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The U.S. Food and Drug Administration is doing its part to make sure that doctors and patients alike are aware of the latest data on the link between antidepressant use and suicide, which indicate that the risk declines steadily with age.

A review of 372 trials involving nearly 100,000 people who took antidepressants showed that the drugs increase the risk for suicide in people younger than 25, have no effect in those 25 to 64 and reduce risk in those 65 and older. A report on the findings is published online Aug. 12 in BMJ.

Information on the suicide risk linked to antidepressant use was posted on the FDA Web site some time ago, but “we thought it needed to be in a peer-reviewed publication, which would make it more useful to professionals,” said Dr. Marc Stone, a senior medical reviewer in the agency’s Center for Drug Evaluation and Research and lead author of the BMJ report.

The risk of suicide among younger users of antidepressant drugs became prominent in 2003, when the FDA cited studies showing such an increased risk of suicide attempts or suicide-related behavior among children and adolescents taking the widely used selective serotonin reuptake inhibitors (SSRIs), such as Zoloft, Celexa and Prozac.

A year later, the agency had the companies that market those drugs revise labeling to include a black-box warning so that health-care providers would be alert to any indication of suicide-related behavior in young users.

In 2006, analysis of the studies described in the new journal report led to a labeling change that expanded the warning to young adults.

The studies show “a bigger picture, where we see a declining rate in older patients that is essentially zero in middle-age adults, and suggest a beneficial effect which lowers the risk of suicidal thoughts in older people,” Stone said.

The analysis revealed eight completed suicides, 134 suicide attempts and 378 instances of suicidal thoughts that did not lead to action. The odds ratio for suicidal behavior declined at a rate of 4.6 percent for every year of age, according to the study.

The report was criticized by Dr. John Geddes, a professor of epidemiological psychiatry at the University of Oxford in England and a co-author of an accompanying editorial in BMJ, who said it relied too much on data from trials sponsored by drug companies.

“In these trials, they compare a drug with a placebo,” Geddes said. A placebo is an inactive substance. “These are hard trials to do so they exclude people who are very ill,” he said. Because of this, he said, “they can’t possibly observe how the drugs affect such people.”

“One of the things that we need to be clear about is that we can’t rely on placebo-control trials of new medications done by the industry,” Geddes said. “They can’t answer all the clinical questions. We need more active comparison trials which don’t have placebo in them and larger trials aimed at antidepressants in clinical practice.”

Geddes also criticized the report for lumping together all SSRIs. “Sometimes people are wary of saying that one drug is safer than another drug in the same class,” he said.

But, he said, the studies indicate that suicide risk varies widely among SSRIs. “Sertraline is best in terms of tolerability,” he said.

Studies cited in the report indicate that sertraline, the generic name for Zoloft, carries only half the risk for suicidal thoughts and behavior of some other SSRIs, Geddes said.

Surgery can significantly improve headaches associated with neck problems, according to the results of a patient survey.

The study included 1,004 patients, aged 25 to 78, who had two types of cervical neck operations — arthroplasty (disk replacement) or arthodesis (spine fusion).

Before the surgery, 86.4 percent of the patients reported headaches — 34.1 percent had mild headaches and 52.1 percent had severe headaches. Among the 803 patients who responded two years after surgery, 34.9 percent reported no headaches, 46.7 percent reported mild headaches, and 18.4 percent reported severe headaches, according to the survey results published in the August issue of the Journal of Bone and Joint Surgery.

“This is not a ‘cure’ for all headaches,” lead author Joseph Riina, of Orthopaedics Indianapolis, said in a news release. “But if you have headaches associated with neck pain and dysfunction, surgery for the neck problem can significantly improve the related headaches. And, any time overall quality of life can be improved with surgical treatment, that is something to note.”

No significant differences in headache severity were reported between the arthroplasty and arthodesis groups, the study authors noted. None of the patients included in the study had surgery to treat their headaches, and headaches were not their only complaint. The study didn’t include people with migraines.

