[Los Angeles Times]

Apr. 27--One need only look at the recent introduction of chocolate Cheerios to fully grasp Americans' fondness for the pulp from cacao beans. Savoring chocolate is normal.

But, researchers said Monday, overindulging in it could be a marker for depression.

Researchers at UC San Diego and UC Davis examined chocolate consumption and other dietary intake patterns among 931 men and women who were not using antidepressants. The participants were also given a depression screening test. Those who screened positive for possible depression consumed an average of 8.4 servings of chocolate -- defined as one ounce of chocolate candy -- per month. That compared with 5.4 servings per month among people who were not depressed.

Those who scored highest on the mood tests, indicating possible major depression, consumed an average of 11.8 servings per month. The findings were similar among women and men.

When the researchers controlled for other dietary factors that could be linked to mood -- such as caffeine, fat and carbohydrate intake -- they found only chocolate consumption correlated with mood.

It's not clear how the two are linked, the authors wrote. It could be that depression stimulates chocolate cravings as a form of self-treatment. Chocolate prompts the release of certain chemicals in the brain, such as dopamine, that produce feelings of pleasure.

There is no evidence, however, that chocolate has a sustained benefit on improving mood. Like alcohol, chocolate may contribute a short-term boost in mood followed by a return to depression or a worsened mood. A study published in 2007 in the journal Appetite found that eating chocolate improved mood but only for about three minutes.

It's also possible that depressed people seek chocolate to improve mood but that the trans fats in some chocolate counteract the effect of omega-3 fatty acid production in the body, the authors said in the paper. Omega-3 fatty acids are thought to improve mental health.

Another theory is that chocolate consumption contributes to depression or that some physiological mechanism, such as stress, drives both depression and chocolate cravings.

"It's unlikely that chocolate makes people depressed," said Marcia Levin Pelchat, a psychologist who studies food cravings at the Monell Chemical Senses Center in Philadelphia. She was not involved in the new study. "Most people believe the beneficial effects of chocolate are on mood and that they are learned. You eat chocolate; it makes you feel good, and sometime when you're feeling badly it occurs to you, 'Gee, if I eat some chocolate I might feel better.' "

Chocolate is popular in North America and Britain, she said. But in other cultures, different foods are considered pleasure-inducing pick-me-ups.

"In the United States, people consider chocolate really tasty," Pelchat said. "It has a high cultural value. It's an appropriate gift for Valentine's Day. But in China, you might give stuffed snails to someone you really like."

Food and Drug Administration (FDA)

A. Medicines in My Home: Information for Adults on Using Over-the-Counter Medicines Safely is now available in 3 versions:

1. English print version (with graphics) that needs no assembly

2. English print version (with graphics) that needs to be assembled into a booklet

3. Spanish (no graphic) version

Find them in: http://www.fda.gov/medsinmyhome in the Consumers’ Room, or in the Teachers’ Room/Teachers’ Tools: Adult program/Teachers’ Kit.

B. Medicines in My Home: Information for Students on the Safe Use of Over-the-Counter Medicines is now available in 2 versions:

1. English print version (with graphics) that needs no assembly

2. English print version (with graphics) that needs to be assembled into a booklet

Find them in : http://www.fda.gov/medsinmyhome in the Students’ Room, and in the Teachers’ Room/Teachers’ Tools: Student Program Grades 6 through 8/Teachers’ Kit

Thomson Reuters Study Offers New Insight on How Physicians Prescribe Psychiatric Drugs

ANN ARBOR, Mich., March 22 /PRNewswire/ -- A study published today outlines the medical conditions that U.S. physicians reported treating with psychiatric drugs.

The research was conducted by Thomson Reuters, sponsored by the federal Substance Abuse and Mental Health Services Administration (SAMHSA), and published in the journal CNS Drugs.

Psychiatric medications are one of the most widely prescribed categories of drugs in the nation, but few studies have comprehensively examined the types of illnesses being treated with these medications. There has been a great deal of interest and some concern about the "off-label" use of psychiatric drugs -- that is, their use for medical conditions not included in their Food and Drug Administration-approved labeling. In most instances it is legal and a common practice for physicians to prescribe drugs off-label, even though less may be known about a drug's risks and benefits for an unapproved indication.      

This study did not evaluate whether drugs were prescribed for on- or off-label use, but it reveals that in the vast majority of cases physicians are prescribing psychiatric medications for patients with psychiatric conditions. These medications -- especially anti-anxiety drugs -- are also sometimes prescribed to treat other conditions. 

"From this study, it seems clear that psychiatric medications are for the most part being prescribed for treating people with psychiatric conditions," said SAMHSA Administrator Pamela S. Hyde, J.D. "Yet, as clinicians broaden their use of psychiatric medications to a variety of mental illnesses, research and education are needed to ensure that the uses are appropriate."

