Wednesday, December 31, 2008

Child Psychiatrist to Curtail Industry-Financed Activities

A prominent Harvard child psychiatrist will curtail activities financed by the drug industry while Massachusetts General Hospital investigates his failure for years to disclose the consulting fees he received from drug makers.

The psychiatrist, Dr. Joseph Biederman, a world-renowned and controversial researcher on childhood mental illness, has agreed to stop participating in speaking engagements and other activities paid for by pharmaceutical companies, and also to stop his work on industry-financed activities within the hospital. That includes clinical trials that are under way at the hospital, said Peggy Slasman, a spokeswoman for Massachusetts General.

READ MORE @ N.Y. TIMES

Tuesday, December 30, 2008

Father blames son's suicide on 'telemedicine'

In August 2005, John McKay, a 19-year-old Stanford student and former high school debate champion, committed suicide by rolling up the windows in a car at his mother's Menlo Park home and piping in exhaust fumes.

In the next few weeks, a Colorado doctor who had prescribed a generic form of Prozac for McKay after receiving his request over the Internet, without ever seeing or examining him, will go on trial in Redwood City on possibly precedent-setting charges of practicing medicine in California without a license.

A conviction of Dr. Christian Hageseth, 67, "would send a clear message to those individuals who are blindly writing prescriptions to patients they know nothing about," said the youth's father, David McKay, a former Stanford professor now living in Colorado. They would have to ask themselves, he said, "whether quick and easy money is worth the risk of a criminal conviction and permanent loss of their medical license."

READ MORE @ SAN FRANCISCO CHRONICLE

Sunday, December 28, 2008

Psychiatric manual's update needs openness, not secrecy, critics say Edition is being prepared with strict oversight, officials counter

Whether revisions to the "bible" of mental illness should be carried out in secret might seem like an academic question.

But the issue carries real weight for parents desperate to address children's difficult behavior or people in distress over their mental state. It also speaks to citizens' concerns over news accounts of an overmedicated America and the troubling financial links between the pharmaceutical industry and some psychiatric researchers.

An update is under way for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM, which defines the emotional problems for which doctors prescribe drugs and insurance companies pay the bills. Psychiatrists working on the new manual were required to sign a strict confidentiality agreement.

Critics say the American Psychiatric Association should lift the curtain of secrecy so outside observers can review the scientific debate behind new and revised diagnoses.

READ MORE @ CHICAGO TRIBUNE

Friday, December 26, 2008

Study will try to improve how mentally ill are cared for in ERs Hospitals have seen increase in mentally ill patients.

Mental health experts in Austin are hoping a research project will help them revamp the way psychiatric patients are treated in emergency rooms.

Advocacy Inc., an Austin-based organization focused on disability rights, is examining what happens to mentally ill patients brought to Austin hospitals because of a psychiatric crisis. The organization will look at things such as how they are medically cared for, how staffers treat them personally and how the environment of often-chaotic emergency rooms affects their mental illnesses.

READ MORE @ AUSTIN AMERICAN-STATESMAN

Thursday, December 25, 2008

Birth Defects and SSRIs—How's a Mother to Know?

In 2006, Elissa's doctor prescribed Cymbalta to help with her depression. Shortly after starting on the antidepressant Elissa became pregnant. On her doctor's advice she continued taking Cymbalta. But it soon became apparent her baby was developing life-threatening defects.

"I had my first ultrasound at 3 months," Elissa said. "That's when I found out something wasn't right. The doctor explained that my baby appeared to have a heart defect, a hole in her heart. Shortly after Elissa's baby girl was born, prematurely, the infant had to undergo heart surgery to repair the damage that could have been induced by the antidepressant. But Elissa was not aware of the association between SSRIs—or selective serotonin reuptake inhibitors—and birth defects.

READ MORE @ LAWYERS AND SETTLEMENTS

Tuesday, December 23, 2008

Psych Patients With Cost-Sharing Plans Use More Services

People whose insurance plans better share the burden of the cost for mental health services use these programs more than those whose plans pick up less of the bill, a new study says.

The findings were based on a study of Medicare patients, some of whose plans provided equal cost-sharing and others whose plans put a greater cost burden on the patients. The patients in the study had recently received psychiatric discharges from facilities.

The study was published in the Dec. 24/31 issue of Journal of the American Medical Association.

U.S. health insurers have historically imposed higher out-of-pocket costs and greater restrictions for the use of mental health services than other medical illnesses.

READ MORE @ WASHINGTON POST

Monday, December 22, 2008

Florida Medicaid, Antipsychotics and Small Children

At a time when growing use of atypical antipyschotics in children is under a microscope, Florida’s Medicaid program recently revised rules that makes it possible for doctors to write prescriptions for children of all ages - including those younger than six years old.

Most of these drugs can lead to weight gain and diabetes, and one prominent study found they were no more effective than older meds. Yet the drugs are increasingly prescribed for children, with Medicaid programs in several states reporting rising expenditures for antipsychotics, sometimes to treat ADD or ADHD, which are unapproved uses (look here and here).

In general, the atypical antipsychotics - a newer class that includes AstraZeneca’s Seroquel; Bristol-Myers Squibb’s Abilify; Pfizer’s Geodon; Lilly’s Zyprexa and Johnson & Johnson’s Risperdal - were not approved by the FDA to treat small children, or those younger than 10 years old. Risperdal has been approved for children older than 5 years of age, but only for those with autistic disorder. To be eligible for Medicaid reimbursement, a drug has to be used for a medically accepted indication, which means the drug has to be approved for a specific use or supported by specific compendia (this link indicates the three compendia do not list any use of the atypicals in children younger than 5 years old).

READ MORE @ PHARMALOT

Sunday, December 21, 2008

FDA Faults Drug Information for Consumers

The printed consumer information that accompanies new prescription drugs is often difficult to read or understand, the U.S. Food and Drug Administration said Tuesday.

In a new report, the FDA said the "consumer medication information" -- intended to spell out the proper use and risks of drugs -- failed to meet a Congressionally mandated goal that 95 percent of all new prescriptions be accompanied by useful guidance.

"The study reveals that consumers are not consistently getting the information they need to promote the safe and effective use of prescription medicines," Dr. Paul Seligman, associate director of safety policy and communication at the FDA's Center for Drug Evaluation and Research, said during a Tuesday teleconference.

READ MORE @ WASHINGTON POST

Saturday, December 20, 2008

Medication For Depression Can Also Fight Cancer Drug Resistance

Prozac is regularly prescribed to ease the emotional pain of patients who are being treated for cancer. But can this common anti-depressant help to fight cancer itself?

Dr. Dan Peer of the Department of Cell Research and Immunology at Tel Aviv University is proving that it can. A study he and his colleagues recently completed validates that Prozac (chemical name fluoxetine) dramatically enhances the effectiveness of a widely used anti-cancer drug.

“The good news is that the medical community won't have to wait — Prozac can be used for this purpose right away,” says Dr. Peer, noting that doctors in the U.S. already prescribe it to treat depression in chemotherapy patients.

READ MORE @ SCIENCE DAILY

Friday, December 19, 2008

Older Antidepressants May Be Better for Parkinson's Patients

For Parkinson's disease patients with depression, an older tricyclic antidepressant outperformed a newer selective serotonin reuptake inhibitor, one of a class that is commonly prescribed, according to researchers here.

In a randomized trial, the older tricyclic antidepressant, nortriptyline, significantly improved symptoms of depression after eight weeks compared with placebo (P<0.002) Matthew Menza, M.D., of Robert Wood Johnson Medical School here, and colleagues reported online in Neurology. A newer SSRI, paroxetine CR, did not (P=0.165) help.

The percentage of patients who had at least a 50% reduction in their depression symptoms was significantly higher in those taking nortriptyline than in those taking paroxetine CR (53% versus 11%, P=0.034).

READ MORE @ MEDPAGE TODAY

Wednesday, December 17, 2008

FDA Adds Suicide Warning to Epilepsy Drugs

The U.S. Food and Drug Administration announced Tuesday that it was adding a label warning on heightened suicide risk for users of antiepileptic drugs.

The move, which follows the advice last summer of an FDA advisory panel, stops short of slapping the strongest "black box" warning on this class of drugs, which includes widely used medications such as clonazepam (Klonopin), phenytoin (Dilantin) and topiramate (Topamax).

"Patients being treated with antiepileptic drugs for any indication should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, or any unusual changes in mood or behavior," Dr. Russell Katz, director of the division of neurology products in the FDA's Center for Drug Evaluation and Research, said in an agency news release.

READ MORE @ WASHINGTON POST

Tuesday, December 16, 2008

Studies Try to Tease Apart the Links Between Depression and Heart Disease

People who are depressed are literally sick at heart: they have a significantly increased risk for cardiovascular disease, and no one knows exactly why. Now three new studies have tried to explain this, and they arrive at subtly different conclusions.

The first, led by Dr. Mary A. Whooley of the Veterans Affairs Medical Center in San Francisco, studied 1,017 patients with coronary artery disease for an average of more than four years. Although the study found an association of depression with heart disease, when researchers statistically corrected for other medical conditions, disease severity and physical inactivity, the association disappeared.

READ MORE @ NY TIMES

Monday, December 15, 2008

'Not enough support' for mentally ill people to work

Government risks 'writing off' people with mental health problems due to lack of trained professionals

The government needs to take urgent action to make sure support and training is available to get more people with mental illness into work, say campaigners in a new report today.

The Sainsbury Centre for Mental Health (SCMH) and the College of Occupational Therapists have published a joint paper arguing that the government risks "writing off" people with mental health problems during the recession if it doesn't take action on employment support immediately.

The paper, 'Vocational Rehabilitation: what is it, who can deliver it and who pays?' claims there is a serious shortage of professionals "with the skills they need to offer expert help" to people who need it most. It says that without expert advisers trained to assess the employment needs of people with mental illness and to offer necessary support once jobs are found, the government will fail to keep its promise to help millions of people with mental health problems long term employment.

