Within 2 years after the October 2003 FDA public health advisory about the risk of suicide in children taking a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs), significant reductions in rates of diagnosis and antidepressant treatment of childhood depression occurred, researchers report.
"Antidepressant use was expected to decline, consistent with effects on other drugs after warnings are issued," Dr. Anne M. Libby of University of Colorado Health Science Center at Denver told Reuters Health.
However, "we were most surprised at the diagnosing rate decline, reversing a national trend as evidence of a decade of work to educate and promote depression treatment in primary care," she added.
"Our concern is the lack of treatment for a disorder that is quite serious in childhood, as depression is a large and significant risk factor for suicide," Libby added.
READ MORE @ REUTERS
Thursday, July 5, 2007
Tuesday, July 3, 2007
Patients Use Less Medicine When They Must Pay More, Study Finds
Patients use fewer prescription drugs when they have to pay more for the medicines, according to research that suggests shifting health-care costs to consumers may lead to more serious illness over time.
Consumers spend 2 to 6 percent less on the drugs for every 10 percent increase in out-of-pocket costs, according to a review of 132 studies released today by the Rand Corp., a Santa Monica, California-based public policy institute.
Companies seeking to hold the line on health-care spending are requiring employees to pay higher deductibles for insurance or offering co-insurance plans that split costs. A study this year in the journal Health Affairs found consumers may spend $440.8 billion out of pocket in 2016, 76 percent more than in 2006. More study is needed to determine if such increases will cause consumers to skip necessary treatment, researchers said.
``For patients with certain chronic illnesses, when you increase cost sharing on the pharmacy side, you end up with more hospitalizations and more use of emergency departments,'' said Dana Goldman, the study's lead author and Rand's director of health economics, in a telephone interview yesterday. The research was presented today in the Journal of the American Medical Association
READ MORE @ BLOOMBERG NEWS
Consumers spend 2 to 6 percent less on the drugs for every 10 percent increase in out-of-pocket costs, according to a review of 132 studies released today by the Rand Corp., a Santa Monica, California-based public policy institute.
Companies seeking to hold the line on health-care spending are requiring employees to pay higher deductibles for insurance or offering co-insurance plans that split costs. A study this year in the journal Health Affairs found consumers may spend $440.8 billion out of pocket in 2016, 76 percent more than in 2006. More study is needed to determine if such increases will cause consumers to skip necessary treatment, researchers said.
``For patients with certain chronic illnesses, when you increase cost sharing on the pharmacy side, you end up with more hospitalizations and more use of emergency departments,'' said Dana Goldman, the study's lead author and Rand's director of health economics, in a telephone interview yesterday. The research was presented today in the Journal of the American Medical Association
READ MORE @ BLOOMBERG NEWS
Monday, July 2, 2007
Suicide attempts decline after depression treatment
In a study of more than 100,000 patients treated for depression, suicide attempts declined during the first month of treatment—whether that treatment consisted of medication, psychotherapy, or both. The findings, published in the July American Journal of Psychiatry, show a similar pattern for populations of adolescents and young adults (up to age 24) as for older adults.
The study sheds new light on the “black box” advisory the FDA placed in 2004 and has revised since then, said a psychiatrist who led the study. The advisory—which has concerned many patients, families, and care providers—warns that suicidal behavior may emerge soon after people younger than 25 start treatment with newer antidepressant medications called selective serotonin reuptake inhibitors (SSRIs). It was spurred by randomized placebo-controlled trials showing that starting to take an SSRI can make thoughts of suicide more common among some teens and young adults.
The study is the first published research to compare the risk of suicide attempts before and after the start of treatment with not only antidepressants but also psychotherapy. It is based on computerized medical and pharmacy records for more than 109,000 patients who started treatment for depression from 1996 to 2005
READ MORE @ EUREKALERT
The study sheds new light on the “black box” advisory the FDA placed in 2004 and has revised since then, said a psychiatrist who led the study. The advisory—which has concerned many patients, families, and care providers—warns that suicidal behavior may emerge soon after people younger than 25 start treatment with newer antidepressant medications called selective serotonin reuptake inhibitors (SSRIs). It was spurred by randomized placebo-controlled trials showing that starting to take an SSRI can make thoughts of suicide more common among some teens and young adults.
