Dr Shock MD PhD

Chocolate rich in flavanols reverses vascular dysfunction in diabetes type 2 diabetic patients between ages 50 and 80 years, highlighting therapeutic potentials in cardiovascular disease. Moreover, flavanol-containing chocolate was well tolerated.

The chocolate condition was a cocoa drink with 321 mg of flavanols thrice daily for 30 days, not your average candy bar. The control condition only contained 25 mg flavanols. In this research CocoaPro cocoa powder made by Mars was used.

How does it work?

We observed the absorption of flavanols in diabetic patients, accompanied by increases in plasma flavanol metabolites, leading to a dose-dependent improvement of endothelial function, corroborating our findings from previous studies in nondiabetic populations

Impaired endothelial function is a key factor for the development of atherosclerosis and its complications in diabetic patients. That's why this is important.

This could be an alternative approach to the prevention of atherosclerosis in this population which is highly needed.

This was a study well done. First the researchers conducted a feasibility study on 10 patients to determine the appropriate dosing, assess safety and tolerability, and measure the effect size of the intervention in order to calculate the appropriate sample size of the subsequent efficacy study.

The efficacy study was undertaken using a randomized, doublemasked, parallel-group design and included 44 patients randomly
allocated to a treatment group (321 mg of flavanols per dose; 3 doses per day) or a control group (25 mg of flavanols per dose; 3 doses per day). Each group ingested a single dose of either treatment or control 3 times a day over a period of 30 days. The authors assessed the acute effects, 2 h after ingestion of the control or the cocoa drink, and the long-term effects, on days 8 and 30.

The accompanying editorial concludes:

These findings expand previous observations to patients with type 2 diabetes and represent a further step in our understanding of the vascular effects of flavanol-rich cocoa.
However, although endothelial function has been shown to predict future cardiovascular events (20), randomized, large scale clinical trials assessing relevant clinical outcomes are necessary before any recommendations are made regarding dietary supplementation with flavanol-rich cocoa.

Related post on this blog: Chocolate and Diabetes, new research


BALZER, J., RASSAF, T., HEISS, C., KLEINBONGARD, P., LAUER, T., MERX, M., HEUSSEN, N., GROSS, H., KEEN, C., SCHROETER, H. (2008). Sustained Benefits in Vascular Function Through Flavanol-Containing Cocoa in Medicated Diabetic PatientsA Double-Masked, Randomized, Controlled Trial. Journal of the American College of Cardiology, 51(22), 2141-2149. DOI: 10.1016/j.jacc.2008.01.059

CAMPIA, U., PANZA, J. (2008). Flavanol-Rich CocoaA Promising New Dietary Intervention to Reduce Cardiovascular Risk in Type 2 Diabetes?⁎. Journal of the American College of Cardiology, 51(22), 2150-2152. DOI: 10.1016/j.jacc.2008.02.058

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Most things in life can be related, one way or another, to an episode of Seinfeld.

It's true. That TV show which claimed to be "about nothing" pretty much said everything that needed to be said about, well, everything.

Take this week's Grand Rounds, the best of the Medical Blogosphere. It's totally Seinfeld. Every post. Why I can hear Jerry, even now...

This weeks grand round is related to episodes of Seinfeld, never heard about this sitcom but the connection to the posts is well done. Love the video's related to the posts, great job, go and read at The Blog that Ate Manhattan

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When both SSRIs and NSAIDs are concomitantly used, it would be sufficient to treat 250 patients per year for 1 case of upper gastrointestinal (GI) tract bleeding to be attributed to such combination, and 500 patients per year if SRIs are concomitantly used with antiplatelet drugs.

SRIs: SSRIs, including sertraline hydrochloride, fluoxetine hydrochloride, fluvoxamine maleate, paroxetine hydrochloride, citalopram hydrobromide, and escitalopram oxalate; selective serotonin and norepinephrine reuptake inhibitors (SNRIs), including venlafaxine and duloxetine hydrochloride.

