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        New Message Board Archives >> Medications, Treatments, Therapies 2003 >> Inositol
        
(Message started by: floridian on Jul 27^th, 2003, 1:12pm)

Title: Inositol
Post by floridian on Jul 27^th, 2003, 1:12pm

Any one used Inositol? At Pubmed, there is some research showing that it is better than serotonin reuptake inhbitors in treating anxiety, depression, and obsessive/compulsive disorder. These conditions occur in the cluster head population more frequently than the general public. Normalizing serotonin with inositol might also conceivably deter cluster headaches themselves, although there is no research one way or the other that it actually does.

Inositol is a vitamin B like substance, few if any side effects, and reasonably innexpensive. There was limited info on how it interacts with other meds, so please do some research before adding this to your regimen. In one study, they compared an SSRI alone to the SSRI plus inositol, and found no difference (inositol doesn't seem to be additive or synergistic with SSRIs).

Inositol is also essential to cell membrane health, another condition that is disrupted in CH patients. The normal diet provides about 1 gram of inositol; the studies I saw involved 12 - 18 grams per day as a supplement. Inositol powder is soluble in water, and has little flavor. The type of inositol studied for the nervous system was myo-inositol (inositol monophoshate). IP6, or inositol hexaphosphate, is a different form that has some effects on cancer and the immune system.

Title: Re: Inositol
Post by Ueli on Jul 27^th, 2003, 2:45pm

on 07/27/03 at 13:12:40, floridian wrote:

.... anxiety, depression, and obsessive/compulsive disorder. These conditions occur in the cluster head population more frequently than the general public.

I never heard about this. Could you please give us a link to these data?

Could be Inositol is better than SSRIs, but SSRIs are not known to be very helpful against CH.

PFNADs
Ueli

Title: Re: Inositol
Post by floridian on Jul 27^th, 2003, 5:18pm

Ueli, Here are two articles dealing with the link between clusters and anxiety. I have seen others, but can't find them off the top of my head.

Cluster headaches: association with anxiety disorders and memory deficits.

Jorge RE, Leston JE, Arndt S, Robinson RG.

Department of Psychiatry, University of Iowa Hospitals & Clinics, Iowa City 52242-1057, USA.

OBJECTIVE: To estimate the frequency of mood and anxiety disorders and to assess memory and executive functions among a representative group of patients with episodic cluster headache (ECH) during the course of an acute episode. METHODS: We compared 21 patients with ECH with 21 patients with tension headache (TH) matched for age, sex, and educational level. Psychiatric diagnosis was made by a semi-structured interview and Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria. Quantitative measures of depression and anxiety were obtained using the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale (HARS). In addition, all patients received a neuropsychological evaluation to assess basic memory and executive functions. RESULTS: Of the 21 patients with ECH, 5 (24%) met DSM-IV criteria for an anxiety disorder during the year before the episode. Panic disorder was diagnosed in two patients (10%). The remaining three patients (14%) met criteria for generalized anxiety disorder. Of the 21 patients with TH, 2 (10%) met diagnostic criteria for an adjustment disorder with depressed mood, and 1 (5%) met criteria for an adjustment disorder with mixed anxiety and depressed mood. HARS scores were higher among patients with ECH (Kruskal-Wallis, chi2 = 4.3, df = 1, p = 0.03). ECH patients also showed significantly lower Auditory Verbal Learning Test scores (Kruskal-Wallis, chi2 = 6.5, df = 1, p = 0.01). CONCLUSIONS: When compared with a group of patients with TH, ECH patients showed a higher frequency of anxiety disorders during the year before the onset of headaches and significantly greater HARS scores during the episode. In addition, patients with ECH were selectively impaired in verbal memory.

Episodic cluster headache. I: Personality and some neuropsychological characteristics in male patients.

Levi R, Edman GV, Ekbom K, Waldenlind E.

Department of Neurology, Soder Hospital, Stockholm, Sweden.

