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A spike in suicide rates in the United States has cast fresh light on the need for more effective treatments for major depression, with researchers

saying it is a tricky development area that has largely been abandoned by big pharmaceutical companies.

U.S. health authorities said this week that there had been a sharp rise in suicide rates across the country since the beginning of the century and called for a comprehensive approach to addressing depression. The report was issued the same week as the high-profile suicides of celebrities Anthony Bourdain and Kate Spade.

Reuters was not able to determine whether either Bourdain or Spade were getting drug treatment. Representatives could not immediately be reached for comment.

Kate Spade’s husband, Andy Spade, said in a statement this week that she had suffered from depression for many years and was working closely with her doctors.

With the availability of numerous cheap generic antidepressants, many of which offer only marginal benefit, developing medicines for depression is a tough sell.

Far more cancer drugs

Drugmakers have 140 therapies in development targeting mental health issues, including 39 aimed at depression, according to the Pharmaceutical Research and Manufacturers of America trade group. That compares with the industry’s work on 1,100 experimental cancer drugs, which can command some of the highest prices.

“Psychiatry has become a disfavored area for investment,” said Harry Tracy, whose newsletter, NeuroPerspective, tracks developments in drug treatments for psychiatric problems. “Insurers say, ‘Why should we pay more for a new treatment?’ ”

Some say anti-depressant drugs take too long to become effective, if they are effective at all. About half of people with depression fail to respond to current therapies, said Dr. Husseini Manji, global head of neuroscience at Johnson & Johnson’s Janssen unit.

Developing antidepressants is risky. Patients in clinical trials often show a big placebo response, masking the efficacy of the drug being tested. In addition, once approved, antidepressants require a large sales force to reach

psychiatrists as well as primary care providers.

Another impediment is the difficulty of conducting early depression research on animals that could form a basis for trials in people.

“This has been a big challenge to translate over to human clinical trials,” said Caroline Ko, project leader of NewCures, a newly formed program at Northwestern University aimed at reducing the risk of investment in treatments for depression, pain, Parkinson’s and other diseases.

Lone major player: Johnson & Johnson

J&J is the only large pharmaceutical company making a major investment in a new antidepressant, Tracy said. Smaller players include Sage Therapeutics, which expects a decision from U.S. regulators on a treatment for post-partum depression by the end of the year.

J&J’s esketamine targets treatment-resistant depression. It is similar to ketamine, which is used as an anesthetic and to relieve pain, and often is abused as a recreational party drug with the street nickname Special K.

The company expects to file for U.S. Food and Drug Administration approval of esketamine, a rapid-acting nasal spray, this year.

“Standard antidepressants can take weeks to work. They really are not useful in a crisis situation,” said Carla Canuso, who is leading J&J’s effort testing the drug in people deemed at imminent risk for suicide, which is most commonly associated with depression.

Allergan Plc is developing rapastinel, a fast-acting intravenous antidepressant the company purchased in 2015. The drug has breakthrough therapy designation from the FDA, with clinical trial results expected in early 2019. Last month, the company acquired another depression drug from its

collaborator, Aptinyx.

Dr. Julie Goldstein Grumet, a behavioral health expert from the Suicide Prevention Resource Center, said 122 people in the United States took their lives by suicide each day last week. Many were never even diagnosed with a mental illness. 

“We’re missing opportunities to screen people for the risk of suicide,” she said.
…

A spike in suicide rates in the United States has cast fresh light on the need for more effective treatments for major depression, with researchers

saying it is a tricky development area that has largely been abandoned by big pharmaceutical companies.

U.S. health authorities said this week that there had been a sharp rise in suicide rates across the country since the beginning of the century and called for a comprehensive approach to addressing depression. The report was issued the same week as the high-profile suicides of celebrities Anthony Bourdain and Kate Spade.

Reuters was not able to determine whether either Bourdain or Spade were getting drug treatment. Representatives could not immediately be reached for comment.

Kate Spade’s husband, Andy Spade, said in a statement this week that she had suffered from depression for many years and was working closely with her doctors.

With the availability of numerous cheap generic antidepressants, many of which offer only marginal benefit, developing medicines for depression is a tough sell.