The study looked at the prescription patterns for three major types of psychiatric drugs:  antipsychotic drugs, antidepressant drugs, and anti-anxiety drugs, but did not evaluate clinical appropriateness per se. 

"The information presented in this study can serve as a guide to future research, policy, and education about these medications, their perceived benefits and risks, and their uses," said lead study author Tami L. Mark, PhD., director of analytic strategies at Thomson Reuters.

The study found that antipsychotic drugs were prescribed for psychiatric conditions 99 percent of the time, including mood disorders (39 percent), schizophrenia or other psychotic disorders (35 percent), cognitive disorders such as dementia (7.4 percent), anxiety (6 percent), and attention-deficit/conduct-disruptive behavior disorders (6 percent).

In terms of antidepressant drugs, the study found that 93 percent of prescriptions were for psychiatric conditions, primarily mood disorders (65 percent), anxiety (16 percent), schizophrenia, and other psychotic disorders (2.6 percent). Non-psychiatric diagnoses for which antidepressants were prescribed included headaches (1.1 percent), connective tissue disease (e.g., fibromyalgia) (1 percent), and back problems (0.7 percent).

The study found that the majority of prescriptions written for anti-anxiety medication were used to treat psychiatric conditions (72 percent), although a significant percentage (28 percent) were used to for non-psychiatric diagnoses including anxiety related to medical interventions (6 percent), allergic reactions (4 percent), and back problems (2.5 percent).

The study analyzed data from the 2005 National Disease and Therapeutic Index, a nationally representative survey of about 4,000 U.S. office-based physicians conducted by IMS Health.

SAMHSA is a public health agency within the U.S. Department of Health and Human Services. Its mission is to reduce the impact of substance abuse and mental illness on America's communities.

Thomson Reuters

Thomson Reuters is the world's leading source of intelligent information for businesses and professionals.  We combine industry expertise with innovative technology to deliver critical information to leading decision makers in the financial, legal, tax and accounting, healthcare and science and media markets, powered by the world's most trusted news organization.  With headquarters in New York and major operations in London and Eagan, Minnesota, Thomson Reuters employs more than 50,000 people and operates in over 100 countries. Thomson Reuters shares are listed on the Toronto Stock Exchange (TSX: TRI) and New York Stock Exchange (NYSE: TRI). For more information, go to www.thomsonreuters.com.

Many Proposed Budget Cuts
Harmful to People with Low Income
REJECTED by the Legislature!
 
At the beginning of January, we asked for your help to defeat many proposed budget cuts that would have been harmful to people with low income, including many MAIN members. 
 
We are happy to report that many of these cuts were REJECTED by the legislature. 

Thanks to all of you who testified, contacted legislators, attended events at the State House and shared your experiences with us!  Your actions helped protect Maine people with low income from these cuts.

1.       Original Budget Proposal: Limit laboratory and x-ray services for adults to 15 procedures a year.
 
 Final Legislative Action:  This proposal was rejected.  These services will NOT be limited.
 
2.       Original Budget Proposal:  Limit out-patient mental health visits for adults to 18 visits per year. Out-patient mental health visits for children would also be limited to 18 visits with more visits allowed with prior authorization.
 
Final Legislative Action:  Outpatient mental health visits for both adults and children will require "prior approval" from DHHS for more than 18 visits.  But, DHHS must allow more than 18 visits when more visits are medically necessary.
 
3.       Original Budget Proposal:  Limit out-patient hospital visits for adults to 15 visits a year.
 
Final Legislative Action:  This proposal was rejected.  These services will NOT be limited.
 
4.   Original Budget Proposal:   Co-payments would go up for some seniors and people with disabilities who receive both Medicare and Medicaid. 
 
Final Legislative Action:  This proposal was rejected. Co-payments will NOT increase for seniors and people with disabilities.  Under federal law these co-payments
 
5.       Original Budget Proposal:  Increase the wait for a temporary MaineCare card when the Department has not been able to make a final disability decision for people applying for MaineCare based on disability from 45 to 90 days.  
 
Final Legislative Action:  This proposal was rejected.  Temporary MaineCare cards will still be available in 45 days for people applying for MaineCare based on disability.  DHHS was given some additional staff to help people applying for MaineCare fill out disability forms and collect medical evidence from their health care providers.
 
6.       Original Budget Proposal:  Reduce state funding for General Assistance for about a dozen municipalities including Portland, Bangor and two of the Native American townships.  MAIN was concerned that this might impact access to General Assistance in those municipalities.
 
Final Legislative Action:  This proposal was rejected.  State General Assistance funds will not be cut for these municipalities and there is no change to the General Assistance program.
 
Thanks for all your help in protecting Maine people with low income from these cuts!

More information on the legislative session will be reported in the spring edition of the MAIN Update -- coming soon!

www.mejp.org