Wednesday, June 17, 2009

Free Online Reminder for All Prescription Medication Users, New MyMedSchedule.com

Designed to provide prescription medication users with daily pill schedule reminders, new MyMedSchedule.com also increases patient understanding and reduces medication mix-ups.

Prescription medication users across the country have become increasingly more dependent upon new MyMedSchedule.com® (www.MyMedSchedule.com) for daily pill reminders. More than half of all insured Americans are taking prescription medications regularly, according to a study recently released by Medco Health Solutions Inc. and thanks to this free website, patients like Donna Hargett of Greencastle can manage their medications more easily while preventing prescription mix-ups.

Offered by MedActionPlan.com, a healthcare education company in Peapack, N.J., MyMedSchedule.com is a free web-based program for managing prescriptions online. The program allows consumers to create medication schedules, including images of their pills, save and print schedules for themselves, and/or family members. They can even set up reminders to "take your pills", remember a follow up appointment, and get a med refill. All for free.

The program enables patients, doctors, nursing and pharmacy staff, as well as adult children, to access, store, update, manage and track all of a patient's medications. Redundant or outdated prescriptions are easily identified and can be immediately omitted from the list, and the schedule can be printed in Spanish or English. All personal health information captured on the site is private and is protected by SSL encryption.

READ MORE @ PR WEB

Tuesday, June 16, 2009

Report on Gene for Depression Is Now Faulted

One of the most celebrated findings in modern psychiatry — that a single gene helps determine one’s risk of depression in response to a divorce, a lost job or another serious reversal — has not held up to scientific scrutiny, researchers reported Tuesday.

The original finding, published in 2003, created a sensation among scientists and the public because it offered the first specific, plausible explanation of why some people bounce back after a stressful life event while others plunge into lasting despair.

The new report, by several of the most prominent researchers in the field, does not imply that interactions between genes and life experience are trivial; they are almost certainly fundamental, experts agree.

But it does suggest that nailing down those factors in a precise way is far more difficult than scientists believed even a few years ago, and that the original finding could have been due to chance. The new report is likely to inflame a debate over the direction of the field itself, which has found that the genetics of illnesses like schizophrenia and bipolar disorder remain elusive.

READ MORE @ NY TIMES

Monday, June 15, 2009

Study Shows Possible Link Between Deaths and ADHD Drugs

Children taking stimulant drugs such as Ritalin to treat attention-deficit hyperactivity disorder are several times as likely to suffer sudden, unexplained death as children who are not taking such drugs, according to a study published yesterday that was funded by the Food and Drug Administration and the National Institute of Mental Health.

While the numbers involved in the study were very small and researchers stopped short of suggesting a cause and effect, the study is the first to rigorously demonstrate a rare but worrisome connection between ADHD drugs and sudden death among children. In doing so, the research adds to the evolving puzzle parents and doctors face in deciding whether to treat children with medication.

Doctors have speculated about such a connection in the past because stimulants increase heart rate and have other cardiovascular effects. Physicians are currently advised to evaluate patients for cardiac risks before prescribing the drugs, and FDA officials said yesterday that those guidelines do not need strengthening in light of the new study. About 2.5 million children in the United States take ADHD medications such as Ritalin and Adderall.

READ MORE @ WASHINGTON POST

Sunday, June 14, 2009

FDA Throws Lifeline to Antipsychotic Pushers

On June 11, 2009, FDA News reported that AstraZeneca’s Seroquel, Pfizer’s Geodon and Eli Lilly’s Zyprexa atypical antipsychotics "won an FDA advisory panel’s recommendations for approval to treat schizophrenia and bipolar disorder in pediatric and adolescent patients."

"The FDA's expanded marketing approval process for antipsychotics, highly toxic drugs, is unaffected by evidence uncovered by the US Justice Department showing that the studies submitted by drug manufacturers were often flawed, if not fraudulent," says Vera Hassner Sharav, president of the Alliance for Human Research Protection, in a June 8, 2009 infomail alert.

"Rather than focus on protecting children's safety, FDA officials are doing their utmost to legitimize irresponsible, off-label prescribing of exceedingly toxic antipsychotics for children--thereby ensuring that far greater numbers of children will be victimized and die," according to Sharav.