Far more cancer drugs

Drugmakers have 140 therapies in development targeting mental health issues, including 39 aimed at depression, according to the Pharmaceutical Research and Manufacturers of America trade group. That compares with the industry’s work on 1,100 experimental cancer drugs, which can command some of the highest prices.

“Psychiatry has become a disfavored area for investment,” said Harry Tracy, whose newsletter, NeuroPerspective, tracks developments in drug treatments for psychiatric problems. “Insurers say, ‘Why should we pay more for a new treatment?’ ”

Some say anti-depressant drugs take too long to become effective, if they are effective at all. About half of people with depression fail to respond to current therapies, said Dr. Husseini Manji, global head of neuroscience at Johnson & Johnson’s Janssen unit.

Developing antidepressants is risky. Patients in clinical trials often show a big placebo response, masking the efficacy of the drug being tested. In addition, once approved, antidepressants require a large sales force to reach

psychiatrists as well as primary care providers.

Another impediment is the difficulty of conducting early depression research on animals that could form a basis for trials in people.

“This has been a big challenge to translate over to human clinical trials,” said Caroline Ko, project leader of NewCures, a newly formed program at Northwestern University aimed at reducing the risk of investment in treatments for depression, pain, Parkinson’s and other diseases.

Lone major player: Johnson & Johnson

J&J is the only large pharmaceutical company making a major investment in a new antidepressant, Tracy said. Smaller players include Sage Therapeutics, which expects a decision from U.S. regulators on a treatment for post-partum depression by the end of the year.

J&J’s esketamine targets treatment-resistant depression. It is similar to ketamine, which is used as an anesthetic and to relieve pain, and often is abused as a recreational party drug with the street nickname Special K.

The company expects to file for U.S. Food and Drug Administration approval of esketamine, a rapid-acting nasal spray, this year.

“Standard antidepressants can take weeks to work. They really are not useful in a crisis situation,” said Carla Canuso, who is leading J&J’s effort testing the drug in people deemed at imminent risk for suicide, which is most commonly associated with depression.

Allergan Plc is developing rapastinel, a fast-acting intravenous antidepressant the company purchased in 2015. The drug has breakthrough therapy designation from the FDA, with clinical trial results expected in early 2019. Last month, the company acquired another depression drug from its

collaborator, Aptinyx.

Dr. Julie Goldstein Grumet, a behavioral health expert from the Suicide Prevention Resource Center, said 122 people in the United States took their lives by suicide each day last week. Many were never even diagnosed with a mental illness. 

“We’re missing opportunities to screen people for the risk of suicide,” she said.
…

Health officials say a salmonella outbreak linked to pre-cut melon has sickened 60 people in five Midwestern states.

The Centers for Disease Control and Prevention said Caito Foods LLC on Friday recalled pre-cut watermelon, honeydew melon, cantaloupe and fruit medleys containing at least one of those melons that were produced at its facility in Indianapolis.

It said the five states where people were sickened were Illinois, Indiana, Michigan, Missouri and Ohio. The CDC said the fruit was also distributed to stores in Georgia, Kentucky and North Carolina. It was sold in clear plastic clamshell containers at Costco, Jay C, Kroger, Payless, Owen’s, Sprouts, Trader Joe’s, Walgreens, Walmart and Whole Foods/Amazon.

Officials said people should throw away or return recalled products. 

The CDC said 31 of the people sickened had been hospitalized, but that there had been no deaths reported. Those sickened often develop diarrhea, fever and abdominal cramps 12 to 72 hours after eating the contaminated food. The illness often lasts four to seven days.
…

Health officials say a salmonella outbreak linked to pre-cut melon has sickened 60 people in five Midwestern states.

The Centers for Disease Control and Prevention said Caito Foods LLC on Friday recalled pre-cut watermelon, honeydew melon, cantaloupe and fruit medleys containing at least one of those melons that were produced at its facility in Indianapolis.

It said the five states where people were sickened were Illinois, Indiana, Michigan, Missouri and Ohio. The CDC said the fruit was also distributed to stores in Georgia, Kentucky and North Carolina. It was sold in clear plastic clamshell containers at Costco, Jay C, Kroger, Payless, Owen’s, Sprouts, Trader Joe’s, Walgreens, Walmart and Whole Foods/Amazon.