NSAIDs: ibuprofen, and naproxen.

The authors of this study were the first to point out the dangers of combining SSRIs with NSAIDs in 1999.

In the present study they found an increased risk although smaller than in their previous publication. Increasing use of acid-suppressing medication and declining cohort prevalence of Helicobacter pylori infection and its widespread treatment might account for this smaller risk. They used the same method with another United-Kingdom based general practitioner database in a more recent study period.

Dosage and duration of using these medications was not associated with GI tract bleeding

Use of acid-suppressing agents limits such increased risk.

With SRIs alone it would be necessary to treat approximately 2000 patients per year with SRIs for 1 case of upper GI tract bleeding to be attributed to them, which indicates that the risk is rather low in the general population.

But when they are combined with NSAIDs or antiplatelet drugs, the number of patients needed to be treated per year for 1 case of upper GI tract bleeding decreases remarkably. These data indicate that in such a high-risk population, the use of acid-suppressing agents would save a relevant number of cases and is worthwhile.

So when you have to use both drugs be careful out there. This is not about the occasional NSAID for a headache while taking antidepressants but using both medications at least for weeks could have these side-effects. Even than some people will not get these kind of complications while others will get them after 2 weeks of medication use. Vulnerability is the explaining factor in these matters.

Vulnerability to gastrointestinal side-effects is that recognizable to some of you? Please let me know in the comments.


de Abajo, F.J. (2008). Risk of Upper Gastrointestinal Tract Bleeding Associated With Selective Serotonin Reuptake
Inhibitors and Venlafaxine Therapy. Archives of General Psychiatry, 65(7), 795-803.

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On Medpage today a summary of a variety of alternative approaches that apply electrical currents to the brain are in the research pipeline, and one is FDA approved. A summary of VNS, rTMS, magnetic seizure therapy, deep brain stimulation , TDCS and Implantable cortical stimulation. Never heard of that last one, a new form of neurostimulation?

Implantable cortical stimulation

Another early-stage investigational technology takes vagus nerve stimulation a step farther. Instead of delivering electrical pulses to a nerve, it sends them to the surface of the brain. Seattle-based Northstar Neurosciences is testing a system that, like vagus nerve stimulation, inserts a pulse generator in the patient's chest. An electrical lead is passed into the skull through a surgically drilled hole, terminating on the dural membrane over the cortex.

A nice overview.

On Psych Central: Brain Pacemaker Shows Potential
A short description of the history of deep brain stimulation and two case reports with exceptional indications for deep brain stimulation: one patient was treated for body dysmorphic disorder and the other was treated for debilitating headaches.

Body dysmorphic disorder is excessive preoccupation with minor or imagined flaws in appearance. Dr. Anderson’s patient was a 20-year-old man who obsessed on perceived flaws with his nose and other facial features. He had attempted suicide once, and described his life as a “living hell.” Eight months after DBS surgery, the patient reported mild depression and obsessive compulsive disorder, but no symptoms of body dysmorphic disorder.

The second patient was a 43-year-old woman who suffered paroxysmal hemicrania headaches around the orbit of her right eye. She would typically get 10 to 20 attacks per day, each lasting 2 to 20 minutes. The headaches did not respond to either medications or a nerve block. But as soon as the DBS device was turned on, the woman reported the pain went away.

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• Physical fatigue or loss of energy is included as a single item in the DSM–IV criteria for major depressive disorder


• Some think of lack of concentration as a mental form of fatigue and lack of concentration is also a symptom of depression


• Anhedonia is an inability to experience pleasure from normally pleasurable life events. This is considered to be a core symptom of depression. Some describe it as emotional fatigue


• Atypical depression is associated with hypersomnia, weight gain or increase in appetite, inertia, and leaden paralysis (i.e., severe lethargy and fatigue; heavy, weighted-down feeling in arms and legs)


• Patients with atypical depression are significantly more likely than patients with other forms of depression to report fatigue