A recent report by the consulting firm Decision Resources found antipsychotics makers spent $993,000,000 in 2006, to promote these drugs to doctors and patients, she reports. In 2008, at more than $14 billion, antipsychotic revenues topped all other classes of drugs in the US, even cholesterol and diabetes medications.

READ MORE @ COUNTERPUNCH

Saturday, June 13, 2009

63 percent of RA patients suffer psychiatric disorders, with depressive spectrum conditions most likely

Over half (63%) of patients with rheumatoid arthritis (RA) also suffer from psychiatric disorders, with the majority of these (87%) occurring in the depressive spectrum, according to the results of a new study presented today at EULAR 2009, the Annual Congress of the European League Against Rheumatism in Copenhagen, Denmark. Interestingly, over half (52%) of the patients studied indicated that they had experienced stress events before the onset of their RA.

The study also revealed a number of other interesting findings about the emotional burden of RA:

* Cognitive dysfunction was diagnosed in 23% of patients, with 16% of this attributed to depression
* A third (33%) suffered from sleep disorders
* Those with depression also exhibited more severe RA (measured by X-ray), greater functional insufficiency and pain, as well as having received less aggressive treatment than patients without depression. (No significant differences in age, duration of illness, gender or DAS28* scores were noted between the two groups)
* Significantly, cognitive impairments were found more often (p=0.02) in patients older than 50 years (39% vs. 9%)
* The age of the first prednisone intake was significantly higher (p<0.05) in patients with depression compared to those without (48 vs. 30 years)

Dr Tatiana Lisitsyna from the State Institute of Rheumatology RAMS, Russian Federation, who conducted the study, said: "Psychiatric disorders are a very common comorbidity for people with RA, and they tend to be stress-related and associated with disease activity and chronic pain. Evaluating and addressing the mental health of those with RA should be a regular feature of rheumatology practice to improve quality of life and reduce the potentially distressing psychological burden of RA."

READ MORE @ EUREKALERT

Friday, June 12, 2009

Can Memory Loss Be Prevented?

At the age of 78, Bob Branham, a retired computer software developer in Dallas, Tex., took up quilting. It wasn’t his idea, actually. He’d never dreamed of piecing together his own Amish diamond coverlet or rummaging around Jo-Ann Fabrics in search of calico prints. But then he enrolled in a trial sponsored by the National Institute on Aging to assess whether learning a new skill can help preserve cognitive function in old age. By random assignment, he landed in the quilting group.

When it comes to mental agility, we’re more likely to think of crosswords than cross-stitch. But neuroscientists suspect that learning a challenging new skill — a new language, a new musical instrument — may be even more effective than mental games at keeping the brain sharp. And quilting is more complicated than it may seem.

“It’s a very abstract task,” said Dr. Denise Park, a cognitive neuroscientist at the University of Texas at Dallas, who is leading the trial. “You have to picture what the pattern will look like, match fabrics, manipulate geometric forms, mentally rotate objects.”

In Mr. Branham’s case, he also had to learn to use a sewing machine. And while it’s too early to tell if quilting is sharpening his mind, he quickly found that he loved his new pastime. He spends as much as 40 hours a week piecing and stitching, both at home and at the social center that Dr. Park set up for the trial.

READ MORE @ NY TIMES

Thursday, June 11, 2009

Cardiac Risk Same With Typical and Atypical Antipsychotics

Second-generation (atypical) antipsychotic drugs may not have an advantage for cardiovascular risk over typical antipsychotics, according to a recent, large retrospective cohort study. Researchers at the Vanderbilt University School of Medicine in Tennessee found that risk of sudden cardiac death is heightened with antipsychotics, whether typical or atypical, and the risk increases significantly with increasing doses.

In a recent issue of the New England Journal of Medicine, lead investigator Wayne Ray, PhD, and colleagues,1 report that while a favorable extrapyramidal adverse–effect profile has led many to consider atypical antipsychotics safer than typical antipsychotics for cardiac risk, “the atypical antipsychotic drugs are no safer than the older drugs.”

