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An interesting question for depression sufferers and their doctors is why antidepressants work for some people and not for others.

 If someone is diagnosed with depression, and his or her doctor prescribes a Selective Serotonin Reuptake Inhibitor (SSRI) such as Prozac or Zoloft, only about 2/3 of people respond to a given drug.

The doctor typically will then try another, and another, until the right one is found. Meanwhile, the patient has endured additional weeks of depression and expenses.

Findings from the University of Iowa shed a little light on why these drugs work for some people and not for others.

“The study focused on a gene associated with the availability of serotonin, a chemical that at low levels can affect mood and sleep. The researchers found that among people with a variation in this gene, women were more likely than men to have altered processes related to serotonin,” according to a press release on the study.

The results were based on genetic analysis and depression assessments for 192 individuals and appeared online Wednesday the American Journal of Medical Genetics.

“While the finding is exciting, the researchers caution that they have not found a ‘depression gene,’ as genes alone cannot cause behaviors,” the release continued.

Researchers  investigated the function of SLC6A4, a serotonin transporter gene. They found that chemically turning off the gene’s function occurred more often in women with the variant than men with the variant.

“This means that in some women less gene expression resulted in less mRNA, which is the genetic material that helps a gene make a protein,” according to the release.

Genes don’t code for behavior. They allow production of proteins, which may or may not influence behavior, depending on their function.

“The gene variant we studied may make some people more prone to develop depression if they experience more stress or abuse — similar to how, if two people have a genetic risk for osteoporosis, the one who runs may be more likely than the one who swims to actually develop osteoporosis,” one researcher said.

Jeff Raymond, Medical Writer

As I looked through the 1,200 e-mail messages I accumulated during my vacation, I ran across this.

According to data from the National Survey on Drug Use and Health released last month, full-time workers ages 18 to 64 in the “personal care” and “service occupations” had the highest rates of depression, followed closely by food service. The survey used 2004-06 data to determine depression rates by occupation.

During this time, an annual average of 7 percent of full-time workers ages 18-64 experienced a “major depressive episode” in the past year.

For women, the highest rates of depression were in food preparation and service occupations — 14.8 percent. For men, the highest rates were in arts, design, entertainment, sports and media — 6.7 percent.

The unemployed had higher rates of depression than did those employed full time and part time.

U.S. companies lost an estimated $30 to $44 billion a year because of depression-related lost productivity, absenteeism and low morale, according to a press release on the study.

And, of course, depression rates vary by occupation and industry. Seems obvious, but it’s interesting to see research bear it out.

Occupations with the lowest rates of depression were engineering, architecture and surveying; life, physical and social sciences; and installation, maintenance and repair.

As this is a health care blog, 9.6 percent of health care practitioners and technical personnel reported being seriously depressed.

I have one observation to make on the men’s end: Many people wind up in arts-entertainment-media jobs straight out of college, with stars in their eyes. When they find out how little money they’ll make, and realize how incredibly competitive the job markets are, they get down.

Take, for example, a dream job as a trainer with a professional sports team. Now imagine having to deal with the debt of a master’s degree, frequent travel, little respect and a paltry salary. That’s just one example I’m personally familiar with.

Wanna talk? E-mail me at jraymond@oklahoman.com.  

Jeff Raymond, Medical Writer

Emergency room payments declined over an 8-year period, with Medicaid paying less overall than do uninsured patients, a recent study in the Annals of Emergency Medicine reported.

In a news release, researcher Dr. Renee Hsia of the University of California at San Francisco said the “falling reimbursements” were a “consistent trend” over the study period.

“What surprised us was that uninsured patients actually pay a higher proportion of their emergency department charges than Medicaid does,” she said.

According to the release, 35 percent of charges for uninsured visits were paid in 2004, compared to 33 percent for Medicaid visits.

Researchers studied charges and payments for 43,128 emergency department visits from 1996-2004. Nationally, the overall proportion of charges paid for outpatient emergency room visits declined from 57 percent to 42 percent.

“Declining reimbursement ratios will cut into the ability of emergency departments to recover their actual costs of providing care,” Hsia said.

Jeff Raymond, Medical Writer