Centre for Addiction & Mental Health

Psychiatrists and mental health professionals have a new standard for managing major depression, thanks to refreshed clinical guidelines. Psychiatrists and mental health professionals have a new standard for managing major depression, thanks to refreshed clinical guidelines published today by the Canadian Network for Mood and Anxiety Treatments (CANMAT). The CANMAT guidelines are the most widely used clinical guidelines for depression in the world. The new version integrates the latest scientific evidence and advances in depression care since the previous guidelines were published in 2016. The update was led by researchers at the University of B.C. and the University of Toronto, alongside a national working group of more than 40 academic clinical experts and patient partners. "These recommendations not only represent the evidence and broad consensus of leading experts in depression research and care, but, importantly, they also reflect the perspectives of patients with lived experience," says co-lead author Dr. Raymond Lam, professor of psychiatry at UBC and co-director of the Mood Disorders Centre at the Djavad Mowafaghian Centre for Brain Health. "Our hope is that this update will empower clinicians with the latest recommendations that can help achieve better outcomes and improved quality of life for the millions of people affected by depression." More than one in 10 Canadians will experience depression at some point in their lives, making it one of the largest public health burdens in Canada. However, it is estimated that only 20 per cent of people receive adequate treatment. The updated guidelines cover eight primary topic areas that map the patient care journey, from assessment and diagnosis through to the selection of treatments and strategies to prevent recurrence. The question-and-answer format is designed to be practical, accessible and easy for clinicians to use. To develop the refreshed guidelines, the working group conducted a comprehensive literature review of new scientific evidence published since the previous 2016 guidelines. Drafts were revised based on review by patient partners, expert peer review and a defined expert consensus process. The resulting recommendations are organized by lines of treatment based on the level of evidence supporting each therapy and factors such as safety, tolerability and feasibility. Guidance is provided to aid healthcare professionals in choosing the right treatment option with an emphasis on collaborative decision-making. "Depression is a complex and highly individualized condition," says Dr. Lam. "The guidelines highlight the importance of collaborating with patients in care decisions and providing a personalized treatment approach that carefully considers a person's needs, preferences and treatment history." The guidelines underline the strong evidence base for well-established first-line treatments, including a number of medications, as well as psychological treatments such as cognitive behavioural therapy, interpersonal therapy and behavioural activation. Based on recent evidence, a number of new psychological and pharmacological treatments were added to the list of treatment options. "Notable additions to the new guidelines are a strong emphasis on patient participation in choosing treatment, applying outcome measures throughout care, and an overview of digital mental health tools in the management of depression," says co-lead author Dr. Sidney Kennedy, professor of psychiatry at the University of Toronto and director of the Centre for Depression and Suicide Studies at Unity Health Toronto. The guidelines include further direction on how healthcare professionals can incorporate lifestyle interventions, such as exercise, nutrition and sleep hygiene. They also explore when neuromodulation treatments should be considered and what should be done when a patient doesn't respond to initial treatments or develops treatment-resistant depression. "Many well-established psychological and behavioural interventions have accumulated more support for their efficacy across different delivery formats," says co-author Dr. Lena Quilty, associate professor of psychiatry at the University of Toronto and senior scientist at the Centre for Addiction and Mental Health. "We are especially pleased to report on evidence for new interventions that target depression as well as commonly co-occurring challenges such as anxiety or disrupted cognitive processes. We hope that these additional alternatives provide more opportunities for integrated attention to these multi-faceted issues." CANMAT is a network of academic and clinical experts dedicated to improving clinical care for people with mood and anxiety disorders. The new depression guidelines were published today in The Canadian Journal of Psychiatry. The researchers will be releasing updated versions of the CANMAT Pocket Guide to Depression for clinicians and the CHOICE-D Patient and Family Guide to Depression Treatment.

