Don't let your incompetent? doctor give you this instead of preventing depression the CORRECT WAY OF EXACT 100% RECOVERY PROTOCOLS!
Let's see how long your doctor has known about and working on preventing post stroke depression. I think a decade is plenty of time to come up with the correct solution, at least for those actually trying to solve the problem! Is your competent? doctor trying to solve the problem, or just regurgitating nonsolutions from medical school?
- 33% survivor depression
(48 posts to May 2016)
Didn't your competent? doctor prescribe this years ago?
Sending Positive Signals: Could Exercise Mimetics Help Treat Depression?
University of Ottawa researchers have been studying a concept that might one day allow functionally limited patients with depression to enjoy the mood-boosting benefits of exercise. Their focus is exercise mimetics, which are compounds that appear to reproduce the effects of endurance exercise on skeletal muscle by activating key signaling pathways important for muscle metabolism.
“I saw that there was a discrepancy in how we treated patients with medication and therapy, but we disregarded other treatment measures like exercise, which has a lot of emerging evidence,” lead author Nicholas Fabiano, PhD, a researcher and psychiatry resident at the University of Ottawa, told Medscape News Canada.
“With the increasing interest in exercise for depression, it only made sense to look into what’s happening on the muscle-brain level,” he said.
The researchers’ findings were published February 19 in Molecular Psychiatry.
Sending Positive Signals
During exercise, muscles contract and release myokines, which mediate communication between the muscles and other organs, including the brain. Low cerebral levels of myokines (eg, brain-derived neurotrophic factor and interleukin-6 and -14) have been associated with impaired quality of life and depression, as well as depression-related inflammation and slowed metabolism.
Exercise mimetics include natural substances (eg, omega-3 fatty acids and resveratrol) and synthetic drugs (eg, metformin). The researchers’ theory is that chronic administration of exercise mimetics might cause skeletal muscle fibers to alter their metabolic and contractile activity, thus providing antidepressive benefits like those seen with endurance training.
Data are limited, however. In mice, ingesting exercise mimetics appeared to improve depressive-like behaviors, and the observed mechanisms (eg, enhanced muscle-brain axis, amplified signaling across membranes, and increased myokine secretion) resembled those observed in humans, Fabiano explained.
“There’s not even a whole lot of research at this preclinical level, looking mechanistically in mice or different organisms at what these compounds may do from a mental health perspective,” he said.
The same is true of human studies. A systematic review and meta-analysis highlighted a small, randomized controlled trial in which metformin was associated with significant reductions in depressive symptoms in patients with comorbid depression and diabetes at 24-week follow-up. The underlying mechanism is related to metformin’s effect on AMP-activated protein kinase, which regulates metabolism and energy.
A second systematic meta-review in heterogeneous populations identified four studies in 226 patients without depression. The findings demonstrated a relationship between resveratrol and nonsignificant mood improvements.
A Future Clinical Role?
Each year in Canada, 1 in 10 adults experiences major depression. Various guidelines mention low-to-moderate intensity exercise as a first-line strategy to prevent and treat depression.
But biological pathways may not be critical for the observed antidepressant effect of exercise, Guy Faulkner, PhD, endowed chair in applied public health at the University of British Columbia in Vancouver, told Medscape News Canada. Faulkner’s research focuses on the implementation gap between recommendations and practice.
“What I think is more important is the process of being physically active, which makes people feel better,” he said. “Essentially, it’s the feelings of competence, autonomy, and relatedness that can be generated through a physical activity intervention and experience. It’s much more than these biological or psychological pathways or mechanisms. That’s not to say they’re not occurring, but they don’t seem to be essential for mental health benefits.”
“It’s not an either/or question,” said Johny Bozdarov, MD, staff psychiatrist at the Centre for Addiction and Mental Health and assistant professor of psychiatry at the University of Toronto. Bozdarov’s work focuses on how the effect of exercise on the brain’s networks can be translated into psychiatric care pathways and structure-based exercise interventions for marginalized populations.
“Depression clearly has a biological correlation that research is showing, like inflammation, neuroplasticity, stress hormones, et cetera. But people don’t experience, to our knowledge, depression at the level of cytokines or synapses.”
Whether exercise mimetics will have a future role in clinical practice is uncertain. “It’s scientifically compelling and exciting. But without robust human clinical trials, it’s too early to be thinking about it in clinical translation,” said Bozdarov. “I’m wondering, if the evidence comes out, if it could be as an adjunct, potentially with therapeutic interventions, or to get people started as a first step. Maybe they’d experience a boost in energy or muscle to motivate them to engage in exercise programming.”
When asked about future applications, Fabiano gave a measured response. “Exercise mimetics will probably have a lower efficacy than exercising itself,” said Fabiano. “I don’t think it completely replaces the whole biopsychosocial part of depression.”
“If we could only roll all the benefits of exercise into a pill, it would be prescribed for everyone,” said Faulkner.
Fabiano, Faulkner, and Bozdarov reported no relevant financial relationships.
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