• A recent twin study showed that fatigue during a severe major depressive episode is more likely to be reported by women than men


• Fatigue is common in major depressive disorder


• Fatigue is more common especially in the atypical subtype


• Fatigue is the depressive symptom that correlates most strongly with diminished functioning


• Fatigue is a common prodromal symptom in patients with their first major depressive episode


• Fatigue strongly predicts progression to a chronic course of depression


• Fatigue is one of the symptoms that appears to be less responsive
  to antidepressant treatment


• After remission of major depressive disorder, approximately
  10%–35% of patients continue to experience fatigue


• Pharmacological augmentation of antidepressant therapy has shown promise in the treatment of residual fatigue. Modafinil and bupropion are the only two augmentation strategies published on this subject

Now lets' be careful, these observations about depression and fatigue were published in a review, not a systematic review. You could at best consider these observations as the opinion of an expert, not the scientific truth about the relationship between fatigue and depression. Moreover most of these observation are recognizable but don't have to be true. I have linked as much as possible to the references used by the author.

To my opinion does fatigue play an important role in depression but you can't say that fatigues always implies depression. Even in science this mistake is often made. It is comparable to using depression severity scales in somatic ill patients and concluding that a large part of these patients have a depression because they have a high score on these scales. They have a high score due to their medical illness not due to a depression, you need a diagnostic scale for that.


Arnold, L.M. (2008). Understanding Fatigue in Major Depressive Disorder and Other Medical Disorders. Psychosomatics, 49(3), 185-190. DOI: 10.1176/appi.psy.49.3.185

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Born in 1942 into a Jewish family in Brooklyn, the teenage Lou Reed was subjected to electroconvulsive therapy to "cure" his homosexuality. He worked as a house songwriter for Pickwick Records before finding cult fame with art-rock band The Velvet Underground. Post-VU, he released a succession of acclaimed albums, most significantly 1972's 'Transformer', whose themes of drug use and cross-dressing chimed with the mood of the glam-rock movement spearheaded by his friend David Bowie.

Since recent I am participating in the update of the guidelines for ECT in The Netherlands. That gave me the privilige to meet patients treated or being treated with ECT, mostly continuation ECT. In a meeting with them a couple of weeks ago they made remarks about the treatment and how the new guideline could improve ECT. Their experience, critique will be used for the new guidelines. Discussing ECT with these hands on experienced patients was a pleasure and very informative.

A week after that I had a meeting with (ex)patients of Mental Health Care and their significant others. Some of them had experience with ECT in the past. Comparable to Lou Reed some of them had been treated in the sixties with ECT for comparable absurd indications. We had a very lively and instructive discussion about ECT in the past and how ECT is used nowadays. To me these meetings are of immense importance, it changes your perspective on what your doing and how your doing it.

This post was inspired by an article on The Independent on Sunday about Lou Reed, Royal Albert Hall, London Beck, Guildhall, Southampton

He reviews a recent performance by Lou Reed of one of his best albums: Berlin.

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In a recent study, radiologists gave nearly 1,500 women at an increased risk of breast cancer both a mammogram and a stereo mammogram. As a result, the stereo mammograms increased detection of cancer by 23 percent and decreased false alarms by 46 percent.

The stereo mammogram

U.S. scientists are experimenting with new ways to view breast X-rays in 3-D, so that today's mammograms can provide a clearer picture of any existing tumors. Some of those methods include wearing special 3-D glasses as well as using a new camera.

On CBS News

On Gearlog

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Transcranial direct current stimulation (TDCS) could improve memory in participants asked to learn and then recall a list of 12 words. The effect was significant in the early learning stages: in the first few trials, in which participants were given the same list over and over again, people in the treatment group could remember more words. But the learning curve for those working without the device quickly caught up to the zapped learners.

This conclusion of a recent research on TDCS published on Technology Review: Want to Enhance Your Brain Power?

At first the encoding of of the words is better in subjects treated with TDCS. Improving the encoding by training this test catches up after a while. The treatment with TDCS was done prior to the learning task, what if it was done during the test?

