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Doubts on suicide-anti-smoking drug Chantix link

Doubts on suicide-anti-smoking drug Chantix link

Despite earlier health agency warnings, there is no strong evidence that the anti-smoking drug Chantix raises the risk of suicidal thoughts or depression compared to other stop-smoking products, researchers reported Thursday in the British Medical Journal.

Back in July of this year, U.S. health officials ordered strong “black box” warnings be added to Chantix (also called varenicline) as well as anti-smoking drug Zyban, following more than five thousand reports of depression, hostility and other behavioral changes possibly associated with use of these drugs.

“There have been recent concerns that varenicline, a relatively new smoking cessation product, may increase the risk of suicidal behavior and suicide,” study co-author Dr. David Gunnell of the University of Bristol, UK, explained in an email to Reuters Health.

“We found no clear evidence of an increased risk of self-harm or depression associated with varenicline,” he said.

The findings stem from data on more than 80,660 would-be quitters in the UK who used different smoking cessation products between September 2006 and May 2008.

A total of 63,265 of these individuals used nicotine replacement products, 10,973 used Chantix, and 6,422 used Zyban, an antidepressant also called bupropion, which has been found to help smokers quit.

When researchers looked at medical records, they didn’t find any evidence of an increased risk of serious mental health problems (i.e., self-harm, suicidal thoughts or depression) while they were using these products and during the three months after the last prescription was filled.

Gunnell cautioned, however, that based on the size of the study, it’s still possible that Chantix does increase the risk of suicide – or even decrease it.

“Other studies should be undertaken to provide further evidence on this issue,” he concluded.

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Exercise beats angioplasty for some heart patients

Exercise beats angioplasty for some heart patients

Working up a sweat may be even better than angioplasty for some heart patients, experts say.

Studies have shown heart patients benefit from exercise, and some have even shown it works better than surgical procedures. At a meeting of the European Society of Cardiology on Sunday, several experts said doctors should focus more on persuading their patients to exercise rather than simply doing angioplasties.

Angioplasty is the top treatment for people having a heart attack or hospitalized with worsening symptoms. It involves using a tiny balloon to flatten a blockage and propping the heart artery open with a mesh tube called a stent. Most angioplasties are done on a nonemergency basis, to relieve chest pain caused by clogged arteries cutting off the heart’s blood supply.

“It’s difficult to convince people to exercise instead of having an angioplasty, but it works,” said Rainer Hambrecht of Klinikum Links der Weser in Bremen, Germany.

Hambrecht published a study in 2004 that found that nearly 90 percent of heart patients who rode bikes regularly were free of heart problems one year after they started their exercise regimen. Among patients who had an angioplasty instead, only 70 percent were problem-free after a year.

Hambrecht is now conducting a similar trial, which he expects to confirm his initial findings: that for some heart patients, exercise is more effective than a surgical procedure.

Other experts agreed that would likely be the case.

An angioplasty “only opens up one vessel blockage,” said Dr. Christopher Cannon, an associate professor of medicine at Harvard University and spokesman for the American College of Cardiology. He was not linked to Hambrecht’s research. “Exercise does a lot more than fixing one little problem.”

Among other benefits, exercise lowers bad cholesterol while raising good cholesterol, helps the body process sugar better, improves the lining of the blood vessels and gets rid of waste material faster. Exercise also lowers blood pressure and prevents plaque buildup in the arteries.

Previous research has estimated one third of heart disease and stroke could be prevented if patients did two-and-a-half hours of brisk walking every week. In the U.S., that would mean 280,000 fewer heart-related deaths every year.

Joep Perk, a professor of health sciences at Sweden’s Kalmar University and spokesman for the European Society of Cardiology, said two thirds of heart patients in line for an angioplasty could probably get better benefits by regularly working up a sweat.

Experts say less than 20 percent of heart patients get the recommended amount of exercise — about 30 minutes of moderate activity five times a week.

Perk said doctors who performed angioplasties on their patients without asking them to change their lifestyles were ignoring the fundamental problem. “It would be like getting rid of the most troubled rust spots on a car without doing anything to stop more rust from appearing tomorrow.”

Still, doctors admitted that persuading patients to exercise instead of simply going in for an angioplasty, which can take less than a day, would be a tough sell.

“Most patients want the quick fix,” Cannon said. Exercise may improve patients’ hearts better than an angioplasty, but it may also take months or even longer for patients to feel the benefits. “It’s a lot easier to get your artery fixed than it is to exercise every day.”

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Junk food makes you eat more

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Junk food makes you eat more

It triggers messages that are sent to the body’s cells, warning them to ignore appetite-suppressing hormones that regulate our weight.

The effect can last for a few days sabotaging efforts to get back to a healthy diet afterwards, the study found.

The study shows for the first time how particular products can create a vicious cycle of food bingeing.

Lead author Dr Deborah Clegg of the study by UT Southwestern Medical Centre in Dallas, said: “Normally, our body is primed to say when we have had enough, but that does not always happen when we are eating something good.

“What we have shown is that someone’s entire brain chemistry can change in a very short period of time.

“Our findings suggest that when you eat something high in fat, your brain gets ‘hit’ with the fatty acids, and you become resistant to insulin and leptin. Since you are not being told by the brain to stop eating, you overeat.”

The hormone leptin is produced in the brain and suppresses hunger while insulin is produced by the pancreas and regulates blood sugar levels.

Although the study was performed on rats and mice the scientists said their results reinforced common dietary recommendations to limit saturated fat intake as “it causes you to eat more.”

The animals received the same amount of calories in one of three forms of fat – palmitic acid, monounsaturated fatty acid or unsaturated oleic acid which is found in olive and grapeseed oils.

The biggest affect on leptin and insulin was caused by molecules from palmitic acid which is found in beef, butter, cheese and milk.

Dr Clegg, whose findings are published in The Journal of Clinical Investigation, said: “The action was very specific to palmitic acid, which is very high in foods that are rich in saturated fat.

She said it may explain why many people who overindulge on a Friday or Saturday say they are hungrier than normal on Monday.

The findings may also have implications for diabetes research because although scientists have known a high-fat diet can cause insulin resistance, little has been known about the mechanism behind it or whether specific types of fat are more dangerous.

Dr Clegg said: “We found the palmitic acid specifically reduced the ability of leptin and insulin to activate their intracellular signalling cascades. The oleic fat did not do this.”

She said the other key finding is this mechanism is triggered in the brain – long before there might be signs of obesity anywhere else in the body.

Dr Clegg said the next step is to determine how long it takes to reverse completely the effects of short-term exposure to high-fat food.

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