Officials said people should throw away or return recalled products. 

The CDC said 31 of the people sickened had been hospitalized, but that there had been no deaths reported. Those sickened often develop diarrhea, fever and abdominal cramps 12 to 72 hours after eating the contaminated food. The illness often lasts four to seven days.
…

Scientists will resume testing the waters off Kenai beaches to see whether efforts aimed at reducing fecal bacteria have been working.

Fecal coliform and enterococci, which grow in the intestines of most animals, have been found to exceed the standards set by the Alaska Department of Environmental Conservation for several summers in the area, the Peninsula Clarion reported this week.

The department has monitored the bacteria off Kenai annually from 2010 to 2014.

The conservation nonprofit Kenai Watershed Forum, which conducted previous testing on behalf of the department, found that gulls were the major contributor of the bacteria, which is often found alongside more harmful pathogens.

“[Gulls] are attracted to the beach because of a fairly unnatural food source,” said Branden Bornemann, a forum environmental scientist. “All these salmon carcasses wouldn’t normally be there. And the gulls are what we’re seeing is the highest bacteria input into these samples.”

The city of Kenai began requiring dipnetters in 2013 to toss fish waste into the water or remove it from the beach.

The department had paused bacteria sampling to see the effects of the city action, said Jeanne Swartz, an environmental program specialist for the department.

“We’ve been focused on remediation effects, management practices and outreach the last couple of years — giving it time to get established, and then going back this year to see if we were successful in reducing the bacteria amounts,” Swartz said.

The scientists intend to see with the new testing if the reduction of fish waste on the beaches has decreased the number of seagull visits, thus leading to a reduction in bacteria. 
…

Scientists will resume testing the waters off Kenai beaches to see whether efforts aimed at reducing fecal bacteria have been working.

Fecal coliform and enterococci, which grow in the intestines of most animals, have been found to exceed the standards set by the Alaska Department of Environmental Conservation for several summers in the area, the Peninsula Clarion reported this week.

The department has monitored the bacteria off Kenai annually from 2010 to 2014.

The conservation nonprofit Kenai Watershed Forum, which conducted previous testing on behalf of the department, found that gulls were the major contributor of the bacteria, which is often found alongside more harmful pathogens.

“[Gulls] are attracted to the beach because of a fairly unnatural food source,” said Branden Bornemann, a forum environmental scientist. “All these salmon carcasses wouldn’t normally be there. And the gulls are what we’re seeing is the highest bacteria input into these samples.”

The city of Kenai began requiring dipnetters in 2013 to toss fish waste into the water or remove it from the beach.

The department had paused bacteria sampling to see the effects of the city action, said Jeanne Swartz, an environmental program specialist for the department.

“We’ve been focused on remediation effects, management practices and outreach the last couple of years — giving it time to get established, and then going back this year to see if we were successful in reducing the bacteria amounts,” Swartz said.

The scientists intend to see with the new testing if the reduction of fish waste on the beaches has decreased the number of seagull visits, thus leading to a reduction in bacteria. 
…

Golden State. Golden still.

Stephen Curry scored 37 points, NBA Finals MVP Kevin Durant added 20 and a triple-double and the Warriors stamped themselves a dynasty after winning their second straight title and third in four years Friday night, 108-85, over the Cleveland Cavaliers to complete a sweep and perhaps drive LeBron James from his home again to chase championships.

Overcoming obstacles all season long, the Warriors were not going to be denied and won the fourth straight finals matchup against Cleveland with ease.

“This is so hard to do and doing it three out of four years is incredible,” guard Klay Thompson said.

Last sweep in 2007

It was the first sweep in the NBA Finals since 2007, when James was dismissed by a powerful San Antonio team in his first one. His eighth straight appearance didn’t go well either, and now there’s uncertainty where the superstar will play next.

James finished with 23 points and spent the final minutes on the bench, contemplating what went wrong and maybe his next move.

The finals between the Warriors and Cavs featured a drama-filled and controversial Game 1. But from there on, Durant, Curry, Thompson, Draymond Green and the rest of this California crew showed why they’re the game’s gold standard.

And they may stay that way.

“Can’t get enough of this feeling so we’re going to celebrate it together,” Curry said.