READ MORE @ THE GUARDIAN

Sunday, December 14, 2008

Is There Really an Epidemic of Depression? A new book argues that the mental illness is being overdiagnosed

LEHRER: In your book, you take a critical look at major depressive disorder (MDD), a mental illness that will afflict approximately 10 percent of individuals at some point during their life. In recent decades, the number of cases of MDD has sharply increased. Are we currently experiencing an epidemic of depression? Or is this surge due to changes in diagnosis?

HORWITZ AND WAKEFIELD: Our book argues that, despite widespread beliefs to the contrary, the rate of depressive disorders in the population has not undergone a general upsurge. In fact, careful studies that use the same criterion for diagnosis over time reveal no change in the prevalence of depression. What has changed is the growing number of people who seek treatment for this condition, the increase in prescriptions for antidepressant medications, the number of articles about depression in the media and scientific literature, and the growing presence of depression as a phenomenon in popular culture. It is also true that epidemiological studies of the general population appear to reveal immense amounts of untreated depression. All of these changes lead to the perception that the disorder itself has become more common.

READ MORE @ SCIENTIFIC AMERICAN

Saturday, December 13, 2008

Not All Antipsychotics Created Equal: Analysis Reveals Important Differences

An analysis of studies on antipsychotics reveals multiple differences among the newer, second-generation antipsychotics as well as the older medications, and suggests the current classification system blurs important differences, rendering it unhelpful. The analysis, partially funded by NIMH, was published online December 5, 2008, in The Lancet.

An analysis of studies on antipsychotics reveals multiple differences among the newer, second-generation antipsychotics as well as the older medications, and suggests the current classification system blurs important differences, rendering it unhelpful. The analysis, partially funded by NIMH, was published online December 5, 2008, in The Lancet.

Stefan Leucht, M.D., of Technische Universität München in Munich, Germany, and colleagues looked at 150 studies from all parts of the world with a total of 21,533 participants. By examining these double-blind studies, they were able to compare nine second-generation—also called atypical—antipsychotics with first-generation antipsychotics. They examined symptom reduction; quality of life; side effects such as movement disorders, weight gain and sedation ( sleepiness ); and other factors.

READ MORE @ MEDIA NEWSWIRE

Friday, December 12, 2008

Generic drug prices falling in US

Finally, a little good health care news for consumers: U.S. prices for generic prescription drugs, which already cost as little as one-third what their brand-name cousins do, have been getting cheaper and likely will keep doing so.

The causes? The ultra-low prices for generic prescriptions offered by giant retailers and drugstore chains and intense competition among the many generic drugmakers fighting for sales, according to health information firm IMS Health.

Those pricing pressures forced down dollar sales of generic drugs in the U.S. by 2.7 percent in the year ending in September, even though the number of generic prescriptions filled actually increased by 5.4 percent over the year before, IMS reported Wednesday.

"We're seeing the combination of pressure from large retailers to make generics available at ever-lower prices for their customers" and the intensified competition among generic drugmakers leading them to cut prices, said Murray Aitken, senior vice president of the Healthcare Insight unit at IMS.

READ MORE @ AP

Thursday, December 11, 2008

Is There a Gene for Postpartum Depression?

"The transition to parenthood is filled to the brim with behavioral extremes. Parents who are otherwise emotionally stable are in one moment thrilled and happier than they have ever been and confused and fearful the next. Afriend of mine once theorized that these reactions occur because "parenting is an amateur sport" played by persons who are highly motivated to do the right thing but who often have no idea what that right thing is."

For some couples, the transition to parenthood is not filled with this rich mixture of great perplexity and great joy. For them, parenthood is mostly filled with sadness and even despair. Postpartum depression was originally coined to describe this experience in the mother, although it is becoming clear that fathers can experience very similar emotions too.

Is there a molecular basis for postpartum depression—at least for the type that mothers experience? Recent findings, which I describe here, may answer this question. First, we will focus on several background behavioral and molecular issues and then move on to some interesting data about births in genetically manipulated laboratory animals. Feel free to skip to the “Data” section if postpartum depression rates and g-aminobutyric acid (GABA) receptor biology are working parts of your vocabulary.

READ MORE @ PSYCHIATRIC TIMES

Wednesday, December 10, 2008

Experts urge wider use of brain-boosting drugs

Three job candidates sit in a quiet room, straining over a tough exam. But one of them has taken a memory-enhancing drug the other two couldn't afford. Is the test fair?

In another futuristic scenario, a drug can help airline pilots keep focused during a long flight, though it causes some side effects. May an airline require pilots to take the drug?

Get ready to confront such questions in daily life, a group of scientists and policy experts urge in a thought-provoking commentary published online Sunday by the journal Nature.

Brain research is accelerating, and a new era of "cognitive enhancement" - the use of brain-stimulating drugs and devices by healthy people - is approaching, the authors said.

READ MORE @ S.F. CHRONICLE

Tuesday, December 9, 2008

Antipsychotics in Children: Experts Report Mixed Results

Studies of antipsychotics in child prenpresented at the 48th Annual New Clinical Drugs Evaluation Unit (NCDEU) Meeting, conducted by the NIMH in Phoenix, May 27-30, provide some data where there have been relatively little on the increasing use of these agents.

In a panel discussion on ethics applications in child and adolescent psychopharmacology research and practice, panel chair Christopher Kratochvil, MD, University of Nebraska, noted, “while children have additional protections as a vulnerable population in research, recognition of underserved treatment needs is driving demand for psychopharmacology progress.”

As psychopharmacotherapy in children may be expanding faster than its evidence base, however, there is also increasing concern that risk-benefit is not being adequately assessed. In the October issue of the Archives of Pediatric and Adolescent Medicine, a retrospective cohort study of antipsychotic use in children and adolescents reveals that these agents are associated with increased risk of adverse metabolic and cardiovascular events.[1] Neurological adverse events in this cohort were reported separately in the Journal of Child Neurology.[2]

READ MORE @ PSYCHIATRIC TIMES

Monday, December 8, 2008

AstraZeneca Was Aware of Seroquel Risks in 2000, Records Show

AstraZeneca Plc., facing more than 15,000 consumer claims alleging the antipsychotic drug Seroquel causes diabetes, knew about the risk as far back as 2000, according to company documents shown in federal court.

AstraZeneca Global Safety Officer Wayne Geller concluded there was “reasonable evidence to suggest Seroquel therapy can cause” diabetes and related conditions, according to documents presented yesterday in federal court in Tampa, Florida. Geller drew his conclusions following a review of available studies and internal trials, according to the documents.

The internal documents were shown publicly for the first time during a hearing over the qualifications of expert witnesses the plaintiffs plan to use at trial. They are to testify in a lawsuit over the drug’s effects when the proceeding begins in February. While portions of the documents were shown in court, the filings remain sealed at the request of the London-based pharmaceutical company.

READ MORE @ BLOOMBERG

Sunday, December 7, 2008

No Reason to Prefer Atypical Antipsychotics over Older Drugs

The common distinction between first- and second-generation antipsychotic drugs has no scientific basis and should be dropped, said researchers here.

A meta-analysis of 150 double-blind studies found little evidence that newer, so-called atypical antipsychotic drugs are more effective than older drugs for symptoms of schizophrenia, reported Stefan Leucht, M.D., of Munich Technical University, and colleagues online in The Lancet.

The researchers also found that although newer drugs induced fewer extrapyramidal effects than haloperidol (Haldol) that was not the case when compared with low-potency first-generation agents.

"Second-generation antipsychotic drugs differ in many properties" -- including structure and mode of action as well as clinical effects -- "and are not a homogeneous class," the researchers concluded.

"Improper generalization creates confusion and, as a result, the classification [of first- versus second-generation agents] might be abandoned," they said.

READ MORE @ MEDPAGE TODAY

Friday, December 5, 2008

Stress-Related Disorders Affect Brain's Processing of Memory

Researchers using functional MRI (fMRI) have determined that the circuitry in the area of the brain responsible for suppressing memory is dysfunctional in patients suffering from stress-related psychiatric disorders. Results of the study will be presented today at the annual meeting of the Radiological Society of North America (RSNA).

"For patients with major depression and other stress-related disorders, traumatic memories are a source of anxiety," said Nivedita Agarwal, M.D., radiology resident at the University of Udine in Italy, where the study is being conducted, and research fellow at the Brain Imaging Center of McLean Hospital, Department of Psychiatry at Harvard Medical School in Boston. "Because traumatic memories are not adequately suppressed by the brain, they continue to interfere with the patient's life."

READ MORE @ MARKET WATCH

Thursday, December 4, 2008

Few Young Adults Seek Treatment for Psych Disorders Alcohol, nicotine use, personality illnesses common, study shows

Psychiatric disorders are common among young adults in the United States, but few seek treatment, a new report shows.

To reach this finding, U.S. researchers analyzed data from more than 5,000 respondents, aged 19 to 25, who took part in the National Epidemiologic Survey on Alcohol and Related Conditions.

The study found that 45.8 percent of the 2,188 college students and 47.7 percent of the young adults not in college met the criteria for at least one psychiatric disorder, but only 25 percent of those with disorders sought treatment over a one-year period.

Among college students, the most common disorders were alcohol use (20.4 percent) and personality disorders (17.7 percent). The most common disorders among young adults not in college were personality disorders (21.6 percent) and nicotine dependence (20.7 percent).

READ MORE @ U.S. NEWS & WORLD REPORT

Wednesday, December 3, 2008

Zapping depression - Approval of a new kind of treatment reflects advances in fields that involve electrical stimulation of the brain.

In the late 1700s, Italian anatomist Luigi Galvani made a dead frog's muscles twitch when struck by a spark, a discovery that paved the way for the modern understanding of electricity's role in living things. It is the basis for countless medical technologies like the pacemaker.

But electricity does not travel easily through the skull to the brain, the organ responsible for every purposeful twitch and altered mood. So when a group of British scientists in 1985 used magnetic pulses from outside the head to induce an electrical field inside the brain - and got a subject's hands to move - their colleagues clamored for a chance to zap themselves.

