Monday, December 31, 2007

They Have Beds, but Not the Ones They Want

NORMAN BLOOMFIELD sat hunched over on his sagging twin bed at Surf Manor, a small adult home in Coney Island, and wondered why he was still there.

An elfin man with a shock of fine gray hair, Mr. Bloomfield, 60, spent three months in the psychiatric ward of Maimonides Medical Center in 2001. He then applied to Surf Manor, a faded red brick building on a bleak stretch of Surf Avenue, thinking it would serve as a temporary residence between the hospital and independent housing.

But his months at Surf Manor have turned into years, because he cannot find another place to live.

Surf Manor is one of 65 private, state-licensed facilities in the city that house a total of more than 8,000 residents. These institutions, known as adult homes, have become de facto repositories for people who have psychiatric disorders but who, like Mr. Bloomfield, can live independently.

“Some people need day-to-day assistance, but some are extremely high functioning,” Mr. Bloomfield said one afternoon in his drab yellow room, which he shares with a roommate. “It’s unfair and irrational when people who could be independent end up in a place like this and languish for years.”

READ MORE @ NY TIMES

Sunday, December 30, 2007

Lilly’s Zypreza, Pfizer’s Geodon could see reimbursement restrictions next year

Psychiatric drugs like Eli Lilly’s Zyprexa could be next on the list for reimbursement restrictions based on comparative effectiveness data, experts in the field told Pharmawire.

The move would also spell trouble for AstraZeneca’s Seroquel and Pfizer’s Geodon, two commonly prescribed and costly antipsychotics. Cost pressures will be felt most acutely starting in June, when the patent expires on Johnson & Johnson’s competing product Risperdal.

Public and private payers have been fueling the growing interest in compiling data that allows them to compare different drugs within the same therapeutic category. The information then helps shape reimbursement programs - like step therapy, where patients are required to try a cheaper drug before a more expensive one will be covered.

Tanisha Carino, a director at research firm Avalere Health and former policy analyst at the Centers for Medicare and Medicaid Services, noted that mental health is a prime target for using comparative effectiveness data to make coverage decisions.

The National Institute of Mental Health is already sponsoring the large-scale Clinical Antipsychotics Trials of Intervention Effectiveness (also known as CATIE), which have shown that older, less expensive drugs can be as effective as newer ones. The data is rife with cost effectiveness comparisons.

READ MORE @ FINANCIAL TIMES

Saturday, December 29, 2007

FDA Safety Changes: Pexeva, Vfend, Suprane

The US Food and Drug Administration (FDA) has approved safety labeling revisions to advise of the risk for serotonin syndrome in patients receiving concomitant treatment with paroxetine mesylate and triptans, drug interactions between voriconazole and efavirenz requiring dose adjustments for both drugs when used concomitantly, and the risk for respiratory adverse events associated with use of desflurane in certain pediatric settings.
Concomitant Use of Paroxetine Mesylate (Pexeva) and Triptans Linked to Risk for Serotonin Syndrome On December 9, 2006, the FDA approved safety labeling revisions for paroxetine mesylate (Pexeva tablets, made by Synthon Pharmaceuticals, Ltd) to advise of the potential increased risk for serotonin syndrome in patients receiving concomitant treatment with other serotonergic drugs (including 5-hydroxytryptamine-receptor agonists [triptans]) or drugs that impair serotonin metabolism (including monoamine oxidase inhibitors [MAOIs]).

Concurrent treatment with paroxetine and MAOIs is therefore contraindicated. Concomitant use of other selective serotonin reuptake inhibitors (SSRIs), serotonin/norepinephrine reuptake inhibitors (SNRIs), or the serotonin precursor tryptophan is not recommended. Caution is advised when using paroxetine in combination with other drugs or agents that can affect serotonergic neurotransmitter systems, such as the antibiotic linezolid (a reversible nonselective MAOI), lithium, tramadol, St. John's Wort, and triptans.

According to the FDA, rare postmarketing cases of serotonin syndrome have been reported with use of SSRIs and triptans. Associated symptoms may include changes in mental status (eg, agitation, hallucinations, and coma), autonomic instability (eg, tachycardia, labile blood pressure, and hyperthermia), neuromuscular aberrations (eg, hyperreflexia and incoordination), and/or gastrointestinal tract symptoms, such as nausea, vomiting, and diarrhea.

READ MORE @ ABKHAZIA

Friday, December 28, 2007

Dementia Drugs a Danger to Seniors - Warnings lost in reams of drug company literature

A group of drugs that can have serious adverse effects when used by the elderly continues to be widely prescribed in Canada and the United States, despite concerns about their safety.

The drugs, called atypical antipsychotics, are used to manage the behavior of seniors who have dementia, but many experts consider them to be dangerous and possibly ineffective in elderly patients.

In 2005, both Health Canada and the Food and Drug Administration (FDA) in the United States warned that atypical antipsychotic medications increased the risk of death among elderly patients with dementia.

The Health Canada warning stated that in 13 scientific studies, elderly patients with dementia who were prescribed atypical antipsychotics had a 60 percent higher death rate on average than similar patients taking placebos.

READ MORE @ EPOCH TIMES

Thursday, December 27, 2007

Searching for Similar Diagnosis Through DNA

The girls had never met, but they looked like sisters.

There was no missing the similarities: the flat bridge of their noses, the thin lips, the fold near the corner of their eyes. And to the families of 14-year-old Samantha Napier and 4-year-old Taygen Lane there was something else, too. In the likeness was lurking an explanation for the learning difficulties, the digestion problems, the head-banging that had troubled each of them, for so long.

Several of the adults wiped tears from their eyes. “It’s like meeting family,” said Jessica Houk, Samantha’s older sister, who accompanied her and their mother to a Kentucky amusement park last July to greet Taygen.

But the two families are not related, and would never have met save for an unusual bond: a few months earlier, a newly available DNA test revealed that Samantha and Taygen share an identical nick in the short arm of their 16th chromosomes.

READ MORE @ NY TIMES

Wednesday, December 26, 2007

An active ingredient in treating mild depression

Study supports findings that exercise can help beat the blues and might reduce need for medication.

This fall, we ran a series of articles called Healthwatch that examined the latest medical studies making the news. The series provoked a lot of discussion, and readers asked for more, so medical journalist Evra Taylor Levy and emergency physician Eddy Lang are back, helping to make sense of sometimes contradictory medical research. Healthwatch runs every other week as a regular Gazette feature. The writers invite you to join them in their online forum. See details on Page D3.

- - -

It's no secret that the holidays and transition into a new year spell depression for many people experiencing loneliness, difficult life events or loss. With this, our end-of-the-year edition of Healthwatch, we bring you an uplifting study that looks at a way of beating some kinds of depression without medication.
Worldwide, depression is the leading cause of years lived with disability. During their lifetime, about five to 12 per cent of men and 10 to 25 per cent of women will have at least one major depressive episode. Interestingly, mood disorders often begin in adolescence, making early diagnosis especially important to offset years of unhappy, impaired living. Additionally, Canadian winters mean reduced sunlight and shorter days, which have been implicated in an increased prevalence of depression at this time of the year.

Symptoms of depression

It has been reported that half of the people who have clinical depression don't know it, so recognizing its symptoms is essential and the first step toward treatment. While not a complete list, symptoms include: persistent sadness; pessimism; feelings of guilt; loss of interest and pleasure in activities; helplessness or hopelessness; difficulty concentrating; insomnia or oversleeping; apathy; anxiety; thoughts of suicide or death.

READ MORE @ MONTREAL GAZETTE

Tuesday, December 25, 2007

Illuminating a seasonal disorder

About this time each year, Lisa Morris starts yearning for more light in her life.

The 31-year-old mother of two from Middle River suffers from seasonal affective disorder (SAD), a condition that prompts her to turn on a specially designed fluorescent lamp for up to an hour every morning when she rises.

Purchased from a medical supply outlet, the light helps ward off the ailment's most common symptoms: persistent fatigue, oversleeping and an increased appetite for sugary and starchy foods that often leads to weight gain.

"The light therapy does do the trick - but I still have my moments where I just want to go up and lay down in my room and not get up," Morris says.

The winter solstice occurred shortly after 1 a.m. today - the lowest point in a pattern of diminishing sunlight that begins each fall as the tilt of the earth's axis sends the northern hemisphere away from the sun. Today we get only 9 hours of sun.

Although SAD symptoms typically begin in September and October as the days get shorter, experts say the solstice period is when the effects of seasonal depression can be most pronounced, particularly if the condition is left untreated.

"It can really affect people for a major chunk of their lives, in a big way," said Dr. David Neubauer, a Johns Hopkins psychiatrist.

READ MORE @ BALTIMORE SUN

Monday, December 24, 2007

Parents Defend School’s Use of Shock Therapy

Nearly a year ago, New York made plans to ban the use of electric shocks as a punishment for bad behavior, a therapy used at a Massachusetts school where New York State had long sent some of its most challenging special education students.

But state officials trying to limit New York’s association with the school, the Judge Rotenberg Educational Center in Canton, southwest of Boston, and its “aversive therapy” practices have found a large obstacle in their paths: parents of students who are given shocks.

“I understand people who don’t know about it think it is cruel,” said Susan Handon of Jamaica, Queens, whose 20-year-old daughter, Crystal, has been at Rotenberg for four years. “But she is not permanently scarred and she has really learned that certain behaviors, like running up and hitting people in the face, are not acceptable.”

Indeed, Rotenberg is full of children who will run up and hit strangers in the face, or worse. Many have severe types of dysfunction, including self-mutilation, head banging, eye gouging and biting, that can result from autism or mental retardation. Parents tend to be referred there by desperate education officials, after other institutions have decided they cannot keep the child.

READ MORE @ NY TIMES

Sunday, December 23, 2007

Generic Antidepressant May Affect Wyeth

The difference between a pill and a capsule might not seem big, but it could result in hundreds of millions of dollars in lost sales for Wyeth's top drug.

The Madison, N.J.-based company makes the best-selling antidepressant in the world, Effexor, with sales on pace to exceed $3.7 billion this year. The most common version is an extended-release capsule, Effexor XR.