Durant MVP

Not wanting to give the Cavs or their fans any hope despite the fact that no team has ever overcome a 3-0 deficit in the NBA playoffs, the Warriors built a nine-point halftime lead when Curry ignored a closeout by James and dropped a 3-pointer.

Then the league’s best team tightened the screws on Cleveland in the third quarter, outscoring the Cavs 25-13.

By the start of the fourth quarter, the only question was whether Curry would win his first NBA Finals MVP or if it would go to Durant for the second year in a row.

And again, it was Durant, who added 12 rebounds and 10 assists, more satisfaction and validation for a player who couldn’t beat the Warriors so he joined them.

Precarious path

The path to this title was more precarious than the first two for coach Steve Kerr and the Warriors, who overcame injuries, expectations, a built-to-dethrone-them Rockets team and the brilliance of James, who scored 51 points in the series opener and carried a Cavs team from the beginning of their roller-coaster season until the end.

It may have been the final game in Cleveland for the 33-year-old, who is expected to opt out of his $35.6 million contract for 2019 next month and become a free agent.

Right now, the Warriors are on another tier and with Durant expected to re-sign with them in weeks and Curry, Thompson, Green and the rest still young and hungry, their reign could last much longer.
…

Golden State. Golden still.

Stephen Curry scored 37 points, NBA Finals MVP Kevin Durant added 20 and a triple-double and the Warriors stamped themselves a dynasty after winning their second straight title and third in four years Friday night, 108-85, over the Cleveland Cavaliers to complete a sweep and perhaps drive LeBron James from his home again to chase championships.

Overcoming obstacles all season long, the Warriors were not going to be denied and won the fourth straight finals matchup against Cleveland with ease.

“This is so hard to do and doing it three out of four years is incredible,” guard Klay Thompson said.

Last sweep in 2007

It was the first sweep in the NBA Finals since 2007, when James was dismissed by a powerful San Antonio team in his first one. His eighth straight appearance didn’t go well either, and now there’s uncertainty where the superstar will play next.

James finished with 23 points and spent the final minutes on the bench, contemplating what went wrong and maybe his next move.

The finals between the Warriors and Cavs featured a drama-filled and controversial Game 1. But from there on, Durant, Curry, Thompson, Draymond Green and the rest of this California crew showed why they’re the game’s gold standard.

And they may stay that way.

“Can’t get enough of this feeling so we’re going to celebrate it together,” Curry said.

Durant MVP

Not wanting to give the Cavs or their fans any hope despite the fact that no team has ever overcome a 3-0 deficit in the NBA playoffs, the Warriors built a nine-point halftime lead when Curry ignored a closeout by James and dropped a 3-pointer.

Then the league’s best team tightened the screws on Cleveland in the third quarter, outscoring the Cavs 25-13.

By the start of the fourth quarter, the only question was whether Curry would win his first NBA Finals MVP or if it would go to Durant for the second year in a row.

And again, it was Durant, who added 12 rebounds and 10 assists, more satisfaction and validation for a player who couldn’t beat the Warriors so he joined them.

Precarious path

The path to this title was more precarious than the first two for coach Steve Kerr and the Warriors, who overcame injuries, expectations, a built-to-dethrone-them Rockets team and the brilliance of James, who scored 51 points in the series opener and carried a Cavs team from the beginning of their roller-coaster season until the end.

It may have been the final game in Cleveland for the 33-year-old, who is expected to opt out of his $35.6 million contract for 2019 next month and become a free agent.

Right now, the Warriors are on another tier and with Durant expected to re-sign with them in weeks and Curry, Thompson, Green and the rest still young and hungry, their reign could last much longer.
…

The Taliban announced Saturday it will halt offensive operations against government security forces across Afghanistan during three-day festivities of Eid al Fitr, which marks the end of the Muslim fasting month of Ramadan.

The cease-fire coincides with the unilateral weeklong halting of anti-Taliban operations by the Afghan government starting Tuesday.

An insurgent statement said the Taliban leadership has also ordered his fighters not to hold meetings in civilian areas during the holiday period to enable their countrymen peacefully celebrate the festival. But it vowed to continue attacks on U.S.-led foreign troops in the country.

