Sleep with the apps

Britain’s NICE — sorta kinda the equivalent of the FDA — is recommending that insomniacs give up sleeping pills (e.g,. zolpidem and zopiclone) in favor of a smartphone app called Sleepio. It’s not a requirement, just a “new treatment option” that could save money and avoid dependency.

It’s based on CBT-I, or cognitive behavioral therapy for insomnia.

The app provides a sleep test, weekly interactive CBT-I sessions and allows users to keep a diary tracking their sleeping patterns. Meanwhile, CBT-I sessions focus on identifying thoughts, feelings and behaviours that contribute to the symptoms of insomnia.

Sleepio is available on both Apple’s App Store and Google Play if you want to give it a go*. (For an app recommended by a government health service, though, it doesn’t have a lot of users.)

Preventing the next shortage (sort of)

The FDA has learned at least one lesson from the pandemic: Drug supply chains are finicky things. So it’s release a draft guidance for industry that it hopes will keep the next one from being so bad. It’s all about risk management plans, or RMPs.

The gist: Drug makers will have to submit RMPs for ‘life-sustaining and life-supporting drugs and APIs’ and other emergency drugs and devices. And they should submit them for other kinds of drugs, e.g., “Drugs that lack appropriate alternatives” and “Sole source drugs.”

It’s not clear that these RMPs need to be approved — it seems more that they’re meant to “provide FDA with greater assurance that stakeholders understand and can manage the associated risks.”

A new brain drug?

Cdk5 inhibitors show a lot of promise for helping with brain issues including depression and even injury. Problem: the ol’ blood-brain barrier keeps them from working very well.

But now University of Alabama researchers say they have a new kind of anti-Cdk5 compound — and theirs is brain-permeable. They call it 25-106.

Right now 25-106 is still pre-clinical, but it seems to work on mice, altering their behavior and reducing anxiety.

Of course a lot more research is needed, but the combination of a Cdk5 inhibitor and brain permeability certainly sounds promising.

Hyperactive kids need their veggies

There’s apparently an easy — well, simple — way to help kids with ADHD that doesn’t involve medication: fruit and veg.

A study out of an Ohio State University found that, in short, “kids who consumed more fruits and vegetables showed less severe symptoms of inattention.” The reason is likely micronutrients:

Researchers believe that ADHD is related to low levels of some neurotransmitters in the brain – and vitamins and minerals play a key role as cofactors in helping the body make those important neurochemicals and in overall brain function.

But food insecurity can also play a role: “[K]ids whose families had higher levels of food insecurity were more likely than others to show more severe symptoms of emotional dysregulation, such as chronic irritability, angry moods and outbursts of anger.”

Monkeypox continues to spread

That’s all you really need to know.

Dolphins, mucus, and skin care

Dolphins are one of a bunch of animals known to self-medicate — using the properties of what’s in their environment to treat or prevent this or that. (Protecting themselves from insect bites seems common.)

The latest trick of theirs to be discovered: skin care. Bottlenose dolphins in the Red Sea will rub against a particular coral that’s “known to excrete mucus with antimicrobial properties.” When Swiss ad German researchers looked closer, they found ”more than a dozen bioactive compounds that are produced by these corals and sponges and which likely help maintain dolphins’ skin health.”

Allergy news

If you know any patients with a seafood allergy, you might want to warn them to avoid crocodile meat.

Sure, we all know that croc (and alligator) meat is healthy, tasty, and easy to get (especially if you’re close to Florida). Lately, though, molecular allergists in Singapore have been getting reports of allergic reactions.

Upon investigation, they found that about 70 per cent of patients with a fish allergy will also have an allergic reaction when eating crocodile.

“We now coined the ‘fish-crocodile syndrome’: Fish-allergic individuals may be at risk of serious allergic reactions upon consumption of crocodilian meat due to them being highly reactive to crocodile parvalbumin.

The Long Read: Social Media Kills edition

High school and college kids are using social media to buy drugs, and too often those drugs are laced with fentanyl … and the kids are dying.

Supplies of tainted pills, crudely pressed by Mexican cartels with chemicals from China and India, have escalated commensurately. Fentanyl, faster and cheaper to produce than heroin and 50 times as potent, made for a highly addictive filler.

Social media companies claim to be cracking down — for example making search results for common drugs go to ‘Don’t do drugs’ pages instead. (Which will undoubtedly have a tremendous effect.) But those efforts are a bit half-hearted:

On Instagram, one recent search for Percocet did set off an automatic warning and an offer of help. But it also yielded numerous results, including an account that posted photos of the pills and contact information, with phone numbers on the encrypted messaging apps Wickr and WhatsApp.