Until recently, it seemed Wyeth would be the exclusive seller of extended-release Effexor in the United States through July 2010, thanks to its resolution of patent litigation in 2005.

But now Wyeth's market exclusivity is being threatened. Sun Pharmaceutical Industries Ltd., a generics manufacturer in India, has applied for U.S. Food and Drug Administration approval to sell a drug with the same active ingredient as Effexor XR, but with an important difference: It's an extended-release tablet, not a capsule.

FDA approval of what is likely to be a lower-priced drug from Sun might come when patent protection for Effexor's active ingredient, venlafaxine, runs out in June 2008. Patent protection for the capsule formulation expires later. Sun's different formulation should allow it to sidestep Wyeth's patent rights, and Wyeth already has told Sun it won't sue for patent infringement.

READ MORE @ AP

Saturday, December 22, 2007

Not Yet: CDC panel questions antidepressant gene test

About half of all depressed people who take standard antidepressant drugs fail to improve. Some suffer unpleasant side effects and abandon the medicines, while others simply don't feel better. Commercial tests claim to predict, by a genetic analysis, how well individual patients will fare on different antidepressants, but a panel convened by the Centers for Disease Control and Prevention (CDC) in Atlanta now says that the tests don't work as advertised.

The panel "discourages" use of such tests until further studies clarify their value, according to a statement the group published in the December Genetics in Medicine.

"That isn't to say that eventually there won't be a role for these tests. We just don't know what that role is yet," says panel member Joan Scott of the Genetics and Public Policy Center in Washington, D.C.

The tests scan a person's DNA for variations in genes for two key liver enzymes. These enzymes break down selective serotonin reuptake inhibitors (SSRIs), a standard class of antidepressants that includes fluoxetine (Prozac) and nearly a dozen other drugs. Variations in the two enzymes affect how quickly different people clear SSRIs from their blood, which in turn influences the drugs' effectiveness.

READ MORE @ SCIENCE NEWS

Friday, December 21, 2007

Brain Center May Link Addiction, Mental Illness

Developmental problems involving a walnut-shaped part of the brain called the amygdala -- linked to fear, anxiety and other emotions -- may explain why mental illness and addiction often appear together, researchers say.

Many kinds of addiction -- such as those for alcohol, drugs and nicotine -- occur in people with various kinds of mental illness, including depression, schizophrenia and anxiety disorders, according to background information in an American Psychological Association news release about the Indiana University study.

Two to five of every 10 anxious or depressed people, and four to eight of every 10 people with schizophrenia, biopolar disorder or antisocial personality, also have some form of addiction, according to epidemiological data.

In this study, published in the December issue of Behavioral Neuroscience, the researchers compared the behavior of adult rats whose amygdalas were surgically damaged in infancy and adult rats with intact amygdalas.

READ MORE @ FORBES

Thursday, December 20, 2007

More Keys To Maintain Your Brain

Here I continue with a subject I can't resist and can certainly use - a series of tips on how to maintain and enhance brainpower. (See earlier column from Dec. 13.) In introducing them, the authors of the book where I found them, You: Staying Young: The Owner's Manual for Extending Your Warranty, Dr. Michael F. Roizen, of the Cleveland Clinic, and Dr. Mehmet Oz, of Columbia University, have some wise words: "There are many ways to keep your brain operating at maximum efficiency, maximum power, and maximum quality."

o get you into the right mood and eliminate any room for excuses, I'll start with a few of the easiest ones.

Feed On Brain Food. Yes, there is such a thing. Serve up one of our best friends, those omega-3 fatty acids found in greatest abundance in the fat of such fish as salmon, mahi-mahi, tuna and herring. These omega-3s have multiple beneficial effects: (1) They improve the function of your message-sending neurotransmitters (chemicals that carry messages back and forth between nerve cells), (2) they slow cognitive decline in people who are at risk, and (3) keep arteries clear, which means they also keep an adequate supply of blood flowing to the brain.

Drs. Roizen and Oz, the authors, suggest you aim for 13 ounces of fish a week, or if you prefer take two grams of metabolically distilled fish oil a day or DHA (a form of omega-3) from algae or an ounce of walnuts every day.

READ MORE @ THE BULLETIN

Wednesday, December 19, 2007

Brought on by Darkness, Disorder Needs Light

n a few days, the winter solstice will plunge us into the longest and darkest night of the year. Is it any surprise that we humans respond with a holiday season of relentless cheer and partying?

It doesn’t work for everyone, though. As daylight wanes, millions begin to feel depressed, sluggish and socially withdrawn. They also tend to sleep more, eat more and have less sex. By spring or summer the symptoms abate, only to return the next autumn.

Once regarded skeptically by the experts, seasonal affective disorder, SAD for short, is now well established. Epidemiological studies estimate that its prevalence in the adult population ranges from 1.4 percent (Florida) to 9.7 percent (New Hampshire).

Researchers have noted a similarity between SAD symptoms and seasonal changes in other mammals, particularly those that sensibly pass the dark winter hibernating in a warm hole. Animals have brain circuits that sense day length and control the timing of seasonal behavior. Do humans do the same?

READ MORE @ NY TIMES

Tuesday, December 18, 2007

Dangerous drugs continue to be prescribed to seniors: CBC report

Doctors are continuing to prescribe drugs dangerous to seniors in spite of government warnings, a CBC News investigation reveals.

More than two years ago, CBC News first reported that more than a million seniors were prescribed atypical antipsychotics. Atypical antipsychotics are specific kinds of antipsychotic drugs. They are considered by many experts to be ineffective or even dangerous for elderly patients.

Health Canada followed up with warnings pointing to the drugs' side effects — including a 60 per cent greater risk of death in seniors who were taking the drugs than in patients taking placebos — gleaned from 13 scientific studies. It also warned that elderly patients taking atypical antipsychotics were almost twice as likely to die from side effects such as heart failure.

In its advisory, Health Canada requested that the drugs' manufacturers include a warning describing the risk in the safety information sheet provided along with the drugs, and that health care providers refrain from relying too much on the drugs to treat dementia.

READ MORE @ CBC

Monday, December 17, 2007

Campaign on Childhood Mental Illness Succeeds at Being Provocative

We have your son. We will make sure he will no longer be able to care for himself or interact socially as long as he lives.

— Autism

SO reads one of the six “ransom notes” that make up a provocative public service campaign introduced this week by the New York University Child Study Center to raise awareness of what Dr. Harold S. Koplewicz, the center’s founder and director, called “the silent public health epidemic of children’s mental illness.”

Produced pro bono by BBDO, an Omnicom agency that worked on two previous campaigns for the Child Study Center, the campaign features scrawled and typed communiqués as well as simulations of classic ransom notes, composed of words clipped from a newspaper.

In addition to autism, there are ominous threats concerning depression, obsessive-compulsive disorder, attention-deficit hyperactivity disorder, Asperger’s syndrome and bulimia. The campaign’s overarching theme is that 12 million children “are held hostage by a psychiatric disorder.”

The public service announcements began running this week in New York magazine and Newsweek as well as on kiosks, billboards and construction sites around New York City.

“Children’s mental disorders are truly the last great public health problem that has been left unaddressed,” said Dr. Koplewicz, adding: “It’s like with AIDS. Everyone needs to be concerned and informed.”

READ MORE @ NY TIMES

Sunday, December 16, 2007

Biocapture Surfaces Produced For Study Of Brain Chemistry

A research team at Penn State has developed a novel method for attaching small molecules, such as neurotransmitters, to surfaces, which then are used to capture large biomolecules. By varying the identity and spacing of the tethered molecules, researchers can make the technique applicable to a wide range of bait molecules including drugs, chemical warfare agents, and environmental pollutants. Ultimately, the researchers also hope to identify synthetic biomolecules that recognize neurotransmitters so that they can fabricate extremely small biosensors to study neurotransmission in the living brain.

In the brain, dozens of different small signaling molecules interact with thousands of large receptive proteins as part of the fundamental communication process between nerve cells. This cacophony of specific interactions is highly dependent on nanoscale molecular structure. One key to advancing our understanding of how the brain works is to identify the nature of the association between neurotransmitters and their binding partners.

READ MORE @ SCIENCE DAILY

Saturday, December 15, 2007

Carbamazepine Gets Warning on Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis

Carbamazepine, a drug used to treat epilepsy and bipolar disorder, will now come with new warnings that Asian patients should undergo genetic testing before using the drug. According to the Food & Drug Administration (FDA), a human leukocyte antigen called HLA-B*1502 that is exclusive to people with Asian ancestry makes it more likely that carbamazepine will cause the serious skin disorders Stevens-Johnson Syndrome and toxic epidermal necrolysis.

Carbamazepine is an anticonvulsant and mood stabilizing drug, used primarily in the treatment of epilepsy and bipolar disorder. It is also used to treat other disorders, including Attention Deficit Hyperactivity Disorder and schizophrenia. It is sold under the brand names Carbatrol, Equetro and Tegretol.

READ MORE @ NEWS INFERNO

Friday, December 14, 2007

Effective new treatment for schizophrenia

Schizophrenia is one of the most debilitating of the major psychiatric disorders, and is also one of the most difficult to treat. Although numerous antipsychotic treatments are available, they can cause significant side effects and many patients experience only a partial relief of their symptoms and up to 30% no relief at all. In a new study scheduled for publication in the December 15th issue of Biological Psychiatry, Marder and colleagues examined the efficacy and safety of a new psychotropic agent for the treatment of schizophrenia in a 6-week, randomized, placebo-controlled trial.

The authors studied paliperidone extended-release (ER) tablets, an investigational drug which orally delivers the active metabolite of the drug risperidone, which is an already established efficacious antipsychotic. The authors recruited 444 patients who were experiencing an acute episode of schizophrenia and, after evaluating the severity of their symptoms, administered one of four treatments for 6 weeks: 6 mg or 12 mg/day of paliperidone ER, 10 mg/day of olanzapine (the active comparator), or placebo. During the six weeks of treatment, the investigators monitored the patients for side effects and assessed their symptom improvement.