This will be the first time since 2002 that the Islamist insurgency will cease hostilities in Afghanistan, where it controls or contests nearly half of 407 Afghan districts.

Afghanistan’s ambassador to Pakistan, Omar Zakhilwal swiftly welcomed the insurgent gesture.

It is an “encouraging and important step towards prospects for peace. Hope the pleasure of shedding no Afghan blood in Eid becomes so overwhelming that rest of year is also declared as Afghan Eid,” Zakhilwal tweeted.

The Taliban in its announcement from its chief Mullah Hibatullah Akhunzada, has also said it will release some prisoners after seeking commitments from them that they will not rejoin Afghan forces.

Afghan President Ashraf Ghani earlier this week ordered his forces to stop offensive operations against the Taliban to encourage insurgents to come to the table and seek a negotiated end to the 17-year-old conflict.

The move has been widely welcomed, and the U.S. has promised to honor Ghani’s peace gesture.

Meanwhile, Afghan officials said Saturday an insurgent ambush in Qala-e-Zal district of northern Kunduz province killed more than 20 police personnel.

The Taliban has inflicted heavy casualties on Afghan forces since launching its spring offensive in April and reportedly killed around 500 of them last month.

Washington confirmed Thursday it has asked neighboring Pakistan to help in facilitating an Afghan peace and reconciliation process by persuading the Taliban to engage in talks with Kabul.

Lisa Curtis, a deputy assistant to U.S. President Donald Trump and senior director for South and Central Asia at the National Security Council, said at a seminar the U.S. is pursuing “multiple lines of effort” to promote Afghan peace. She said an important component of the effort is to ensure that Pakistan plays “a constructive role” in it.

“We have asked for Pakistan’s assistance in facilitating a peace process, and we have sought to understand Pakistan’s own core security concerns and ensure that its interests are taken into account in any peace process,” Curtis said.

Insurgents allegedly have long used sanctuaries on Pakistani soil to plan attacks in Afghanistan.

The Pakistan military says its forces have cleared their territory of all terrorism infrastructure and no insurgent safe havens are left in the country.

Pakistani officials however acknowledge families of some Taliban leaders and fighters might be residing along with nearly 2.7 million Afghan refugees the country hosts, and they do not rule out the presence of “residual” insurgent fighters hiding in the refugee population.

But Islamabad says its forces are closely monitoring and making sure any Afghan living on Pakistan soil as a refugee is not participating in the violence in Afghanistan.
…

The Taliban announced Saturday it will halt offensive operations against government security forces across Afghanistan during three-day festivities of Eid al Fitr, which marks the end of the Muslim fasting month of Ramadan.

The cease-fire coincides with the unilateral weeklong halting of anti-Taliban operations by the Afghan government starting Tuesday.

An insurgent statement said the Taliban leadership has also ordered his fighters not to hold meetings in civilian areas during the holiday period to enable their countrymen peacefully celebrate the festival. But it vowed to continue attacks on U.S.-led foreign troops in the country.

This will be the first time since 2002 that the Islamist insurgency will cease hostilities in Afghanistan, where it controls or contests nearly half of 407 Afghan districts.

Afghanistan’s ambassador to Pakistan, Omar Zakhilwal swiftly welcomed the insurgent gesture.

It is an “encouraging and important step towards prospects for peace. Hope the pleasure of shedding no Afghan blood in Eid becomes so overwhelming that rest of year is also declared as Afghan Eid,” Zakhilwal tweeted.

The Taliban in its announcement from its chief Mullah Hibatullah Akhunzada, has also said it will release some prisoners after seeking commitments from them that they will not rejoin Afghan forces.

Afghan President Ashraf Ghani earlier this week ordered his forces to stop offensive operations against the Taliban to encourage insurgents to come to the table and seek a negotiated end to the 17-year-old conflict.

The move has been widely welcomed, and the U.S. has promised to honor Ghani’s peace gesture.

Meanwhile, Afghan officials said Saturday an insurgent ambush in Qala-e-Zal district of northern Kunduz province killed more than 20 police personnel.

The Taliban has inflicted heavy casualties on Afghan forces since launching its spring offensive in April and reportedly killed around 500 of them last month.

Washington confirmed Thursday it has asked neighboring Pakistan to help in facilitating an Afghan peace and reconciliation process by persuading the Taliban to engage in talks with Kabul.

