Anxiety disorders are chronic conditions that follow a relapsing/remitting course.1 The evidence to support this view comes primarily from cross-sectional and retrospective assessments of duration of illness and, in part, from prospective studies. The waxing and waning nature of panic disorder and generalized anxiety disorder (GAD), for example, has been clearly demonstrated. Much less information is available about the course of illness of social phobia. However, both community studies and patient samples suggest an age of onset of social phobia in mid to late teens with a chronicity that is equal to or greater than that of panic disorder.2 Nevertheless, this recognition has not reshaped our basic treatment approach, which focuses almost entirely on the acute control of symptoms and only secondarily acknowledges relapse prevention.
In addition, the natural history of anxiety disorders is frequently complicated by Axis I and Axis II comorbidity that seems to be significantly higher among patients who seek treatment than in persons in the community who are not in treatment.1 In fact, it has been estimated that 73% of patients with panic disorder had other comorbid conditions that ranged from major depression to substance abuse until the onset of the Axis II disorders, mostly cluster C type 1 to 2. It is, therefore, evident that any long-term anxiolytic treatment strategy must take account of these high rates of comorbidity that appear to develop during the longitudinal phase of the anxiety disorder.
READ MORE @ PSYCHIATRIC TIMES
Showing posts with label anticonvulsants. Show all posts
Showing posts with label anticonvulsants. Show all posts
Friday, February 6, 2009
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
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
Monday, July 14, 2008
Politics In The Suicide Black Box Decision For Bipolar, Epilepsy Meds
As some of you know, yesterday the FDA's psychopharmacology advisory committee declined to approve the FDA's recommendation that a black box warning be added to 11 anti-seizure drugs used to treat bipolar disorder and epilepsy. I've not seen a lot of press on the decision yet, so the committee's reasoning is not clear to me, but you can glean a bit from this early piece by the Dow Jones News Service:
"Panel members raised concerns about the unintended consequences of adding a black-box warnings to epilepsy [drugs], saying such a move would make doctors wary of prescribing the drugs.
"Panel member Sean Hennessy, a doctor, said he thinks there should be an additional warning on epilepsy drug labels, but added the FDA's analysis shows suicidal risks are 'modest.'
"'To me (the data) says there ought to be a warning, but given what we know about the effects on prescribing, I don't know if they rise to the level of a black box,' Hennessy said.
"GlaxoSmithKline Plc's (GSK) Jack Modell, vice president of clinical development, said his company believes additional warnings should be included on the label. An FDA analysis showed that Glaxo's epilepsy drug Lamictal had a higher increased risk of suicidal behavior and suicidal thoughts than other drugs."
READ MORE @ FURIOUS SEASONS (PHILIP DAWDY)
"Panel members raised concerns about the unintended consequences of adding a black-box warnings to epilepsy [drugs], saying such a move would make doctors wary of prescribing the drugs.
"Panel member Sean Hennessy, a doctor, said he thinks there should be an additional warning on epilepsy drug labels, but added the FDA's analysis shows suicidal risks are 'modest.'
"'To me (the data) says there ought to be a warning, but given what we know about the effects on prescribing, I don't know if they rise to the level of a black box,' Hennessy said.
"GlaxoSmithKline Plc's (GSK) Jack Modell, vice president of clinical development, said his company believes additional warnings should be included on the label. An FDA analysis showed that Glaxo's epilepsy drug Lamictal had a higher increased risk of suicidal behavior and suicidal thoughts than other drugs."
READ MORE @ FURIOUS SEASONS (PHILIP DAWDY)
Friday, July 11, 2008
Risks of Suicidal Ideation and Behavior with Epilepsy Drugs Reaffirmed
All epilepsy drugs should carry a warning -- not necessarily boxed -- about increased risks for suicidal ideation and behavior, a joint meeting of two FDA committees concluded here.
In January, the FDA released results of an analysis that found almost double the risk of suicidality with the use of 11 drugs used to treat epilepsy or psychiatric conditions. (See: FDA Finds Suicidal Behavior in Studies of 11 Epilepsy Drugs)
Today, a joint meeting of the FDA's Peripheral and Central Nervous System Drugs Advisory Committee and the Psychopharmacologic Drugs Advisory Committee voted overwhelmingly in favor of the agency's conclusions that the finding of increased risk should apply not only to all of the drugs in the analysis, but to all anticonvulsants currently on the market.
The committees also voted to describe the risks in a medication guide that would be handed out to patients who were prescribed the drugs.
However, the idea of including a black box warning on the drugs was rejected. Committee members feared that such a warning would discourage physicians from appropriately prescribing the drugs to those who need them.
READ MORE @ MEDPAGE TODAY
In January, the FDA released results of an analysis that found almost double the risk of suicidality with the use of 11 drugs used to treat epilepsy or psychiatric conditions. (See: FDA Finds Suicidal Behavior in Studies of 11 Epilepsy Drugs)
Today, a joint meeting of the FDA's Peripheral and Central Nervous System Drugs Advisory Committee and the Psychopharmacologic Drugs Advisory Committee voted overwhelmingly in favor of the agency's conclusions that the finding of increased risk should apply not only to all of the drugs in the analysis, but to all anticonvulsants currently on the market.
The committees also voted to describe the risks in a medication guide that would be handed out to patients who were prescribed the drugs.
However, the idea of including a black box warning on the drugs was rejected. Committee members feared that such a warning would discourage physicians from appropriately prescribing the drugs to those who need them.
READ MORE @ MEDPAGE TODAY
Sunday, February 3, 2008
Sleep disorders: Don't take it lying down
Millions suffer from sleep disorders – and many never seek help. But the cures are out there, says Roger Dobson
Getting to sleep tonight will be a big problem for millions of Britons. Insomnia affects one in four of us at some time, but it's far from the only disorder that spoils our sleep – researchers have now identified 75 such conditions, from snoring, sleep apnoea, restless legs, bruxism and nocturnal cramps, to sleep-talking, rhythmic movement disorder and confusional arousal. Some 31 per cent of people, including children and teenagers, have one or more of these disorders at some time. They can severely affect everyday life.
"Most of those with sleeping problems considered them to have an impact on their daily functioning, with family life most affected," say Paris University researchers who quizzed 10,000 men and women in the UK and other countries.
The research shows that many people don't seek help with their problems. "Almost half had never taken any steps to resolving them, and the majority had not spoken to a physician about their problems," researchers found. Yet treatments exist for many of the conditions that work well for large numbers of patients. Although half of those who see a doctor are prescribed drugs, other treatments and lifestyle changes can work, too.
READ MORE @ THE INDEPENDENT
Getting to sleep tonight will be a big problem for millions of Britons. Insomnia affects one in four of us at some time, but it's far from the only disorder that spoils our sleep – researchers have now identified 75 such conditions, from snoring, sleep apnoea, restless legs, bruxism and nocturnal cramps, to sleep-talking, rhythmic movement disorder and confusional arousal. Some 31 per cent of people, including children and teenagers, have one or more of these disorders at some time. They can severely affect everyday life.
"Most of those with sleeping problems considered them to have an impact on their daily functioning, with family life most affected," say Paris University researchers who quizzed 10,000 men and women in the UK and other countries.
The research shows that many people don't seek help with their problems. "Almost half had never taken any steps to resolving them, and the majority had not spoken to a physician about their problems," researchers found. Yet treatments exist for many of the conditions that work well for large numbers of patients. Although half of those who see a doctor are prescribed drugs, other treatments and lifestyle changes can work, too.
READ MORE @ THE INDEPENDENT
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