The study is the first published research to compare the risk of suicide attempts before and after the start of treatment with not only antidepressants but also psychotherapy. It is based on computerized medical and pharmacy records for more than 109,000 patients who started treatment for depression from 1996 to 2005
READ MORE @ EUREKALERT
Sunday, July 1, 2007
Analysis: SSRIs-fetal brain defect linked
Two new studies of anti-depressant use during pregnancy have found new evidence of a previously suspected link between anti-depressants and fetal heart defects. In addition, a troubling connection to additional problems with the fetus's developing skull and intestines have been identified for the first time.
The new research -- published in the June 28 New England Journal of Medicine -- includes a review of national data on birth defects by researchers at the Centers for Disease Control that found women who took a class of anti-depressants called selective serotonin re-uptake inhibitors, or SSRIs, had a 2.4 percent higher risk of having an infant with anencephaly, or no brain.
The study also linked SSRI use with craniosynostosis, when the skull forms too early so the brain cannot grow properly, and gastroschisis, when organs protrude from the navel.
READ MORE @ UPI
The new research -- published in the June 28 New England Journal of Medicine -- includes a review of national data on birth defects by researchers at the Centers for Disease Control that found women who took a class of anti-depressants called selective serotonin re-uptake inhibitors, or SSRIs, had a 2.4 percent higher risk of having an infant with anencephaly, or no brain.
The study also linked SSRI use with craniosynostosis, when the skull forms too early so the brain cannot grow properly, and gastroschisis, when organs protrude from the navel.
READ MORE @ UPI
Saturday, June 30, 2007
Dosage Adjustment in Special Populations
Special consideration may be necessary when prescribing pharmacologic therapy for depression and anxiety disorders in certain populations of patients. These populations are diverse in demographics and symptomatology. As a result, discussions of the special considerations their comorbid conditions require tend to be outside of the mainstream literature. This article discusses 3 special populations: patients with traumatic brain injury (TBI), patients with HIV or AIDS, and Asian Americans. When prescribing pharmacologic therapy for depression to patients in these special populations, clinicians must perform thorough patient assessments, maintain a high index of suspicion for comorbidities, and proceed with slow and gentle titration of medications.
READ MORE @ ABKHAZIA
READ MORE @ ABKHAZIA
Friday, June 29, 2007
Antidepressant studies find low birth-defect risk
Use of antidepressants by pregnant women doesn't significantly increase the risk of birth defects, with rare exceptions, two studies found.
The overall risk of having a child with a defect increased by less than 1 percent in women on the drugs, including Pfizer Inc.'s Zoloft, GlaxoSmithKline PLC's Paxil and Forest Laboratories Inc.'s Celexa, according to research published today in The New England Journal of Medicine.
READ MORE @ BALTIMORE SUN
The overall risk of having a child with a defect increased by less than 1 percent in women on the drugs, including Pfizer Inc.'s Zoloft, GlaxoSmithKline PLC's Paxil and Forest Laboratories Inc.'s Celexa, according to research published today in The New England Journal of Medicine.
READ MORE @ BALTIMORE SUN
Thursday, June 28, 2007
Approval of J&J's Antipsychotic Delayed for Teens
U.S. regulators delayed a request by Johnson & Johnson to expand use of its top-selling Risperdal to include schizophrenia and bipolar disorder in adolescents.
The FDA didn't request new studies on the treatment in a letter to the company, J&J said in a statement today. J&J said it would work with the agency to complete prescribing information on the drug, which is already approved for use in children with autism and adults with schizophrenia and bipolar disorder.
Use of antipsychotic drugs for younger patients has risen sharply in recent years, prompting concern among some doctors and parents about side effects including weight gain and diabetes. Risperdal, which generated $4.2 billion last year, is the second such drug delayed by U.S. regulators for teen use. Eli Lilly's Zyprexa was held up in April.
