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A mind-altering medication related to the club drug Special K won U.S. approval Tuesday for patients with hard-to-treat depression, the first in a series of long-overlooked substances being reconsidered for severe forms of mental illness.
The nasal spray from Johnson & Johnson is a chemical cousin of ketamine, which has been used for decades as a powerful anesthetic to prepare patients for surgery. In the 1990s, the medication was adopted as a party drug by the underground rave culture due to its ability to produce psychedelic, out-of-body experiences. More recently, some doctors have given ketamine to people with depression without formal FDA approval.
The Food and Drug Administration approved Spravato as a fast-acting treatment for patients who have failed to find relief with at least two antidepressants. Up to 7.4 million American adults suffer from so-called treatment-resistant depression, which heightens the risk of suicide, hospitalization and other serious harm, according to the FDA.
The drug will cost between $590 and $885 depending on the dosage and before various insurance discounts and rebates.
There have been no major pharmaceutical innovations for depression since the launch of Prozac and related antidepressants in the late 1980s. Those drugs target the feel-good brain chemical serotonin, and can take weeks or months to kick in.
Ketamine and J&J’s version work differently than those drugs, targeting a chemical called glutamate that is thought to restore brain connections that help relieve depression.
When the drug works, its effect is almost immediate. That speed “is a huge thing because depressed patients are very disabled and suffer enormously,” said Dr. John Mann, a psychiatrist and researcher at Columbia University. If the drug doesn’t work, physicians can quickly switch to other options, he noted.
The FDA approved Spravato, known chemically as esketamine, based on study results that showed patients taking the drug experienced a bigger improvement in their depression levels than patients taking a sham treatment, when measured with a psychiatric questionnaire.
The drug is designed to be lower-dose and easier to use than ketamine, which is normally given as an intravenous infusion.
Robin Prothro, 60, began taking antidepressants more than 20 years ago. But she says none of the five medications she tried relieved the depression that has stymied her personal and professional life.
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Since enrolling in a Spravato trial two years ago, Prothro says her depression has lifted and she’s returned to hobbies she abandoned years ago, like gardening.
She takes the drug every two weeks at her psychiatrist’s office while reclining in a comfortable chair.
“You can feel it coming on, it’s a strong drug,” she said, describing colors and shapes that drift before her eyes. “I just let the drug work. I close my eyes and my mind is amazingly quiet.”
The ketamine-like drug is the first of several psychoactive substances making their way through the U.S. regulatory process as physicians search further afield for new therapies. Researchers are conducting late-stage trials of psilocybin, the active ingredient in magic mushrooms, and MDMA, a euphoria-inducing club drug, as potential treatments for depression and post-traumatic stress disorder.
“Substantially different agents are only rarely appearing from pharmaceutical companies or other laboratories,” said Dr. Paul Summergrad, a psychiatrist at Tufts University. “That’s prompting people to investigate other compounds.”
Unlike ketamine, psilocybin and MDMA have no legal medical use. Classified in the same category as heroin and LSD, they are tightly restricted by the federal government. But the FDA’s approval of esketamine could smooth their path.
Burden of depression
Depression is among the leading causes of disability in the U.S. and is being closely monitored by health authorities amid rising suicides nationwide. In 2017, the U.S. suicide rate rose to 14 deaths per 100,000 people, the highest rate in at least 50 years, according to federal records.
Government officials haven’t suggested an explanation for the trend, though academic researchers point to the nation’s widening income gap, financial struggles and divisive politics.
J&J’s drug will be subject to a number of restrictions due to its abuse potential, side effects and lingering safety questions.
The drug will only be given by accredited specialists who must monitor patients for at least two hours after administration, due to its trippy, disorienting effects. Additionally, all patients will be tracked in a registry to monitor long-term safety and effectiveness.
The immediate impact of ketamine is thought to last just four to seven days and there’s no consensus yet on how long patients can benefit from ongoing treatment.
Still, there are few other options for patients who fail to respond to antidepressants. The most effective treatment in such cases, electroshock therapy, requires patients to be fully sedated and can cause persistent memory loss.
Wall Street has high expectations for J&J’s medication, with analysts predicting more than $600 million in annual sales by 2022. But J&J will face competition in the marketplace.