That breakthrough, known as transcranial magnetic stimulation (TMS), led to the Food and Drug Administration's approval last month of the first noninvasive, non-pharmacological treatment for depression.

As a practical matter, approval of the device made by Neuronetics Inc., a five-year-old Malvern company, is intended for patients with major treatment-resistant depression who do not respond to any one medication. Millions of Americans fail to benefit from antidepressants, and millions more quit because of side effects.

READ MORE @ PHILADELPHIA INQUIRER

Tuesday, December 2, 2008

Tragedies Underscore Crisis in U.S. Public Mental Health System: National Advocacy Organization Demands Reforms

In the wake of the deaths of two persons in public psychiatric institutions - highlighting a pattern of abuse and neglect of those who have psychiatric disabilities - a national coalition of such individuals is calling on the incoming Obama administration and the nation's top mental health officials to institute widespread, substantive reforms in America's mental health treatment system. These would include raising standards and regulatory expectations, and identifying and funding pilot programs to demonstrate best practices in psychiatric emergency, inpatient and community-based care.
The death of Steven Sabock, a 50-year-old man diagnosed with bipolar disorder who died on April 29 in a North Carolina state psychiatric institution after he had choked on medication - while, nearby, hospital employees, ignoring his plight, entertained themselves with cards and TV - is just one example of the dangerous dysfunction of the public mental health system, said Dan Fisher, M.D., Ph.D., of the National Coalition of Mental Health Consumer/Survivor Organizations (NCMHCSO).

READ MORE @ MARKET WATCH

Monday, December 1, 2008

Depression Treatment: Mindfulness-based Cognitive Therapy As Effective As Anti-depressant Medication, Study Suggests

Research shows for the first time that a group-based psychological treatment, Mindfulness Based Cognitive Therapy (MBCT), could be a viable alternative to prescription drugs for people suffering from long-term depression.

In a study, published December 1, 2008 in the Journal of Consulting and Clinical Psychology, MBCT proved as effective as maintenance anti-depressants in preventing a relapse and more effective in enhancing peoples' quality of life. The study also showed MBCT to be as cost-effective as prescription drugs in helping people with a history of depression stay well in the longer-term.

The randomised control trial involved 123 people from urban and rural locations who had suffered repeat depressions and were referred to the trial by their GPs. The participants were split randomly into two groups. Half continued their on-going anti-depressant drug treatment and the rest participated in an MBCT course and were given the option of coming off anti-depressants.

READ MORE @ SCIENCE DAILY

Sunday, November 30, 2008

Treating depression seen important in heart failure

Depression increases the risk of death in patients with heart failure, but the risk apparently disappears with antidepressant use, according to a study.

"Recent studies suggest that the use of antidepressants may be associated with increased mortality (death) in patients with cardiac disease," Dr. Christopher M. O'Connor, of Duke University Medical Center, Durham, North Carolina, and colleagues note in the medical journal Archives of Internal Medicine.

"Because depression has also been shown to be associated with increased mortality in these patients, it remains unclear if this association is attributable to the use of antidepressants or to depression."

The researchers therefore studied roughly 1,000 patients hospitalized for heart failure who were followed up annually. The authors prospectively collected data on depression status and use of antidepressants.

READ MORE @ REUTERS

Saturday, November 29, 2008

Ailing FDA May Need a Major Overhaul, Officials and Groups Say

The Obama administration will inherit a Food and Drug Administration widely seen as struggling to protect Americans from unsafe medication, contaminated food and a flood of questionable imports from China and other countries.

Shaken by a series of alarming failures, the FDA desperately needs an infusion of strong leadership, money, technology and personnel -- and perhaps a major restructuring, say former officials, members of Congress, watchdog groups and various government reports.

"Everywhere you go, you hear the same chorus: The agency's in trouble," said David A. Kessler, who served as FDA commissioner under Presidents George H.W. Bush and Bill Clinton. "There's a general perception the agency is suffering mightily."

With nearly 11,000 employees and an annual budget of more than $2 billion, the FDA is charged with overseeing products that account for one-quarter of consumer spending in the United States, including over-the-counter and prescription medications, heart valves, stents and other medical devices, the blood supply, and food.

READ MORE @ WASHINGTON POST

Friday, November 28, 2008

AP IMPACT: Govt pays for risky unapproved drugs

The government is paying millions for risky medications that have never been reviewed for safety and effectiveness but are still covered under Medicaid, an Associated Press analysis of federal data has found.

Taxpayers have shelled out at least $200 million since 2004 for such drugs. Yet the Food and Drug Administration says unapproved prescription drugs are a public health problem, and some unapproved medications have been linked to dozens of deaths.

Millions of private patients are taking them as well, and their availability may create a false sense of security.

The AP analysis found that Medicaid, which serves low-income people, paid nearly $198 million from 2004 to 2007 for more than 100 unapproved drugs. Data for 2008 were not available but unapproved drugs still are being sold. The AP checked the medications against FDA databases, using agency guidelines to determine if they were unapproved. The FDA says there may be thousands of such drugs on the market.

READ MORE @ AP

Thursday, November 27, 2008

Two Antidepressants Taken During Pregnancy Linked To Heart Anomalies In Babies

Women who took the antidepressant fluoxetine during the first three months of pregnancy gave birth to four times as many babies with heart problems as women who did not and the levels were three times higher in women taking paroxetine.

Although some of the conditions were serious, others were not severe and resolved themselves without the need for medical intervention, according to a three-country study in the November issue of the British Journal of Clinical Pharmacology.

Researchers have advised women taking the drugs to continue unless they are advised to stop by their doctor or consultant. But they are being urged to give up smoking, as the study also found that more than ten cigarettes a day was associated with a five-fold increase in babies with major heart problems.

The team has also suggested that women on fluoxetine should be given a foetal echocardiogram in their second trimester to diagnose possible heart anomalies.

READ MORE @ SCIENCE DAILY

Wednesday, November 26, 2008

Study Calls for Greater Scrutiny of 'Off-Label' Drug Use Doctors often prescribe medicines for conditions that haven't been studied thoroughly

It's called "off-label" prescribing, and it's the common practice of doctors prescribing a drug to treat a disease or condition that's different from the one studied by federal regulators that led to the drug's approval in the first place.

Despite the scope of the practice, there's often little evidence that using a drug for an unapproved purpose is always beneficial or safe, a new study found.

The study by American researchers has identified 14 widely prescribed medications that they think need additional study to see how effective and safe they are for off-label use. Many of the drugs are antidepressants and antipsychotics.

"Off-label prescribing is not based on the same level of evidence as on-label prescribing," said study lead researcher Surrey Walton, an assistant professor of pharmacy administration at the University of Illinois at Chicago.

Most patients aren't aware that once a drug is approved for one use, any doctor can prescribe it for any other use, Walton explained. Doctors may turn to a drug for off-label use, because studies or evidence suggest that it might benefit a patient with a disease or condition that was not studied when U.S. Food and Drug Administration regulators approved the drug in the first place.

READ MORE @ U.S. NEWS & WORLD REPORT

Tuesday, November 25, 2008

Psychiatric care's peril and profits

Lapses at , ., a major hospital chain with high earnings, have put patients at risk, regulators find. Some have even died.

Psychiatric Solutions Inc. was on its way to becoming the nation's leading provider of private psychiatric care when it snapped up Sierra Vista Hospital in Sacramento in mid-2005.

The company put its well-honed business formula into action: Staffing fell. Beds filled up. Profits soared.

It was a winning strategy for investors. But for some patients, federal records show, checking into Sierra Vista proved dangerous -- at times deadly.

READ MORE @ LOS ANGELES TIMES

Monday, November 24, 2008

Psychiatrists Give Mixed Reviews on ACP Antidepressant Guideline

A practice guideline on the use of second-generation antidepressants, issued here this week by the American College of Physicians, has earned cheers as well as jeers from psychiatrists.

"I don't see anything that's at variance with the American Psychiatric Association's [current] treatment guidelines or the ones that are in process now," said Alan Gelenberg, M.D., chair of the APA's working group on depression management and clinical professor of psychiatry at the University of Wisconsin.

The group is now revising the APA's guidelines on the topic.

"I just applaud them for taking depression seriously," Dr. Gelenberg added.

But a past chair of the group, T. Byram Karasu, M.D., of Albert Einstein College of Medicine in New York, who was lead author of the APA's existing depression guideline, slammed the ACP effort, calling it the "worst possible practice."

The ACP's guideline was based on a review of 203 clinical trials involving selective serotonin reuptake inhibitors (SSRIs), selective norepinephrine reuptake inhibitors, and other antidepressants introduced in the last 20 years.

READ MORE @ MEDPAGE TODAY

Sunday, November 23, 2008

FDA Panel Slams Rising Antipsychotic Use In Kids

After a steady stream of reports that antipsychotics are increasingly prescribed to children, often for unapproved uses, such as treating attention deficit disorders (back story), an FDA advisory committee yesterday chastised the FDA for not doing more to discourage such prescribing.

For instance, more than 389,000 youngsters last year were given Johnson & Johnson’s Risperdal, and 240,000 were 12 or younger, The New York Times writes. Often, the drug was prescribed to treat attention deficit disorders, but Risperdal is not approved for that use and its risks - weight gain, metabolic disorders and possibly permanent muscular tics - aren’t justified, panel members said.

“This committee is frustrated,” Leon Dure, a pediatric neurologist from the University of Alabama School of Medicine and panel member, told the meeting. “And we need to find a way to accommodate this concern of ours.”

However, Tom Laughren, director of the FDA’s division of psychiatry products, told the panel that the agency could do little to fix the problem and, instead, pointed the finger at medical specialty societies, which he insisted must do a better job educating doctors about side effects.

READ MORE @ PHARMALOT

Saturday, November 22, 2008

Federal Court Upholds Drug Privacy Law

A federal appeals court in Boston on Tuesday dealt a setback to the pharmaceutical industry and companies that collect prescription data for use in drug marketing.