READ MORE @ REUTERS NEWS
The FDA didn't request new studies on the treatment in a letter to the company, J&J said in a statement today. J&J said it would work with the agency to complete prescribing information on the drug, which is already approved for use in children with autism and adults with schizophrenia and bipolar disorder.
Use of antipsychotic drugs for younger patients has risen sharply in recent years, prompting concern among some doctors and parents about side effects including weight gain and diabetes. Risperdal, which generated $4.2 billion last year, is the second such drug delayed by U.S. regulators for teen use. Eli Lilly's Zyprexa was held up in April.
READ MORE @ REUTERS NEWS
Wednesday, June 27, 2007
Errors Drop 66% When Doctors Computerize Prescriptions
Medication errors such as prescribing or administering the wrong drugs to patients dropped 66% in hospitals used a computerized system to record doctors' orders.
Prescription errors costing each U.S. hospital as much as $5.6 million a year declined when doctors directly entered their instructions into an electronic system, rather than having staff transcribe handwritten notes, according to a review by the University of Minnesota of 12 separate studies.
"The problem is more complicated than bad handwriting or individual negligence," said Tatyana A. Shamliyan, a research associate at the University of Minnesota's School of Public Health. "There are several steps, and through all the steps errors can be introduced."
Switching from handwritten prescriptions to direct computer entry by doctors would reduce the medication errors that injure or kill half a million patients each year, the researchers said.
READ MORE @ BLOOMBERG NEWS
Prescription errors costing each U.S. hospital as much as $5.6 million a year declined when doctors directly entered their instructions into an electronic system, rather than having staff transcribe handwritten notes, according to a review by the University of Minnesota of 12 separate studies.
"The problem is more complicated than bad handwriting or individual negligence," said Tatyana A. Shamliyan, a research associate at the University of Minnesota's School of Public Health. "There are several steps, and through all the steps errors can be introduced."
Switching from handwritten prescriptions to direct computer entry by doctors would reduce the medication errors that injure or kill half a million patients each year, the researchers said.
READ MORE @ BLOOMBERG NEWS
Tuesday, June 26, 2007
Psychiatrists Top in Drug Maker Gifts
As states begin to require drug companies disclose their payments to doctors for lectures and other services, a pattern has emerged: psychiatrists earn more money from drug makers than doctors in any other specialty.
How this money may be influencing psychiatrists and other doctors has become one of the most contentious issues in health care. For instance, the more psychiatrists have earned from drug makers, the more they have prescribed a new class of powerful medicines known as atypical antipsychotics to children, for whom the drugs are especially risky and mostly unapproved.
READ MORE @ NY TIMES
How this money may be influencing psychiatrists and other doctors has become one of the most contentious issues in health care. For instance, the more psychiatrists have earned from drug makers, the more they have prescribed a new class of powerful medicines known as atypical antipsychotics to children, for whom the drugs are especially risky and mostly unapproved.
READ MORE @ NY TIMES
Monday, June 25, 2007
Anti-depressants weaken elderly bones
Two studies published add to growing evidence the most popular class of drugs taken to treat depression may contribute to fragile bones in elderly people.
The research focused on a class of antidepressant drugs called selective serotonin reuptake inhibitors. Millions of people, including many elderly, take these drugs, known as SSRIs, which include Eli Lilly's Prozac, known generically as fluoxetine.
Two teams of researchers found that older men and women taking SSRIs had more bone loss than those not taking the drugs, which account for more than 60 percent of U.S. antidepressant drug prescriptions. A drop in bone mass can lead to osteoporosis and bone fractures.
A team led by Dr. Susan Diem of the University of Minnesota tracked 2,722 women, average age 78, including 198 SSRI users. They measured their bone mineral density five years apart
READ MORE @ REUTERS
The research focused on a class of antidepressant drugs called selective serotonin reuptake inhibitors. Millions of people, including many elderly, take these drugs, known as SSRIs, which include Eli Lilly's Prozac, known generically as fluoxetine.