READ MORE @ EUREKALERT

Thursday, December 13, 2007

British Psychiatrists Criticize Rise Of Bipolar Disorder In Adults, Children

David Healy and his colleague Joanna Le Noury have a new paper out, which examines the rise of bipolar disorder in both adults and children and puts it all in some kind of historical context. It's a lengthier examination of what Healy calls disease mongering than his PLoS paper of 2006. If you want to avoid my summary of this new piece, which I think is a withering attack on just about everyone in the mental health industry, then read their paper here (it's a .pdf file).

This is a lengthy post, but I think it's worth laying out the authors' key points since they are pushing back against some powerful forces in our culture and, at the end, asking if the bipolar child paradigm isn't a new form of Munchausen’s syndrome. I should also note that this site makes an appearance by inference in the article, which was published in the International Journal of Risk & Safety in Medicine.

READ MORE @ FURIOUS SEASONS

Wednesday, December 12, 2007

Possible Markers For Mental Illness Discovered

Researchers have discovered natural genetic differences that might help predict the most effective antipsychotic drugs for particular patients with mental disorders such as schizophrenia, Parkinson's and drug addiction.

They found the differences in the gene for a molecule called the dopamine D2 receptor (DRD2), a protein present on brain cells that are sensitive to the neurotransmitter dopamine.

The receptor is known to play a key role in memory and in a variety of mental illnesses. Most antipsychotic drugs work at least in part by blocking this protein, but scientists don't yet understand how this helps patients. Nor can they explain why some people respond well to certain antipsychotic drugs and others respond poorly.

READ MORE @ SCIENCE DAILY

Tuesday, December 11, 2007

How moods affect our health

HAVING AN ARGUMENT

As your irritation mounts, you can feel your blood pressure rising. And that's exactly what is happening to your body when you have an argument. The effects, it seems, can be lasting. In the week after the irritating incident, you just need to think about the argument and your blood pressure will rise again, according to research published in the International Journal of Psychophysiology. So if you've recently experienced a dispute, a seething irritation or a simple frustration, you could be best off forgetting about it.

A half-hour argument with your lover can also slow your body's ability to heal by at least a day. In couples who regularly argue, that healing time is doubled again. Researchers at Ohio State University discovered this by testing married couples with a suction device that created tiny blisters on their arm. When couples were then asked to talk about an area of disagreement that provoked strong emotions, the wounds took around 40 per cent longer to heal. This response, say researchers, was caused by a surge in cytokines – immune-molecules that trigger inflammation. Chronic high levels of these are linked to arthritis, diabetes, heart-disease and cancer.

READ MORE @ THE INDEPENDENT

Monday, December 10, 2007

Brain Differences Identified In Adolescents With Mental Illness

Puberty may have an impact on areas of the brain that contribute to bipolar disorder or schizophrenia in youth, according to a study presented December 7 at the annual meeting of the American College of Neuropsychopharmacology (ACNP).

Researchers studying the brains of youth with bipolar disorder (also known as manic depressive illness) and schizophrenia found that these children have size differences in some brain areas between these disorders and between genders. These changes exist in key areas of the brain that are involved in reward, motivation, sensory input, emotion and memory, and researchers say examining these areas can help researchers understand developmental processes that occur around the time mental disorders develop.

The brains of children with bipolar disorder are different from the brains of children with schizophrenia, and there are brain differences between boys and girls, and investigators say such findings can help them better understand gender's role in brain processes, and how it affects the development of mental illness. Additionally, they could help lay the foundation for identifying different possible treatment approaches to these illnesses in boys and girls.

READ MORE @ SCIENCE DAILY

Sunday, December 9, 2007

Research finds link between depression

Findings suggest patterns of risk in co-occurring conditions

Depression nearly triples the risk of death following a heart attack, even when accounting for other heart attack risk factors, according to research presented today at the American College of Neuropsychopharmacology (ACNP) annual meeting, which showed that among 360 depressed, post myocardial infarction patients followed for more than six years, those who did not recover from their depression in the first six months were more than twice as likely to die.

This study was one of several presented at a panel which examined the links between depression and vascular disease. “There is an unequivocal link between depression and heart disease, but it is not clear what causes this link,” said Alexander Glassman, M.D., Professor of Psychiatry at Columbia University, College of Physicians and Surgeons and ACNP member. “There is a whole series of factors that link depression and heart disease and we are just beginning to understand how antidepressants act in people who have these conditions together.” Additional risk factors that tend to be major medical predictors of death from a heart attack include the severity of the heart attack and variability in various measures of heart function during recovery.

READ MORE @ EUREKALERT

Saturday, December 8, 2007

Flawed Studies Underscore Need for More Rigorous PTSD Research

Despite PTSD's prominence in a trauma-ridden world, therapies for the disorder rest on some very slim reeds, says the Institute of Medicine.

"Significant gaps" in the evidence underlying nearly all treatments for posttraumatic stress disorder make it impossible to judge their value, according to a study released in October by the Institute of Medicine (IOM).

Poorly designed and executed studies have failed to include enough veterans or account for important comorbidities like depression, substance abuse, or traumatic brain injury, said the IOM committee that conducted the study.

READ MORE @ PSYCHIATRIC NEWS

Friday, December 7, 2007

Antipsychotics, Nursing Homes And Abuse

Keeping them quiet down on the farm. That’s the tone of one story after another these days about how nursing homes increasingly give antipsychotics to patients, whether they need them or not. And of course, the tab is often picked up, unnecessarily by Medicaid, for instance. A couple of weeks ago, The St. Petersburg Times ran such a piece in which Barbara Hengstebeck, executive director of the Coalition to Protect America’s Elders in Tallahassee, Fla., offered an explanation: “A lot of people feel like the elderly in nursing homes are expendable.”

The latest spend-a-gram comes from The Wall Street Journal, which notes that the Centers for Medicare & Medicaid Services says nearly 21 percent of nursing-home patients who don’t have a psychosis diagnosis are on antipsychotic drugs. The use comes amid a wider debate about how to care for the rising numbers of seniors, many of whom have behavior problems stemming from dementia. And a big question, the paper writes, is whether to use a medical model - administering these meds as the way to alleviate distressing symptoms or trying to find other ways to help these patients.

READ MORE @ PHARMALOT

Wednesday, December 5, 2007

Newly-identified Exercise Gene Could Help With Depression

Boosting an exercise-related gene in the brain works as a powerful anti-depressant in mice--a finding that could lead to a new anti-depressant drug target, according to a Yale School of Medicine report in Nature Medicine.

"The VGF exercise-related gene and target for drug development could be even better than chemical antidepressants because it is already present in the brain," said Ronald Duman, professor of psychiatry and senior author of the study.

Depression affects 16 percent of the population in the United States, at a related cost of $83 billion each year. Currently available anti-depressants help 65 percent of patients and require weeks to months before the patients experience relief.

Duman said it is known that exercise improves brain function and mental health, and provides protective benefits in the event of a brain injury or disease, but how this all happens in the brain is not well understood. He said the fact that existing medications take so long to work indicates that some neuronal adaptation or plasticity is needed.

READ MORE @ SCIENCE DAILY

Monday, December 3, 2007

Mental illness and drug addiction may co-occur due to disturbance in part of the brain

Why do mental illness and drug addiction so often go together" New research reveals that this type of dual diagnosis may stem from a common cause: developmental changes in the amylagda, a walnut-shaped part of the brain linked to fear, anxiety and other emotions. A full report on why these “comorbid” disorders may develop appears in the December Behavioral Neuroscience, published by the American Psychological Association (APA).

Dual diagnosis is common yet difficult to treat. Addiction of all types – to nicotine, alcohol and drugs – is often found in people with a wide variety of mental illnesses, including anxiety disorders, unipolar and bipolar depression, schizophrenia, and borderline and other personality disorders. Lead author Andrew Chambers, MD, cites clinical reports that at least half the people who seek help with addiction or mental-health treatment have co-occurring disorders. Epidemiological data says that from two to five of every 10 anxious or depressed people, and from four to eight of every 10 people with schizophrenia, bipolar disorder, or antisocial personality, also have some type of addiction.

READ MORE @ EUREKALERT

Sunday, December 2, 2007

One Gene Variant Puts Stressed Women At Risk For Depression; Has Opposite Effect In Men

A common variation in genes puts women who are under chronic stress at risk for increased depressive symptoms, but has the exact opposite effect in men, according to new findings from Duke University Medical Center researchers.

The researchers analyzed two independent samples of healthy individuals for the presence of a genetic variant that regulates levels of serotonin — a neurotransmitter that is linked to health in numerous ways, including emotion regulation.

One version of the gene puts women who are under chronic stress at risk for more severe depressive symptoms. But among men, the same gene variant appeared to be protective against depression. In fact, men with the opposite gene variant were the ones who experienced more depressive symptoms when under chronic stress.



READ MORE @ SCIENCE DAILY

Saturday, December 1, 2007

Novel Antidepressant Agomelatin Targets Melatonin and Serotonin Receptors: Presented at CPA

The soon-to-be-available antidepressant agomelatin offers excellent efficacy with great tolerability and sleep improvements to boot.

Raymond W. Lam, MD, Professor and Head of Clinical Neuroscience, Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, Canada, presented the latest findings on this agent here at the 57th Annual Conference of the Canadian Psychiatric Association (CPA).

Agomelatin is a new antidepressant with a novel mechanism of action. It acts as an agonist to both the melatonin receptors MT1 and MT2. It is also an antagonist to the 5HT2C serotonin receptor. It also appears to have no other action in any other receptor site, and over 80 sites have been studied so far, said Dr. Lam.

Both the M1 and M2 receptors are known to be involved in regulation of circadian rhythms. Stimulation of M1 has a positive effect on sleep by attenuating the alerting signal produced by the suprachiasmatic nucleus (SCN) in the brain. M2 has a phase-shifting effect on circadian rhythms. Antagonism of the 5HT2C increases the activity of dopamine and noradrenalin in the frontal cortex, which can have both anxiolytic and antidepressant effects. It also promotes slow wave sleep or deep, restorative sleep.

READ MORE @ DOCTOR'S GUIDE

Friday, November 30, 2007

Lifespan link to depression drug

An antidepressant drug lengthens tiny worms' lives and offers hope of humans living longer too, US scientists say.

In the study, detailed in journal Nature, nematode worms were exposed to 88,000 chemicals in turn and mianserin extended lifespan by almost a third.