Ruling in support of a New Hampshire law, the court upheld the right of states to prohibit the sale of doctor-specific prescription drug data that is widely used in pharmaceutical marketing.

The case is a defeat for two large data-mining companies, IMS Health and Verispan. They sued in 2006 to block implementation of the New Hampshire law, which prohibited the sale of computerized data showing which doctors were prescribing what drugs.

The law was intended to cut down on state health care costs by eliminating the tool used by drug sales representatives in promoting brand name drugs. By purchasing the data describing which doctors prescribe what drugs, pharmaceutical sales forces are better able to identify which doctors might use their products and be receptive to their sales pitches. They can also focus on persuading doctors who do not write many prescriptions for their products to change their minds.

READ MORE @ NY TIMES

Friday, November 21, 2008

Parity Law's Next Hurdle: Working Out Fine Print

Now that the country has a mental health parity law, advocates turn their attention to how it should be implemented and made as comprehensive as possible.

The extent to which the recently enacted mental health parity law (PL 110-343) will expand access to mental health care nationwide will be impacted by the reaction of insurance companies and employers to how the law is implemented and any additional costs that might arise from the benefit (see Experts Disagree Over Future of MH Care Spending).

Mental health advocates including APA, who have battled to improve insurance coverage for psychiatric illnesses since the 1970s, achieved a substantial victory when the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 was signed by President George W. Bush in October. The law requires health plans that offer mental health coverage to have the same benefits, copayments, and treatment limits as other types of health care (Psychiatric News, October 17 and November 7).

READ MORE @ PSYCHIATRIC NEWS

Wednesday, November 19, 2008

ADHD Medications Do Not Cause Genetic Damage in Children

In contrast to recent findings, two of the most common medications used to treat attention deficit hyperactivity disorder (ADHD) do not appear to cause genetic damage in children who take them as prescribed, according to a new study by researchers at the National Institutes of Health (NIH) and Duke University Medical Center.

The study published online this month in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) provides new evidence that therapeutic doses of stimulant medications, such as methylphenidate and amphetamine, do not cause cytogenetic (chromosomal) damage in humans. The researchers looked at three measures of cytogenetic damage in white blood cells of each child participating in the study and found no evidence of any changes after three months of continuous treatment.

"This is good news for parents," said Kristine L. Witt, M.Sc., a genetic toxicologist at the National Institute of Environmental Health Sciences (NIEHS) and co-author on the study, which was funded through the Best Pharmaceuticals for Children Act by NIEHS and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), both parts of NIH. "Our results indicate that methylphenidate- and amphetamine-based products do not induce cytogenetic damage in children."

READ MORE @ NIH

Tuesday, November 18, 2008

Use of Antipsychotics in Children Is Criticized

Powerful antipsychotic medicines are being used far too cavalierly in children, and federal drug regulators must do more to warn doctors of their substantial risks, a panel of federal drug experts said Tuesday.

More than 389,000 children and teenagers were treated last year with Risperdal, one of five popular medicines known as atypical antipsychotics. Of those patients, 240,000 were 12 or younger, according to data presented to the committee. In many cases, the drug was prescribed to treat attention deficit disorders.

But Risperdal is not approved for attention deficit problems, and its risks — which include substantial weight gain, metabolic disorders and muscular tics that can be permanent — are too profound to justify its use in treating such disorders, panel members said.

READ MORE @ NY TIMES

Monday, November 17, 2008

Medication misuse

As people live longer and suffer from more chronic diseases, the risk of inappropriately using drugs or overmedicating increases among the elderly, says Susan Zieman, geriatric cardiologist and assistant professor of medicine at the Johns Hopkins University School of Medicine.

Most elderly people are on multiple medications and frequently metabolize drugs differently from younger people, she says. The drugs may build up in their systems and interact with other drugs in unexpected ways.

READ MORE @ BALTIMORE SUN

Sunday, November 16, 2008

In a Novel Theory of Mental Disorders, Parents’ Genes Are in Competition

Two scientists, drawing on their own powers of observation and a creative reading of recent genetic findings, have published a sweeping theory of brain development that would change the way mental disorders like autism and schizophrenia are understood.

The theory emerged in part from thinking about events other than mutations that can change gene behavior. And it suggests entirely new avenues of research, which, even if they prove the theory to be flawed, are likely to provide new insights into the biology of mental disease.

At a time when the search for the genetic glitches behind brain disorders has become mired in uncertain and complex findings, the new idea provides psychiatry with perhaps its grandest working theory since Freud, and one that is grounded in work at the forefront of science. The two researchers — Bernard Crespi, a biologist at Simon Fraser University in Canada, and Christopher Badcock, a sociologist at the London School of Economics, who are both outsiders to the field of behavior genetics — have spelled out their theory in a series of recent journal articles.

READ MORE @ NY TIMES

Saturday, November 15, 2008

SEROQUEL XR™ And SEROQUEL(R) Approved In Europe For New Indications For The Treatment Of Bipolar Disorder

AstraZeneca today announced that the once-daily formulation SEROQUEL XR™ (quetiapine fumarate extended release tablets) and SEROQUEL® (quetiapine fumarate) have been approved via the Mutual Recognition Procedure for new indications in bipolar disorder. SEROQUEL XR and SEROQUEL have been approved for treatment of major depressive episodes in bipolar disorder. Additionally, SEROQUEL XR has been approved for treatment of moderate to severe manic episodes in bipolar disorder.

This follows the October 2008 approval of SEROQUEL XR in similar indications by the U.S. Food and Drug Administration (FDA). As a result of these new indications for adult patients, SEROQUEL (both formulations) is currently the only atypical antipsychotic approved to treat the spectrum of mood episodes associated with bipolar disorder and the only licensed treatment for bipolar depression in the EU. The mechanism of action of SEROQUEL, which involves both antipsychotic and antidepressant activities, may help explain its unique efficacy across the spectrum of mood episodes associated with bipolar disorder.

READ MORE @ MEDICAL NEWS TODAY

Friday, November 14, 2008

Watch for depression in the elderly - Know the signs, step in if necessary

Experts are quick to say that depression isn't a normal part of aging, nor is it a sign of weakness.

But older family members who suffer from the condition may need your help to overcome those misconceptions and get treatment.

"In the elderly community, there is a lot of stigma still about depression and anxiety," said Dr. Greg Jicha, a neurologist at the University of Kentucky Sanders-Brown Center on Aging. "People are very hesitant to seek out any kind of help for these sorts of things."

Jicha believes it's important for relatives to be alert to signs of depression in older people to help restore joy in their lives and keep them from entering nursing homes too early. He recommends raising a red flag with primary care physicians, who may otherwise miss the signs.

READ MORE @ LOUISVILLE COURIER-JOURNAL

Thursday, November 13, 2008

Large Pharma Cos Shift Focus To Research, From Cost Cuts

Pharmaceutical executives, faced with generic competition and other challenges, have shifted their primary focus from cost-cutting campaigns to reinvigorating research efforts, a new survey suggests.

Some 66% of industry executives said reinvigorating research-and-development was their top strategic initiative, while 40% said "optimizing costs" was the top priority, according to the survey released Wednesday.

That's a shift from last year, when a survey by E&Y together with The Economist found that 92% of executives ranked cost reduction as their number one initiative. "Large pharmaceutical companies have been intensely focused on costs for the last two years and are moving beyond short-term reductions to longer- term strategic cost management," the new report said.

READ MORE @ CNN MONEY

Wednesday, November 12, 2008

Drugged-out seniors a prescription for disaster

They are the drugged-out generation, and they're not who you think they are.

They're 80. And 85 and 90 and 95 – overmedicated seniors clogging emergency departments, blocking hospital beds and sicker than they have any reason to be.

The Number 1 drug users in North America, outside of patients in long-term care facilities, are women over the age of 65. Twelve per cent are on 10 or more meds, sometimes up to 20 or more drugs; 23 per cent take at least five drugs. In long-term care, seniors are on six to eight medications, on average. Fifteen per cent of seniors admitted to hospital are suffering drug side effects. It's not uncommon to find seniors dizzy and dotty from being prescribed so many drugs.

"You'd fall down, too, if you were on so many drugs," says Dr. William Dalziel, a prominent Ottawa geriatrician.

Typically, overmedicated seniors have been seen by numerous specialists who have prescribed various medications to treat a host of chronic ailments – high blood pressure, hypertension, diabetes, osteoporosis, arthritis, heart disease, cancer – but there hasn't been any oversight by a geriatrician skilled in looking at the big picture and assessing contra-indications and side effects. Ask any doctor with expertise in seniors what their top health concerns are and they all cite overmedication.

read more @ THE TORONTO STAR

Tuesday, November 11, 2008

Antipsychotics Aren't Anti-Depressants

I saw the Abilify for depression TV ad again over the weekend and I continue to be concerned about how Bristol-Myers Squibb is very craftily making the drug, an atypical antipsychotic, sound as if it's an anti-depressant. Nowhere in the TV is it mentioned that the drug is an antipsychotic, at least not in what I've caught on-air.

I've written about the ad previously here and have also written about how the drug's clinical trials for depression show a greater chance for a patient to experience akathisia than to have his or her depression improved.

READ MORE @ FURIOUS SEASONS

Monday, November 10, 2008

Antidepressant treatment may reduce male fertility

Treatment with paroxetine (Paxil), which belongs to the selective serotonin reuptake inhibitor (SSRI) class of antidepressant drugs, increases DNA fragmentation in sperm, according to research presented today at the 64th annual meeting of the American Society for Reproductive Medicine in San Francisco.

Although the study did not directly evaluate male fertility, the five-fold increase in the number of men who developed abnormal sperm DNA while being treated with paroxetine is "troubling" and "suggests an adverse effect on fertility," co-investigator Dr. Cigdem Tanrikut, from Harvard Medical School in Boston, told Reuters Health.