“This is the largest study that we know of in which incidence and improvement of headaches has been studied related to anterior spine surgery,” Riina said. “I think we answered a big question: Can patients have less neck pain and fewer headaches after this kind of surgery? And, the answer is yes.”

A new gene mutation linked to muscular dystrophy has been identified by Japanese researchers.

The finding came from genetic analyses of five people with muscular dystrophy and degeneration of their fat tissue, called lipodystrophy. Their muscles were deficient in caveolin-3 protein, but they did not have mutations in the caveolin-3 gene, which have been linked to muscular dystrophy.

The researchers found a mutation in the PTRF gene, which makes a protein believed to influence caveolin protein stabilization. Further investigation showed that the mutated forms of the PTRF gene produced mutant PTRF proteins that could not localize correctly or associate with caveolin proteins.

Based on their findings, the researchers concluded that the muscular dystrophy in the five people they studied was probably the result of caveolin deficiencies secondary to PTRF gene mutations.

Children with high IQs live longer, but it is not clear exactly what role IQ plays in longevity, new British research shows.

Previous studies have shown an association between IQ and mortality, but an explanation for that has proved elusive. This is an important question because identifying those mechanisms would help in understanding the origins of health inequalities, the researchers said.

“The IQ-mortality association emerges already early in adult life, even when most life-threatening diseases are not yet that common,” said lead researcher Markus Jokela, who is now with the department of psychology at the University of Helsinki, in Finland. “So the role of IQ is not only restricted to how people become ill or cope with their illnesses in old age.”

The report is published in the Aug. 10 online edition of Pediatrics.

For the study, Jokela’s team collected data on 10,620 men and women who participated in the 1958 British Birth Cohort Study and had their IQs tested when they were 11. Researchers followed these individuals until they were 46 years old.

The investigators found that IQ assessed in childhood at age 11 predicted mortality risk from age 11 to age 46, so that the risk of dying by midlife was about two times higher in individuals with low IQs compared to those with high IQs (3.4 percent versus 1.7 percent, respectively).

This association was largely independent of several measures of childhood developmental characteristics and family background such as birth weight, childhood height at age 11, problem behavior, father’s occupation, parents’ interest in child’s education, family size and family difficulties, Jokela said.

Adult sociodemographic variables such as education, occupation, marital status and health behaviors such as smoking, weight, alcohol use and psychosomatic symptoms “explained only relatively little of the IQ-mortality association,” he said.

“The findings imply that IQ is an important determinant of health and mortality risk independently of many well-established health risk factors,” Jokela said. “This calls for new lines of research identifying the mechanisms by which IQ becomes associated with health and mortality risk.”

Perhaps individuals with high IQ are better at distilling important health information from public health messages and thereby better in making healthy everyday choices that are not captured by the usual measures of health behaviors, Jokela said.

“We currently have an incomplete understanding of health inequalities originating from individual psychological characteristics, such as IQ,” he said. “Identifying these mechanisms could inform us how to plan more effective public health interventions accessible to wider audiences.”

Ellen deLara, an assistant professor of social work at Syracuse University, thinks that nurturing parents may be the key to living longer, regardless of IQ.

“Positive adult/parental attention is typically a contributor to positive youth outcomes in terms of development and behavior,” deLara said. “This applies across the board to all youth, all socioeconomic groups, all levels of intelligence.”

Conversely, negative adult attention in the form of rejection or neglect, for example — something that some parents exhibit towards lower IQ children — is associated with poor outcomes for these children in terms of their development, and their childhood and adult behavior, she said.

“What it boils down to is, no matter your IQ, if you feel accepted — your parents are interested in your education and your future — you thrive,” deLara said.

“If you feel that you are rejected — your parents show little or no interest in you or your future — you don’t feel good about yourself,” she said. “That in itself, promotes poor decision-making. If your decision-making ability is already compromised by lower IQ, this does not bode well for a successful or long life.”