Two teams of researchers found that older men and women taking SSRIs had more bone loss than those not taking the drugs, which account for more than 60 percent of U.S. antidepressant drug prescriptions. A drop in bone mass can lead to osteoporosis and bone fractures.
A team led by Dr. Susan Diem of the University of Minnesota tracked 2,722 women, average age 78, including 198 SSRI users. They measured their bone mineral density five years apart
READ MORE @ REUTERS
Sunday, June 24, 2007
Hospitalised Heart Patients Safer with Anti-depressants
According to the research findings, patients with “acute coronary syndrome” are less likely to have certain subsequent heart-related events if they are taking a selective serotonin reuptake inhibitor or SSRI. Primarily used for relieving depression, SSRI drugs also stop platelets from clumping together.
Led by Dr. Roy C. Ziegelstein, the research team based their study on the fact that SSRIs are often used for treating anxiety and depression in coronary heart disease patients. They wanted to ascertain if this has an effect on the patients’ outcome.
READ MORE @ HEARTZINE
Led by Dr. Roy C. Ziegelstein, the research team based their study on the fact that SSRIs are often used for treating anxiety and depression in coronary heart disease patients. They wanted to ascertain if this has an effect on the patients’ outcome.
READ MORE @ HEARTZINE
Saturday, June 23, 2007
BEHAVIOUR DRUGS FOR CHILDREN 'UBIQUITOUS'
Canadian children are being widely prescribed antipsychotic drugs for behaviour and mood problems, with a significant proportion of the powerful drugs going to children under the age of nine, new research shows.
Ninety-four per cent of 176 child psychiatrists in Canada surveyed are prescribing drugs known as atypical antipsychotics for a variety of disorders and symptoms, including anxiety, attention-deficit hyperactivity disorder and "poor frustration tolerance."
While most prescriptions were for children 13 and older, researchers found that a "surprising" number were for the very young: Twelve per cent of all prescriptions were for children aged eight or under, including three-year-olds.
None of the drugs has been officially approved for use in children. All are in a different class from Ritalin, a stimulant used to treat attention deficit disorder in children.
READ MORE @ NATIONAL POST
Ninety-four per cent of 176 child psychiatrists in Canada surveyed are prescribing drugs known as atypical antipsychotics for a variety of disorders and symptoms, including anxiety, attention-deficit hyperactivity disorder and "poor frustration tolerance."
While most prescriptions were for children 13 and older, researchers found that a "surprising" number were for the very young: Twelve per cent of all prescriptions were for children aged eight or under, including three-year-olds.
None of the drugs has been officially approved for use in children. All are in a different class from Ritalin, a stimulant used to treat attention deficit disorder in children.
READ MORE @ NATIONAL POST
Friday, June 22, 2007
FDA Delays Risperdal For Teenagers
Untold numbers 0f kids may be prescribed antipsychotics on an off-the-label basis every year, but the FDA held back from giving Johnson & Johnson its blessing to market the drug officially to teenagers suffering from schizophrenia.
The agency has issued an approvable letter in response to the drugmaker’s request to market Risperdal for schizophrenia in youngsters between 13 and 17, and for short-treatment of bipolar mania associated with bipolar I disorder in kids between 10 and 17. J&J was quick to note, however, that the FDA didn’t request new studies, according to its statement today.
READ MORE @ PHARMALOT
The agency has issued an approvable letter in response to the drugmaker’s request to market Risperdal for schizophrenia in youngsters between 13 and 17, and for short-treatment of bipolar mania associated with bipolar I disorder in kids between 10 and 17. J&J was quick to note, however, that the FDA didn’t request new studies, according to its statement today.
READ MORE @ PHARMALOT
Thursday, June 21, 2007
Gates Vows to Fix Mental Health System
Defense Secretary Robert Gates promised Thursday to speed up changes to the military's much-criticized mental health system, declaring ''this is something that we can, must and will get fixed.''
