Wednesday, January 28, 2009

Most Second-Generation Antipsychotics Effective for Treatment of Negative Schizophrenia Symptoms: Presented at EPA

Amisulpride and ziprasidone show better overall effects in comparison with other second-generation antipsychotics in the of negative symptoms of schizophrenia, according to results of 2 meta-analyses of randomised controlled trials.

Principal investigator Javier Rejas, MD, PhD, Medical Unit, Health Outcomes Research, Pfizer EspaƱa, Madrid, Spain, presented these results on January 27 here at the 17th European Congress of Psychiatry, organised by the European Psychiatric Association (EPA).

While research has demonstrated the efficacy of numerous first-generation antipsychotics, such as haloperidol, for treatment of positive symptoms of schizophrenia, negative symptoms are difficult to treat and can result in severe impairment and poor quality of life, said Dr. Rejas.

His research team therefore conducted 2 meta-analyses to compare the efficacy of second-generation antipsychotics versus haloperidol and versus placebo in the treatment of negative schizophrenia symptoms.

READ MORE @ DOCTOR'S GUIDE

Tuesday, January 27, 2009

Obama battles big pharma

Pfizer's latest mega deal reflects the threats faced by global drugs firms, not least from the new US president, says Alistair Dawber

"We will lower drug costs by allowing the importation of safe medicines from other developed countries, increasing the use of generic drugs in public programmes and taking on drug companies that block cheaper generic medicines from the market." The wording of President Obama's healthcare policy could not be clearer and should send a shiver through the boardroom of every major pharmaceutical group in the world.

For some time, the big players in the drugs market have faced a simple problem. Treatments that the likes of Pfizer, Novartis and GlaxoSmithKline (GSK) have spent years and millions of dollars developing are increasingly coming under threat from the generics companies, which invest nearly as much energy in challenging patents and developing cheaper alternatives. The established groups may consider the generics firms parasitical, but the likes of Barack Obama and the European Commission are tiring of the big beasts hiding behind patents ensuring that healthcare is more expensive to the ultimate user.

The European Commission said in November that the pharmaceutical groups are blocking the entry of new, cheaper drugs on to the market and that this cost EU healthcare providers, including the National Health Service, an estimated €3bn between 2000 and 2007. It added that it "will not hesitate to open antitrust cases against companies where there are indications that the antitrust rules may have been breached."

READ MORE @ INDEPENDENT

Monday, January 26, 2009

Hallucinations Are Rare Side Effects of ADHD Medications

Children who take medications for attention-deficit hyperactivity disorder (ADHD) may rarely experience some disturbing side effects, such as hallucinations.

U.S. government experts reviewed clinical trials and post-marketing reports of side effects from the commonly prescribed ADHD stimulant medications, such as Concerta, Ritalin and Strattera. They found that out of every 100 "person-years" of treatment, one or two children will experience serious side effects, such as hallucinations of bugs or snakes.

"Patients and physicians should be aware that psychosis or mania arising during drug treatment of attention-deficit hyperactivity disorder may represent adverse drug reactions, the study's authors wrote in the February issue Pediatrics.

READ MORE @ WASHINGTON POST

Sunday, January 25, 2009

Sex and Depression: In the Brain, if Not the Mind

As everyone knows, sex feels good.

Or does it? In recent years, I’ve come across several patients for whom sex is not just unpleasurable; it actually seems to cause harm.

One patient, a young man in his mid-20s, described it this way: “After sex, I feel literally achy and depressed for about a day.”

Otherwise, he had a clean bill of health, both medical and psychiatric: well adjusted, hard-working, lots of friends and a close-knit family.

Believe me, I could have cooked up an explanation very easily. He had hidden conflicts about sex, or he had ambivalent feelings about his partner. Who doesn’t?

But search as I could for a good explanation, I could find none. Though his symptoms and distress were quite real, I told him he did not have a major psychiatric problem that required treatment. He was clearly disappointed leaving my office.

READ MORE @ NY TIMES

Saturday, January 24, 2009

Pfizer said to be in talks to buy Wyeth

Pfizer's discussions to acquire Wyeth, the drug company that makes the antidepressant Effexor, have advanced, bringing the two pharmaceuticals giants closer to a potential merger, people briefed on the matter said Friday.

While no agreement had been reached, it was possible that a deal for Pfizer to buy Wyeth could be announced within days, said these people. Such a deal could be worth $60 billion or more, analysts say.

