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Anchor lead: Psilocybin may help depression when other therapies fail, Elizabeth Tracey reports

A small Johns Hopkins study led by Alan Davis has shown that some people with depression that hasn’t responded to other types of intervention may respond to psilocybin therapy.

Davis: Many of them had had depression, on average, for decades. Most of them had tried several trials of antidepressants, several times had been in therapy, some of them reported benefit to that but never complete remission. Some of them said that nothing ever helped. This was not what would be considered an easy to treat population of people with depression. These people had not really responded to other attempts at helping their depression and so the fact that we saw so many of them improve was really quite exciting.   :31

More than half of study participants experienced remission of their depression symptoms and remained that way for at least four weeks after the intervention. Davis says these results add to the growing body of evidence for a clinical role for psilocybin and bring hope to the millions of people worldwide who experience depression. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Can psilocybin help depression? Elizabeth Tracey reports

Psilocybin-assisted therapy helped the majority of participants with major depressive disorder experience resolution of their symptoms, a small study led by Alan Davis and colleagues at Johns Hopkins has found. Davis says that initially half the group was offered therapy, then everyone was. 

Davis: Once everyone had the treatment, we found that one week after treatment, we had 67% who had a clinically significant response to the treatment. And at four weeks that was 71%. We defined a clinically significant response as a drop by more than half of their baseline depression scores. In terms of complete remission of depression, at one week after treatment, 58% were in remission. And at four weeks after treatment, 54% were still in remission.   :30

Davis says the treatment involved two five-hour psilocybin sessions at the medical center and results persisted at least four weeks. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: More cases of reinfection with Sars-CoV2 are turning up, Elizabeth Tracey reports

More than a dozen cases of reinfection with Sars-CoV2 have been reported worldwide, causing alarm over just how protective antibodies to the virus are and how long they remain that way. Arturo Casadevall, an antibody expert at Johns Hopkins, says almost everyone who is infected is protected for a time.

Casadevall: If the antibody responses do drop, to a point at which they’re no longer measurable, or they’re not made, we should consider as to whether they’re candidates for vaccination. The same thing can be said for the asymptomatic individuals, who got through it but mount a very weak response. We don’t really know what is protection, now, I am very encouraged that the reinfections are going to be the exception rather than the rule, at least in the short term, because these antibodies that are being made in this infection they are neutralizing. The evidence is that they’re making good reponses.  :31

Casadevall says many details of reinfection cases are unknown, so research is ongoing. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Should we be concerned about immunity when antibodies are given as therapy? Elizabeth Tracey reports

At least two types of antibody therapy are now being used for Covid-19, yet some concerns remain about whether such therapy will compromise the patient’s own immune response. Arturo Casadevall, an antibody expert at Johns Hopkins, says only following such patients over time will provide an accurate answer.

Casadevall: We need to do one thing first. We need to study those who are treated, and we need to see what happens to their antibody responses. There is a lot of noise out there that these antibody responses go all the way down, and people are making what I think are the association of low antibody response increases susceptibility. We don’t know that. The amount of antibody that is needed to protect you may be a minute amount, compared to the amount that you make right after.  As these patients get treated, they go home, they recover, some of them need to be studied to see what happens to their antibody responses.  :32

Casadevall says what is known is that when antibodies are given early they help. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: A monoclonal antibody against Covid-19 has been granted emergency use authorization, Elizabeth Tracey reports

Antibodies developed in a laboratory against a protein Sars-CoV2 uses to enter cells have been granted emergency use authorization by the FDA. Arturo Casadevall, an antibody expert at Johns Hopkins, says this is based on the evidence that the therapy works.

Casadevall: Once again you have another trial showing that administration of antibodies is an antiviral and I think everybody is expecting that if you have something that is functioning as an antiviral and you give it early, you’ll check the disease. Something that we all think happened to President Trump who basically was given antibodies early which functioned as an antiviral, and you see the rapid recovery afterward.  :20

Casadevall says its unknown whether giving antibodies will compromise someone’s own immune reponse.

Casadevall: We’ll know in a few months, but my view is that if you save people’s lives I’ll take low antibody responses, they can always be vaccinated in the future.  :09

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: FDA regulators may have contributed to the prescription opioid epidemic, Elizabeth Tracey reports

Enhanced enrichment randomized withdrawal. Hmmm, not sure what that might sound like to you, but Caleb Alexander, a physician and researcher at Johns Hopkins, shows in a recent study that this is a study design that may have allowed quite a few opioids that have contributed to our current epidemic on the market.

Alexander: Using this trial design everybody is started on the drug. If you don’t respond to the drug or if you have a bad adverse effect, then you’re just removed from the pool of people. This is a fundamentally flawed method of studying the safety and effectiveness of these products. We found both when looking at effectiveness as well as when looking at safety that the FDA missed important opportunities to require manufacturers to generate more information at the time of market approval.  :29

Many are observing that both the opioid and Covid-19 epidemics are continuing apace, yet the former might have had less momentum with better oversight of prescription opioid medications. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: While telemedicine visits provide many advantages there are some gaps, Elizabeth Tracey reports

Telemedicine has been a lifeline for many, enabling people to see their physicians for many types of visits. Yet a Johns Hopkins study led by Caleb Alexander, a physician and researcher, shows that some fundamental metrics may be missing.

Alexander: What we found is huge changes in the structure of primary care delivery since the pandemic started, with very large shifts to telemedicine, but the content of these telemedicine visits differs a lot from those that are being performed face to face. And we find large reductions in the assessment of blood pressure, cholesterol, assessment of these basic cardiovascular risk factors.  :27

Since heart disease remains the number one cause of death, keeping an eye on those risk factors is very important. Alexander says you can help yourself by getting more involved in your own care, perhaps by keeping your own record of blood pressure, diet and exercise, and asking for cholesterol measurement. At Johns Hopkins, I’m Elizabeth Tracey.