Lisa Curtis, a deputy assistant to U.S. President Donald Trump and senior director for South and Central Asia at the National Security Council, said at a seminar the U.S. is pursuing “multiple lines of effort” to promote Afghan peace. She said an important component of the effort is to ensure that Pakistan plays “a constructive role” in it.

“We have asked for Pakistan’s assistance in facilitating a peace process, and we have sought to understand Pakistan’s own core security concerns and ensure that its interests are taken into account in any peace process,” Curtis said.

Insurgents allegedly have long used sanctuaries on Pakistani soil to plan attacks in Afghanistan.

The Pakistan military says its forces have cleared their territory of all terrorism infrastructure and no insurgent safe havens are left in the country.

Pakistani officials however acknowledge families of some Taliban leaders and fighters might be residing along with nearly 2.7 million Afghan refugees the country hosts, and they do not rule out the presence of “residual” insurgent fighters hiding in the refugee population.

But Islamabad says its forces are closely monitoring and making sure any Afghan living on Pakistan soil as a refugee is not participating in the violence in Afghanistan.
…

From summit-themed burgers and online scalpers peddling “World Peace” medallions and “Peace Out from Lion City” T-shirts, Singaporeans are cashing in on a historic meeting between U.S. President Donald Trump and North Korea’s Kim Jong Un.

The buzz around the Trump-Kim summit Tuesday has stirred Singaporeans’ entrepreneurial spirit and raised hopes of a tourism dividend long after the summit dust settles.

One person is trying to sell his weekend reservations at the Shangri-La Hotel, mentioned in media as the possible lodging of one of the leaders, at three times the price.

“It was for a personal ‘staycation,’ but I reckon that because of the summit, people might actually offer to pay a higher price,” Joel Lin, who is asking for S$1,600 for each of two rooms he has booked, said by telephone.

Commemorative medallion

The Singapore Mint, which this week unveiled a commemorative medallion for the summit, later raised the mintage for the gold and silver medallions after an overwhelming response.

At more than S$1,000 ($750) a piece for the gold version, and more than S$100 for the silver one, the issue could yield upward of S$5 million if they are all sold.

Scalpers are preparing to sell the medallions they get in an online sale.

Impersonators

An Australian Kim impersonator, who goes by the name Howard X, has also been cashing in but said he got an unpleasant surprise Friday when he was detained for questioning on arrival back in the country for a second time in two weeks.

He said he was allowed to go on his way after being told to stay away from summit venues.

​Summit-themed food

A Singapore burger chain, Wolf Burgers, urged the two leaders to #settlethebeef and invited them to try its “Burger for World Peace,” with American sharp cheddar cheese and Korea’s marinated Bulgogi shabu brisket.

Mexican restaurant Lucha Loco is selling “Rocket Man” and “El Trumpo” tacos, and guests stand a chance to smash Trump-Kim pinatas.

Trump called Kim “little rocket man” last year, when the two were exchanging threats of nuclear war and the prospect of a summit was nothing but a distant dream for even the most optimistic marketing man.

More than 3,000 journalists are due in town, along with delegations and security entourages.

​Sip the Bromance

Those who enjoy a tipple might seek out a bar offering cocktails featuring the Korean spirit soju. One bar has named its special summit drink, which mixes beer, tequila, Diet Coke and soju — the Bromance.

Singapore, which welcomed a record 17.4 million international visitors last year, is likely to see a bump, albeit small, in retail spending because of the summit.

Every tourist to Singapore spends an average 3½ days and contributes about S$1,500 to overall tourism receipts, said brokerage CGS-CIMB.

Assuming a seven-day stay and about 4,000 people coming for the event, a CGS-CIMB analyst estimated they could spend about S$12 million ($9 million).

That’s a drop in the bucket in the short-term: the Singapore Tourism Board has forecast tourism receipts of between S$27.1 billion ($20.3 billion) and S$27.6 billion this year.

But a glitch-free summit will increase the chances of more big-ticket events.

“As with all high-profile visits, it places Singapore on the map for international audiences and showcases Singapore as an ideal destination, especially for business and meetings,” said Oliver Chong, executive director of communications and marketing capability at the tourism board.

 
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