A study released last week said more money and people are needed to care for troops suffering depression, anxiety, post-traumatic stress symptoms and other mental health problems because of their war experiences. It also said the Pentagon needs to build a culture of support throughout the military to help remove the stigma of asking for and getting psychological help.
READ MORE @ NY TIMES
A study released last week said more money and people are needed to care for troops suffering depression, anxiety, post-traumatic stress symptoms and other mental health problems because of their war experiences. It also said the Pentagon needs to build a culture of support throughout the military to help remove the stigma of asking for and getting psychological help.
READ MORE @ NY TIMES
Wednesday, June 20, 2007
On the Horizon, Personalized Depression Drugs
Imagine that you are depressed and see a psychiatrist who explains that you have clinical depression and would benefit from an antidepressant. So far, so good. But then the doctor tells you there is a 60 percent chance that you’ll feel better with this antidepressant and that it could take as long as four to six weeks to find out, during which time you’ll probably have some side effects from the drug.
With a simple blood test, the doctor will be able to characterize a patient’s unique genetic profile, determining what biological type of depression the patient has and which antidepressant is likely to work best.
Scientists have identified genetic variations that affect specific neurotransmitter functions, which could explain why some patients respond to some drugs but not to others. For example, some depressed patients who have abnormally low levels of serotonin respond to S.S.R.I.’s, which relieve depression, in part, by flooding the brain with serotonin. Other depressed patients may have an abnormality in other neurotransmitters that regulate mood, like norepinephrine or dopamine, and may not respond to S.S.R.I.’s.
READ MORE @ NY TIMES
With a simple blood test, the doctor will be able to characterize a patient’s unique genetic profile, determining what biological type of depression the patient has and which antidepressant is likely to work best.
Scientists have identified genetic variations that affect specific neurotransmitter functions, which could explain why some patients respond to some drugs but not to others. For example, some depressed patients who have abnormally low levels of serotonin respond to S.S.R.I.’s, which relieve depression, in part, by flooding the brain with serotonin. Other depressed patients may have an abnormality in other neurotransmitters that regulate mood, like norepinephrine or dopamine, and may not respond to S.S.R.I.’s.
READ MORE @ NY TIMES
Tuesday, June 19, 2007
Diagnosis, Treatment of Youth for Depression Fell After FDA Alert
Researchers are troubled by data indicating that large numbers of young people with depression are being left untreated after the FDA issued its first advisory about the antidepressants in 2003.
Rates of the diagnosis and pharmacological treatment of depression among children and adolescents dropped sharply after October 2003, when the U.S. Food and Drug Administration (FDA) issued its first public health advisory informing health care professionals of an increased risk of suicidality among youngsters taking antidepressants.
These findings, which appeared in the June American Journal of Psychiatry, have heightened the concerns of researchers and clinicians alike that suicide rates among untreated children and adolescents will rise unchecked. In fact, a study published in the February Pediatrics revealed an 18.2 percent increase in suicide from 2003 to 2004 among youngsters under the age of 20 (Psychiatric News, March 2).
READ MORE @ PSYCHIATRIC NEWS
Rates of the diagnosis and pharmacological treatment of depression among children and adolescents dropped sharply after October 2003, when the U.S. Food and Drug Administration (FDA) issued its first public health advisory informing health care professionals of an increased risk of suicidality among youngsters taking antidepressants.
These findings, which appeared in the June American Journal of Psychiatry, have heightened the concerns of researchers and clinicians alike that suicide rates among untreated children and adolescents will rise unchecked. In fact, a study published in the February Pediatrics revealed an 18.2 percent increase in suicide from 2003 to 2004 among youngsters under the age of 20 (Psychiatric News, March 2).
READ MORE @ PSYCHIATRIC NEWS
Monday, June 18, 2007
Backlash on bipolar diagnoses in children
No one has done more to convince Americans that even small children can suffer the dangerous mood swings of bipolar disorder than Dr. Joseph Biederman of Massachusetts General Hospital.