What is TDCS?

The device is simple: a nine-volt battery that's been approved by the Food and Drug Administration for delivering drugs across the skin is connected to large flat sponges that are moistened and then applied to the head. It delivers a gentle 2 to 2.5 milliamps of current spread over a 20 to 50 square millimeter area of the scalp for up to 15 minutes. Little of that current actually reaches the brain--about half is shunted away from the target area, and the other half quickly dissipates as it gets farther from the scalp. The target in this research was the part of the brain known as the dorsolateral prefrontal cortex, a brain area involved in higher-level organization and planning, as well as in working memory. Because activity in this region has been shown in previous imaging studies to predict an individual's ability to recall information, the idea is that giving it an electrical boost will enhance memory function.

TDCS is something completely different than ECT. It is not used to elicit a general seizure, it doesn't require anesthesia and it is not tested properly for the treatment of depression.

Side-effects of TDCS
In the afore mentioned article only a slight dizziness was reported as side effect. In a upcoming publication in Brain Stimulation other side-effects are reported with TDCS. In 4 out of 4 patients treated with a higher dose (2mAmpere) during each active TDCS session with over 20 minutes (15-second ramp in and ramp out each) of stimulation on 5 days per week during a 2-week period, skin lesions were present. Generally, these lesions occurred after the fourth or fifth DC-stimulation, showed stable superficial extensions during further tDCS, and healed without scars about 1-3 weeks after the end of tDCS treatment.

The occurrence of lesions may depend on the intensity and duration of TDCS as well as on the impedance between electrode and skin.

Thanks Neuromod Blog

Related post on this blog: tDCS electrifying?


PALM, U., KEESER, D., SCHILLER, C., FINTESCU, Z., REISINGER, E., PADBERG, F., NITSCHE, M. (2008). Skin lesions after treatment with transcranial direct current stimulation (tDCS). Brain Stimulation DOI: 10.1016/j.brs.2008.04.003

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After remission on ECT for psychotic depression the combination of nortriptyline and ECT prevented relapse or recurrence in 11 of 16 patients during follow-up of 2 years, of the 17 nortriptyline treated patients only 5 were considered without relapse or recurrence. The mean survival time until relapse was 23 months in the ECT with nortriptyline group and 16 months in the nortriptyline group.

ECT or electroshock is the only treatment in psychiatry that is stopped when successful. Usually treatment is continued with an antidepressant or the combination of an antidepressant with lithium. Tricyclic antidepressants are mostly used because most research on continuation treatment after ECT is done with these antidepressants.

Most research is done with adults not specifically with elderly. When a severely depressed elderly is admitted to our ward and recovers I usually advice them not to stop their antidepressants. I have seen to many relapse when tapering or stopping their antidepressants. There time left is to valuable to spent on psychiatric wards.

A severe form of depression, psychotic depression usually warrants ECT treatment in the elderly. This severe form of depression leads to deterioration fast which can be interrupted effectively by ECT.

In this research a group of elderly with psychotic depression was treated with ECT and nortrityline. When remitted (33/38, 86.8%) they were randomized single blind to continuation ECT with nortriptyline or nortriptyline alone. The high percentage of remitters is no exception with ECT for psychotic depression.

The combination of continuation ECT with nortriptyline is exceptional. In adults a recent trial comparing continuation ECT to nortriptyline with lithium showed no significant difference in relapse during a 6 month follow-up. You can read about this study published in the Archives of General Psychiatry in a post on this blog. Nevertheless both treatments were well tolerated although cognitive side effects were not adequately monitored.

Other limitations of this study are the small sample size, only 14 had initially received pharmacotherapy for their episode before ECT.


Navarro, V. (2008). Continuation/Maintenance Treatment with Nortriptyline Versus Combined
Nortriptyline and ECT in Late-Life
Psychotic Depression: A Two-Year Randomized Study. American Journal of Geriatric Psychiatry, 16(6), 498-505.

