Vitamin D: The New Anti-Depressant?

Depression; often thought of as this “dark, inescapable place. Like being locked in a room with no light, windows or door. It's so dark you can't even see your hands in front of your face let alone find a way out."

Stuart Shankman spoke at Loyola University Chicago about his research he and his fellow colleagues had been conducting pertaining to the comorbidities and in particular that of depression and anxiety. Dr. Shankman going so far as to find these distinguishable characteristics between anxiety disorders and depression and then follow suit with figuring out whether the heightened sensitivity to threat was specific to panic disorder (PD) and whether a reduction in sensitivity to reward was specific to major depressive disorder (MDD). Once they gathered their information from the tests, they concluded that both PD and MDD can occur one without the other and have their own specific characteristics. The importance of this is to know that in regards to abnormal Frontal Electroencephalographic (EEG), it is written that the asymmetry of the EEG would be a better “indicator of affective processes and a marker for depression.” In terms of PD it has always been said that the abnormality of the frontal EEG as associated with anxiety, however Shankman and his colleagues demonstrated that this is not the case.

Furthermore, Dr. Shankman et al. concluded that while the research domain criteria (RDoC) and their research framework for the studying of mental disorder is in good spirits, it continues to demonstrate “discriminant validity” when analyzing pathological constructs and that their domains are too narrow. By expanding the levels of dimensions of the RDoC, one would have a clearer determination of both the similar and different constructs and neurobiology.

Therefore as it is mentioned in the article, if comorbidities are the norm then why not examine the possible relationship between a lack of vitamin D in the body and depression onset as a possible contributor to the cause in some cases depression? In a given year, approximately 14.8 million adults age 18 or older are affected each year by depression, so wouldn’t we want to explore new ways into treating this common disorder that go beyond the mainstream therapies?

The Endocrine Society released an article in 2012 relating to a case study of three women aged 42-66, all who had been diagnosed with major depressive disorder. Dr. Sonal Pathak argued that “Vitamin D may have an as-yet-proven effect on mood, and its deficiency may exacerbate depression. If an association is made present, we may see an improved treatment of depression.”

For the three women he examined, he tested them on a 25-hydroxyvitamin D blood test. Each woman had a low level of vitamin D, roughly 8.9-14.5 nanograms per milliliter (ng/mL). According to The Endocrine Society, the normal range for vitamin D levels are above 30 ng/mL.Afterwards these women underwent an oral vitamin D replacement therapy for between 8-12 weeks. Once finished, these women’s vitamin D levels increased to a range of 32-38 ng/mL. Using the Beck Depression inventory all three women previously diagnosed with moderate to severe depression, were now diagnosed with minimal to mild depression.While Dr. Pathak suggests that more research needs to be done in regards to the causal relationship between vitamin D levels and mood and depression, there clearly is a link between them.

Researchers from an international partnership from the University of Georgia, the University of Pittsburgh and the Queensland University of Technology took this study one step further and analyzed the relationship between Seasonal Affective Disorder (SAD) and the lacking amounts of sunlight. 

They concluded that there was likely a relationship to vitamin D being a contributing factor to seasonal depression. Their evidence is supported by the fact that vitamin D levels do fluctuate in the body seasonally, which is in direct relation to the amount of seasonably available sunlight. Especially given the fact that vitamin D is a key component in the synthesizing of dopamine and serotonin within the brain.

Relating this back to Dr. Shankman’s presentation, one needs to look at the comorbidities oftentimes unknown in order to fully address the health needs of a patient. Both articles by Dr. Pathak and the University of Georgia researchers offer differing recommended levels of vitamin D; 30 ng/mL from the Endocrine Society and 20 ng/mL U.S. Institute of Medicine respectively.This indicates that within a 2 year period of time, researchers are still in need of trying to solve what the relationship between vitamin D levels and depression is.

Articles:

https://www.sciencedaily.com/releases/2014/12/141202111148.htm

https://www.sciencedaily.com/releases/2012/06/120625152358.htm

http://www.huffingtonpost.co.uk/danny-baker/depression_b_5267263.html

Pictures:

https://www.psychologytoday.com/blog/reading-between-the-headlines/201307/vitamin-d-deficiency-and-depression

http://www.watercures.org/vitamin-d-depression-and-water-cures.html

Sources:

Endocrine Society. "Treating vitamin D deficiency may improve depression." ScienceDaily. ScienceDaily, 25 June 2012. <www.sciencedaily.com/releases/2012/06/120625152358.htm>.

