Love and Other (Gateway) Drugs

How do you keep things fresh in a relationship after 55 years of marriage? If you are prolific Columbia University scientists Eric and Denise Kandel, you collaborate on a research project for the first time.

While every neuroscience undergraduate knows Nobel Laureate Eric Kandel, his wife, Denise, has some serious science chops of her own. A professor of sociomedical science at Columbia’s Mailman School of Public Health, Denise’s main research interests center on risk factors and consequences of drug use. Decades of epidemiological research suggested that smoking acted as a gateway to harder drugs. After hearing Eric give a lecture on cocaine, plasticity, and histone acetylation, she wondered if perhaps an epigenetic model might help explain the relationship between nicotine and cocaine addiction.

“That’s how the whole thing started, really. It triggered this idea,” she says. “And it is important to mention because I think that oftentimes a scientific collaboration or scientific success arises out of a chance event and a prepared mind.”

Still, she didn’t ask her husband to collaborate on this particular “chance event” at first. “I didn’t think he was interested,” she says matter-of-factly. So, instead, she asked him to recommend a few other scientists who might want to collaborate. None of them were available.

“I don’t know why but Denise had trouble coming up with another collaborator,” Eric says. “But as we discussed it more, I felt the problem was interesting so, at that point, I stepped in. But it was the failure to come up with another collaborator that really encouraged me to try it.”

The study, heralded as a landmark experiment by both the neurobiological and epidemiological communities, demonstrated for the first time how nicotine can act as a “gateway,” accelerating the cellular and epigenetic processes that facilitate drug addiction (see Dana's story about it).

When I asked the Kandels how well their personal partnership translated to one in the lab, Eric laughed. “It was difficult at the beginning. Denise asked a lot of questions that I felt were interfering with my own line of thought,” he said. “But I soon realized that I needed to hear those questions. That’s the point of collaboration. You pick two very different approaches to address a problem. Once I realized that, we fell into step.”

“Eric was exasperated because I said we needed to do more work on the figures for the paper,” she says. “But he admits now that I was right. The figures look very good.”

“Yes, they do,” he says. “The figures look very good.”

And any advice to other couples on the brink of scientific collaboration?

“It’s been very exciting to work together,” says Denise. “But it’s not easy.”

“I don’t think one can give general advice to the lovelorn here,” Eric adds. “We’re both strong, independent people and I think, in any collaboration with two strong, independent people, there’s going to be some awkwardness initially. But I have a sense of enormous satisfaction that we accomplished this together. And I’m glad that we’re continuing on together.”

The two are currently working on a study to see whether alcohol results in a similar gateway mechanism. And they hope to later examine marijuana, too. And while the two are excited by the scientific possibilities, they admit they are pleased to have the chance to work together, too.

“It’s wonderful to be able to spend this time together,” says Eric. “And it’s wonderful to finally have a way to look at these questions about gateway drugs. I’m hoping that our collaboration will inspire a whole new field of translational epidemiology.”

What better Valentine could a scientific couple ask for?

–Kayt Sukel

Sukel's first book, Dirty Minds: How our brains influence love, sex, and relationships, is available now.

Dearth of depression treatment

If you’re feeling down and out but struggling to get through
it on your own, you’re not alone.

A large new survey has found that only half of those in the
United States with depression
are receiving any sort of treatment for the condition—many because they have
not been formally diagnosed.

For the study,
which appears in the January issue of Archives
of General Psychiatry,
researchers assessed nearly 16,000 people to study
how commonly depression occurs in the United States and what kinds of treatment
people with the disorder receive. Because the participants were carefully
selected from three large national surveys instead of from hospital records,
the survey represents a snapshot of the U.S. population as a whole, the
scientists say.

“We can talk about population estimates for the whole of the
U.S. Ours is a cross-sectional, nationally representative sample,” says lead
author Hector
González
, an assistant professor of family medicine and public health
sciences at Wayne State University in Detroit. “That’s the beauty of our
study.”

Approximately 9 percent of the participants either met the
criteria for depression or had met them sometime within the past 12 months. Of
those with depression, only half had received any treatment for the condition
and only one-fifth had received treatment that conformed to the American Psychological Association’s recommended
guidelines.

Because the survey team assessed each person independently
for depression based on data and interviews, those numbers include many people
who have not been officially diagnosed by a physician, González says. He does
not have firm numbers on how many people that might be but expects they
represent a significant proportion of the U.S. population.

If the sample is indeed representative, then the country holds
roughly 14 million untreated residents. People with untreated depression are
not only in danger of jeopardizing their jobs, personal relationships, and
general health, but many also have an increased risk of harming or killing
themselves. According to the Dana Guide to Brain
Health
, approximately 20 percent of depressed people will make a suicide
attempt and around 6 percent will ultimately succeed.

The survey also found that therapy is used to treat
depression more often than drugs. Although the study didn’t directly address
the reasons, one cause for the disparity might be that antidepressants seem to
work only for those patients with the most severe cases of depression. A study released
yesterday
in the Journal of the
American Medical Association
found that for mild to moderate cases of
depression, drug treatment was similar to treatment with a placebo pill. “Only
15 percent of people in the U.S. with depression have very severe depression,” González
says. “So 85 percent don’t respond to antidepressants better than placebo.”
This doesn’t mean that the drugs have lost favor, though, he adds; half of the
antidepressant prescriptions doctors now write are for conditions other than
depression.

The scientists also looked at whether incidence and
treatments differed among particular ethnic subgroups. While overall rates of
depression were similar to the national average among all groups, González
says, African and Mexican Americans had a notably reduced chance to receive
both any care at all and the recommended treatment.

The scientists plan to use their results and additional data
to see what kinds of treatments are most effective against depression.
“Depression is a leading cause of disability worldwide,” González says. “We
think we can help meet the health needs of Americans and others, by seeing how
well these people are supported.”

—Aalok Mehta

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