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It's becomes clear that games can have a positive effect on health, whether by helping to improve kids' fitness levels, or by being used as physical rehabilitation tool for the elderly.

These are just two examples of video games used in health care in a recent post on BBC News: Video games get into shape.

In summary video games are used in:

• A motivational and education tool towards a healthier lifestyle


• Virtual reality games as a form of pain control for burns patients


• Virtual environments can be very useful for treating patients suffering from "phantom limb" experiences following amputations


• Virtual reality systems to help treat some of the many Iraq war veterans who return home with post-traumatic stress disorder


• Games are being used to treat migraine, based on research into neurofeedback treatment techniques


• Virtual clinic for training doctors and nurses to deal with the injuries caused by large-scale natural disasters or on the battlefield


• Surgeons who frequently play ordinary videogames make more than a third fewer mistakes in simulations of laparoscopic surgery than those who don't

You can read more about these roles of games in health care here

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This week the medical grand rounds is on The Covert Rationing Blog.

This week, bloggers from across the Internet have submitted articles that will help us celebrate the 232nd birthday of the United States of America.

Go read the finest and newest posts on the medical blogosphere.

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Drug use does not appear to be related to drug policy, as countries with more stringent policies (e.g., the US) did not have lower levels of illegal drug use than countries with more liberal policies (e.g., The Netherlands).

This is the conclusion in a recent publication in PLoS Medicine: Toward a Global View of Alcohol, Tobacco, Cannabis, and Cocaine Use: Findings from the WHO World Mental Health Surveys.

The researchers set out to collect basic patterns of alcohol, tobacco, cannabis, and cocaine use in different countries. They documented lifetime use of these substances in each county, focusing on young adults. They also wanted to examine the age of onset of use and whether the type of drugs used was affected by one's social and economic status.

Other important results of this survey:

• In the Americas, Europe, Japan, and New Zealand, alcohol had been used by the vast majority of survey participants, compared to smaller proportions in the Middle East, Africa, and China


• The US has the highest levels of both legal and illegal drug use among all countries surveyed


• Males were more likely than females to have used all drug types: legal and illegal


• Younger adults were more likely than older adults to have used all drugs examined


• Higher income was related to drug use of all kinds


• Marital status was found to be linked only to illegal drug use


• The use of cocaine and cannabis is more likely in people who have never been married or were previously married

PLoS Medicine is an excellent open journal , you can read the whole article or the editors'summary here


Degenhardt, L., Chiu, W., Sampson, N., Kessler, R.C., Anthony, J.C., Angermeyer, M., Bruffaerts, R., de Girolamo, G., Gureje, O., Huang, Y., Karam, A., Kostyuchenko, S., Lepine, J.P., Mora, M.E., Neumark, Y., Ormel, J.H., Pinto-Meza, A., Posada-Villa, J., Stein, D.J., Takeshima, T., Wells, J.E., Hay, P. (2008). Toward a Global View of Alcohol, Tobacco, Cannabis, and Cocaine Use: Findings from the WHO World Mental Health Surveys. PLoS Medicine, 5(7), e141. DOI: 10.1371/journal.pmed.0050141

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"Sequencing the cocoa genome is a significant scientific step that will allow more directed breeding of cocoa plants and perhaps even enhance the quality of cocoa, the key ingredient in chocolate," privately held Mars said in a statement.

In order to protect the cocoa bean and improve survival from diseases such as pest due to a higher disease resistance, MARS and IBM join together in exploring the cocoa genome.

"Sequencing the genomes of agriculture crops is a critical step if we want to better understand and improve a crop,"

Thanks The Great Beyond

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The Cloud was build by MIT. It is now part of the “Redesigning Fashion Trade Shows” in Florence, Italy (map here). So if your in the neighborhood go and see. Never thought lights could be this sensual (see clip).

