June 2010

Olanzapine Long-Acting Injection
Extended-release injectable olanzapine (Zyprexa Relprevv) appears to be similar in efficacy to oral olanzapine for relapse prevention in patients with schizophrenia.

Preventing Relapse in Bipolar I Disorder: Lithium, Valproate, or the Combination?
In an open-label trial, the combination of lithium and valproate (Depakote and others) was more effective at preventing breakthrough mood episodes than valproate monotherapy in patients with bipolar I disorder.

Choosing among SSRIs: How Does Fluvoxamine Rate?
Fluvoxamine (Luvox and others) is similar to other selective serotonin reuptake inhibitors (SSRIs) in efficacy and overall tolerability for the acute treatment of major depression. Specific side effects vary among antidepressants.

In Brief
"Traditional" Diet Lowers Risk of Depression and Anxiety; ECT Benefits Patients with Chronic PTSD

Green Tea and the Risk of Depression
In a cross-sectional study, increased consumption of green tea was associated with a decreased risk of depression.

Green Tea and the Risk of Depression

June 2010

Growing evidence suggests that inflammatory processes may contribute to psychiatric disorders (BTP 2009;32:16) and that diet may influence brain pathology (BTP 2010;33:12-13, "In Brief," p. 25, this issue). Now comes a report that the consumption of green tea, perhaps because of its anti-inflammatory effects, might lower the risk of depression in the elderly.

Over one thousand cognitively healthy community-dwelling Japanese, aged 70 years and older, participated in a cross-sectional study conducted by Niu and coworkers.1 Just over half of the subjects were women. How much green tea each subject consumed was determined by self report, and depressive symptoms were evaluated using the 30-item Geriatric Depression Scale. A statistically significant decrease in the risk of depression was associated with increased daily consumption of green tea.

A cross-sectional study can only suggest hypotheses, not prove them. One of the main components of green tea, theanine, an amino acid derivative, ameliorates the overproduction of proinflammatory cytokines and mediators. This would be consistent with an inflammation component to depression. On the other hand, independent variables, such as a generally healthy lifestyle, might encourage green tea intake and separately protect against depressive symptoms. Nonetheless, these findings support other observations concerning the association of diet and inflammatory processes with mental illness and deserve attempts at replication.

We thank Dr Chittaranjan Andrade, whose article on this topic in his newsletter, Synergy Times, inspired this piece.

1Niu K, Hozawa A, Kuriyama S, Ebihara S, Guo H, Nakaya N, Ohmori-Matsuda K, Takahashi H, Masamune Y, Asada M, Sasaki S, Arai H, Awata S, Nagatomi R, Tsuji I: Green tea consumption is associated with depressive symptoms in the elderly. Am J Clin Nutr 2009;90:1615-1622.