The drug seems to mimic the effects on the body of the only known animal long-life regime - virtual starvation.

Experts said the findings might point to there being genes in humans that could be targeted to increase lifespan.

READ MORE @ BBC

Wednesday, November 28, 2007

Hormonal Changes And Depression: What Is The Connection?

Women are more susceptible to mood disorders and depression during hormonal transitions, such as pregnancy, postpartum and perimenopause, according to a new report by the Society for Women's Health Research, a Washington, D.C.-based advocacy organization, released at a media briefing held at the Palace Hotel in New York City.

The report summarizes a June 2007 thought leaders' roundtable of eight national experts convened by the Society and the National Institute of Mental Health to discuss current efforts to understand the effects of hormonal transitions on mood disorders in women and to make recommendations for future research.

READ MORE@MEDICAL NEWS TODAY

Tuesday, November 27, 2007

Brain scans 'may detect OCD risk'

Brain scans may be able to reveal which people are at genetic risk of developing obsessive compulsive disorder (OCD), researchers say.

Individuals with OCD and their close relatives have distinctive patterns in their brain structure, a team at Cambridge University found.

The genes responsible remain unknown, but it appears they change the brain's anatomy, which may aid diagnosis.

The study is published in the latest edition of the journal Brain.

OCD is an anxiety disorder in which the person is compelled by irrational fears and thoughts to repeat seemingly needless actions over and over again.

It can manifest itself in repetitive behaviours, such as excessive hand washing, cleaning or repeated checking, affects 2%-3% of the population and is known to run in families.

READ MORE @ BBC

Monday, November 26, 2007

Transcranial Magnetic Stimulation Repels Severe Depression

Transcranial magnetic stimulation significantly reduces acute symptoms of major depression and offers an alternative to conventional therapy, investigators in a multicenter trial have concluded.

Patients treated with transcranial magnetic stimulation had almost a twofold higher remission rate at six weeks compared with patients who received sham therapy in the randomized study, John P. O'Reardon, M.D., of the University of Pennsylvania, and colleagues reported in the Dec. 1 issue of Biological Psychiatry.

As many as 40% of patients with major depression do not get adequate improvement in symptoms with medication and psychotherapy, the investigators noted. Depression may progress into treatment-resistant illness for which transcranial magnetic stimulation could be useful.

Transcranial magnetic stimulation involves discharge of a time-varying current from an insulated coil placed on the scalp surface. The discharge generates a brief dynamic magnetic field that induces current flow when reaching a conductive medium, such as neural tissue. The current offers the potential to modulate neural circuitry in a therapeutic fashion.

Sunday, November 25, 2007

Ritalin: The scandal of kiddy coke

When he was in the throes of his worst tantrums, Daniel Fletcher would rip wallpaper off the walls at home and hit and kick anyone who came near him.

Once, he put his pet mouse in the microwave. On another occasion he jumped out of a moving car.

He was first diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD) at the age of two, and just three years later the little boy was prescribed the amphetamine-like drug Ritalin.

The effect, says his mother Hayley, was a loss of appetite but no difference in his behaviour.

"So the doctor kept upping the doses until he was on six times the normal dose, yet he was still hyperactive."

Eight months ago, Daniel, now 14, was put on Risperdal - an antipsychotic drug usually given to schizophrenics.

"It was as if my son had been replaced by a doped-up zombie,' says Hayley, 35, who took him off it a month later.

READ MORE @ DAILY MAIL

Saturday, November 24, 2007

Trials in Obsessive Compulsive Disorder Highlight Group Therapy, Escitalopram, and Anticonvulsants: Presented at CPA

The latest research on the management of obsessive compulsive disorder (OCD) suggests that cognitive behaviour therapy (CBT) can be as effective in groups and in the office as it is in one-on-one sessions and in the home. Also, the antidepressant escitalopram and anticonvulsants topiramate and lamotrigine may play a more important therapeutic role than has previously been recognised.

Pratap Chokka, MD, Associate Clinical Professor, University of Alberta, Psychiatrist, Grey Nuns Hospital, Edmonton, Canada, presented the latest findings on the management of OCD here on November 17 at the 57th Annual Conference of the Canadian Psychiatric Association (CPA).

Currently, CBT is a mainstay of treatment for OCD. As a stand-alone treatment, it has been found in some studies to be as effective as antidepressants. While one-on-one CBT therapy was believed until recently to be the most effective option, 2007 data has revealed that, in fact, both individual and group therapy are effective. While response rates were faster with individual therapy, overall response rates were similar with both modalities. This is an important finding for a real world setting, where patients are often on waiting lists to receive CBT, said Dr. Chokka.

READ MORE @ DOCTOR'S GUIDE

Thursday, November 22, 2007

Dementia relief, with a huge side effect

The off-label use of some drugs is helping elderly patients, but may be killing thousands.

Two years ago, federal regulators sounded a dire warning: Elderly people with dementia who take drugs like Seroquel, Risperdal and Zyprexa could suffer the ultimate side effect.

They could die.

Yet today, about one in four nursing home residents still take these antipsychotic drugs. Sales to the elderly continue to rise, generating a total of $13-billion in revenues for their manufacturers this year.

The disconnect between government warnings about the increased risk of death and physician prescribing practices led a prominent Food and Drug Administration safety expert to make a stunning estimate.

Dr. David Graham, who had blown the whistle on the dangers of Vioxx, was back before a congressional panel in February. He testified that Zyprexa and other antipsychotics kill about 15,000 nursing home residents each year.

His pronouncement did not spark any followup investigations; it did not prompt government-sponsored research for safer alternatives. Instead, there was resounding silence.

READ MORE @ ST. PETERSBURG TIMES

Wednesday, November 21, 2007

Study Questions 'Real World' Benefits of Newer Antipsychotics

The second-generation antipsychotics may not change the compromised neurobiology that underlies cognitive deficits.

Are the cognitive benefits claimed by manufacturers of second-generation antipsychotics an artificial result of repetitive practice in test conditions?

That's what a randomized trial of risperidone and olanzapine comparing cognitive improvements among first-episode schizophrenia patients and healthy controls suggests. Risperidone is marketed by Janssen Pharmaceutica as Risperdal, and olanzapine is marketed by Eli Lilly and Co. as Zyprexa.

The study, reported in the October Archives of General Psychiatry, found that the cognitive improvements among patients were consistent in magnitude with the "practice effects"—the effects of exposure, familiarity, and procedural learning that naturally occur in test conditions—seen in healthy patients.

READ MORE @ PSYCHIATRIC NEWS

Tuesday, November 20, 2007

Lower Response Rates To Antidepressants Found With African-Americans, Latinos

Drawing from data in the nation's largest real-world study of treatment-resistant depression, a team led by researchers at Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center reported in November's Medical Care journal that African-Americans and Latinos didn't respond as well as whites to medication for their depression.

The study suggests that the lower response rates may stem from differences in socioeconomic background -- rather than race or ethnicity per se. When some of the socioeconomic and health disparities present when subjects entered the study were taken into account, the researchers found the response to antidepressant medications was more similar among all groups.

Dr. Ira Lesser, a LA BioMed investigator who authored the report along with a team of researchers including LA BioMed investigator Daniel B. Castro, said these findings suggest African-Americans and Latinos from lower socioeconomic backgrounds may need more than medication to be treated successfully for depression.

READ MORE @ SCIENCE DAILY

Monday, November 19, 2007

ADHD Drugs Ineffective Over The Long Term

Apart from being ineffective over the long term, ADHD (attention deficit/hyperactivity disorder) drugs may also undermine your child's physical growth, a BBC television program, Panorama, has revealed. Scientists seem to be saying that claims made about ADHD drugs some years ago were overstated.

A long-term monitoring program involving 600 kids across the United States since the beginning of the 1990s was shown in the TV program - with some of its results. It is called the Multimodal Treatment Study of Children with ADHD. The study concluded that over the long term, such ADHD drugs as Concerta and Ritalin have no demonstrable benefit for children - long term means after three years of taking the drug(s).

The use of ADHD drugs in much of the developed world has doubled over the last five years - many say it has become a cure-all for bad behavior.

READ MORE @ MEDICAL NEWS TODAY

ADHD Drugs Ineffective Over The Long Term

Apart from being ineffective over the long term, ADHD (attention deficit/hyperactivity disorder) drugs may also undermine your child's physical growth, a BBC television program, Panorama, has revealed. Scientists seem to be saying that claims made about ADHD drugs some years ago were overstated.

A long-term monitoring program involving 600 kids across the United States since the beginning of the 1990s was shown in the TV program - with some of its results. It is called the Multimodal Treatment Study of Children with ADHD. The study concluded that over the long term, such ADHD drugs as Concerta and Ritalin have no demonstrable benefit for children - long term means after three years of taking the drug(s).

The use of ADHD drugs in much of the developed world has doubled over the last five years - many say it has become a cure-all for bad behavior.

Sunday, November 18, 2007

Moody Is the New Bipolar

In Eugene Jarecki's documentary film Why We Fight, about the U.S. military-industrial complex, U.S. foreign policy critic Chalmers Johnson states: "I guarantee you when war becomes that profitable, you are going to see more of it." Similarly, as mental illness has become extremely profitable, we are seeing more of it.

On September 4, 2007, the New York Times reported, "The number of American children and adolescents treated for bipolar disorder increased 40-fold from 1994 to 2003 ... Drug makers and company-sponsored psychiatrists have been encouraging doctors to look for the disorder."

Not too long ago, a child who was irritable, moody, and distractible and who at times sounded grandiose or acted without regard for consequences was considered a "handful." In the U.S. by the 1980s, that child was labeled with a "behavioral disorder" and today that child is being diagnosed as "bipolar" and "psychotic" -- and prescribed expensive antipsychotic drugs. Bloomberg News, also on September 4, 2007, reported, "The expanded use of bipolar as a pediatric diagnosis has made children the fastest-growing part of the $11.5 billion U.S. market for antipsychotic drugs."

