Dizziness

Herbal medicinal product: Agni casti fructusArray, C: ongoing call for scientific data

• The ongoing study evaluates the safety, pharmacokinetics, and efficacy of continuous subcutaneous administration of low-dose lenalidomide (STAR-LLD) in conjunction with dexamethasone and bortezomib (Velcade®).
• Remarkably, the trial is progressing ahead of schedule and with the addition of RMOC is now projected to conclude enrollment by Q1/2024.
• I’m excited about the potential opportunity STAR-LLD can bring to multiple myeloma patients.”
  Earlier last month, Starton disclosed preliminary trial findings regarding the safety and efficacy of STAR-LLD for multiple myeloma.
• Notably, no hematologic toxicities greater than Grade 1 have been observed following up to 3 cycles of treatment thus far.

• All you need is love.
• It’s better to have loved and lost than never to have loved at all.
• But is love all pink hearts, roses and teddy bears – or is there a darker side?

Pathological Love

• Love can hurt.
• Ian McEwan framed a pathological form of affection, leading to obsession in his 1997 novel “Enduring Love”.
• They appear even in the words of Hippocrates, described as a form of unrequited love.
• The condition has seen a renaissance, over the past three centuries, shifting from unanswered love to sex addiction, to its current standing of delusions of love.

I love Paris in the springtime

• Love, or perceptions of love for material objects or places rather than individuals might also be enough to trigger psychiatric illness.
• Stendhal was not a psychiatrist, but a writer, who found himself overcome by the beauty of Florence when travelling there in 1817.
• For others, unfortunately not – leading to a condition known as Paris Syndrome.

Too many broken hearts in the world

• The term broken heart syndrome applies to a genuine cardiac condition – Takotsubo cardiomyopathy.
• The underlying cause of broken heart syndrome?
• The raised levels of adrenaline have been proposed as an underlying cause of broken heart syndrome – a link between heart and mind – though more research is required to tell for sure.

Dan Baumgardt does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

• Around one in seven Australians take antidepressants; more than 3.5 million of us had them dispensed in 2021–22.
• Guidelines mostly recommend antidepressants for more severe depression and anxiety but not as first-line treatment for less severe depression.
• So why are so many Australians taking antidepressants and why are prescriptions rising?

Enter the antidepressant ‘blockbusters’

• In the 1990s, pharmaceutical companies heavily promoted new selective serotonin reuptake inhibitors (SSRI) antidepressants, including Prozac (fluoxetine), Zoloft (sertraline) and Lexapro (escitalopram).
• These drugs were thought to be less dangerous in overdoses and seemed to have fewer side effects than the tricyclic antidepressants they replaced.
• Pharmaceutical companies marketed SSRIs energetically and often exaggerated their benefits, including by paying “key opinion leaders” – high-status clinicians to promote them.

Why are antidepressants prescribed?

• GPs also prescribe antidepressants to patients experiencing distress but who don’t have a psychiatric diagnosis.
• Another, who cried when informed she had breast cancer, was immediately offered a prescription for antidepressants.

• Most patients believe antidepressants restore a chemical imbalance that underpins depression.
• Antidepressants are emotional (and sexual) numbing agents – sometimes sedating, sometimes energising.
• Around half of users have impaired sexual function and for some, this sexual dysfunction persists after stopping antidepressants.

How long do people take antidepressants?

• Around half of patients who start antidepressants don’t like them and stop within weeks.
• Of those who do take them for months, many continue to use them indefinitely, often for many years.
• Read more:
  Antidepressants can cause withdrawal symptoms – here’s what you need to know

We need to adjust how we view mental distress

• Overprescribing antidepressants is a symptom of our lack of attention to the social determinants of mental health.
• GPs also need to ensure they discuss with their patients the potential adverse effects of antidepressants, and when and how to safely stop them.
• But the fundamental problem is social and can only be properly addressed by meaningfully addressing inequality and changing community attitudes to distress.

Jon Jureidini receives research funding from MMRF. He is affiliated with Critical Psychiatry Network Australasia.