From his perch as one of the world's most influential child psychiatrists, Biederman has spread far and wide his conviction that the emotional roller coaster of bipolar disorder can start "from the moment the child opened his eyes" at birth. Psychiatrists used to regard bipolar disorder as a disease that begins in young adulthood, but now some diagnose it in children scarcely out of diapers, treating them with powerful antipsychotic medications based on Biederman's work.
READ MORE @ BOSTON GLOBE
From his perch as one of the world's most influential child psychiatrists, Biederman has spread far and wide his conviction that the emotional roller coaster of bipolar disorder can start "from the moment the child opened his eyes" at birth. Psychiatrists used to regard bipolar disorder as a disease that begins in young adulthood, but now some diagnose it in children scarcely out of diapers, treating them with powerful antipsychotic medications based on Biederman's work.
READ MORE @ BOSTON GLOBE
Sunday, June 17, 2007
F.D.A. Panel Rejects Drug for Obesity
A drug once viewed as a possible magic bullet against obesity was rejected yesterday by a federal advisory panel because of worries that it causes neurological and psychiatric problems and increases the risk of suicide.
Although the drug, rimonabant, is already marketed in 37 countries, it is now unlikely that the FDA will approve its sale in the US without additional safety data.
The advisory panel voted unanimously, 14 to 0, against recommending the drug, saying there was inadequate evidence of its safety. The FDA is not required to follow the advice of such panels, but it typically does.
READ MORE @ NY TIMES
Although the drug, rimonabant, is already marketed in 37 countries, it is now unlikely that the FDA will approve its sale in the US without additional safety data.
The advisory panel voted unanimously, 14 to 0, against recommending the drug, saying there was inadequate evidence of its safety. The FDA is not required to follow the advice of such panels, but it typically does.
READ MORE @ NY TIMES
Saturday, June 16, 2007
Eli Lilly: Drug ads influencing patients
Eli Lilly, which has faced thousands of lawsuits over its anti-psychotic Zyprexa, says lawyers' ads about the drug are prompting some patients to stop taking mental illness medications when they shouldn't.
The advertising blitz "presents yet another barrier for patients who suffer from severe mental illness" and increases the risks that people will not get the care they need, said Carole Puls, a spokeswoman for the Indianapolis-based drug maker.
Lilly released the results of a company-funded survey that asked 402 psychiatrists who treat patients with bipolar disorder or schizophrenia to complete an online questionnaire. More than half of the participating psychiatrists said they believed their patients who stopped medication or reduced the dosage did so after seeing lawyers' advertisements about anti-psychotic drugs.
READ MORE @ AP
Eli Lilly: Lawyers' Ads Are Hurting Patients - Law.com
The advertising blitz "presents yet another barrier for patients who suffer from severe mental illness" and increases the risks that people will not get the care they need, said Carole Puls, a spokeswoman for the Indianapolis-based drug maker.
Lilly released the results of a company-funded survey that asked 402 psychiatrists who treat patients with bipolar disorder or schizophrenia to complete an online questionnaire. More than half of the participating psychiatrists said they believed their patients who stopped medication or reduced the dosage did so after seeing lawyers' advertisements about anti-psychotic drugs.
READ MORE @ AP
Eli Lilly: Lawyers' Ads Are Hurting Patients - Law.com
Friday, June 15, 2007
Gabapentin (Neurontin) Eases Chronic Pain in Fibromyalgia
For treating the chronic pain and other symptoms of fibromyalgia, the anticonvulsant gabapentin (Neurontin) proved safe and effective, researchers here reported.
In a 12-week randomized, double-blind clinical trial, patients taking gabapentin displayed significantly less pain, better sleep, and less fatigue than placebo controls, Lesley M. Arnold, M.D., of the University of Cincinnati, and colleagues reported in the April issue of Arthritis and Rheumatism.
READ MORE @ MEDPAGE TODAY
In a 12-week randomized, double-blind clinical trial, patients taking gabapentin displayed significantly less pain, better sleep, and less fatigue than placebo controls, Lesley M. Arnold, M.D., of the University of Cincinnati, and colleagues reported in the April issue of Arthritis and Rheumatism.
READ MORE @ MEDPAGE TODAY
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