Product now available in the U.S. with global distribution planned TORONTO, April 10, 2024 /PRNewswire/ - A new study published in the Lancet discovery science journal eClinicalMedicine has confirmed that a novel natural supplement—invented, researched, developed and commercialized at the Centre for Addiction and Mental Health (CAMH)—prevents postpartum blues, and reduces symptoms of postpartum depression over the following six months after giving birth. Continue Reading CAMH researcher Dr. Jeffrey Meyer provides details about his invention, the first ever clinically validated natural supplement to prevent postpartum blues. Centre for Addiction and Mental Health (CAMH) researcher Dr. Jeffrey Meyer stands with his invention, the first ever clinically validated natural supplement to prevent postpartum blues. Image courtesy of CAMH. All rights reserved. (CNW Group/Centre for Addiction and Mental Health) Up to 8 out of ten new mothers experience postpartum, or 'baby,' blues, characterized by mood swings, crying spells, anxiety and difficulty sleeping. The condition usually begins within the first few days after delivery and may last for up to two weeks. Postpartum blues strongly raises the risk of postpartum depression, a serious mental illness affecting 13 per cent of mothers. Postpartum depression has important health care consequences: impairing quality of life, increasing risk for future depressive episodes and suicide, and is associated with cognitive and emotional effects in children. Until now, options for widespread prevention have been lacking for either condition. The study, entitled Dietary Supplement for Mood Symptoms in Early Postpartum: A Double-Blind Randomized Placebo Controlled Trial, involved more than 100 postpartum participants between January 2019 and December 2022 who either took four doses of the natural supplement several days after giving birth, or a matching placebo. Within the supplement group, two-thirds (66 per cent) experienced either no symptoms or only negligible symptoms of postpartum blues. Furthermore, in the following six months, participants who received the supplement experienced less symptoms of depression with none reaching the clinical threshold of postpartum depression six months after giving birth. "Globally 140 million births take place every year. Most women then experience postpartum blues, which, when severe, increases the likelihood of getting full-blown postpartum depression at least fourfold. Our study showed that both postpartum blues and later symptoms of depression were lower in women who received the dietary supplement," said Dr. Jeffrey Meyer, inventor of the nutraceutical and study senior author. "Providing this specialized dietary support in the first few days after giving birth is a crucial window to avoid depressive symptoms which is tremendously important given there is considerable risk that they may recur and have lifelong impact." Dr. Meyer has been investigating postpartum blues for more than 15 years. His previous imaging research found that a protein called MAO-A rises dramatically in the brains of postpartum women and this protein removes important brain chemicals—like serotonin and dopamine—that support normal mood. It also acts as an oxidant and is linked to the development and progression of certain mental illnesses. To combat this effect, the nutraceutical is made up of a patented unique combination of natural ingredients, including blueberry extract, which contain antioxidants, and amino acids that replenish essential neurochemicals in the brain to support healthy mood and the ability to concentrate under stress. The supplement was well tolerated and women who took it tended to report less symptoms, in part due to less drowsiness, headache and restlessness. The researchers previously showed that the amino acids in the supplement do not affect their total concentrations in breast milk, which was expected since these amino acids are already found in proteins in breast milk. CAMH has partnered with international women's health supplement and pharmaceutical company Exeltis via a licensing agreement to bring the product to market under the name Blues Away®. Exeltis has maintained the natural health product approach in their preparations and manufacture for widespread distribution of the supplement. It is expected that the product will be available for sale in the U.S. beginning April 11, 2024. It is also in the process of being brought to other global markets—including Canada—with the pace of approvals being dependent on each country's regulatory requirements and reviews. "We are thrilled to unveil the culmination of years of dedication and collaboration in the form of our groundbreaking nutraceutical for postpartum blues prevention. It is great that we are able to simultaneously share our clinical research around this product while also partnering with a global women's health industry leader to make it available to the new mothers who need it," said Klara Vichnevetski, Director of Industry Partnerships and Technology Transfer. CAMH has nurtured this innovation from its inception, guiding it from bench to bedside where it can make an immediate and profound difference in the lives of millions of women and their families." A limitation of the study was that, of the several measures of depression in the study, the supplement did not demonstrate the expected protective effect in an experimental test that involves inducing low mood with sad stimuli, although it is possible that the stress of the COVID-19 pandemic and moving the setting of the study to participants' homes during the pandemic may have influenced the results of this particular test. Aristotle Voineskos, Vice President of Research, added: "Two major pillars of our CAMH approach to research are the importance of integrating scientific findings into advancing mental health care and the value of early intervention. Through the perseverance and dedication of our researchers and technology transfer team, this novel preventative therapy may contribute to best practice when it comes to postpartum care and help women around the world avoid more serious and chronic mental illness." This research was funded by CAMH, with some additional funding from Exeltis. About the Centre for Addiction and Mental Health (CAMH) CAMH is Canada's largest mental health and addiction teaching hospital and a world leading research centre in this field. CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental illness and addiction. CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre. For more information, please visit camh.ca or follow @CAMHnews on Twitter. SOURCE Centre for Addiction and Mental Health

THURSDAY, Jan. 18, 2024 -- Many studies have found that getting high on weed and then getting behind the wheel is dangerous for young drivers, and now new research finds it's no different for seniors. In a driving-simulator experiment, seniors who were long-term marijuana smokers were weaving in and out of their lanes 30 minutes after getting high, Canadian researchers report. The effect was not seen when the same drivers were tested again three hours after smoking weed. However, the seniors themselves still rated their ability to drive as "impaired." There was one silver lining: Senior tokers tended to slow their driving speed once high, perhaps because they knew they were intoxicated, said a team led by Patricia Di Ciano , a scientist at the Center for Addiction and Mental Health in Toronto. Di Ciano's team noted that the percentage of aging Boomers who regularly use marijuana continues to rise. They believe that "older adults may be particularly affected by cannabis, given age-related changes in cognition," they added. Many seniors are also prescribed medications, and the combination of those meds with marijuana could also be problematic. While there's been lots of study on the effect of marijuana on younger drivers, the effects of cannabis on driving among seniors "remain unknown," according to the Toronto team. To help answer the question, they recruited 31 seniors, averaging about 69 years of age, to sit in a special virtual driving simulator. All participants were longtime, frequent weed users (40 years, on average), and all were told to come to the experiments with their preferred type of legal marijuana. They were told to smoke the marijuana at their "usual amount." Each participant's driving skills were then tested in the simulator at two time points: 30 minutes after getting high and then again at 180 minutes. Significant evidence of "weaving" appeared at the 30-minute mark, although drivers also tended to slow down at this point, the researchers noted. This wandering in and out of lanes appeared to disappear by the 180-minute mark, Di Ciano's group said. However, when queried, participants "still rated their ability to drive at 180 minutes as impaired," according to the study. Blood samples were taken during the experiments, and "THC levels were above the legal threshold [for driving] for most participants," Di Ciano's group noted. There's a theory that people who've regularly smoked marijuana for decades might build up a "tolerance," so perhaps their driving skills wouldn't be affected. The new study proved that theory false. Based on the findings, "cannabis can impair driving in older adults when they smoke their usual product," Di Ciano and her team concluded. Their advice: "Older drivers should refrain from using cannabis when contemplating operation of a motor vehicle." The study was published in the Jan. 18 issue of JAMA Network Open . Sources JAMA Network Open, Jan 18, 2024 Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions. Posted January 2024 More news resources FDA Medwatch Drug Alerts Daily MedNews News for Health Professionals New Drug Approvals New Drug Applications Drug Shortages Clinical Trial Results Generic Drug Approvals Subscribe to our newsletter Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.