A decades-old drug, ketamine is already used off-label to treat depression by some doctors. At least 150 clinics around the U.S. provide treatment with various forms of the drug, which is available as a low-cost generic. Patients often pay hundreds or thousands of dollars for intravenous infusions of the drug over several weeks or months. Such therapies are generally not covered by insurance because they haven’t been approved as safe and effective by FDA regulators.
Some doctors plan to offer both ketamine and the new J&J drug.
Dr. Steve Levine says having FDA-approved standards for dosing and administering the new drug should raise standards in the field and drive out some of the bad actors who are not qualified to treat depression.
“This is going to bring in some standards, regulation and it’s going to make it safer and more accessible to patients,” said Levine, who serves as vice president of the American Society of Ketamine Physicians, a group representing doctors, nurses and others using ketamine for treating depression or other non-approved uses. (VOA)
By Siddhi Jain
The author who named the book after her twin sons -- Puhor and Niyor -- is a parent who has seen and heard the tales of ridicule and discrimination suffered by many in India and beyond. She says the book is an artistic illustration for kids that details how different families can live and coexist. Whether it's children with two dads or two moms, children with a single dad or single mom, and even multiracial family units, Borthakur's book teaches love, understanding, and compassion towards unconventional families.
Beyond race, gender, color, and ethnicity which have formed the bases for discrimination since the beginning of time, this book aims to bring to light a largely ignored issue. For so long, single parents have been treated like a taboo without any attempt to understand their situations; no one really cares how or why one's marriage ended but just wants to treat single parents as villains simply for choosing happiness and loving their children.
Homosexual parents, a relatively new family system, is another form that has suffered hate and discrimination for many years. Pritisha emphasizes the need to understand that diversity in people and family is what makes the world beautiful and colourful. 'Puhor and Niyor's Mural of Family Stories' is a firm but compassionate statement against all forms of discrimination on the bases of sexual identity, gender, race, and even differences in background
'Puhor and Niyor's Mural of Family Stories' is a firm but compassionate statement against all forms of discrimination on the bases of sexual identity, gender, race and even differences in background. | Photo by Ben Wicks on Unsplash
Written for a global audience, the book is targeted at kids between the ages of five and 10, the reason it is embellished with colourful images of families of different types is to appeal to children's sense of sight and drive home the message at the same time. Borthakur believes children are the best place to start because the ages between five and 10 are the most formative, where little ones pick up habits, beliefs and perceptions.
The Guwahati-born author says, "With this book, I'm not trying to take away the job of parents in forming habits, I simply want to do my part as a parent. It is important that we impart the right values in our kids in a bid to build a better, more inclusive and tolerant global society that is fair to everyone." The author's first attempt at a book was an Assamese poetry 'Anubhav', published in 2010.
Set to be published under the label of Author's Channel, the book is like an adventure; a journey into uncharted territories, untouched subjects and matters long ignored. In her words. "The book takes a critical stand in defense of people in society who have had to undergo severe emotional torture for no cause of theirs. It is a terrible conception to think such people any less of a human just for being different," says publisher Aruna Naidu. By September 30, this title, priced at Rs 299, will be available online and in offline bookstores. (IANS/ MBI)
Keywords: Book, children, Guwahati, Puhor and Niyor's Mural of Family Stories, moral, story, kids, discrimination, equality
If you feel that clean and well-groomed hands are just an essential prerequisite for women, you might like to think twice. Men should equally pay attention to their hands because our hand houses 1,500 bacteria living on each square centimeter of its skin. You can easily assume what havoc it can create in our body because in India we have the culture of eating with our hands and spaces beneath nails can become breeding heaven for germs. Moreover, clean and maintained hands boost confidence in their daily life activities. Therefore, it's important to keep your hands clean irrespective of your gender by washing or sanitizing at regular intervals. And, to keep them groomed, you don't have to visit a salon.
Rajesh U Pandya, Managing Director, KAI India, gives easy and completely doable tips to follow at home:
* Refrain from harsh soaps: You should be mindful of the soap you are using to wash your hands. Your soap can have a moisturizing element in it like aloe vera or shea butter. Ensure that you're washing your hands with normal water as hot water can make your hand's skin dry and scaly.
You should be mindful of the soap you are using to wash your hands. | Photo by Aurélia Dubois on Unsplash
* Clip your nails regularly: Make use of your personal nail clipper to cut your nails. After cutting your nails at a comfortable length also file them using a nail filer. Never share your nail care clipper as the germs can get transferred to your loved ones. Also, don't forget to use grime remover to remove hidden germs in corners and beneath nails. Also, you may like to file your nails to have a smooth finish.