An organic sculptural landmark that responds to human interaction and expresses context awareness using hundreds of sensors and over 15,000 individually addressable optical fibers. Constructed of carbon glass, spanning over four meters, and containing more than 65 kilometers of fiber optics, the Cloud encourages visitors to touch and interact with information in new ways, manifesting emotions and behavior through sound and a dichotomy of luminescence and darkness.

Thanks Bright

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As a two-person team of photographer and biologist, our aim is to combine scientific exactness with aesthetic appearances, and thereby help to bridge the gap
between the world of science and the world of art

Biologist Nicole Ottawa and photographer Oliver Meckes utilize Scanning Electron Microscopy (SEM). They expose a fascinating world beyond human vision.

Beautiful pictures of bacteria, viruses, from medical science, zoology crystals and many others. Have a look at Eye of Science

Blood, erythrocytes.

Bacteria: E. Coli

Thanks Divine Caroline

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In this song Nellie McKay sings about the creation of the ultimate companion, clonie.

Listen closely, she sings awfully fast for non native english speakers.

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fMRI or functional magnetic resonance imaging is the measurement of activity in the brain or more precise it measures the haemodynamic response related to neural activity in the brain or spinal cord of humans or other animals. It is one of the most recently developed forms of neuroimaging.

Often results of research with fMRI have promised that we can now look inside the brain and really see what is happening in the brain during certain tasks such as memory tasks and many others.

Although brain scanner technology is often described as a "window into the brain," Logothetis, in this most recent article, makes it clear that the metaphor of transparency is inappropriate. He cites a long list of factors that complicate the interpretation of fMRI data, from the challenge of distinguishing between excitation and inhibition to the difficulty of measuring the relative activation of different brain areas. If brain scanners are like a window, then the window has some very dirty glass.

In a recent article in Nature these claims are said to be very limited by technical shortcomings of this kind of neuroimaging. The article is written by one of the experts that helped develop the fMRI technique.

Now I am not the first one to write about this nature article, but this news looked important to me so that is why I wanted to point out the other excellent descriptions of this nature article in the blogosphere:

Pure Pedantry, he also describes an excellent example of misuse of fMRI.

The Frontal Cortex

Mind Hacks

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A number of studies have shown cardiovascular benefits of eating flavanol rich cocoa. In this post I will discuss the possible underlying mechanisms of these cardioprotective properties of chocolate as published in a recent review article: Flavanol-rich cocoa, a cardioprotective nutriceutical.

• Cocoa flavanols as antioxidants. Antioxidants are substances that may protect cells from the damage caused by unstable molecules known as free radicals.Oxidation of low-density lipoprotein (LDL) has been implicated in atherogenesis. Or LDL, a form fat in your blood that plays an important role in harming especially your larger blood vessels can lead to hypertension, lack of oxygen supply to the heart with as complication a hart attack. Antioxidants such as flavanols in chocolate that prevent LDL from oxidizing may reduce atherosclerosis. Although the precise mechanism of flavanol’s antioxidant action has not been agreed upon, research findings do suggest that the consumption of cocoa flavanols in the diet can significantly improve the
  oxidative defense system.


• Modulation of vascular function. Impaired arterial endothelial function or impaired function of the inner layer of blood vessels has been shown to be a significant early event in atherogenesis and has been associated with an increased cardiovascular risk. Other diseases such as stress, ischemia (short oxygen supply), atherosclerosis, diabetes mellitus, and hypertension, can disrupt endothelial function. As a result, a dysfunctional endothelium may lose its protective effects on the vascular system. The acute consumption of dark chocolate by healthy volunteers have shown the acute dilatation of muscular arteries and an increased arterial elasticity


• Inhibition of platelets. Platelet aggregation or the forming of small blood cloths is the critical event occurring during the initiation of coronary thrombosis which can lead to cardial infarction. Several studies have provided strong support for the antiaggregatory effects of cocoa flavanols.