University of Georgia. "Vitamin D deficiency, depression linked in international study." ScienceDaily. ScienceDaily, 2 December 2014. <www.sciencedaily.com/releases/2014/12/141202111148.htm>. 

Shankman, S., Nelson, B., Sarapas, C., Robison-Andrew, E., Campbell, M., Altman, S., . . . Goodman, Sherryl. (2013). A Psychophysiological Investigation of Threat and Reward Sensitivity in Individuals With Panic Disorder and/or Major Depressive Disorder. Journal of Abnormal Psychology, 122(2), 322-338. 

Are Electronic Cigarettes a Good Way to Quit Smoking?

 More laws are being passed on banning the use of cigarettes in both public and private places, but the addictive component is not so easy to ban, as nicotine is one of the most addictive substances in the world. Researcher Daniel McGehee gave a talk for the Neuroscience Seminar at Loyola University Chicago this past February and posted an article with Danyan Mao and Keith Gallagher titled: “Nicotine Potentiation of Excitatory Inputs to Ventral Tegmental Area Dopamine Neurons.” The article discussed how "nicotine activates nicotinic receptors (nAChRs) to initiate a series of adaptive changes at the cellular and circuit levels in brain, particularly the ventral tegmental area" (Dao, Gallagher, McGehee). His research found that exposure to nicotine over longer periods of time induce a plasticity in the brain which makes the nicotine even more addictive than when it was initially exposed, even in small quantities.

As the dangers of prolonged use of tobacco have been publicized for years, many people have been attempting different methods of quitting to avoid lung cancer and other harmful diseases caused by smoking. In the past few years, the new Blu electronic cigarettes have been on the market to make it easier for people to quit cigarette smoking, as there is less nicotine in these vapor-producing devices. However, a concern has surfaced that perhaps the exact opposite may occur, making the Blue e-cigs a culprit behind the difficulty of quitting.

According to The Atlantic article "The Nicotine Fix," people think they are consuming a lot of nicotine with these e-cigs, however, there is only a small amount that will line a person's mouth and throat, which makes absorbing the nicotine into the bloodstream a slow process. People will use these e-cigs at work during periods where they can't actually smoke. "By sustaining their nicotine blood levels, the products will actually keep their addiction going, and they'll continue to use cigarettes the rest of the day. Were the alternative products not available, the argument goes, these smokers would be more likely to quit altogether. Research has established, for instance, that smoke-free workplace policies increase quitting" (Warner and Pollack). As McGehee had mentioned, longer exposure to the nicotine creates changes in the brain that produces greater pleasurable effects than the time before. People who smoke cigarettes are likely to use these electronic cigs at work in between their breaks, as there is not enough nicotine to stimulate their receptors and induce the excitatory synapse to the degree of regular cigarettes. There is also a concern by THR (Tobacco Harm Reduction) critics that using smokeless tobacco products will cause people who have quit to relapse, however there is not enough evidence to support these claims.  

If you are looking to quit cigarettes, it may be advisable to avoid the Blu e-cig. Better to stay safe than sorry.

Article: http://www.theatlantic.com/national/archive/2014/11/the-nicotine-fix/382666/

Pictures: https://www.google.com/search?q=blu+e+cig&biw=1152&bih=595&source=lnms&tbm=isch&sa=X&ved=0ahUKEwi4_LGZ45vLAhWkw4MKHfwJCx0Q_AUIBygC#imgrc=3jPn9u7anmdIeM%3A

https://www.google.com/search?q=cigarettes+in+workplace&biw=1152&bih=561&source=lnms&tbm=isch&sa=X&ved=0ahUKEwiBt4qO7JvLAhXFtYMKHThJCB8Q_AUIBigB#tbm=isch&q=cigarette+affecting+brain&imgrc=Zzg93LQ67WQCuM%3A

Citation:

Warner, Kenneth E., and Harold A. Pollack. "The Nicotine Fix." The Atlantic. Atlantic Media Company, 13 Nov. 2014. Web. 28 Feb. 2016.