READ MORE @ ALTERNET

Friday, November 16, 2007

ADHD Brains Might Need More Growing Time

Scientists are divided on what causes attention deficit hyperactivity disorder, which affects 3 to 5 percent of school-age children. Some say it's a developmental delay, while others argue that the brains of children with ADHD are abnormal from the start. One puzzle: Some, but not all, kids seem to "grow out" of the disorder, which can cause restlessness, inattention, and difficulty focusing. An intriguing new finding by researchers at the National Institute of Mental Health, reported in today's Proceedings of the National Academy of Sciences, suggests that for about half of kids with ADHD, the troubling symptoms they experience in childhood could be a result simply of slower—but otherwise normal—maturation of the brain.

What should harried parents make of the findings? U.S. News asked Judith Rapoport, a coauthor of the study and chief of the child psychology branch at the National Institute of Mental Health. She has pioneered efforts to study the relationship between brain structure and mental disorders.

Rapoport cautions that the research is in the early stages. The delays, which put areas of the brain used in higher order decision making behind schedule by an average of three years, were most evident in areas at the front of the brain's outer covering, or cortex, that house the ability to control thinking, attention, and planning. In some of the children and teens with ADHD, the brain regions reached peak thickness when the children averaged 10.5 years old, compared with 7.5 in children without ADHD.

READ MORE @ US NEWS & WORLD REPORT

Wednesday, November 14, 2007

Brain Chemicals Involved In Aggression Identified: May Lead To New Treatments

School shootings. Muggings. Murder. Road rage. After decreasing for more than a decade, the rate of violent crime in the United States has begun to inch up again. According to the FBI's Uniform Crime Reporting Program, violent crime rose 2.3 percent in 2005 and 1.9 percent in 2006, the first steady increase since 1993.

And new studies are helping scientists gain deeper insight into the neurobiology of aggression and violence. One analysis of brain imaging studies has revealed that brain structures involved in making moral judgments are often damaged in violent individuals. Another study involving teenage boys suggests that disruptions in a brain region linked to impulsive, aggressive behavior may underlie a certain type of violent, reactive behavior.

Still other research has shed new light on the role that certain brain chemicals play in aggressive behavior, including in maternal aggression. And new animal studies reveal that aggressive encounters cause changes in the brains of aggressors as well as their victims that increase vulnerability to depression and immune-related illnesses.

READ MORE @ SCIENCE DAILY

Tuesday, November 13, 2007

Pharmacological Management of Major Depressive Disorder

About 121 million people worldwide suffer from depression. Major depression is one of the main causes of disability adjusted life years (DALY) as measured by the global burden of disease.1 The lifetime risk of major depression is about 15% for men and about 30% for women.2 Numerous types of depression exist, such as melancholic, atypical, psychotic, postpartum, bipolar, resistant, and mixed depression.3 The most commonly encountered types of depression and specific recommendations for their pharmacologic management are discussed below.
Many medications are used for the management of major depression. These include tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), selective norepinephrine reuptake inhibitors (SNRIs), second generation atypical antidepressants (eg, bupropion, mirtazapine), psychostimulants (eg, methylphenidate), mood stabilizers (eg, lithium), and augmentation drugs (eg, triiodothyronine). Antidepressants work through a variety of mechanisms, a topic beyond the scope of this newsletter, but generally influence the function of neurotrasmitters such as norepinephrine, serotonin, or dopamine by exerting an impact on the interaction of these neurotransmitters with their receptors.

READ MORE @ ABKHAZIA

Sunday, November 11, 2007

Why Quitting Smoking Is So Difficult

New findings clarify the brain mechanisms that explain many aspects of dependency on nicotine, the addictive substance in tobacco. Among them: Individual differences in brain chemistry can have a profound effect on a person's susceptibility to addiction, and smoking may predispose adolescents to mental disorders in adolescence and adulthood. In addition, researchers have identified a potential neural network that regulates the body's craving response and have demonstrated how smoking may affect decision-making.

"As the negative health consequences of smoking have become more and more obvious, the majority of smokers have attempted to quit," says Marina Picciotto, PhD, of Yale University. "Unfortunately, people who want to quit often find that they cannot, and recent neuroscience research has identified many of the molecular mechanisms that lead to nicotine addiction.

"It is notable that many who smoke cigarettes have affective disorders, and many who have affective disorders such as major depression also smoke cigarettes and find it much harder to quit. We need new treatments for smoking cessation based on neuroscientific evidence and we need to understand the interaction between smoking and affective disorders so we can target new therapies to people who have the hardest time quitting."

READ MORE @ SCIENCE DAILY

Saturday, November 10, 2007

Antidepressants, Exercise, Age, Even Food Intake, Affect Generation Of New Brain Cells

Recent research shows that the production of new brain cells may be crucial for antidepressants to be effective and that the medication's effectiveness is strongly influenced by age. What's more, meal frequency, type of food, and physical exercise affect the brain's ability to manufacture these new cells.

For the first time in nonhuman primate models, scientists have documented the cause-and-effect relationship between antidepressant drugs and neurogenesis. The researchers found that the antidepressant drug fluoxetine improved the behavior of macaque monkeys with depression-like symptoms.

They also discovered that administering the drugs to normally behaving monkeys did not influence their behavior but did alter their brains by boosting neurogenesis in the hippocampus, an area involved in memory and learning.

READ MORE @ SCIENCE DAILY

Friday, November 9, 2007

ADHD Medication Doesn't Work on Some Preschoolers - Children May Not Respond If They Have Other Disorders

Children diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD) may not respond to methylphenidate, otherwise known as brand name Ritalin, if the child suffers from other behavioral and social disorders. The number of coexisting conditions can diminish the effectiveness of the medication, according to a new look at a study from the National Institutes of Health's National Institute of Mental Health (NIMH).

The Preschoolers with ADHD Treatment Study (PATS) was released last October, and showed that young children between the ages of 3 and 5 who were diagnosed with ADHD responded well to doses of methylphenidate. However, a new article published in the latest issue of the Journal of Child and Adolescent Psychopharmacology reports that the effectiveness of methylphenidate lessens if the child has other disorders, such as anxiety disorders, conduct disorder, and/or oppositional defiant disorder.

READ MORE @ ASSOCIATED CONTENT

Wednesday, November 7, 2007

Behavior therapy plus medication may help teens with depression and substance use disorders

The antidepressant fluoxetine combined with cognitive behavioral therapy appears as effective for treating depression among teens who also have substance use disorders as among those without substance abuse problems, according to a report in the November issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

“Adolescents with substance use disorders (SUDs) have higher rates of depression (15 percent to 24 percent) than adolescents in the general population,” the authors write as background information in the article. “Comorbid [co-occuring] depression is also associated with more severe substance abuse, poorer drug treatment outcomes and higher relapse rates.”

READ MORE @ EUREKALERT

Tuesday, November 6, 2007

U.S. rejects Glaxo's gepirone ER antidepressant

U.S. regulators have rejected GlaxoSmithKline Plc's (GSK.L: Quote, Profile, Research) experimental drug gepirone ER for adults with major depression.

The U.S. Food and Drug Administration (FDA) issued a not approvable letter for the extended-release tablets, which Glaxo had licensed from privately owned Fabre-Kramer Pharmaceuticals Inc in February, Europe's biggest drugmaker said on Saturday.

The news is a blow to Glaxo, which needs new drugs to make up for pending patent expiries on key blockbusters and a recent slump in sales of its second-biggest seller, the diabetes pill Avandia, which has been hit by fears over a possible link to heart attacks.

READ MORE @ REUTERS

Monday, November 5, 2007

Non-English Speakers Charge Bias in Prescription Labeling

Pharmacies across the city routinely fail to help non-English speakers understand their prescriptions, raising the chances that customers could harm themselves by taking medicines incorrectly, immigrant advocacy groups charge in a discrimination complaint that they plan to file today with the New York attorney general’s office.

The complaint names 16 pharmacies in Brooklyn, Queens and Long Island, most of them operated by chains. It argues that federal civil rights law and state health regulations require pharmacies to provide linguistic help to guarantee that people who speak little or no English receive equal access to health care. That assistance should include interpreters at pharmacies and written translations of medication instructions, the advocates say.

Nisha Agarwal, a lawyer for one of the groups filing the complaint, said the attorney general’s office had already issued subpoenas to several pharmacies listed in an earlier version of the complaint filed in July. The new version names more pharmacies, and an accompanying report includes more examples of comprehension problems non-English speakers have had.

READ MORE @ NY TIMES

Sunday, November 4, 2007

Aripiprazole Decreases Symptoms of Mania in Paediatric Bipolar Disorder: Presented at AACAP

Children and adolescents at the onset of bipolar disorder may achieve improvements in manic symptoms with aripiprazole, according to research presented here at the 54th Annual Meeting of the American Academy of Child & Adolescent Psychiatry (AACAP).

Lead author Kiki D. Chang, MD, Assistant Professor and Director, Pediatric Mood Disorders Clinic, Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California, United States, and colleagues undertook a 54-centre, 4-week study of 296 patients 10 to 17 years of age with bipolar disease.

READ MORE @ DOCTOR'S GUIDE

Saturday, November 3, 2007

Concomitant Psychotropic Medications Overprescribed in Foster-Care Youth: Presented at AACAP

Nearly 20% of youths in foster care receiving psychotropic medications received two or more such drugs in the same drug class, in a study presented here at the 54th Annual Meeting of the American Academy of Child & Adolescent Psychiatry (AACAP).

Professionally developed monitoring guidelines would help to validate any necessary prescriptions for multiple psychotropic medications, noted lead author Julie M. Zito, PhD, MS, Associate Professor in Pharmacy and Psychiatry, Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, Baltimore, Maryland, United States.

Dr. Zito and colleagues selected a random sample (n = 472) from a total of 32,135 Medicaid foster-care enrolees in Texas in 2004. All subjects were 19 years of age or younger (64% over the age of 10; 5% were age 4 years and under) and all received at least one psychotropic drug in the study year (2004).

The psychotropic drugs were classified under 8 drug descriptions: anticonvulsants; alpha agonists; antianxiolytics; antidepressants (selective serotonin reuptake inhibitors, tricyclic antidepressants, other); antipsychotics (atypical and conventional); ADHD drugs (amphetamines, methylphenidate, atomoxetine); lithium; and miscellaneous.