The study was designed to detect an increased incidence of sudden cardiac death in patients treated with antipsychotics. The researchers identified new users of the study drugs and established the temporal relationship between patient characteristics before treatment and outcomes after treatment initiation. They analyzed data from 44,218 patients treated with a typical antipsychotic, 46,089 patients treated with an atypical antipsychotic, and 186,600 matched nonusers. The participants’ mean age was 45.7 years. The analysis controlled for an array of cardiovascular disease variables.

READ MORE @ PSYCHIATRIC TIMES

Wednesday, June 10, 2009

Psychiatric Disability: A Step-by-Step Guide to Assessment and Determination Tips on a Complex and Challenging Role for Consulting Psychiatrists

The epidemiology and management of psychiatric disability have gained increased attention for a variety of reasons in the past 3 decades. There are issues of empowerment, advocacy, and reduction of stigma. There are also concerns about cost containment as well as reliability, validity, and efficacy of the determination process.

About 20% of adults who receive Social Security disability benefits have psychiatric disability. Psychiatric disability accounts for a significant proportion of private long-term disability claims and payments.1,2 Advances in technology that have had an impact on physical disabilities have not had a corresponding effect on psychiatric disability.

This article is based on the United States Social Security Administration (SSA) model of disability assessments for psychiatric impairment. Since its inception in 1935, there have been several amendments and rul-ings that have attempted to expand and refine the Disability Act. Despite these efforts, the reliability and validity of the disability determination process have been impaired by several factors:

• The inherent difficulty of objectifying psychiatric signs and symptoms

• The fluctuating nature of psychiatric disorders

• Problems with language and communication (central to the collection of data from patients), which may be compromised by the disease process

In addition, many individuals who apply for disability on the basis of physical illness also have comorbid mental disorders. Hence, psychiatrists may be called on as treating physicians, consultative examiners, and expert witnesses to provide disability reports.

READ MORE @ PSYCHIATRIC TIMES

Tuesday, June 9, 2009

Recession fills area’s ER beds with mentally ill State ‘back to square one’ on issue, official says

On Thursday, nearly one-third of the patients in Las Vegas Valley emergency rooms were awaiting psychiatric care.

That morning’s tally — 117 people whose minds had unraveled to a point where they were considered a danger to themselves or others — was higher than the number cited when Clark County declared a mental health emergency in 2004. The resurgence has health care officials concerned that the stress of the economic collapse could be fueling another communitywide psychiatric crisis.

A coalition formed to address the issue five years ago stopped meeting in 2007. But its members regrouped Thursday to try, once again, to reconcile an increasing demand for psychiatric care with a dwindling supply.

“There are more people in crisis, we still have overcrowding and a lack of services, bringing us kind of back to square one,” said Janelle Kraft Pearce, a retired Metro Police official and chairwoman of the Southern Nevada Mental Health Coalition.

She was speaking to a group that included directors of hospital emergency rooms, psychiatrists, drug and alcohol abuse counselors, and state mental health officials. Many of them had come together in years past to talk about the same problem.

READ MORE @ LAS VEGAS SUN

Sunday, June 7, 2009

FDA Reverses Earlier Decision, Approves Schizophrenia Drug

The new antipsychotic medication has pharmacological and clinical profiles similar to those of other second-generation drugs on the market and appears to carry comparable risks.

After being turned down by the Food and Drug Administration (FDA) almost a year ago, iloperidone has gained approval for the acute treatment of schizophrenia in adult patients.

Iloperidone is a second-generation antipsychotic (SGA) medication mixed antagonism for dopamine D2 and serotonin 5HT2A receptors and is owned by Vanda Pharmaceuticals.

In two randomized, placebo-controlled, phase-3 trials in patients with schizophrenia, iloperidone was found more efficacious than placebo in reducing schizophrenia symptoms among study subjects.

In one trial, 604 patients with schizophrenia received iloperidone 24 mg/day, placebo, or ziprasidone for four weeks, with patients on iloperidone showing significant benefits in Positive and Negative Syndrome Scale total scores compared with placebo. In the other trial, involving 706 patients, iloperidone was compared with placebo and risperidone. After six weeks, the drug was superior to placebo in the reduction of total score on the Brief Psychiatric Rating Scale. The company did not release any data on how iloperidone compared with either ziprasidone or risperidone on efficacy indicators.