* Good quality Nail Clipper: Do not use a rusted or chromium coated nail clipper as it might be harmful to skin and might cause dangerous bacterial infections.
* Stop the habit of nail chewing: Sometimes anxiety or extreme boredom can lead to chewing of nails. This habit only makes your nails uneven and ugly. Sometimes, our unclean nail folds give rise to viral, bacterial or fungal infections, which in turn can make us sick if we chew our nails.
Make use of your personal nail clipper to cut your nails. | Pixabay
* Exfoliate your hands: Similar to the way you exfoliate your face; your hands also need it. It helps to keep the dry skin at bay and keep your hands soft. You can buy a scrub or make one at home using brown sugar and olive oil. After scrubbing, you need to massage your hands with moisturizer.
Similar to the way you exfoliate your face; your hands also need it. It helps to keep the dry skin at bay and keep your hands soft. | Wikipedia
* Don't use your nails as tools: Always keep in mind that your nails are like jewels. Never use them to pry things open such as pop cans, removing keys from the ring, opening letters, or scraping off labels. This results in unnecessary breakage of nails, making your hands look dirty.
Never use your nails to pry things open such as pop cans, removing keys from the ring, opening letters or scraping off labels. | Photo by Sammy Williams on Unsplash
* Be aware of nail or cuticle inflammation or redness: If there are any signs of infection, disinfect the skin as soon as possible with an anti-bacterial or anti-fungal ointment.
(Article originally written by N.Lothungbeni Humtsoe) (IANS/ MBI)
Keywords: Nails, groom, hand, exfoliate, chew, nail clipper, bite, cuticle
Bitcoin has become an essential crypto asset in modern portfolios and investment funds. The confidence generated in this cryptocurrency will depend a lot on the diversification that companies make in their balance sheets in Bitcoin and the increase of institutional investors that allocate a percentage of their funds in this crypto. American fund manager Cathie Wood makes some interesting predictions, both in the rise that the Bitcoin price will experience in the next 5 years, suggesting these institutional investors allocate 5% of their funds; this will help leverage the Bitcoin market.
Bitcoin will grow by a tenfold
Bitcoin is projected to grow by 10 times its current value in five years, i.e., it could reach $500,000. Of course, this will require companies to invest in cryptocurrencies. This makes it necessary to increase the weight of Bitcoin on balance sheets through investments. One of the investment gurus who supports this prediction is Catherine Wood. Contrarily, Ray Dalio, despite being clear that relying on cash is not a good strategy, views Bitcoin with suspicion, although he calls for its investment. This behavior is due to the actions of governments against the cryptocurrency market.
If something is undoubted is the vertiginous increase that cryptocurrencies have had in general, they have risen more than 60% so far this year. So, even when some governments are trying to regulate cryptocurrencies, they will fail. This attempt to regulate will end up triggering even more cryptos, especially Bitcoin, which is the oldest and most solid of that market.
Bitcoin, is the oldest and most solid of the market. | Photo by Executium on Unsplash
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The current Bitcoin price means is time to buy:
The current price of bitcoin invites you to buy, and perhaps it would be foolhardy not to. In either case, bitcoin will always represent money. Maybe some external factors generate some misgivings, but if you refuse to invest in cryptocurrencies, you are basically denying the near future, it would be as if you didn't have a cell phone or internet.
In India, more and more people are becoming convinced of the benefits of holding some Bitcoin. This can be clearly seen in the rapid increase in the number of new accounts at crypto exchanges such as WazirX and CoinDCX.
ALSO READ: How can you trade in Bitcoin in India?
Bitcoin, despite its fluctuations, represents an excellent financial strategy. The support users give is significant. The same cannot be said of the FIAT currencies, which have lost value and support, showing how fragile they are, being subjected to a constant devaluation. As long as confidence in cryptos grows, the foundations will continue to be laid to maintain their rise and to be able to continue making transactions. We know this by previous experience, as has happened with Ether, thanks mainly to the growing activity of Defi and NFT, i.e. decentralized finance and non-fungible tokens.
Remember that when you invest in Bitcoin, you can do it by buying or trading. When you want to make these transactions do it in a secure Exchange, study your finances to invest, manage the risk, and learn to manage your portfolio efficiently.