READ MORE @ DOCTOR'S GUIDE

Friday, November 2, 2007

Previous Suicidality a Greater Risk Than Antidepressant Medication in Suicidal Teens: Presented at AACAP

Antidepressant drugs have a lesser effect on teenagers' risk of suicidality than do female gender and previous plans to kill oneself within the past year, according to research presented here at the 54th Annual Meeting of the American Academy of Child & Adolescent Psychiatry (AACAP).

Lead author Neera Ghaziuddin, MD, MRCPsych, Associate Professor, Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, United States explained that previous paediatric studies have not examined antidepressants in conjunction with other psychiatric medications in the teenage population. Additionally, antidepressant trials with depressed youth have generally excluded acutely suicidal patients.

READ MORE @ DOCTOR'S GUIDE

Thursday, November 1, 2007

Use of Antidepressants in Pregnancy Affects Neonatal Outcomes: Presented at AACAP

Babies born to mothers who take antidepressant medication during pregnancy have high levels of cortisol in cord-blood at birth, and their mothers are more likely to experience delivery complications, according to a study presented here at the 54th Annual Meeting of the American Academy of Child & Adolescent Psychiatry (AACAP).

When examined at 2 weeks of age, the infants of women taking antidepressants demonstrated more tremulousness and were more excitable than infants born to women not taking antidepressants.

The study results were presented by lead author Sheila Marcus, MD, Clinical Associate Professor, Departments of Psychiatry and Depression Center, University of Michigan, Ann Arbor, Michigan, United States, on October 24.

READ MORE @ DOCTOR'S GUIDE

Wednesday, October 31, 2007

Bipolar Disorder or Manic Depression Causes and Treatment

Bipolar disorder is a psychiatric condition defined as recurrent episodes of significant disturbance in mood. These disturbances can occur on a spectrum that ranges from debilitating depression to unbridled mania. Individuals suffering from bipolar disorder typically experience fluid states of mania, hypomania or what is referred to as a mixed state in conjunction with depressive episodes. These clinical states typically alternate with a normal range of mood. While dealing with bipolar disorder isn’t always easy, it doesn’t have to run your life. With proper treatment and a solid support system, people with bipolar disorder are capable of leading rich and fulfilling lives. They can hold jobs, sustain loving marriages, raise children, and be productive members of society. But in order to successfully manage bipolar disorder, it is essential to fully understand the condition and its challenges.

READ MORE @ AMERICAN CHRONICLE

Monday, October 29, 2007

Decision-makers Seek Internal Balance, Not Balanced Alternatives

A researcher at the University of California, San Diego (UCSD) School of Medicine suggests that psychiatrists may need to approach the treatment of psychiatric patients from a new direction -- by understanding that such individuals' behavior and decision-making are based on an attempt to reach an inner equilibrium.

Martin Paulus, M.D., professor in UCSD's Department of Psychiatry, has compiled a body of growing evidence that human decision-making is inextricably linked to an individuals' need to maintain a homeostatic balance.

"This is a state of dynamic equilibrium, much like controlling body temperature," said Paulus. "How humans select a particular course of action may be in response to raising or lowering that 'set point' back to their individual comfort zone. In people with psychiatric disorders or addictions, the thermostat may be broken."

READ MORE @ SCIENCE DAILY

Saturday, October 27, 2007

Forest Laboratories' Lexapro Still Leads First-Line Therapy in the Treatment of Major Depression, but Atypical Antipsychotics Are Coming On Strong

Decision Resources, one of the world's leading research and advisory firms focusing on pharmaceutical and healthcare issues, finds that Forest Laboratories' Lexapro leads first-line therapy in the treatment of major depression. According to the new report entitled Treatment Algorithms in Major Depression, selective serotonin reuptake inhibitors (SSRIs), which include Lexapro, serve 63.6 percent of patients on first-line therapy. Surveyed physicians say the reasons for SSRIs being so heavily used are efficacy, cost and physician familiarity. Eighty percent of surveyed psychiatrists and 70 percent of surveyed primary care physicians (PCPs) say they choose SSRIs over benzodiazepines because of efficacy. Forty-nine percent of surveyed psychiatrists cite cost as the prime reason they choose SSRIs over serotonin/norepinephrine reuptake inhibitors (SNRIs), while 49 percent of PCPs say they choose SSRIs over SNRIs owing to familiarity with the former class.

READ MORE @ EARTHTIMES

Friday, October 26, 2007

Confronting Sadness in Seniors

A bit of sadness is a common companion of aging. Over time, after all, seniors may lose vigor, independence, and even loved ones. But when melancholy becomes outright depression, the elderly are at risk of diabetes, heart disease, and even suicide. It's often up to their unofficial caretakers—their children—to spot depression's signs and take steps to address it.

Depression often manifests differently in the elderly than in younger people. Rather than expressing feelings of sadness, depressed seniors may describe physical complaints—increased aches and pains, headaches, weakness, and, commonly, trouble sleeping. "Look for changes in levels of interest, too," says Dan Blazer, professor of psychiatry and behavioral sciences at Duke University Medical Center. Increases in anxiety, irritability, withdrawal, and a decrease in attention to appearance are also common signs. Sometimes, depression arises because of a physical health problem, says Gary Moak, president of the American Association for Geriatric Psychiatry and a professor at the University of Massachusetts Medical School. For example, he says, "as many as 40 percent of stroke victims will develop depression, because many [strokes] occur in an area of the brain that's closely related to the processing and management of emotions." Overall, about 1 in 5 people age 65 and older has depression, according to Moak. The vast majority don't receive the professional treatment they need.

READ MORE @ US NEWS & WORLD REPORT

Thursday, October 25, 2007

Psychiatric Conditions Increase the Risk of Heart Disease

Although mortality rate among people suffering from cardiovascular diseases has declined in the United States over the past years, patients suffering from acute mental illness remain deprived of the benefits experienced by healthy individuals. These views were expressed in the Journal of the American Medical Association (JAMA) by a psychiatrist --John W. Newcomer at Washington University School of Medicine in St. Louis.

Newcomer, who is the professor of psychiatry and psychology and of medicine and medical director of the Center for Clinical Studies at Washington University, said that people suffering from mental ailments including schizophrenia, bipolar disorder and various forms of depression live 25 -30 years shorter than those with no such ailments. Though suicide remains one of the major causes of death among these individuals, but most of them die prematurely on account of cardiovascular diseases.

READ MORE @ MEDHEADLINES

Wednesday, October 24, 2007

Veterans are denied mental health help

After two combat tours in Iraq on a "quick reaction team" that picked up body parts after suicide bombings, Donald Schmidt began suffering from nightmares and paranoia. Then he had a nervous breakdown.

The military discharged Schmidt last Oct. 31 for problems they said resulted not from post-traumatic stress disorder but rather from a personality disorder that pre-dated his military service.

Schmidt's mother, Patrice Semtner-Myers, says her son was told that if he agreed to leave the Army he'd get full benefits. Earlier this month, however, they got a bill in the mail from a collection agency working for the government, demanding that he repay his re-enlistment bonus, plus interest — $14,597.72.

Schmidt, 23, who lives near Peoria, Ill., is one of more than 22,000 service members the military has discharged in recent years for "pre-existing personality disorders" it says were missed when they signed up.

"They used these guys up, and now they're done with them and they're throwing them away," Semtner-Myers said.

Her frustration extends to Capitol Hill, where the stage is being set for a confrontation between Congress and the Pentagon.

Rep. Bob Filner, D-Calif., chairman of the House Veterans Affairs Committee, calls the treatment of these troops "disgraceful."

READ MORE @ ST. LOUIS POST DISPATCH

Tuesday, October 23, 2007

Little evidence to support therapies for post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is a severe and ongoing emotional reaction to an extreme psychological trauma; it affects significant numbers of people, in particular military personnel and veterans, who have seen active duty in war zones.

It also affects people who have suffered major injuries or illnesses.

As many as 25% or more of patients that suffer from PTSD will have attempted suicide.

It is thought to be basically an anxiety disorder and is different from normal grief and adjustment after traumatic events; symptoms which appear within the first month of the trauma are called acute stress disorder but if no improvement of symptoms are seen after a month, PTSD is diagnosed.

PTSD is divided into three categories: Acute PTSD which subsides within three months; if symptoms persist, the diagnosis is changed to chronic PTSD.

The third category, delayed-onset PTSD, may occur months, years or even decades after the traumatic event.

READ MORE @ NEWS-MEDICAL.NET

Sunday, October 21, 2007

Evidence unclear on treating US veterans' stress

Many U.S. combat veterans from Iraq and Afghanistan are clearly suffering from post-traumatic stress disorder but it is not at all clear which treatments work to help them, an Institute of Medicine panel said on Thursday.

The only therapies that have been shown to work are so-called exposure therapies, in which people are guided in a gradual, step-by-step confrontation with a fear or stressor, the expert committee said.

"At this time, we can make no judgment about the effectiveness of most psychotherapies or about any medications in helping patients with PTSD," said Dr. Alfred Berg of the University of Washington in Seattle.

READ MORE @ REUTERS

Saturday, October 20, 2007

How Schizophrenia Develops: Major Clues Discovered

Schizophrenia may occur, in part, because of a problem in an intermittent on/off switch for a gene involved in making a key chemical messenger in the brain, scientists have found in a study of human brain tissue. The researchers found that the gene is turned on at increasingly high rates during normal development of the prefrontal cortex, the part of the brain involved in higher functions like thinking and decision-making -- but that this normal increase may not occur in people with schizophrenia.

The gene, GAD1, makes an enzyme essential for production of the chemical messenger, called GABA. The more the gene is turned on, the more GABA synthesis can occur, under normal circumstances. GABA helps regulate the flow of electrical traffic that enables brain cells to communicate with each other. It is among the major neurotransmitters in the brain.

Abnormalities in brain development and in GABA synthesis are known to play a role in schizophrenia, but the underlying molecular mechanisms are unknown. In this study, scientists discovered that defects in specific epigenetic actions -- biochemical reactions that regulate gene activity, such as turning genes on and off so that they can make substances like the GAD1 enzyme -- are involved.