READ MORE @ PSYCHIATRIC NEWS

Saturday, June 6, 2009

Depression may indicate early Parkinson's disease

Results of a new study provide more evidence that depressive symptoms are an early feature of Parkinson's disease, preceding the characteristic movement problems seen Parkinson's such as tremor and rigid muscles.

In the study, researchers found that starting antidepressant therapy was associated with a twofold increased risk of developing Parkinson's disease in the next 2 years.

Although several reports have shown a link between depressive symptoms and Parkinson's disease, it was unclear whether one caused the other or if both may arise from some common mechanism, Dr. A. Alonso and colleagues note in their report.

READ MORE @ REUTERS

Friday, June 5, 2009

Antipsychotic drugs appear to work in kids: FDA staff

Three antipsychotic drugs appear to work in children and teens but their risks must be weighed as the makers seek to promote them for younger patients, the head of the U.S. Food and Drug Administration's psychiatric division said in a memo released on Friday.

The FDA has yet to make a final decision on whether to approve drugs made by AstraZeneca, Pfizer and Eli Lilly and Co for children and teens with schizophrenia or bipolar disorder.

An FDA panel is to meet next week to give recommendations on the companies' bid to promote the drugs for children and teenagers with schizophrenia or bipolar disorder.

Doctors can already prescribe the medications for children, but FDA approval would allow the manufacturers to market them more widely.

The drugs, known as atypical antipsychotics, are widely used to treat various psychiatric conditions but have come under scrutiny for links to weight gain.

"We generally are in agreement that the sponsors have provided adequate support to suggest effectiveness," FDA's Thomas Laughren wrote in the memo released on Friday.

He added that the safety of the drugs in children appeared "to be qualitatively similar to those observed with these drugs in adult patients."

READ MORE @ REUTERS

Thursday, June 4, 2009

Common Autism Medication Is Ineffective For Repetitive Behaviors, Study Finds

Citalopram (Celexa), a medication commonly prescribed to children with autism spectrum disorders (ASD), was no more effective than a placebo at reducing repetitive behaviors, according to a multi-site clinical trial guided by lead author Bryan H. King, MD, director of child and adolescent psychiatry at Seattle Children's Hospital and professor and vice chair of psychiatry at the University of Washington School of Medicine.

Because citalopram is also prescribed for patients with obsessive compulsive disorders (OCD), these study results may challenge the widely held premise that repetitive behaviors in children with ASD are similar to repetitive behaviors often found in cases of OCD.

"We're continuing to learn new information about the multiple variables that may cause or contribute to autism spectrum disorders, as well as how to treat them," said King. "Even as our understanding of autism grows, so much still remains a mystery. While our study's findings may be frustrating news for hopeful families and clinicians, each new finding helps us to re-examine and revise treatment plans, refine future studies and build upon what we know as we search for effective treatments and eventually cures for this complex group of disorders."

READ MORE @ SCIENCE DAILY

Wednesday, June 3, 2009

Drug Agency May Reveal More Data on Actions

For years, the Food and Drug Administration has withheld information about transparency from the public when their makers cite trade secrecy — even in cases where the agency suspects that the products are causing serious illness or death.

Now the new leadership at the F.D.A. may change that. The Obama administration plans to announce on Tuesday that it is setting up a task force within the agency to recommend ways to reveal more information about F.D.A. decisions, possibly including the disclosure of now secret data about drugs and devices under study.

The task will be complicated. Agency confidentiality decisions are governed by several interconnected laws, including the Federal Trade Secrets Act. Changing them would “involve more than one Congressional committee and impact thousands and thousands of companies, and thus would be an extremely difficult legislative path,” said Peter Barton Hutt, a former general counsel to the agency.

Still, the goal is to open up a system in which the agency failed to inform the public that a widely prescribed heartburn drug was especially toxic to babies; that a diabetes medicine and a painkiller increased heart attack risks; and that antidepressants increased suicidal thoughts and behavior in children and teenagers.

READ MORE @ NY TIMES

Tuesday, June 2, 2009

Depression Treatment Wanes Following FDA Warnings

Newly diagnosed cases of depression in America have dropped sharply since the government's warning of an increased risk of suicidal behavior among children and teens taking antidepressants, a new analysis finds.