In a clinical trial she described as "the first study to assess the impact of an SSRI on semen parameters in healthy men," 35 men took paroxetine for 5 weeks. The drug was administered in once-daily doses of 10 mg the first week, 20 mg in the second week, 30 mg the third and fourth week, and 20 mg in the fifth week.

READ MORE @ REUTERS UK

Sunday, November 9, 2008

Increased Bipolar Risk Linked to Father's Age

Older men are more likely than younger men to father children with autism, schizophrenia, or early-onset bipolar disorder.

Fathering a child later in life seems to increase its risk of having autism or schizophrenia, research has shown. And now it seems to increase a child's risk of having bipolar disorder as well, a new study suggests.

The study was headed by Emma Frans, a doctoral student in epidemiology at the Karolinska Institute in Stockholm. Results were published in the September Archives of General Psychiatry.

Sweden's Multigeneration Register, as well as Sweden's National Hospital Discharge Register, made this new investigation possible. The former, which has been in existence since 1947, gives demographic information about all people living in Sweden as well as about their parents. The latter, which has been in existence since 1973, lists all people living in Sweden who have been hospitalized for various conditions.

READ MORE @ PSYCHIATRIC NEWS

Saturday, November 8, 2008

US general bucks military silence on mental health

It takes a brave soldier to do what Army Maj. Gen. David Blackledge did in Iraq.

It takes as much bravery to do what he did when he got home.

Blackledge got psychiatric counseling to deal with wartime trauma, and now is defying the military's culture of silence on the subject of mental health problems and treatment.

"It's part of our profession. ... Nobody wants to admit that they've got a weakness in this area," Blackledge said about mental health problems among troops who return from America's two wars.

"I have dealt with it. I'm dealing with it now," said Blackledge, who came home with post-traumatic stress. "We need to be able to talk about it."

As the United States marks another Veterans Day on Tuesday, thousands of troops continue coming home with anxiety, depression and other emotional problems.

Up to 20 percent of the more than 1.7 million who have served in Iraq and Afghanistan are estimated to have symptoms. In a sign of how tough it may be to change attitudes, roughly half those who need help are not seeking it, studies have found.

READ MORE @ INTERNATIONAL HERALD TRIBUNE

Friday, November 7, 2008

Many more children on medication, study says - 'Surprising' rise targets diabetes, other obesity-related diseases

Hundreds of thousands more children are taking medications for chronic diseases, with a huge spike over a four-year period in the number given drugs to treat conditions once seen primarily in adults and now linked to what has become an epidemic of childhood obesity.

In a study appearing today in the journal Pediatrics, researchers saw surges in the number of U.S. children taking prescription medicines for diabetes and asthma, with smaller increases in those taking drugs for high blood pressure or high cholesterol. All of those conditions, to varying degrees, have been associated with obesity.

Though doctors have been seeing the trend in their practices, "the rate of rise is what's surprising," said Dr. Donna R. Halloran, a pediatrician at St. Louis University in Missouri and one of the study's authors.

The study found a doubling in the number of children taking medication for type 2 diabetes, with the largest increases seen among pre-teen and teenage girls. The number of asthma prescriptions was up nearly 47 percent.

READ MORE @ BALTIMORE SUN

Thursday, November 6, 2008

Kidney Transplantation Can Improve Mental Performance, Study Finds

Individuals with kidney disease often suffer from cognitive impairment, but kidney transplantation can improve their mental performance, according to a paper being presented at the American Society of Nephrology's 41st Annual Meeting and Scientific Exposition in Philadelphia, Pennsylvania.

While researchers and clinicians consider cognitive decline to be a common occurrence in patients with chronic kidney disease, it is unclear if this impairment is due to patients' advanced age, their chronic health conditions, or potential treatment-related factors. In addition, the effects of surgery and immunosuppressant medications on memory and overall cognitive performance have been poorly studied, but previous research suggests that kidney transplantation may have a beneficial effect on patients' mental function.

READ MORE @ SCIENCE DAILY

Wednesday, November 5, 2008

Most kids get no therapy with antidepressants

At least half of U.S. children taking antidepressants aren't in therapy, suggests a large study, and that delays recovery while greatly increasing the number of kids on the medication who are suicidal.


"Therapy with antidepressants is the standard of care. But is it what's going on in the real world? No," says Sheila Marcus, child and adolescent psychiatry chief at the University of Michigan Medical School.

The report tracks insurance claims for antidepressants from a database of 6.8 million children and teens from 2002 to 2006. The analysis was done by Thomson Reuters, a research firm that helps companies evaluate health care.

READ MORE @ ELMIRA STAR GAZETTE

Tuesday, November 4, 2008

Johnson & Johnson Psychiatric Gifts Probed by Senate (Update2)

Johnson & Johnson, the world's largest health-care company, said a U.S. Senate committee probing payments to doctors by drug and medical-device makers has asked about company support of psychiatric professional groups.

J&J, of New Brunswick, New Jersey, is responding to the request, received Oct. 23 from the Senate Committee on Finance, the company said today in a regulatory filing. The letter asks about ``any payments or benefits to a number of specified psychiatrists associated with psychiatric professional associations or otherwise authorities in their field.''

Committee members Charles Grassley, an Iowa Republican, and Herb Kohl, a Wisconsin Democrat, sent a similar request Oct. 16 to J&J, Medtronic Inc. and Abbott Laboratories about support for a medical-device conference. Grassley has also said he is probing payments by AstraZeneca Plc and Eli Lilly & Co. to psychiatrists and disclosures by Stanford University professor Alan Schatzberg, president-elect of the American Psychiatric Association.

READ MORE @ BLOOMBERG

Monday, November 3, 2008

Fears over new drug orders for mental health patients - Powers to administer compulsory treatment come into force today

Campaigners have expressed concern about the potential misuse of new powers for the compulsory treatment of people with mental illness that come into force in England today.

Under changes to mental health legislation, some patients discharged from hospital may be placed under a community treatment order (CTO) that forces them to take their medication – even where they may have damaging side-effects and be of limited use.

The changes are designed to help so-called "revolving door" patients, those stuck in a cycle where they stop taking their medication and become so unwell that they require hospital admission.

Now where a patient refuses to take medication, they can be held and treated in hospital for 72 hours. If they still refuse, the CTO is revoked and they become a detained patient again.

READ MORE @ THE GUARDIAN

Sunday, November 2, 2008

Wyeth latest drugmaker to narrow focus of research

Like many of the top pharmaceutical companies, Wyeth is narrowing its research focus to far fewer diseases as it tries to produce more successful new drugs, particularly for conditions lacking good treatments.

Wyeth is even ending research in its signature areas in women's health - contraceptives and menopause treatments - and switching to other female health problems with an unmet need, such as ovarian cancer and lupus.

The Madison, N.J.-based company is scaling back from doing research in its current 14 therapeutic areas to just six, Dr. Evan Loh, a Wyeth vice president, said Wednesday. Instead of doing research on a total of 55 diseases, it now will work on 27.

READ MORE @ SEATTLE POST INTELLIGENCER

Saturday, November 1, 2008

Heart Patients Should Be Screened, Treated for Depression

Studies show that depression is about three times more common in patients following a heart attack than in the general community. Heart patients should be screened for depression, and treated if necessary. Heart patients should be screened for depression - a common condition that can profoundly affect both prognosis and quality of life -according to the American Heart Association's first scientific statement on depression and coronary heart disease. The statement was published in Circulation: Journal of the American Heart Association.

The recommendations, which are endorsed by the American Psychiatric Association, include:

-early and repeated screening for depression in heart patients;
the use of two questions to screen patients -if depression is suspected the remaining questions are asked ( 9 questions total );
coordinated follow-up for both heart disease and depressive symptoms in patients who have both.

“The statement was prompted by the growing body of evidence that shows a link between depression in cardiac patients and a poorer long-term outlook,” said Erika Froelicher, R.N., M.A., M.P.H., Ph.D., a professor at the University of California San Francisco, School of Nursing and Medicine and co-chair of the writing group. Dale Briggs, who experienced depression after his heart valve surgery, said the statement is welcome news. “I think it’s long overdue. It is unfortunate that some patients aren’t warned of the possibility of some depression after surgery,” he said.

READ MORE @ MEDIA NEWSWIRE

Friday, October 31, 2008

Medication insufficient for depression due to traumatic head injury

In a large clinical sample of patients with traumatic brain injury with symptoms of major depression, antidepressant medication has been shown to lead to remission of symptoms in a minority of patients.

"Although citalopram treatment was associated with a statistically significant reduction in depressive symptoms, the results of this study show the response rate in the present sample is substantially lower than previously reported in past research," says Dr. Mark Rapoport, lead investigator of the study and geriatric psychiatrist at Sunnybrook Health Sciences Centre. "Our findings suggest that other multidisciplinary treatment modalities will be needed to achieve adequate control of depressive symptoms following traumatic brain injury (TBI)."

The goal of the study was to examine the rates of response and remission in patients treated with a selective serotonin reuptake inhibitor (SSRI), citalopram in this case, for major depression following TBI.
In the past, open-label studies of SSRIs have shown statistically significant reductions on depression, but methodological problems in the studies and the small samples limited the ability to interpret the results.
Therefore the goal of this study was to assess the response of patients in a larger sample of clinical patients with mild-to-moderate TBI.

READ MORE @ MARKETWIRE

Thursday, October 30, 2008

Drug-therapy combo best for anxiety in kids -study

A combination of a common antidepressant and a specialized form of talk therapy offer the best treatment for children and youth with anxiety disorders, U.S. researchers said on Thursday.

The findings come from the largest study of anxiety in children yet and offer much-needed guidance about how best to treat young people with separation anxiety, social phobia and generalized anxiety disorder -- conditions that affect as many as 20 percent of children and teenagers in the United States.

The study "clearly showed that combination treatment is the most effective for these children," Dr. John Walkup of Johns Hopkins University in Baltimore, who worked on the study, said in a statement.