READ MORE @ SCIENCE DAILY

Friday, October 19, 2007

Schizophrenics gain by practice, not meds

A U.S. study suggested cognitive gains in schizophrenic patients treated with newer antipsychotic medications are due to practice effects, not the drugs.

Second-generation antipsychotic medicines were designed to improve the speed, clarity, and rationality of thought among people with schizophrenia and other psychotic illnesses.

But psychiatric researchers at the Zucker Hillside Hospital and the Feinstein Institute for Medical Research studied the cognitive performance of 104 people newly diagnosed with schizophrenia who were taking second-generation medicines.

READ MORE @ NEWS DAILY

Wednesday, October 17, 2007

Valdoxan(R), the First Melatonergic Antidepressant, Confirms its Efficacy in Preventing Relapse Whatever the Severity of the Depression

Valdoxan(R) (agomelatine), the first melatonergic antidepressant, is an effective, long-term treatment for Major Depressive Disorder (MDD) according to new data presented today at the European College of Neurospsychopharmacology(ECNP) annual congress. The new international study showed Valdoxan's efficacy in preventing relapse in out-patients with MDD over six-months, irrespective of the severity of depression(1).

"The short term efficacy of this novel antidepressant has already been demonstrated in several clinical studies", points out study investigator Professor Guy Goodwin from the Department of Psychiatry,University of Oxford, UK. "This new study demonstrated the long-term efficacy of Valdoxan in the prevention of depressive relapses, after an initial response to the drug, over a treatment period of six months. The results show that Valdoxan is a promising therapeutic agent for the short-and-long-term management of MDD, which offers remission to our depressed patients with very few adverse effects".

READ MORE @ JURA FORUM

Tuesday, October 16, 2007

Mental Disorders Are Disorders Of The Brain

Depression, anxiety disorders such as panic disorder and obsessive-compulsive disorders, alcohol and drug dependence, dementia and Parkinson's disease are just a few examples of "disorders of the brain."

The size, the burden and cost of brain disorders in the EU is immense, and has so far been underestimated," as Prof. Dr. Hans Ulrich Wittchen emphasized at the Official Press Conference to the 20th ECNP Congress for Neuropsychopharmacology in Vienna (October 13-17, 2007).

Increasing Lifetime Risk -- Unmet Needs

Mental disorders such as anxiety and depressive disorders are disorders of the brain and involve complex patterns of disturbances of cognition (such as perception, attention, memory), affect and emotion (such as depressed mood, panic), somatic functioning (e.g. appetite, heart rate variability) and behaviour. These patterns and disturbances are all associated with disturbances in the transmitter systems of the brain and the central nervous system. What is special about most mental disorders is that they predominantly manifest early in life, before the age of 20. They are also associated across the life span with a high risk of developing complications and other -- so called comorbid -- disorders.

READ MORE @ SCIENCE DAILY

Monday, October 15, 2007

Depressed at work? Get a new career

Child care workers, home health care aides and other people who provide personal services have the highest rates of depression among U.S. workers, according to a new survey to be published on Monday.

It found that 10.8 percent of personal care and service workers and 10.3 percent of food preparation and serving workers -- both usually low-paying jobs -- experienced one or more major depressive episodes in the past year.

The least depressing careers appear to lie in architecture, engineering, the sciences and in the installation, maintenance and repair fields, the survey from the Substance Abuse and Mental Health Services Administration found.

READ MORE @ REUTERS

Sunday, October 14, 2007

A dark age for mental health - A therapy last used on a mass scale in China's cultural revolution is to be unleashed on the NHS

It looks like good news. In an era where psychological problems are increasingly explained in terms of biological deficits, the government has announced that it will spend £170m by 2010 on talking therapies for depression and anxiety. The scheme should pay for itself as better mental health will mean fewer sick days and benefits - £170m isn't much compared with an annual £12bn cost to the economy. But will it really help?

The answer, sadly, is negative. Talking therapy means not psychotherapy, but cognitive behavioural therapies (CBTs). These aim at the removal of symptoms and the return to work of sufferers, who will have learned to identify and manage patterns of undesirable behaviour. However, clinicians know that patients are likely to be back on a waiting list within a year to 18 months. Their underlying problems will not have been resolved, resulting in new symptoms or the return of old ones.

READ MORE @ THE GUARDIAN

Saturday, October 13, 2007

Report questions generic antidepressant - ConsumerLab.com finds cheaper drug may not work the same as brand

For seven years Linda Douglas has been treating her depression with the antidepressant Wellbutrin, first with a twice-a-day version and then later with a more convenient once-a-day pill called Wellbutrin XL. The drug, she says, "renewed my joy for living."

All that changed earlier this year when she switched to a generic version of Wellbutrin XL 300 milligrams to save money. Instead of paying $250 for a three-month supply of the brand drug, she was paying just $53. The cost savings were welcome, but Douglas, 48, a telecommunications project manager in Columbia, Md., says the depression returned during the six months she took the generic antidepressant.

READ MORE @ MSNBC

Friday, October 12, 2007

Antidepressants Emerge as Coolant for Hot Flashes

Doctors are writing a new prescription for menopause: the antidepressant.

It’s not that all menopausal women are depressed. Instead, the antidepressant has emerged as the drug of choice among women searching for new ways to cool the hot flash.

There is no way to track how often antidepressants are prescribed to treat hot flashes, the unpredictable, sticky wave of heat that for many women is the defining symptom of menopause. None are specifically approved for hot flashes, and doctors who prescribe them are doing so “off label.”

READ MORE @ NY TIMES

Thursday, October 11, 2007

The Politics Behind Despair and Depression

On September 14, 2007, New York Times reporters Alex Berenson and Benedict Carey foiled, at least temporarily, Big Pharma and its psychiatry allies' attempt to eliminate the U.S. Food and Drug Administration warning label about increased suicidal thoughts and behaviors in minors using antidepressants.

Berenson and Carey refuted a September 2007 American Journal of Psychiatry article that had claimed an increase in the youth suicide rate in 2004 was related to declining antidepressant prescriptions for that group (caused by the FDA warning). Berenson and Carey reported that, in fact, in 2004 the "number of prescriptions for antidepressants in that group was basically unchanged and did not drop substantially." The New York Times did not, however, report that the lead author of the American Journal of Psychiatry article had served as an expert witness for Wyeth Pharmaceuticals, makers of the antidepressant Effexor.

While the recent smoke and mirrors of Big Pharma and the American Journal of Psychiatry was detected by The New York Times, the media, once again, is losing sight of a more important revelation: scientists currently agree that "the neurotransmitter-deficiency theory of depression"--the rationale for antidepressants--has no validity.

READ MORE @ HUFFINGTON POST

Wednesday, October 10, 2007

Reported suicides – more than 80 percent got psychiatric drugs, well over 50 percent got antidepressants

Health care providers in Sweden are per a new law required to report all suicides committed in health care and up to four weeks after last health care visit. The reports are sent to the National Board of Health and Welfare for investigation.

367 suicides were reported per this law for 2006.

Data gotten via FOIA requests show: More than 80 percent of persons committing suicide were “treated” with psychiatric drugs; in well over 50 percent of the cases the persons got antidepressants, in more than 60 neuroleptics or antidepressants.

This information has been concealed by senior (psychiatric) officials at the National Board of Health and Welfare. It was contrary to the best interests of Big Pharma and biological psychiatrists. It blew the myths of antidepressants and neuroleptics as suicide protecting drugs to pieces. It would also have hurt the career of many medical journalists to take up this subject; journalists who for years have made their living by writing marketing articles about new antidepressant drugs. So nothing has been written about this in major media in Sweden.

READ MORE @ TRANSWORLDNEWS

Tuesday, October 9, 2007

Anti-depressants And Painkillers Combined Linked To Gastrointestinal Bleeding

New research shows that selective serotonin reuptake inhibitors (SSRIs), a group of drugs commonly used to treat depression, may double the risk of gastrointestinal bleeding, according to researchers from Wake Forest University School of Medicine and colleagues. When the drugs are taken with aspirin and other similar pain medications, the risk is more than 600 percent higher.

Painkillers such as ibuprofen are widely used by the public and can be purchased from supermarkets and pharmacies without prescription.

"Clinicians who prescribe these medications should be aware of the potential risk and may need to consider alternatives," said Sonal Singh, M.D., senior researcher and an assistant professor of internal medicine. "In addition, regulatory authorities should consider revising existing package inserts to highlight the magnitude of the risk."

READ MORE @ SCIENCE DAILY

Monday, October 8, 2007

New Medication For The Treatment Of Schizophrenia Significantly Reduces Symptoms And Improves Patients’ Daily Lives(1,2)

INVEGA™ controls symptoms around the clock and may reduce the risk of some drug interactions, which can be a problem in the treatment of schizophrenia

Toronto, ON .- Health Canada has approved INVEGA™ (paliperidone) for the treatment of schizophrenia.1 INVEGA™ is the only once-daily oral treatment for schizophrenia that uses a unique OROS® technology designed to deliver and sustain a controlled level of medication throughout the day.1 Moreover, INVEGA™ is not extensively metabolized in the liver, which may mean fewer drug interactions for patients.1,3

People with schizophrenia are often on more than one medication (called polypharmacy) for conditions including anxiety disorders, depression, cardiovascular disease, diabetes, HIV and hepatitis C.3 In fact, studies have shown that 43 per cent of patients on an atypical antipsychotic are on five or more other medications.4 Taking several drugs along with antipsychotic medication can alter the potency of the medication and may lead to serious and potentially life-threatening adverse events.3 Thus, reducing the risk of drug interactions in the treatment of schizophrenia is an important consideration.

READ MORE @ WEBWIRE

Sunday, October 7, 2007

Cognitive Behavioral Therapy Reduces Risks of Teen Antidepressant Use

The combination of fluoxetine (Prozac) and cognitive behavior therapy for depressed teens may accelerate treatment response and protect against suicidality.

In a randomized trial, combination therapy was not superior to fluoxetine or cognitive behavior therapy after 36 weeks, reported John S. March, M.D., M.P.H., of Duke here, and colleagues, in the October issue of Archives of General Psychiatry.

But a previously published analysis of the same patients, which showed an early advantage in response rate at 12 weeks with combination therapy (73% versus 62% and 48%), suggests that it may be a superior strategy, they said.