Researchers at the University of Colorado say the U.S. Food and Drug Administration's advisories about the use of selective serotonin reuptake inhibitors (SSRIs) appear to be associated with "unintended" and "persistent" changes in the diagnosis and treatment of depression, especially in children and teens. They also observed a "spillover effect" on adult depression care.

"We don't know why; we just do know after the warnings these things did change, so it had an effect on treatment patterns for depression," said study co-author Robert J. Valuck, a professor of clinical pharmacy at the University of Colorado Denver's School of Pharmacy.

The report appears in the June issue of the Archives of General Psychiatry.

From the time the FDA issued its warning in 2003 through June 2007, primary-care physicians wrote 44 percent fewer SSRI prescriptions for pediatric patients than historical trends predicted, and 37 percent fewer for young adults. Yet there was no change in alternative medications or psychotherapy to compensate for the decline in SSRI prescriptions for these patients.

"It does look concerning, that the patients are not getting treated," said John F. Curry, director of clinical psychology training at Duke University Medical Center in Durham, N.C.

In October 2003, the FDA warned about the increased risk to children and teens of taking SSRIs, citing an increased risk of attempted suicide and suicidal behavior. A little over a year later, the agency directed pharmaceutical manufacturers to add a "black box" warning to medication labels, urging close monitoring of patients taking these drugs.

RERAD MORE @ ATLANTA JOURNAL CONSTITUTION

Monday, June 1, 2009

Common autism medication is ineffective for repetitive behaviors, study finds

New information may change treatment protocols for children with autism spectrum disorders

Citalopram (Celexa), a medication commonly prescribed to children with autism spectrum disorders (ASD), was no more effective than a placebo at reducing repetitive behaviors, according to a multi-site clinical trial guided by lead author Bryan H. King, MD, director of child and adolescent psychiatry at Seattle Children's Hospital and professor and vice chair of psychiatry at the University of Washington School of Medicine. Because citalopram is also prescribed for patients with obsessive compulsive disorders (OCD), these study results may challenge the widely held premise that repetitive behaviors in children with ASD are similar to repetitive behaviors often found in cases of OCD. The study "Lack of Efficacy of Citalopram in Children with Autism Spectrum Disorders and High Levels of Repetitive Behavior" was published in the June 2009 issue of Archives of General Psychiatry.

"We're continuing to learn new information about the multiple variables that may cause or contribute to autism spectrum disorders, as well as how to treat them," said King. "Even as our understanding of autism grows, so much still remains a mystery. While our study's findings may be frustrating news for hopeful families and clinicians, each new finding helps us to re-examine and revise treatment plans, refine future studies and build upon what we know as we search for effective treatments and eventually cures for this complex group of disorders."

"When prescribing any medication we must always weigh the possible benefits against possible risks," added King. "Because citalopram showed no more benefit than placebo and it may produce side effects, providers need to carefully examine whether it is appropriately prescribed for repetitive behaviors in children with an ASD."

Citalopram is in a class of antidepressant medications called selective serotonin reuptake inhibitors (SSRIs), which are sometimes prescribed for children with ASD to reduce repetitive behaviors. These behaviors include hand flapping or wringing, repetitive complex body movements like spinning, swaying, or rocking back and forth, repetitive play, and inflexible daily routines.

"Parents of children with autism spectrum disorders face an enormous number of treatment options, not all of which are research-based," said Thomas R. Insel, MD, director of the National Institute of Mental Health (NIMH). "Studies like this help us to better understand which treatments are likely to be beneficial and safe."

Previous research has suggested that some children with ASD may have abnormalities in their serotonin, a brain chemical that, among many other functions, plays an important role in early brain development. Children with OCD may also have abnormal serotonin function, as well as repetitive or inflexible behaviors. OCD is effectively treated with SSRIs, which leads many doctors to prescribe SSRIs to reduce repetitive behaviors in children with ASD. Even though studies have shown mixed results for use in ASD, SSRIs remain among the most frequently prescribed medications for children with ASD.

READ MORE @ EURFEKALERT