• Antihypertensive effects. The results of 2 separate studies in healthy subjects and later in hypertensives have shown possible benefits of cocoa in blood pressure lowering.This also can be considered as cardioprotective since hypertension leads to an overload of the heart.


• Anti-infammatory effect. Cocoa flavanols have also been shown to have potential anti-inflammatory activities that are relevant to cardiovascular health. With inflammation, substances are formed which can produce adverse cardiovascular effects.

Now, Dr Shock will never let a change to promote chocolate consumption slip although lack of positive effects are also published on this blog in: Short-term Chocolate Effects on Health.

Moreover, it should also be noted that the evidence for any cardiovascular benefits of cocoa flavanols has been gathered predominantly from short-term and uncontrolled
studies. Therefore, additional research in well-designed, long-term human clinical studies using cocoa would be most helpful in assessing whether flavanol-rich cocoa
could be a potential candidate for the treatment, or possible prevention of cardiovascular disease. The beneficial effects of chocolate also need to be balanced against its high caloric and high fat contents.

Mehrinfar, R., Frishman, W.H. (2008). Flavanol-Rich Cocoa. Cardiology in Review, 16(3), 109-115. DOI: 10.1097/CRD.0b013e31815d95e2

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Light and depression is of interest in recent scientific publications. On Science Daily the use of bright light elderly group care facilities in the Netherlands leads to improvements.

The use of daytime bright lighting to improve the circadian rhythm of elderly persons was associated with modest improvement in symptoms of dementia, and the addition of the use of melatonin resulted in improved sleep, according to a new study.

According to one of the authors dr Eus van Someren: "elderly are somewhat less depressed and more active due to the use of bright light in the facilities for the elderly". "Even melatonin level in the elderly in the bright light facilities was significantly higher during the night". You can read the abstract in a recent JAMA issue.

A recent systematic review examined the efficacy of light therapy in nonseasonal depression. Light therapy is efficacious in seasonal depression but its role in non seasonal depression is unclear. The authors identified 62 reports from which 15 were selected according to their selection criteria. The sample sizes were small, blindness is a troublesome issue in this kind of research and publication bias is probable. Negative results are seldom published especially in such a difficult fieled of research. Their conclusion about light therapy for nonseasonal depression:

Overall, bright light therapy is an excellent candidate for inclusion into the therapeutic inventory available for the treatment of nonseasonal depression today, as adjuvant therapy to antidepressant medication.

So there is more to see that meets the eye with light and depression. Bright light therapy alone for the treatment of nonseasonal depression is not efficacious according to results to date. Further research especially with nonseasonal depression and circadian rythm disturbaces are needed.

What are your experiences with light and depression?

Related posts on this blog:
4 Nonseasonal Depressive Disorders treated with Light Therapy
Chronotherapeutics what is it good for?
8 articles about seasonal affective disorder

Riemersma-van der Lek, R.F., Swaab, D.F., Twisk, J., Hol, E.M., Hoogendijk, W.J., Van Someren, E.J. (2008). Effect of Bright Light and Melatonin on Cognitive and Noncognitive Function in Elderly Residents of Group Care Facilities: A Randomized Controlled Trial. JAMA: The Journal of the American Medical Association, 299(22), 2642-2655. DOI: 10.1001/jama.299.22.2642

EVEN, C., SCHRODER, C., FRIEDMAN, S., ROUILLON, F. (2008). Efficacy of light therapy in nonseasonal depression: A systematic review. Journal of Affective Disorders, 108(1-2), 11-23. DOI: 10.1016/j.jad.2007.09.008

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The three shrinks of Shrink rap did an amazing job with this Grand Rounds, Volume 4, #40. Since the anticipated release of the Apple iPhone 3G is just around the corner (July 11), they asked for submissions to have some connection to the iPhone, no matter how twisted the logic is to make the connection.They made nice graphics and icons to go along with their update of the medical blogosphere.

They even supplied graphics for links to their grand round, see the picture above this post. The red circle is the contribution of Dr Shock, on their site you can click this icon to read the post. Enjoy....

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