TIME Research

Can Antidepressants Be Safe for Kids?

A new study looks into how antidepressants can best be used to help kids quickly without initial side effects

Currently, antidepressants carry a “black box warning” cautioning people that the pills can cause an increased risk for suicidal thoughts and behaviors. But researchers in a new study published in the journal Translational Psychiatry have taken a closer look at what exactly is causing these behaviors, and how to avoid them.

The warning was first affixed to antidepressants 10 years ago, after the U.S. Food and Drug Administration (FDA) determined that a phenomena of increased “suicidality”—which means suicidal thoughts and behaviors, as opposed to actual suicide—could occur in young people who begin taking antidepressants.

As TIME has previously reported, many in the psychiatry community were upset by the addition of the warning, saying it discourages prescribing the drugs to people who need them. Depression is the greatest risk for suicide, not antidepressants, they argue.

In the new study, researchers decided to take a closer look at what exactly was happening when young people started on antidepressants. It’s been known for some time that often, when people take antidepressants, the individuals’ symptoms can get worse before they get better. Dr. Adam Kaplin, an assistant professor of psychiatry and neurology at the Johns Hopkins University School of Medicine and his colleagues looked closely at this period, and how this adjustment period might be mitigated in young people.

Serotonin re-uptake inhibitors (SSRI) cause serotonin levels to rise. But there is a receptor in the brain called the 5-HT1AR, which acts like a break and prevents this from happening. Eventually, the receptor regulates, and allows serotonin levels to increase, but before that happens, patients can feel worse. The researchers tested this with mice, and showed that mice became anxious when they were first given an SSRI. But when the researchers gave these mice drugs that blocked the 5-HT1AR receptor in addition to the SSRI, the mice fared better.

“Not only did it completely reverse that anxiety, it made them less anxious than they were at baseline. It made the SSRI’s positive effects kick in almost immediately,” says Kaplin.

Currently, fluoxetine (Prozac) is the slowest-acting SSRI, and the only one approved for kids ages 8 to 12, the authors say. The researchers used a computer simulation to determine how long the adjustment period is for other types of SSRIs as well. They found that starting with half the normal dose and slowly increasing to the full dose over the course of a month was the best strategy for limiting the downside that comes with the adjustment period.

The researchers say they hope their study sheds light on what’s happening when kids start on antidepressants, and what an appropriate dosing strategy may look like. “We are saying, Look, these drugs are perfectly safe once you understand them, and you understand that you have to start them low and go slow or add something that blocks the 5-HT1AR receptor,” says Kaplin. “We are trying to say this is not a mystery. We understand the mechanism.”

Currently there are no drugs that effectively block the 5-HT1AR receptor in the way the researchers would like, but Kaplin says they are looking for a company that may be interested in developing one for human use.

 

TIME Research

See How What Makes Us Happy Has Changed Over the Past 80 Years

Man jumping in mid air on beach
Daniel Ingold—Cultura RF/Getty Images

These days we consider good humor and leisure time to be crucial to our happiness

Psychologists from the University of Bolton in the U.K. have re-created a famous study conducted in the same town almost eight decades ago that sought to find out what made people happy.

In 1938, an advert was placed in the local paper asking readers “What is happiness?” reports Science Daily. After rating the importance of 10 factors from 226 people, researchers found that people believed security, knowledge and religion were the most important aspects of happiness.

Last year, Sandie McHugh and Professor Jerome Carson repeated the social experiment and found that while security was still in the top three, good humor and leisure came in poll position.

Meanwhile, religion, which was the third most important factor in 1938, has fallen to the bottom of the current list. In 1938, most people said they were happiest at home in Bolton, whereas today 63% said they were happier away from the town.

One factor that hasn’t changed, though, is the importance people place on luck — 40% believed good fortune was vital to their happiness both back then and in 2014. And in both eras, most people said they didn’t think happiness was related to material possessions and wealth.

“The overall impression from the correspondence in 1938 is that happiness factors were rooted in everyday lives at home and within the community,” said McHugh. “In 2014, many comments value family and friends, with good humor and leisure time also ranked highly.”

[Science Daily]

Read next: 7 Easy Happiness Boosters According to Harvard Research

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TIME animals

Gigantic Whales Eat Huge Amounts Thanks to ‘Bungee-Cord’ Nerves

Humpback whale breaches 3 miles off of Rockaway Beach on August 31, 2014 in New York City
Artie Raslich—Getty Images Humpback whale breaches 3 miles off of Rockaway Beach on August 31, 2014 in New York City

The discovery was an accident

Rorqual whales (blue, fin, humpback among others) are not only the world’s largest animals but when they eat they open their mouths to such an extent that they are capable of ingesting a volume of water larger than their own bodies. On Monday, scientists from the University of British Columbia explained how they do this — stretchy nerves.

