Antidepressants and alcohol abuse

Taking antidepressants can reduce someone’s risk of alcohol-abuse relapse … except when it increases that risk.

You read that right. When the drugs work against a patient’s depression, they’ll also reduce the risk of relapse. That’s good. But when the antidepressant is ineffective against depression (as many are), patients “may have an increased risk for relapse into problem alcohol use.”

The Swiss authors, though, caution that “findings should not be considered causal relationships.”

New birth control

The FDA has approved Millicent’s Femlyv (norethindrone acetate and ethinyl estradiol) — the first orally disintegrating birth control tablet. That is all.

Another front in the Alzheimer’s war

If you have a mouse with Alzheimer’s, a nasal spray might remove some of the protein tangles that cause it. Not the amyloid plaque — this drug clears up the tau “tangles.” Like amyloids, tau proteins can form those tangles, which in Alzheimer’s patients aren’t cleared as they should be. That eventually leads to the dementia that’s the hallmark of the disease.

The big difference between amyloid plaque and tau tangles is that amyloid accumulates outside neurons, while tau accumulates inside them. That makes those tau tangles harder to tackle because they’re harder to reach.

That’s the problem that University of Texas neurologists say they’ve solved with a nasal spray: They packed nanoscopic lipid bubbles — which are small enough to slip through the blood-brain barrier — with tau-destroying antibodies. “Once in the brain, the outer layer of the bubble dissolved, releasing the antibodies and clearing the build up of tau.”

The results showed that a single dose of this nasal spray in the old Alzheimer’s mice significantly reduced tau accumulation in their brains. The same results were also discovered when applying the spray to human nerve tissue samples.

ICYMI: Alzheimer’s blood test

A blood test for Alzheimer’s is not only as good or better than current invasive testing methods, it doesn’t require a specialized lab; it can be used in a primary care setting. The best part? It’s already commercially available in the US.

The test measures levels of p-tau217 and Aβ42/40^* and a Swedish-American team found it can predict the accumulation of amyloid beta in the brain, i.e., it “can determine with 90% accuracy whether a person experiencing memory loss is suffering from Alzheimer’s.” That compares to specialist physicians, whose assessments are right about 73% of the time.

“The next steps include establishing clear clinical guidelines for the blood test’s use in healthcare.” […] “Initially, it will mainly be used in specialist memory clinics, and it may take approximately one to two years to implement guidelines and training in primary care.”

^* I’m putting this detail in hoping you’ll know what it means, but I sure don’t. 

FDA’s social crackdown

The FDA is serious about cracking down on social media posts about pharmaceuticals — at least when a pharma company pays for an informercial. In this case, that infomercial came from Brittany “My husband is Patrick” Mahomes. She wrote about Kaléo Auvi-Q — the alternative to Epi-Pens.

Mahomes talked about the benefits of Auvi-Q but didn’t mention the side effects and risk information. It’s one thing for a celebrity to talk about her personal experiences, but once she crossed the line into talking about product benefits (and was paid by the company to do so), the rules come into play.

The FDA told Kaléo to send a response addressing its concerns within 15 working days of receiving the letter, which the agency sent July 17. The link to the Instagram post now returns a result that says “Sorry, this page isn’t available.”

Chemo-damage mystery solved

Doxorubicin is often the first-line chemo treatment for cancer patients, but it has a serious side effect: heart damage. Now scientists at Tufts have figured out why, which could be the first step toward reducing it.

You should know this by now: Everything bad is either caused by gut bacteria or inflammation. In this case it’s inflammation — apparently doxorubicin increases the levels of immune cells called CD8+ cytotoxic T-cells.

Their research showed that in mice the T-cells are releasing molecules that are meant to cause cell death, which are normally intended to combat viruses and other invaders, but these molecules cause fibrosis and stiffen the heart, preventing it from contracting well.

They don’t know how to prevent it … yet. But their finding “suggests that blocking T-cells from going into the heart might be a strategy to make a medication to prevent the cardiac damage associated with the drug.”

The Long Read: Flovent fallout

Since GSK stopped selling Flovent in favor of its identical generic, patients (and their parents) are left scrambling for an alternative, as PBMs aren’t covering the generic.

[T]he generic version costs more, and pharmacy benefit managers did not want to pay more, so they didn’t cover it in many insurance plans. The end result of the negotiation stalemate is that patients lost out.

Next time someone says, “We don’t want the government deciding what drugs I can take!” ask them if it’s better to have insurance companies making that choice….