Nicotine: Eviction of the Addiction

              Danyan Mao, Keith Gallagher, and Daniel S. McGehee studied nicotine and its role in the brain and published an article titled “Nicotine Potentiation of Excitatory Inputs to Ventral Tegmental Area Dopamine Neurons” and McGehee gave a lecture on the topic to a Neuroscience Seminar course at Loyola University, Chicago.  Nicotine activates nicotinic receptors that create changes in the ventral tegmental area of the brain.  So what does this mean?

            Nicotine is the addictive substance found in cigarettes and cigarettes lead to roughly $440,000 deaths just in Americans each year.  In an article written by Gregory Lande for Medscape it is stated that nicotine addiction is the second leading cause of death in the world.   Nicotine affects the body by increasing heart rate, blood pressure, and weight loss.   Along with these physical effects nicotine also has behavioral effects such as more alertness, accelerated speech, and a feeling of being frantic and irritable. 

Lande describes nicotine as, “It meets the criteria of a highly addictive drug, in that it is a potent psychoactive substance that induces euphoria, reinforces its own use, and leads to nicotine withdrawal syndrome when it is absent.”

Your body becomes dependent on this substance and when it is without it you experience withdrawal symptoms which are removed once your body receives that nicotine again.

              While tobacco and nicotine use is the second leading cause of death in the world, it is also the greatest preventable cause of death in the United States.   There are various methods for breaking the nicotine addiction, one is called nicotine replacement therapy or NRT.   This is exactly what it sounds like, nicotine from tobacco is being replaced with various products/methods such as nicotine inhalers, transdermal nicotine patch, nicotine nasal spray, nicotine gum, and more.  There are also methods which are non-nicotine pharmacotherapy.  There are medications such as bupropion and varenicline which research has shown are very effective and efficient in stopping smoking.

              Bupropion works by removing the symptoms which are associated with nicotine withdrawal.  Varenicline also works in this way however it is a more risky choice of medication because it has been linked to cardiovascular problems.  The two medications are often used together and have proven to be most effective.

              Overall it is a fairly common fact that smoking is bad for you.  So why do people continue to do it and struggle so much with quitting?  The nicotine found in cigarettes leaves your body addicted and craving the substance which is a vicious and dangerous cycle.  There are various developments in science and medication which helps to cure the addiction of nicotine and ways of receiving nicotine without the horrendous side-affects that come with smoking.

Links

Article: http://emedicine.medscape.com/article/287555-overview

Pictures: http://www.trc-canada.com/prod-img/N412420.png

https://committedquitters.nicodermcq.com/PageFiles/990/truth_about_nicotine_02.jpg

Citation

Lande, Gregory R., DO, FACN. "Nicotine Addiction." : Practice Essentials, Background, Pathophysiology. Ed. Eduardo Dunayevich. Medscape, 2013. Web.

Once a Smoker, Always a Smoker?

There are over 23.5 million Americans that are addicts. Common addictions are cocaine, marijuana, painkillers, and alcohol. However, more individuals in the United States of America are addicted to nicotine than anything else.  With over 40 million nicotine addicts in the U.S., nicotine addiction has become a major issue, especially due to the correlated health effects from chronic use of nicotine. Heavy users of nicotine are more likely to develop heart disease, stroke, and lung cancer.

Daniel McGhee spoke at Loyola University Chicago about the research his fellow colleagues and him conducted which provided additional evidence of the effect of nicotine. Dr. McGhee mentioned that activation of nicotinic receptors via nicotine, cause the brain activity to activate which can be both rewarding and addicting for the brain. In fact, after exposing “nicotine to brain slices from drug-Naïve adults rats” with a recovery period, “ it was noted that there was “NMDA receptor (NMDAR)-dependent increase of AMP receptor/NMDAR ratio in VTA DA neurons, which is consistent with the induction of LTP.” In other words, the experiment conducted by Dr. McGhee and his colleagues, noted that even after a miniscule amount of exposure to nicotine, AMPA/NMDA ratios within the VTA increase.  In fact, Dr. McGhee mentioned that plasticity of the brain begins to occur after 2-4 of nicotine exposure. Thus, if an individual is chronically using nicotine, ratios of AMPA/NMDA will increase which will cause the brain to become addicted to nicotine.