“These large nerves actually stretch and recoil like bungee cords,” A. Wayne Vogl, an author of the study to be published in May in the journal Current Biology, said in a press release.

Normally, a firm collagen wall surrounds nerves and if stretched they become damaged. For example, humans can suffer from “nerve stretch injury.”

In rorqual whales, the nerves are packed into a centralized core surrounded by limber “elastin fibers.” When the whale opens its mouth the design enables the nerve fibers to unfold. The feeding whale will then gulp-up floating prey before the nerve snaps back and the sea water is filtered through baleen plates in its mouth, leaving behind a massive quantity of small prey.

What’s more, the discovery was an accident. A team member picked up what he believed to have been a blood vessel and stretched it. But upon closer examination the researchers realized that the blood vessel was in actuality a nerve.

The scientists plan to keep studying the whales in the hopes to better understand the folding and unfolding process.

TIME Research

Parents May Pass On Sleepwalking to Their Kids

Somnambulant parents likely to have kids who walk in their sleep too

Kids are more likely to sleepwalk if their parents also did, a new study suggests.

The new research, published in the journal JAMA Pediatrics, found that over 60% of kids who developed somnambulism had parents who were both sleepwalkers.

The study authors looked at sleep data for 1,940 kids whose history of sleepwalking and sleep terrors (episodes of screaming and fear while falling asleep) as well as their parents sleepwalking were reported through questionnaires.

The data showed that kids were three times more likely to become a sleepwalker if they had one parent who was, and seven times more likely to sleep walk if both parents had a history of it. The prevalence of sleepwalking was 61.5% for kids with dual parent sleepwalking history.

The overall prevalence of sleepwalking in childhood reported among kids ages 2.5 to 13 years old was 29.1%, while the overall prevalence of sleep terrors for kids between age 1.5 to 13 was 56.2%. Kids who had sleep terrors were more likely to also develop sleepwalking, compared to kids who did not have them.

“These findings point to a strong genetic influence on sleepwalking and, to a lesser degree, sleep terrors,” the study authors write. “This effect may occur through polymorphisms in the genes involved in slow-wave sleep generation or sleep depth. Parents who have been sleepwalkers in the past, particularly in cases where both parents have been sleepwalkers, can expect their children to sleepwalk and thus should prepare adequately.”

TIME A Year In Space

Here’s How Coffee Cups in Space Could Help Save Lives on Earth

Six Space Cups as delivered to NASA January, 2015 for the Capillary Effects of Drinking in the Microgravity Environment (Capillary Beverage) investigation.
Image courtesy of Andrew Wollman/NASA Six Space Cups as delivered to NASA January, 2015 for the Capillary Effects of Drinking in the Microgravity Environment (Capillary Beverage) investigation.

The so-called Space Cups can reveal much about fluid physics

Astronauts aboard the International Space Station can now enjoy a much-needed hot cup of joe with their very own espresso machine and six specially designed microgravity coffee cups.

But NASA says these Space Cups will do a lot more than lift espresso to an astronaut’s lips. They will also provide scientists with data on how complex fluids (such as coffee or tea with sugar) move in zero gravity, writes Mark Weislogel, professor at Portland State University and former senior aerospace engineer for NASA working on microgravity fluid physics.

MORE: See the Trailer for TIME’s Unprecedented New Series: A Year in Space

Before the invention of the Space Cup, astronauts would have a drink by sucking liquid out of a bag. The new coffee cups (which are transparent 3-D-printed jugs) have a sharp inner corner that allows the liquid to be pushed along the inside of the cup — a process called capillary flow — towards the drinker’s lips.

By experimenting with capillary fluid physics in small containers like cups, scientists believe it will help them build better and safer advanced fluid systems that are relied on in space, including oxygen supply, water coolants, air conditioners, toilets and fuel and recycling systems.

But NASA says the data collected in the study can also be applied to fluid systems on earth, like improving portable medical diagnostic devices used to quickly test blood for infectious diseases in remote areas of the world.