But he said either therapy alone or sertraline alone helped well. Sertraline is the generic name of Pfizer Inc's (PFE.N: Quote, Profile, Research, Stock Buzz) Zoloft, which is one of a class of antidepressants called selective serotonin reuptake inhibitors.

READ MORE @ REUTERS

Wednesday, October 29, 2008

Depression often untreated in black heart patients

African Americans with heart disease are as likely to suffer from depression as their white counterparts, but they are less likely to be on medication for it, a new study suggests.

The study of 864 adults with coronary heart disease found that 35 percent of African Americans and 27 percent of whites had symptoms of depression. Yet black patients were less than half as likely to be on an antidepressant medication.

The findings are important, the researchers say, because depression in people with heart disease has been linked to a two- to four-fold higher risk of complications.

Studies have found that depressed heart disease patients have higher risks of a heart attack or stroke, and may die earlier than those without depression.

READ MORE @ REUTERS

Tuesday, October 28, 2008

Anti-Inflammatory Medications May Become A Treatment For Schizophrenia

Many of the structural and neurochemical features of schizophrenia are present long before the full syndrome of schizophrenia develops. What processes tip the balance between the ultra-high risk states and the development of schizophrenia? One candidate mechanism is cerebral inflammation, studied by Dr. Bart van Berckel and colleagues in the November 1st issue of Biological Psychiatry.

Using positron emission tomography, or PET, imaging, the researchers provide evidence of a brain inflammatory state that may be associated with the development of schizophrenia. The authors reported increased binding levels of [11C]PK11195, a radiotracer with high affinity for the peripheral benzodiazepine receptor (PBR) in patients who had carried the diagnosis of schizophrenia for five years or less. PBR is a molecular target that is present at higher levels in activated microglia. Microglia are activated during inflammatory states. Drs. van Berckel and Kahn further explain: “It was found that microglia activation is present in schizophrenia patients early after disease onset, suggesting brain cells are damaged in schizophrenia. In addition, since microglia can have either a protective or a toxic role, activated microglia may be the result, but also the cause of damage to brain cells.”

READ MORE @ SCIENCE DAILY

Monday, October 27, 2008

Zyprexa and Seroquel Side Effects May Increase Heart Disease Risk

New research suggests that Zyprexa and Seroquel may increase the risk of heart disease when compared to other antipyschotic medications.

Eli Lilly’s Zyprexa (olanzapine) and AstraZeneca’s Seroquel (quetiapine fumarate) are both blockbuster medications which are part of a class of drugs known as “atypical” antipsychotics. They are commonly used to treat symptoms of schizophrenia, but have also been widely used for other conditions like bipolar disorder, dementia, autism and obsessive-compulsive disorders.

Both drugs have previously been linked to a number of serious side effects, including severe weight gain, diabetes and pancreatitis. However, a new study published in the October 2008 issue of the journal Schizophrenia Research raises the potential for concerns about a small increased risk of coronary heart disease associated with the drugs.

read more @ AboutLawsuits.com

Sunday, October 26, 2008

States Taking Pharma to Court for Risky Antipsychotic-Prescribing Spree

Certain antipsychotics are leaving legions of children and elderly in chemical straightjackets for treatment of conditions they didn't even have.

Some state legislators are mad as hell and not going to take it anymore.

They've seen state outlays for controversial antipsychotics like Zyprexa grow as much as twelvefold since 2000, with a corresponding growth in side effects like weight gain, blood sugar changes and cholesterol problems.

In March, Alaska won a $15 million settlement from Eli Lilly in a suit to recoup medical costs generated by Medicaid patients who developed diabetes while taking Zyprexa.

Last year Bristol-Myers Squibb settled a federal suit for $515 million charging that it illegally hawked the antipsychotic Abilify to children and the elderly, bilking taxpayers.

Now Idaho, Washington, Montana, Connecticut, California, Louisiana, Mississippi, New Mexico, New Hampshire, Pennsylvania, South Carolina, Utah, West Virginia, Arkansas and Texas are taking pharma to court over its antipsychotic prescrib-athon that has left the poor and mentally ill in even worse health and legions of children and elderly in chemical straightjackets for treatment of conditions they didn't even have.

The atypical antipsychotics Zyprexa, Risperdal, Seroquel, Abilify and Geodon can be thought of as the credit swaps of the pharmaceutical world.

READ MORE @ ALTERNET

Saturday, October 25, 2008

Coping With Depression During Pregnancy

Christine Doherty Ashley, currently six months pregnant, realizes that her first trimester was fraught with depression. Now, with the perspective of an improved mood, Ashley recalls being particularly judgmental of her doldrums, questioning, "Am I allowed to say I'm sad or that I hate how I feel?" Nausea kept her on the couch and logistics kept her isolated: She was a high school teacher on summer break, had just moved to a new town, and she and her husband were not yet sharing the news because, at 41, she was at higher risk of early miscarriage. "It was a perfect storm," she explains.

Depression in pregnancy not only causes mom to suffer; it can also pose health risks to the baby. Research published today in the journal Human Reproduction found that women with symptoms of depression were more likely to experience a preterm birth. The greater the severity of depression symptoms, the greater the likelihood of early delivery. This research adds "strong evidence that depression during pregnancy is bad for the fetus," says lead study author De-Kun Li, reproductive and perinatal epidemiologist at Kaiser Permanente's Division of Research in Oakland, Calif., "This should not be dismissed anymore." Preterm birth, write the study authors, is the leading cause of infant mortality and medical expenditures for newborns.

READ MORE @ U.S. NEWS & WORLD REPORT

Friday, October 24, 2008

Lilly Will Take $1.42 Billion Charge in Zyprexa Probe (Update1)

Eli Lilly & Co. said it is having ``advanced discussions'' to settle investigations by U.S. and state authorities over marketing the antipsychotic Zyprexa and will take a $1.42 billion charge in the third quarter.

The charge will amount to $1.29 a share and reflects Lilly's ``currently estimable exposure'' to investigations into whether it promoted Zyprexa for unapproved uses, the Indianapolis-based company said today in a statement.

Investigations by the U.S. Attorney's Office for the Eastern District of Pennsylvania and more than 30 state Medicaid fraud units focus on Lilly's marketing to U.S. doctors and the drugmaker's payments to consulting physicians and other advisers. The announcement follows Lilly's Oct. 7 settlement of consumer fraud investigations by 32 states and the District of Columbia into the company's marketing of Zyprexa, its top-selling drug.

``The government's investigation of Zyprexa has been ongoing for five years and we now have a heightened sense of responsibility to all our stakeholders to intensify efforts to resolve these issues,'' said Robert A. Armitage, Lilly's general counsel, in the statement. The company is cooperating with the investigations, Lilly said.

READ MORE @ BLOOMBERG

Thursday, October 23, 2008

Half of Doctors Routinely Prescribe Placebos

Half of all doctors in the United States regularly prescribe placebos to patients despite clear professional rules that forbid the practice, according to a nationwide survey. The results troubled medical ethicists, who said that more research is needed to determine whether doctors must deceive patients for placebos to work.

In response to three separate questions included as part of the larger survey, about half of 679 internists and rheumatologists chosen randomly from a national list of doctors reported recommending placebos on a regular basis.

The most common placebos the doctors reported using were headache pills and vitamins, but a significant number also reported prescribing antibiotics and sedatives. Although these drugs are not all inert, the usual definition of placebos, doctors reported using them for their effect on patients’ psyches, not their bodies.

READ MORE @ NY TIMES

Tuesday, October 21, 2008

Magnet device aims to treat depression patients

The government has approved the first noninvasive brain stimulator to treat depression - a device that beams magnetic pulses through the skull.

If it sounds like science-fiction, well, those woodpecker-like pulses trigger small electrical charges that spark brain cells to fire. Yet it doesn't cause the risks of surgically implanted electrodes or the treatment of last resort, shock therapy.

Called transcranial magnetic stimulation or TMS, this gentler approach isn't for everyone. The Food and Drug Administration approved Neuronetics Inc.'s NeuroStar therapy specifically for patients who had no relief from their first antidepressant, offering them a different option than trying pill after pill.

"We're opening up a whole new area of medicine," says Dr. Mark George of the Medical University of South Carolina in Charleston, who helped pioneer use of TMS in depression. "There's a whole field now that's moving forward of noninvasive electrical stimulation of the brain."

While there's a big need for innovative approaches - at least one in five depression patients is treatment-resistant - the question is just how much benefit TMS offers.

READ MORE @ WINSTON SALEM JOURNAL

Monday, October 20, 2008

Certain Antipsychotic Medications May Increase Risk for Heart Disease

Certain atypical antipsychotic medications may raise the risk for heart disease in people with schizophrenia, according to an analysis of data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study published in the October 2008 issue of Schizophrenia Research.

Heart disease is prevalent among people with schizophrenia. Patients with schizophrenia also have higher rates of diabetes and high blood pressure, and lower levels of high-density lipoprotein or "good" cholesterol. Although factors such as smoking and lack of access to quality medical care may be 2 reasons for higher heart disease rates, atypical antipsychotics are known to be associated with cardiovascular side effects as well.

READ MORE @ DOCTOR'S GUIDE

Sunday, October 19, 2008

Providing safe, daily doses helps addicts, study finds

Most of the hardened heroin addicts who were given free, daily doses of the illegal drug over a 12-month period underwent a positive transformation, committing far fewer crimes while their physical and mental health steadily improved, according to researchers.

Addicts also cut their illegal heroin use by 70 per cent, on average, according to researchers from the North American Opiate Medication Initiative.

The results of the trial, said Martin Schechter, the project's main investigator, show that hard-core addicts - those with the dimmest chances of recovery - can stabilize their lives when heroin is made free and administered by teams of health-care professionals.

"Heroin-assisted therapy is a safe and effective treatment for people with chronic heroin addiction who have not benefited from previous treatment," Dr. Schechter told a news conference in Vancouver.

The federally funded clinical trial began three years ago with researchers at Vancouver's University of British Columbia and the University of Montreal scouring both cities for heroin addicts, eventually finding 251 drug users who had previously tried - and failed - to overcome their addictions.