Once the brain becomes addicted to nicotine, it becomes hard for an individual to quit using nicotine. In the journal of Diabetes Care, Dr. David Mannino, mentions that activation of nicotinic receptors leads to positive effects such as “pleasure, arousal, and the reduction of anxiety and tension”. However, habitual use of nicotine will also result in “both a desensitization of these receptors to nicotine and an increase in the number of receptors”.  Yet, when and individual tries to quite “desensitized receptors may recover and elicit symptoms of withdrawal” such as “irritability, depressed mood, anxiety, difficulty concentrating, insomnia, and caving”. Thus, these changes prompt an individual to use nicotine again. In fact, in a recent study it was calculated that there is an 80% relapse rate within the first month of quitting nicotine.

References:

Dr. Daniel McGhee’s Presentation on February 23, 2013 at Loyola University Chicago

Article 1: http://care.diabetesjournals.org/content/32/suppl_2/S426.full

Picture 1: https://static-secure.guim.co.uk/sys-images/Guardian/Pix/pictures/2012/11/30/1354283386179/smoking-addiction-008.jpg

Picture2: http://static1.squarespace.com/static/54db756ae4b0cf15c28e7b8a/t/54e21e30e4b0bb15dcacc4c9/1424105009889/tumblr_mlsetsKySj1rkz363o4_1280.jpg

It Takes One to Become Addicted

              More people in the United States are more addicted to nicotine than any other drug including heroin or even alcohol. Nicotine addiction has become a big issue in the United States in terms of heavy smokers having lung cancer and deaths related to lung disease or heart failure, that were caused by smoking.

According to Dr. Daniel McGhee, nicotine activates nicotinic receptors, which then activate brain activity and can be rewarding and addicting for the brain. In his presentation at Loyola University Chicago he states, “Brief exposure of nicotine to brain slices from drug-Naïve adult rats followed by a period of recovery resulted in an NMDA receptor (NMDAR)-dependent increase of AMPA receptor/NMDAR ratio in VTA DA neurons, which is consistent with the induction of LTP”. Which means, from the experiment he conducted, he had noticed that even after a single exposure to nicotine, there is an increase in AMPA/ NMDA ratios in the VTA. Which can build up over time and cause the brain to become addicted to nicotine to feel the pleasure it felt when nicotine was injected the first time. According to McGhee’s research, plasticity starts to occur after about 2- 4 hours after consumption of nicotine.

ABC news reported the same finding in terms of nicotine addiction like symptoms occurring immediately after the first or second use. Dr. Richard Hurt, director of the Nicotine Dependency Unit at the Mayo Clinic, confirms that they have proven that from his research teenagers showed evidence of addiction after they had their first cigarette (.”(“Study: Nicotine Addiction Can Be Immediate” 2015). ABC news reported that addiction also depends on who is consuming nicotine, the amount of intake, and the susceptibility of the consumer. According to the Mayo clinic research, “Ninety-five of the youths said they had started smoking occasionally — at least one cigarette a month — during the study. The scientists found that 60, or 63 percent, had one or more symptoms of addiction.”(“Study: Nicotine Addiction Can Be Immediate” 2015). Which of these symptoms actually occurred within 2-3 days after the research began. Addiction symptoms can be cravings, withdrawal, addiction to tobacco substances, and not being able to control one’s emotions towards nicotine.

ABC news stated, “It is also possible that adolescents could be more sensitive to nicotine and that addiction may take longer in people who start smoking at a later age”(“Study: Nicotine Addiction Can Be Immediate” 2015). This can relate to the idea of plasticity from Dr. McGhee’s presentation.  In adolescents, plasticity occurs at a higher rate because the brain is still not fully developed and thus more sensitive to drugs, nicotine being one. Adults have a fully-grown brain, and thus plasticity doesn’t occur as intensively as in children or teenagers.

 

If teenagers continue to consume nicotine they will be killing themselves. Nicotine can cause cancer, especially lung caner, since nicotine is found in cigarettes. United States has many heavy smokers and they need to realize that it takes only one to ruin the rest of their life. Addiction is a permanent pain to overcome, but only a temporary pleasure.

References:

Article:  http://abcnews.go.com/Health/story?id=117976&page=1

Picture 1: http://abcnews.go.com/Health/Wellness/alabama-tops-list-states-addicted-smoking/story?id=20707318

Picture 2 https://archives.drugabuse.gov/NIDA_Notes/NNVol20N2/Site.html

Picture 3 http://drantoniohowell.com/demystifying-nicotine-withdrawal-symptoms/

Picture 4 : http://www.todayifoundout.com/index.php/2013/07/why-is-nicotine-addictive/