TIME Research

This New Drug Might One Day Cure Even the Most Painful UTIs

Desperate lady toilet door sign
Getty Images

More and more women are getting antibiotic-resistant UTIs

Antibiotic resistance is becoming a growing global problem, and for many women that’s having an unexpected effect. One very common infection among women, the urinary tract infection, is becoming increasingly resistant to the drugs used to treat it. New research published in the journal PLOS Pathogens sheds light on the rise of the antibiotic-resistant UTI and hints at a potentially new treatment that may one day offer women some relief.

More than half of women will experience at least one UTI in their lifetime, and between 30 and 40% of those infections will come back within six months. UTIs account for around eight million visits to the doctor’s office every year, totaling about $450 million in medical costs. Most UTIs are caused by the bacteria Escherichia coli (E. coli), and recent surveillance data shows a significant rise in cases of UTIs caused by E. coli that are resistant to the antibiotics most commonly used to that treat them. One study that looked at cases of UTIs from 2000 to 2010 found that the number of UTIs caused by E. coli that were resistant to the antibiotic ciprofloxacin increased five fold, and the number of UTIs resistant to the commonly used antibiotic trimethoprim-sulfame-thoxazole rose from about 18% to 24% during the same time period.

UTIs typically cause women to have a severe urge to urinate, and to do so frequently. It’s also often very painful when they do, and many experience a burning sensation in their bladder or urethra. Uncomplicated UTIs usually go away with drugs within two to three weeks, but in some cases women may take antibiotics for 6 months or longer if their UTIs keep coming back.

“It’s definitely a growing problem,” says Dr. Victor Nizet, a professor of pediatrics and pharmacy at the University of California, San Diego School of Medicine. “Some women get them over and over again, year in and year out.”

In the new study, Nizet and his colleagues looked at an alternative way to treat UTIs. The researchers tested an experimental drug—not an antibiotic but an immune-boosting agent. The drug stabilizes a protein called HIF-1alpha, which was shown to protect mice and human bladder cells from infection with a common UTI pathogen, a kind of E. coli. The researchers found that using the experimental drugs in healthy human urinary tract cells made the cells more resistant to infection by the pathogen. The researchers also discovered that using the stabilizers directly in the bladders of mice protected against infection and that mice who were treated saw a 10-fold reduction in bacteria colonization in their bladders compared to untreated mice.

“A classic antibiotic is something that targets the bacteria directly,” says Nizet. “This [new drug] would be a treatment that would stimulate the body to produce its natural antimicrobials, which are many.” Nizet says the next step is to explore testing in humans and learn more about the effectiveness of oral versions of the drugs.

Dr. Mamta M. Mamik, an assistant professor of obstetrics, gynecology and reproductive science at the Icahn School of Medicine at Mount Sinai (who was not involved in the study) says she’s seen more and more women with UTIs that are resistant to drugs. In those situations, physicians will sample and isolate the bacteria to see what it’s sensitive to and then recommend a drug based on those results, she says. In a worst-case scenario, they may need to give women intravenous antibiotic therapy.

“I think use of antibiotics should be monitored strictly,” says Mamik. “Very judicious use of antibiotics is really necessary or we will end up in a situation that’s really terrifying. If everyone starts attracting these bacterial-resistant infections, we don’t have the resources. We can’t give intravenous antibiotics to everybody—that’s not a solution.”

Mamik says that women who think they have a UTI should schedule an appointment to see their doctor in person, and not to ask their physician to call them in a prescription for antibiotics. Doctors should insist on seeing their patients too, if they want to cut down on the risk, she says. “It’s uncomfortable but not life-threatening, so [women] don’t go in,” says Mamik. “That’s a practice that has to stop. It perpetuates the problem. You don’t know what you’re treating.”

TIME Research

Growing Number of Babies Have Drug Withdrawal Symptoms, Study Shows

It's called neonatal abstinence syndrome

The number of infants born in the U.S. with drug withdrawal symptoms is growing rapidly, a new study shows.

The percentage of babies born with neonatal abstinence syndrome (NAS), which has been linked to illegal drug or prescription opioid use in pregnant women, nearly doubled between 2009 and 2012, according to a Vanderbilt study published in the Journal of Perinatology.

By 2012, one infant was born every 25 minutes with the syndrome, leading to $1.5 billion in yearly health care charges, the study found.

Through examining data from the Kids’ Inpatient Database and the Nationwide Inpatient Sample, the study found that the occurrence of NAS in the U.S. rose from 3.4 births per 1,000 to 5.8 births per 1,000 between 2009 and 2012.

