same thing, though he does not rail so much about pollution and play upon our fears of survival. He is just a business man whereas Musk is a visionary! I concluded long ago that “visionaries” were all hucksters like P. T. Barnum and much more dangerous. I think that Musk would be better served if his publicity campaign for space travel and colonization went like this.

‘You Don’t Have to Worry About Aliens’ like the ones that nearly ate Sigourney Weaver in all those signature “Alien” movies. There are no more giant lizard like aliens out there with flesh eating heads inside of heads! The only tongue sucking beings you will have to worry about will be deep French kissing hotties. Without their bubble headed space helmets of course.

And the NRA will be able to save years of any new PR campaign inveighing against home invasion by aliens from space.

And homeowners can stop paying for sky directed anti-burglary nightlights to scare off aliens sneaking into their backyards from the sky.

And I can stop writing whimsical blog posts on rampaging aliens and get back to truly boring, mind numbing psychiatric articles…

 

The Active Shooter Controversy

Just two days ago I became aware of the controversy over a new version of the very popular video game “Active Shooter.” The game’s designers have included a module/section/world–whatever that permits the player to select a school shooter experience. As predictable, instant outrage has erupted everywhere in the media. My reaction was typical I suppose, thinking things like this is not appropriate, this is the height of bad taste, how could anyone be so heartless/clueless etc. My second line of reactions centered on anyone who has suffered trauma from school shootings lost someone to such incidents etc.

Then I realized that my son and I have this game and have played for a few years. He is my last “yearling” as I sometimes call him, near graduation, avid video game player since his youngest days with a Nintendo DS etc. I also realized that this kind of game and this game itself is one of the few I can master. I can shoot bad guys and terrorists through the rifle’s sights. I can hold my own in car racing games, Donkey Kong, and older generation games. All these have the forgiving characteristic that the controls are very simple; anything more complicated and I cannot keep up or play at all. After a few years of trying and occasional exasperated tutoring from my son, it has been clear to him for a long time, I have maxed out my hand-eye, and hand finger coordination and dexterity and I will never ever get beyond a certain level. So when he buys a new game, he will say, “Dad this is too hard for you (too, like all the others).” When we peruse the new games highlighted in his various game magazines, he will point to some fluff or “baby” game and tease me that this is one I can handle.

So this is my confession, the one person shooter, sniper type games are ones I can handle in my gaming dotage, and this game I enjoy and like. Gets out my aggression harmlessly etc. I also take goofy solace in thinking that if all kids are as skilled as my son and ALL his friends are on this type game, the Taliban do not stand a chance if they invade here. First, their gun-owning fathers will wipe them out and the sons will take care of the second wave as all dads would look on with pride. I am safe here and video games probably help to make it so…

But this issue of treating school shootings so cavalierly has ‘crossed the line’ for almost all of us. It was inevitable this would happen in our take any opportunity to make money society I suppose. I do not think that somehow trivializing school shooting into a widely loved video game will subtly train teens to not do such horrific acts. So no, I do not see some noble methodology of prevention at work here.

Continue reading