READ MORE @ GLOBE AND MAIL

Saturday, October 18, 2008

Not Enough Research on SSRIs and Pregnancy

Kerri T. wants women to know that antidepressants and pregnancy don't mix. Kerri says that she was never told about the link between SSRIs and birth defects and she believes her daughter's health problems are the result of exposure to an SSRI antidepressant.

"During my whole pregnancy, I took 300 mgs of Effexor XR," Kerri says. "My psychiatrist never told me about any of the warnings and I never saw any of the sample packets where it said that if the baby was exposed to Effexor in the third trimester there could be problems and longer hospital stays.

"I delivered Caroline at full term. She had no seizures during the pregnancy. She was born via C-section and immediately after birth started having seizures. The doctor took her out and took her right to NICU (neonatal intensive care unit). I couldn't even hold Caroline right away; they just took her away. She was put on 4 seizure medications and on the ventilator.

"At 3 days old, Caroline basically died. They had tried to take her off the ventilator and she died. The doctors did 2 minutes of chest compressions and intubated her. She was hypotonic from the medicine. Luckily, they brought her back. The following week they tried to take her off the ventilator again and she coded again."

READ MORE @ LAWYERS & SETTLEMENTS

Friday, October 17, 2008

Most Psychiatrists Unlikely To Use Depot Antipsychotics

Innovative strategies to train more psychiatrists and their staff in the use of depot antipsychotics may help promote their use in different settings and in patients whoare less severely ill but are still medication nonadherent.

Less than 20 percent of psychiatrists prescribed a long-acting depot antipsychotic medication for patients with schizophrenia who were nonadherent with the original medication.

That was the finding of a nationwide survey by researchers with the American Psychiatric Institute for Research and Education (APIRE), Columbia University College of Physicians and Surgeons, and the University of Pennsylvania School of Social Policy and Practice. The study was conducted between September 2003 and January 2004.

Moreover, the decision to use depot medications appears to be a function of patient, physician, and practice-setting characteristics. For instance, initiation of depot medication was significantly and positively associated with public insurance, prior inpatient admission, proportion of time nonadherent, average or above average intellectual functioning, and living in a mental health residence. Psychiatrists who were optimistic about managing nonadherence were also more likely to prescribe long-acting antipsychotics for nonadherent patients.

READ MORE @ PSYCHIATRIC NEWS

Thursday, October 16, 2008

Treatment on a plate - A dietary approach to treating addiction seems worth investigating

PEOPLE are programmed for addiction. Their brains are designed so that actions vital for propagating their genes—such as eating and having sex—are highly rewarding. Those reward pathways can, however, be subverted by external chemicals (in other words, drugs) and by certain sorts of behaviour such as gambling.

In recent years, neuroscientists have begun to understand how these reward pathways work and, in particular, the role played by message-carrying molecules called neurotransmitters. These molecules, notably serotonin, dopamine and gamma-aminobutyric acid (GABA), hop between nerve cells, carrying signals as they go. Some drugs mimic their actions. Others enhance them. Either way, the body tends, as a result, to give up making them. At that point the person needs the drug as a substitute for the missing transmitter. In other words, he is an addict.

READ MORE @ THE ECONOMIST

Wednesday, October 15, 2008

Prozac on the Playground - The dangers of off-label use of psychiatric medications in children.

Problem: We are now more aware of emotional illness in children and much more likely to diagnose and treat conditions like attention deficit disorders. But as difficult and expensive as it is to test new medications on adults, it's even harder to do the testing on children. Many treatments applied to children reflect "off-label" use of medications that have been specifically approved for adults—but not for kids. When the FDA grants a license to a new prescription medication, it lists its permitted uses ("indications") and the patients for whom it is intended (including their age range), usually reflecting the population it was tested on—children with strep throat, women with breast cancer. If a drug company even mentions a use not specifically approved, it has violated FDA rules and can be fined or otherwise punished. However, once a drug has received FDA approval, physicians are free to use it for applications or populations for which it was not formally approved. After (usually adult) FDA approval has been obtained, manufacturers often don't bother with expensive testing that would allow them to request a label extension for use in kids, since they'll have the (off-label) market, anyway. Off-label use accounts for somewhere between half and three-quarters of all medications used in children and is also commonly used for adult treatment. Pediatricians are often uncomfortable with this practice, but they consider it the lesser of two evils when confronting an illness with effective adult treatment but nothing for children. Most medications behave similarly in children and adults, but that rule has exceptions, as we sometimes discover too late. Aspirin can lead to a horribly dangerous liver and brain disease in children or teens. Tetracycline, a common antibiotic, can damage the teeth of children under 8 years old. The problem is particularly troublesome when it comes to prescribing psychiatric medications to kids, which is increasingly common.

READ MORE @ SLATE

Tuesday, October 14, 2008

Teen suicides have risen alarmingly. It doesn't have to be that way.

Yet the view persists that adolescents are somehow immune to the debilitating clinical depression that afflicts many adults. And such carefree-days-of-youth thinking on the part of some parents and caregivers can yield tragic results.

Teen suicides, which had been on a downward trajectory for the previous two decades, showed an 18 percent rise in 2004 over the previous year, according to a recent report by Journal of the American Medical Association. Although the rate dipped slightly in 2005, the most recent year charted, the number remains well above predicted levels.

As for depression, the World Health Organization reports that one in 33 children and, among them, one in eight teens, is clinically depressed. The organization predicts those numbers could double by 2020.

READ MORE @ SACRAMENTO BEE

Monday, October 13, 2008

Antidepressants Could Improve Symptoms of Irritable Bowel Syndrome: Presented at ACG

Antidepressants are an effective treatment for patients with irritable bowel syndrome (IBS), according to results presented here at the American College of Gastroenterology (ACG) 73rd Annual Scientific Meeting.

Alexander Ford, MD, McMaster University Medical Centre, Hamilton, Ontario, reported the results of a systematic review in a poster session here on October 5.

"I think the most exciting finding [of our study] is that this hasn't been shown before. It's probably the first time that a systematic review and meta-analysis has shown that antidepressants are a benefit in treating irritable bowel syndrome," said Dr. Ford.

"Previous meta-analyses have not demonstrated such an effect for a number of reasons. Obviously, there's more data now but also [researchers] haven't quite looked at all of the eligible studies for various reasons. I think one of [the studies] should have been able to demonstrate this benefit 3 or 4 years ago, but just didn't manage to."

READ MORE @ DOCTOR'S GUIDE

Sunday, October 12, 2008

The long, wild ride of bipolar disorder - A severe childhood mood disorder often lasts into young adulthood

Children who grow up with the psychiatric ailment known as bipolar disorder rarely grow out of it. Almost half of youngsters who suffered from bipolar’s severe, rapid-fire mood swings at around age 11 displayed much of the same emotional volatility at ages 18 to 20, even if the condition had improved for a while during their teens, according to the first long-term study of children diagnosed with the disorder.

Bipolar disorder took off with a vengeance in these kids. Initial episodes, often periods of frequent, dramatic mood swings, lasted for up to three years. Second episodes lasted for slightly more than one year, while third episodes continued for roughly 10 months.

During these periods, youngsters can veer back and forth several times a day between a manic sense of euphoria and a serious, even suicidal depression, say psychiatrist Barbara Geller of Washington University in St. Louis and her colleagues. Manic euphoria typically includes grandiose delusions or hallucinations.

READ MORE @ SCIENCE NEWS

Friday, October 10, 2008

Millions with mental disorders in the developing world are deprived of necessary treatment and care

More than 75% of people suffering from mental disorders in the developing world receive no treatment or care. A new WHO programme launched today, on World Mental Health Day 2008 highlights the huge treatment gap for a number of mental, neurological and substance use disorders. Across Africa for example, nine out of ten people suffering from epilepsy go untreated, unable to access simple and inexpensive anticonvulsant drugs which cost less than US$5 a year per person.

WHO is now calling on governments, donors and mental health stakeholders to rapidly increase funding and basic mental health services to close this huge treatment gap. The programme, Mental health Gap Action Programme (mhGAP): Scaling up care for mental, neurological and substance use disorders asserts that with proper care, psychosocial assistance and medication, tens of millions could be treated for diseases such as depression, schizophrenia, and epilepsy and begin to lead healthy lives, even where resources are scarce.

“Governments across the world need to see mental health as a vital component of primary health care. We need to change policy and practice. Only then can we get the essential mental health services to the tens of millions in need”, said Dr Margaret Chan, Director-General of the World Health Organ.

READ MORE @ WORLD HEALTH ORGANIZATION

Monday, October 6, 2008

Side-Effects of Antipsychotics

A new federally funded study will examine ways to control the metabolic side effects associated with the use of the newer atypical antipsychotic medications in children with schizophrenia or bipolar disorder.

The use of atypical antipsychotic medications to treat children and adolescents with schizophrenia or bipolar disorder is relatively common, but the side effects associated with them are troubling.

The recent NIMH-funded Treatment of Early Onset Schizophrenia Study (TEOSS) found that two atypical medications were associated with more metabolic side effects than an older generation antipsychotic.

The new grant will test ways in which the metabolic side effects, such as weight gain, insulin sensitivity and other factors that can lead to type 2 diabetes and heart disease, may be controlled or reduced.

READ MORE @ PSYCHCENTRAL

Sunday, October 5, 2008

Bailout Provision Provides Equal Coverage for Mental and Physical Ailments

More than one-third of all Americans will soon receive better insurance coverage for mental health treatments because of a new law that, for the first time, requires equal coverage of mental and physical illnesses.

The requirement, included in the economic bailout bill that President Bush signed on Friday, is the result of 12 years of passionate advocacy by friends and relatives of people with mental illness and addiction disorders. They described the new law as a milestone in the quest for civil rights, an effort to end insurance discrimination and to reduce the stigma of mental illness.

Most employers and group health plans provide less coverage for mental health care than for the treatment of physical conditions like cancer, heart disease or broken bones. They will need to adjust their benefits to comply with the new law, which requires equivalence, or parity, in the coverage.