The study also found that NAS rates varied across the country. “The rise in neonatal abstinence syndrome mirrors the rise we have seen in opioid pain reliever use across the nation. Our study finds that communities hardest hit by opioid use and their complications, like overdose death, have the highest rates of the NAS,” lead author Stephen Patrick, assistant professor of pediatrics and health policy in the Monroe Carell Jr. Children’s Hospital at Vanderbilt, said in a press release. The area with the highest rate of NAS in 2012, 16.2 births per 1,000, was the region that includes Kentucky, Tennessee, Mississippi and Alabama.

William Cooper, Cornelius Vanderbilt professor of pediatrics and health policy and the senior author for the study, called the rise of NAS “a growing public health problem.”

Being born with NAS makes infants more likely to have respiratory problems, difficulty feeding, seizures and low birth weight.

TIME Addiction

Habitual Gamblers See Patterns Where There Are None, Study Says

Las Vegas Sands deceived a Nevada court in an attempt to stall a lawsuit by the former head of its Macau operations, a state judge ruled on Friday, fining the casino operator and abridging its right to object in a fight over key evidence. REUTERS/Tyrone Siu (CHINA - Tags: BUSINESS CRIME LAW SOCIETY) - RTR386IJ
Siu Chiu—Reuters A croupier sits in front of a gaming table inside a casino on the opening day of Sheraton Macao hotel at Sands Cotai Central in Macau September 20, 2012

"Gamblers are more willing to bet impulsively on perceived illusory patterns," researcher says

Researchers have found gamblers are more prone to find non-existent patterns in completely random sequences — and are more likely to bet on those erroneous perceptions — adding to a large amount of research that suggests pathological gambling is the result of cognitive distortions.

The study, published Wednesday in Springer’s Journal of Gambling Studies, says that all humans fall victim to illusory patterns — if a roulette ball lands on black five turns in a row, for example, it is normal to think that it must surely land on red next. But compulsive gamblers see more such imaginary patterns and are different to recreational gamblers by their increased likelihood to bet on the false trends.

“Our results suggest that gamblers are more willing to bet impulsively on perceived illusory patterns,” stated co-lead author Wolgang Gaissmaier in a press release.

In a laboratory, the team compared the betting habits of 91 habitual gamblers versus 70 people who were not. Participants were shown pictures of two slot machines and had to predict the winner, but the catch was one had a 67% chance of producing a win while the other machine produced a win only 33% of the time. Participants were not explicitly told of the probability difference but the study said it “could be learned from experience via feedback.”

The results showed that gamblers were more likely than non-gamblers to use ‘probability matching’ — or making predictions based on past results.

“They are overly prone to accept random series of events as, in fact, non-random — and non-random enough to be worth betting on,” said Gaissmaier.

TIME Research

Air Pollution May Make Your Brain Age Faster, Study Says

Air pollution can also increase your risk of a stroke

Long-term exposure to air pollution may cause your brain to age more quickly and put you at higher risk for a stroke, a new study suggests.

Exposure to higher levels of air pollution may be linked to lower total cerebral brain volume, according to a study published in the May issue of Stroke, which analyzed health data from nearly 1,000 men and women over 60 who did not have dementia and had not had a stroke.

Total cerebral brain volume naturally decreases as humans age, resulting in declines in ability to learn new things and retrieve information, but the researchers found that air pollution exposure may be linked to premature brain aging and higher risks for certain brain strokes.

The findings add new knowledge to the impact of air pollution on the structure of the brain, a link that has remained largely unclear in research.

Specifically, a 2 microgram per square meter increase in PM2.5 (particulate matter in the air that is less than 2.5 micrometers wide) was associated with a 0.32% lower total cerebral brain volume, the study said. To put that in context, brain volume decreases at about 0.5% per year after age 40, and PM2.5 levels can vary widely across the world. For example, the PM2.5 in Beijing is about 175 micrograms per square meter, while the PM2.5 in New York City is about 30 micrograms per square meter.

TIME Innovation

Social Justice and the Cellphone Camera

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

These are today's best ideas

1. Technology’s greatest gift to social justice is the mobile phone camera.

By Robinson Meyer in the Atlantic

2. How did America fall so far behind on basic scientific research?

By Michael Hiltzik in the Los Angeles Times

3. The U.S. needs a drone oversight board.

By David Medine and Eliza Sweren-Becker in Defense One

4. Here’s how citizen scientists discovered five new supernovas.

By Calla Cofield in Space.com

5. U.S. CEOs are eager to do business in Iran — but they’re not alone.

By Barbara Slavin in Al-Monitor

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

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