"Because accelerating symptom reduction by using medication is an important clinical outcome in psychiatry, as it is in other areas of medicine, use of fluoxetine should be made widely available, not discouraged," they wrote.

READ MORE @ MEDPAGE TODAY

Saturday, October 6, 2007

Antidepressant response may predict cardiac event

Among patients who have had a heart attack and subsequently develop depression, a lack of response to antidepressant treatment signals a high risk of another cardiac episode, according to a secondary analysis of data from Myocardial Infarction and Depression-Intervention Trial (MIND-IT).

MIND-IT involved 2,177 patients who were hospitalized with an acute heart attack. During follow-up, 375 patients developed post-heart attack depression. Two hundred nine of these patients were randomly assigned to receive mirtazapine, sold under the trade name Remeron, or to "care as usual."

If there was an inadequate response to mirtazapine after 8 weeks, the patients were switched to citalopram, sold under the trade name Celexa, according to the report in the American Journal of Psychiatry

READ MORE @ REUTERS

Friday, October 5, 2007

Lilly Adds Label Warnings for Mental Illness Drug

Eli Lilly today added strong warnings to the label of Zyprexa, its best-selling medicine for schizophrenia, citing the drug’s tendency to cause weight gain, high blood sugar, high cholesterol and other metabolic problems.

For the first time, Zyprexa’s label now acknowledges that the drug causes high blood sugar more than some other medicines for schizophrenia and bipolar disorder, called atypical antipsychotics.

Lilly previously argued that Zyprexa had not been proven to cause high blood sugar at a more frequent rate than its competitors.

Concern about Zyprexa’s side effects has been increasing since at least 2004, and Zyprexa’s prescriptions and market share have fallen sharply over the same period. As a result, the new warnings may have only a moderate impact among doctors and patients, said S. Nassir Ghaemi, director of the Bipolar Disorder Research Program at Emory University.

READ MORE @ NY TIMES

Wednesday, October 3, 2007

Anti-Anxiety Medications For Treating Anxiety Disorders

Everyone suffers a bit of anxiety on occasion. But does that mean you need anti-anxiety medication? Not necessarily.

Your palms begin to sweat and your stomach begins to flutter but you're fine. You're experiencing simple cases of nervousness and your body is responding in ways that are manageable. But, anxiety can explode into a serious problem.

Anxiety disorders, in addition to generalized anxiety, include phobias, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. For millions of sufferers anxiety disorders are disruptive, debilitating and often the reason for loss of job and serious problems in family relationships. So what can be done to control anxiety disorders?

READ MORE @ AMERICAN CHRONICLE

Tuesday, October 2, 2007

Drug firm, subsidiary settle suits for $515m - Pricing schemes, fraud alleged

Bristol-Myers Squibb and a subsidiary have agreed to pay more than $515 million to settle civil suits over fraudulent drug marketing and pricing schemes, including illegally promoting an anti-psychotic drug to children and the elderly, US Attorney Michael J. Sullivan said yesterday.

The settlement between the federal government and Bristol-Myers Squibb and Apothecon Inc. is the third-largest between a pharmaceutical company and the US Attorney's Office in Massachusetts, which has obtained more than $4 billion in healthcare fraud settlements since 2000 and acquired a national reputation for pursuing such cases.

As with many of the earlier settlements, the agreement came after several employees of the pharmaceutical giant turned whistleblowers and filed federal suits in Massachusetts, enticed in part by the track record of federal prosecutors here.

The agreement says Bristol-Myers Squibb gave kickbacks to physicians and healthcare providers from 2000 through mid-2003 to get them to prescribe the company's drugs. The kickbacks came in several forms, including consulting fees and trips to luxury resorts.

READ MORE @ BOSTON GLOBE

Monday, October 1, 2007

Drug Makers Seek Clues to Side Effects in Genes

Seven of the largest pharmaceutical companies have formed a group to develop genetic tests to determine which patients would be at risk from dangerous drug side effects.

The new group, the International Serious Adverse Events Consortium, is one of a wave of cooperative research efforts sweeping the drug industry, as companies come under pressure to cut costs and increase their success rates in developing medications. The Food and Drug Administration has encouraged the formation of such groups.

If drugs could be withheld from patients who have a genetic risk for serious side effects, it could not only protect the patients but might help manufacturers get their drugs approved or avoid having to remove them from the market.

READ MORE @ NY TIMES

Sunday, September 30, 2007

Zyprexa may get OK for teen use - Senior regulator overrules peers on drug's benefits for adolescents

Eli Lilly and Co.'s best-selling schizophrenia drug Zyprexa is poised to get U.S. approval for treating adolescents diagnosed with mental illness after a senior government regulator overruled his colleagues.
A three-member Food and Drug Administration team initially urged rejecting the drug for pediatric use because of inconsistent data from studies in U.S. and Russian teens. In an April 29 memo posted on the FDA's Web site, Thomas Laughren, head of the agency's psychiatry division, said the drug's benefits in some studies outweighed the reviewers' concerns.
Zyprexa, with $4.4 billion in global sales in 2006, is Lilly's biggest revenue producer and the best-seller among five drugs known as atypical antipsychotics.
The drug's market leadership has slipped because of surging pediatric prescriptions for competing products and side effects linked to Zyprexa. Johnson & Johnson's Risperdal last month became the only drug in the class cleared for pediatric use though doctors long have prescribed the pills to children, according to market research.

READ MORE @ Indianapolis Star

Saturday, September 29, 2007

Genes Tied to Bad Reactions to Antidepressant Drug

Variations in two genes may increase the likelihood that a person will report suicidal thoughts after taking an antidepressant, researchers reported yesterday. The finding could help doctors develop tests to predict which patients will do well on such medications and which will react badly.

The authors of the study, which was released to reporters yesterday and will appear in The American Journal of Psychiatry on Monday, said that the findings were preliminary and would need to be verified by further testing.

The study focused on reactions to only one drug, Celexa from Forest Laboratories, and found no link between the gene variations and dangerous behavior like suicide attempts.

READ MORE @ NY TIMES

Friday, September 28, 2007

Report Assails F.D.A. Oversight of Clinical Trials

The Food and Drug Administration does very little to ensure the safety of the millions of people who participate in clinical trials, a federal investigator has found.

In a report due to be released Friday, the inspector general of the Department of Health and Human Services, Daniel R. Levinson, said federal health officials did not know how many clinical trials were being conducted, audited fewer than 1 percent of the testing sites and, on the rare occasions when inspectors did appear, generally showed up long after the tests had been completed.

The F.D.A. has 200 inspectors, some of whom audit clinical trials part time, to police an estimated 350,000 testing sites. Even when those inspectors found serious problems in human trials, top drug officials in Washington downgraded their findings 68 percent of the time, the report found. Among the remaining cases, the agency almost never followed up with inspections to determine whether the corrective actions that the agency demanded had occurred, the report found.

READ MORE @ NY TIMES

Thursday, September 27, 2007

Fear Mongering Suicide Statistics to Revive Antidepressant Sales

It's been a busy year for pharma, creating new diseases to make healthy people take pills, reformulating existing drugs to win "new! improved!" patents, hiring high heel wearing reps to intercept the doc before ailing patients--and fear mongering suicide statistics to revive waning antidepressant prescriptions.

Long before the New York Times reported this month that youth suicides were up 8% from 2003 to 2004 and experts blamed an "antidepressant deficiency" big pharma was trying to plant the story.

There's too much money in diagnosing children with major psychiatric illnesses and keeping them on psychotropic drugs their whole lives to let a little thing like the black box warnings the FDA imposed on antidepressants for children in 2004 ruin sales.

READ MORE @ FOOD CONSUMER

Wednesday, September 26, 2007

Patch could up Alzheimer's medication compliance

The European Commission has on today approved the use of a transdermal patch to deliver medicine to patients with mild-to-moderately severe Alzheimer's disease.

The patch is the first type of transdermal treatment for Alzheimer's disease and is applied once a day to the back, chest or upper arm of patients.

Experts say the patch improves compliance for Alzheimer's patients and also reduces side-effects.

READ MORE @ NURSING IN PRACTICE

Tuesday, September 25, 2007

A Plan for Better Troop Mental Care

The Department of Defense has released a plan to improve mental-health care for American troops who are facing multiple tours in war zones.

The report lays out a "road map for change" in an effort to "put psychological health and fitness on an equal footing with physical health and fitness." The recommendations address findings from a report released earlier this year that found that troops going to war face increasing levels of anxiety and depression with each successive deployment, with shorter "dwell times," or times at home with their families.

READ MORE @ US NEWS & WORLD REPORT

Monday, September 24, 2007

Use of atypical antidepressants in elderly patients

Late-life major depressive disorder (MDD) is a common disorder that is associated with severe symptoms and substantial functional impairment. With an estimated prevalence of 3% in people aged 60 years or more, MDD has growing health implications for the aging population. In addition, MDD is often associated with physical disability in this age group as well as a high mortality rate. Conditions leading to chronic pain, the presence of comorbid medical illnesses, social isolation, and dysphoria secondary to life-cycle issues predispose the elderly population to the development of depression. These factors also point elderly individuals with depression in the direction of more severe symptoms and a relatively poor outcome.
While it is a commonly known psychiatric disorder, depression in the geriatric population is under-recognized and under-treated, leading to unnecessary impaired social and occupational functioning.1 Studies suggest that approximately 25% of patients aged 65 years or more who have a chronic medical illness also experience symptoms of depression. Evidence supports the increased prevalence of depression in several specific chronic medical illnesses, including vascular disease, diabetes mellitus, and arthritis; the relative risk for depression is 2-3 times higher in these patients than in individuals without these comorbidities.1 Depression in the geriatric population has also been reported to be more somatic and less ideational than depression in younger adults. Elderly people who suffer from comorbid depression and medical illness have an increased morbidity and mortality.1 Authors have also noted a brittle response to antidepressant therapy and an increased risk for chronic depression in the elderly population.2 Safe, effective, well-tolerated antidepressants are needed for elderly patients with MDD, especially for those who are also struggling with chronic medical illness.1

READ MORE @ ABKHAZIA