READ MORE @ NY TIMES

Saturday, October 4, 2008

Seeking Treatment for Mental Disorders Has Lasting Effect

Middle-age patients taking medication for anxiety or depression are less likely to have mental disorders a decade later, a population-based study showed.

Among 157 patients who had a mental disorder at age 43, those who took antidepressants, anxiolytics, or both were 70% less likely to have a disorder 10 years later (OR 0.3, 95% CI 0.1 to 1.0), Ian Colman, Ph.D., of the University of Alberta here, and colleagues reported in the October issue of the British Journal of Psychiatry.

"What this tells us is that, if people get treated initially, they are less likely to have a relapse in the future," Dr. Colman said.

Because only 24.2% of those taking medications at age 43 were still being treated at age 53, the researchers said, the lasting benefits of taking antidepressants and anxiolytics "may be because of a demonstrated willingness to seek help rather than long-term maintenance therapy."

They said the lasting benefit may be "explained by an initial willingness to be treated, potential successful initial treatment, and an increased likelihood that these patients would seek and accept help when encountering symptoms of depression and anxiety in the future."

READ MORE @ MEDPAGE TODAY

Friday, October 3, 2008

Long-term psychotherapy is superior, study finds

Psychotherapy lasting for at least one year is more effective than shorter periods of therapy for people with complex mental disorders, such as personality and chronic disorders, according to a study published today in the Journal of the American Medical Assn. The success of dedicated psychotherapy may matter little, however, because fewer doctors are offering the service and fewer insurers are covering it.

In long-term psychodynamic psychotherapy, the therapist provides continued, close support for the patient while the pair work through problems and interventions. The JAMA study, from researchers in Germany, was an examination of 23 studies on the success of psychotherapy. It found that longer-term therapy (one year or longer) was superior to shorter-term methods in regard to overall outcome and personality functioning. On average, patients with complex mental conditions who were treated long-term were better off than 96% of the patients in the comparison groups.

READ MORE @ LOS ANGELES TIMES

Thursday, October 2, 2008

Depression linked to higher death rates from all causes among elderly with diabetes

2-year study looked at more than 10,000 Medicare beneficiaries with diabetes

In a large group of Medicare beneficiaries with diabetes, depression was associated with a higher death rate from all causes during a two-year study period. The findings are published in the October 2008 Journal of General Internal Medicine.

Lead author Dr. Wayne Katon, professor of psychiatry and behavioral sciences at the University of Washington (UW), noted that previous research indicates that depression and diabetes is a potentially lethal mix among young to middle-aged patients. Depression also puts patients at greater risk of complications from their diabetes. This more recent study suggests that depression is also a risk factor for mortality in older patients with diabetes. Most Medicare beneficiaries, like the ones in this study, are over age 65. The mean age of the participants was 75.6 years.

The study tracked 10,704 Medicare beneficiaries with diabetes who were enrolled in a disease management program in Florida. They were surveyed at the start of the study with a health assessment questionnaire. Evidence of depression among members of the group came from physician diagnosis, patient reports of having a prescription for an antidepressant in the year before the survey, or patient answers to a brief screening test. For the next two years, the research team recorded the death and cause of death of participants through bi-monthly checks of Medicare claims and eligibility files, or from phone calls with the participants' families.

READ MORE @ EUREKALERT

Wednesday, October 1, 2008

AHRQ Study: Conventional Antipsychotics May Pose Risk To Elderly

Elderly patients who are prescribed a conventional, or first-generation, antipsychotic medication are at an increased risk of death from cardiovascular or respiratory diseases, as compared to those who take an atypical, or second-generation, antipsychotic medication, according to a study funded by the Agency for Healthcare Research and Quality.

The new study, "Potential Causes of Higher Mortality in Elderly Users of Conventional and Atypical Antipsychotic Medications," which was recently posted online in the Journal of the American Geriatrics Society, adds to growing evidence that conventional antipsychotics may not be safer than atypical anitpsychotics for the elderly. Researchers had previously identified that such second-generation medications may pose increased mortality. The new study compares specific causes of death among elderly patients newly started on conventional versus atypical antipsychotics.

READ MORE @ U.S. MEDICINE

Tuesday, September 30, 2008

Persons With Serious Mental Illness Face Higher Prevalence of Obesity

Obesity is a public health crisis within the general population; however, overweight and obesity issues are even more prevalent in persons with serious mental illness, according to a new report, scheduled to be released on October 3, 2008 by the National Association of State Mental Health Program Directors (NASMHPD).
Findings and recommendations from the report appear in the September 22 issue of Mental Health Weekly, making the journal the first major media outlet to inform the public of this new technical report.
NASMHPD calls the crisis "an epidemic within an epidemic," and say they hope the new report will go a long way toward improving the systems that provide care and treatment to the SMI population.

READ MORE @ MARKET WATCH

Monday, September 29, 2008

U.S. Kids Take More Psychotropic Drugs Than Europeans

American children are three times more likely to be prescribed psychotropic medications for conditions such as ADHD and bipolar disease than European children are, a new study finds.

Differences in regulatory practices and cultural beliefs about the benefit of medication for emotional and behavioral problems may explain this dramatic difference, the U.S. researchers added.

"There is significantly greater use of atypical antipsychotics and SSRI-type antidepressants for child mental health treatment in U.S. than in Western Europe," said lead researcher Julie Zito, from the pharmaceutical health services research department in the School of Pharmacy at the University of Maryland. "Since most of the use is 'off-label' -- without adequate evidence of benefits and risks, close monitoring should be considered when these medications are used."

The report was published in the Sept. 24 online edition of Child and Adolescent Psychiatry and Mental Health.

READ MORE @ FORBES

Sunday, September 28, 2008

Antidepressants 'may harm sperm'

Drugs taken by millions of men to alleviate depression may affect their fertility, say US scientists.

A small number of healthy men given the antidepressant paroxetine for four weeks had far higher levels of sperm with damaged DNA.

The results, reported in New Scientist magazine, do not necessarily mean these men would have serious problems becoming a father.

However, a UK fertility specialist said they were a "cause for concern".

Paroxetine, sold as Seroxat or Paxil, is one of the most commonly prescribed antidepressants in the UK.

This is the second study by a team of researchers at Cornell Medical Center in New York which points to a possible effect on sperm quality.

READ MORE @ BBC

Friday, September 26, 2008

Understanding preemption, Part II

This is Part 2 of a letter to the editor that discusses preemption in the health industry, citing Dr. Bruce West in a Health Alert newsletter from August of this year.

To the Editor:

"The list of drugs known in advance to be dangerous with sometimes lethal side effects, is long indeed. There have been a dozen just in the last few years - always with the drugmakers' attempts to obscure, cover up, mask, lie, and hide the truth before it is finally revealed to the public in a court case. It is all routine.

READ MORE @ MARSHALL INDEPENDENT

Thursday, September 25, 2008

Understanding preemption

To the Editor:

If a company created a product which caused injury and/or death, would you be outraged and demand corrective action, i.e. lawsuit, etc.?

I would, and I believe you would also. Do the tobacco companies come to mind? Of course, many states redirected funds into areas foreign to their original agreement with the court, but who cares, they are the government. Right?

Well, when it comes to your health, loosen up, because the drug industry wants to be exempt from damage awards due to injuries or death caused by their drugs, medical devices, etc. It is referred to in law circles as preemption!

To come to a more comprehensive understanding of what this entails, I refer you to what Dr. Bruce West said in his Health Alert newsletter, dated August 2008, Volume 25, Issue 8, pp. 1-2. This will be a two part letter, due to length.

READ MORE @ MARSHALL INDEPENDENT

Wednesday, September 24, 2008

Statins Increase Risk Of Postoperative Delirium In Elderly Patients, Study Suggests

The use of statins is associated with a 28% increased risk of postoperative delirium in elderly patients, found University of Toronto professor Dr. Donald Redelmeier and colleagues in a retrospective cohort analysis involving more than 280 000 patients.

Ontario's Institute for Clinical Evaluative Sciences (ICES) looked at elderly patients who underwent elective surgery in Ontario and who had received 2 or more prescriptions for statins in the year before surgery, including at least one prescription in the 90 days preceding surgery. Many patients took multiple medications, underwent abdominal, musculoskeletal or urogenital surgery which had a mean duration of about 115 minutes.

Delirium, in addition to causing anxiety in patients and families, contributes to longer hospital stays, a prolonged need for intensive care, and can disrupt and delay care.

READ MORE @ SCIENCE DAILY

Tuesday, September 23, 2008

Inside Medicine: Doctors torn by end-of-life philosophies

Doctors and the American public are afraid to let people die – and even help them do so – with comfort and dignity.

That has become clear to me over my 20 years of practice and through the stories that my colleagues have shared with me.

One doctor e-mailed me about his patient, a woman of 80, who found herself dying of emphysema. Despite being tethered to green oxygen cylinders and having her face constantly enmeshed in clear plastic face masks, she was continually short of breath.

Talking was very difficult and walking even short distances was out of the question. Faced with a terminal illness, she chose hospice care rather than spend her last days in a hospital.

She asked for a pill to end her life. The doctor told her she was depressed (which, given her situation, she might well have been). He offered antidepressant medications. She refused – "no more treatments."

READ MORE @ SACRAMENTO BEE

Monday, September 22, 2008

No longer depressed, or on meds

Doctors show new interest in mind-body therapies for mental illness and are using everything from herbs to meditation and massage to treat depression without medication.

Henry Quant was just 5 years old and bedridden with chronic fevers when he began taking pills for anxiety and depression.

His mother knew that the drugs helped, but they made her nervous.

"The really scary part," Elizabeth Quant said, "is we don't know what these do long term."

This summer, under the watchful eye of his physician, Henry, now 7, replaced his antidepressants with vitamins and learned some stress-relief exercises to calm himself.

READ MORE @ MINNEAPOLIS STAR TRIBUNE