The etiology and pathogenesis of cluster headache remain largely unknown. Some previous studies have focused on personality characteristics in cluster headache. However, no consistent personality profile has been found. The present study applied two personality inventories, the Karolinska Scales of Personality (KSP) and the Heart and Lifestyle Type A Measure (HALTAM), that have not previously been used in the context of cluster headache. A correlation has been suggested between left-handedness and early learning difficulties, and cluster headache. Thus, these variables were included and measured by inventory techniques. Forty-nine out of 51 consecutive male patients with episodic cluster headache participated in the present study. As compared to controls, the cluster headache patients were significantly more anxiety-prone (higher scores in the KSP Somatic anxiety and Muscular tension subscales), less successfully socialized (low scores in the KSP Socialization scale), and had a more hostile attitude towards others (higher scores in the HALTAM Hostility scale). No relationships between left-handedness or early learning difficulties, and cluster headache disease were found. The implications of the personality differences for the etiology of cluster headache disease are discussed.

PMID: 1563942 [PubMed - indexed for MEDLINE]

Title: Re: Inositol
Post by floridian on Jul 27^th, 2003, 7:37pm

I went back to check the other references. The link to depression is not simple. Some of the articles went as far as claiming that there is no link between CH and depression, but I think this is because small sample size in the studies led to rejection of all but the strongest associations. For example, the first article below says that depression is notably comorbid with anxiety. CH is also strongly comorbid with anxiety. Is it possible that CH is not comorbid with depression? Yes, but it seems unusual, and might be related to statistical limitations as mentioned above. Maybe its my personal bias - depression starting in my teens, anxiety starting in my 20s, and clusters starting in my 30s. I have always thought of the three conditions as manifestations of the same underlying pathology. I guess I buy into the "affective spectrum disorder" model cited in the second abstract - maybe that idea will be proven wrong, although there is some evidence for it. But I think the spectrum is real, and that CH is part of it.

Further reflection: Maybe my original statement was too broad. I was able to find absolutely nothing on Pubmed that contained the terms "Cluster Headache" and "Obsessive Compulsive disorder" (or "OCD"). Although I find this lack of research strange, it may be that some research looked for many things (using the DSM, MMPI, etc) found nothing, and simply reported the lack of correlation to "other disorders."

more thoughts to come later. . .

[Epidemiology and comorbidity of depressive disorders]

[Article in German]

Wacker HR.

Psychiatrische Universitatspoliklinik Basel.

Recent epidemiological surveys in general populations of different countries of the world found lifetime prevalence rates of major depressions between 3.3% and 17%. For dysthymia (depressed mood over a period of at least two years with at least two concomitant depressive symptoms) the prevalence rate was found to be between 2% and 7%. The prevalence rates of major depressions and dysthymia are usually higher for females than for males. Bipolar disorders can be observed in about 1% of a general population over lifetime, and they seem to be somewhat more common among males than females. Divorced and separated persons have a higher risk of suffering from major depressions than married persons. Major depressions are thought to be more common among members of the lowest social class than among people belonging to the upper classes. Major depressions usually start between the age of 25 and 30 years, and the age of onset of bipolar disorders is between the age of 18 and 30 years. For western industrial nations a secular trend towards an increase in the prevalence of major depressions may be presumed. However, such a secular trend has not yet been confirmed, owing to biases associated with methodological problems. A notable comorbidity of major depressions can be observed with all anxiety disorders, obsessive-compulsive disorders, eating disorders, post-traumatic stress disorder, disorders of impulse control, abuse and dependence of alcohol and of other legal and illegal drugs, pathological gambling, migraine, fibromyalgia and irritable bowel syndrome. This observation has led to the concept of an "affective spectrum". This phenomenon has to be kept in mind during the diagnostic process and treatment.

Affective spectrum disorder: does antidepressant response identify a family of disorders with a common pathophysiology?

Hudson JI, Pope HG Jr.

Biological Psychiatry Laboratory, McLean Hospital, Belmont, MA 02178.

Response to pharmacologic treatments may identify groups of disorders with a common pathophysiology. The authors applied a treatment-response model, based on four classes of antidepressants (tricyclic types, monoamine oxidase inhibitors, serotonin uptake inhibitors, and atypical agents), to the medical literature. The model identified eight disorders that may share a pathophysiologic abnormality: major depression, bulimia, panic disorder, obsessive-compulsive disorder, attention deficit disorder with hyperactivity, cataplexy, migraine, and irritable bowel syndrome. Phenomenologic and family studies support this grouping. If the model is validated, this family of disorders, which the authors term "affective spectrum disorder," would represent one of the most prevalent diseases in the population.