Anorexia nervosa
Fluoxetine, an established anti-depressant, may be helpful in the treatment of anorexia nervosa, according to preliminary research. A selective serotonin receptor inhibitor (SSRI), fluoxetine may be indicated after initial weight restoration has been achieved. The study found that those treated with fluoxetine for one year had a significant increase in weight, reduction in core eating disorder symptoms, obsessive thoughts and depressive or anxiety symptoms. Larger studies will be needed to confirm these initial findings. (Therapeutics Today, July 2001, No 4)
Thiomersal
Thiomersal has been used as an effective preservative in vaccines since the 1930s to prevent microbial contamination. Thiomersal contains mercury - a substance both European and American regulators recommend manufacturers should phase out. In the US, there have been suggestions that thiomersal-containing vaccines have been linked with the rise in incidence of autism. This theory conflicts with UK evidence, where the use of thiomersal-containing vaccines has declined while reports of autism continue to rise. All vaccines in the Immunisation Guidelines for Ireland (1999) for children under two are thiomersal-free and manufacturers are aiming to have all adult and childhood vaccines thiomersal-free in the coming year. (Drugs 2001; 61:565-572)
Poison therapy
A study in the British Medical Journal found that psychotherapy may be a valuable treatment for patients who deliberately poison themselves. Over 100 adults who attended a hospital emergency department were included in the study. Patients were randomly allocated to two groups. The intervention group received four sessions of psychological therapy at their home. The control group received routine care, which in most cases consisted of referral back to their general practitioner. After six months, patients receiving therapy had fewer suicidal thoughts compared with those receiving routine care. They were also more satisfied with their treatment and were less likely to report repeated attempts to harm themselves. These findings could be a first step towards improving the management of suicidal behaviour, according to the authors. (British Medical Journal, July 2001, Volume 323: 135-137).
Folic acid
Improved awareness of the importance of folic acid in the prevention of neural tube defects in babies has not resulted in more women taking it, as recommended, for three months before conception and in the first three months of pregnancy. In a study of women attending ante-natal clinics in Dublin, 92 per cent had heard of folic acid and 67 per cent knew it could prevent neural tube defects. Thirty per cent were advised to take it peri-conceptually yet only 18 per cent did. The researchers concluded that folic acid was not "visible" enough and that fortification of food was a more realistic option. (Irish Medical Journal)
Embryo screening
The screening of embryos for an abnormal number of chromosomes has been approved in Britain, according to a report in the British Medical Journal. This is the first time the Human Fertilizsation and Embryology Authority has approved a technique that detects a range of genetic abnormalities rather than one specific genetic disease. It was accused by Human Genetics Alert, a group that monitors developments in genetic medicine, of crossing 'the crucial ethical line between testing individuals for specific genetic disabilities and a broad screening programme'. The technique is thought to increase the success rate of in-vitro fertilisation by eliminating those embryos that have a poor chance of implanting in the womb. (British Medical Journal)
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