The merger would be popular among investors and analysts who have been pushing Pfizer to make a bold move. The drug maker has been struggling with flat revenue, diminishing returns on research and looming generic competition to Lipitor, the world's top-selling drug.

READ MORE @ INTERNATIONAL HERALD TRIBUNE

Friday, January 23, 2009

More Americans Skipping Necessary Prescriptions, Survey Finds

One in seven Americans under age 65 went without prescribed medicines in 2007 as drug costs spiraled upward in the United States, a nonprofit research group said on Thursday.

That figure is up substantially since 2003, when one in 10 people under 65 went without a prescription drug because they couldn’t afford it, according to the Center for Studying Health System Change in Washington, D.C.

The current figure may be even higher because of the recent economic downturn, said Laurie E. Felland, a senior health researcher at the center and lead author of the study.

“Our findings are particularly troublesome given the increased reliance on prescription drugs to treat chronic conditions,” she added. “People who go without their prescriptions experience worsening health and complications.”

The people who were least able to afford medicine were often those who needed it most, Ms. Felland said: uninsured, working-age adults suffering from at least one chronic medical condition. Almost two-thirds of them in the survey said they had gone without filling a prescription.

READ MORE @ NY TIMES

Thursday, January 22, 2009

People With Schizophrenia Say Bias Is Part of Their Lives

People with schizophrenia often expect to be discriminated against, and are, in various aspects of their life, new research finds.

The study, which included 732 people with schizophrenia in the United States and 26 other countries, found that 47 percent reported discrimination in making or keeping friends, 43 percent from family members, and 27 percent in intimate or sexual relationships. Also, 29 percent of the participants said they experienced discrimination while trying to find or keep a job.

What the study referred to as positive discrimination was reported by less than 5 percent of the participants.

The researchers also found that 64 percent of the participants didn't bother applying for work, training or education because they expected to fail or to face discrimination, and 55 percent anticipated discrimination when seeking a close relationship. However, more than a third of participants who expected these types of discrimination did not actually experience it.

READ MORE @ WASHINGTON POST

Wednesday, January 21, 2009

Antidepressant Has Modest Benefits in Anxious Older Patients

Treating generalized anxiety disorder in patients 60 and older with a selective serotinin reuptake inhibitor (SSRI) significantly improved their symptoms as long as they took the drug, researchers here said.

The response rate among patients taking escitalopram (Lexapro) for up to 12 weeks was 69%, compared with 51% assigned to placebo in a randomized trial (P=0.03), reported Eric J. Lenze, M.D., of Washington University, and colleagues in the Jan. 21 issue of the Journal of the American Medical Association.

There were significantly greater improvements with the active drug versus placebo for activity limitations, social function, worry questionnaire scores, and overall anxiety symptoms and role functioning, the researchers said.

But the researchers characterized the improvements in the 179-patient trial as "modest," and diminished further by nonadherence.

READ MORE @ MEDPAGE TODAY

Tuesday, January 20, 2009

ADHD Medication: Can Your Child Go Without? Behavioral therapy for ADHD—and parent retraining, too—can be good alternatives to medication

Attention deficit hyperactivity disorder can be a distressing diagnosis, but families have more treatment options than they might realize. Although Ritalin and other stimulant drugs are the most common prescription, ADHD treatments that don't involve medication have a proven track record. And here's a surprise: One of the most beneficial options treats the parents, not the child. For children, skills training programs and ADHD summer camps can help teach techniques to overcome everyday problems that often make life miserable, such as remembering to bring assignments home from school or to listen without interrupting.

How training parents helps the child. Parent skills training has been used for years to improve the behavior of children, and multiple clinical trials have validated its effectiveness. Those same programs improve the behavior of kids with ADHD. Although it may seem odd to be changing parents' behavior to treat what's considered a medical condition in children, research has found that for children with ADHD, having parents who use effective parenting techniques is one of the best predictors of success in adulthood. These programs teach parents to make clear, specific requests of children, for instance, and to use praise and rewards for good behavior far more often than punishment.

READ MORE @ U.S. NEWS & WORLD REPORT

Monday, January 19, 2009

New study: Bipolar disorder and schizophrenia are genetically linked

A new study suggests that if schizophrenia runs in a family, there's a good chance that bipolar disorder does as well (and vice versa). The findings, published today in the journal The Lancet, suggest that the two disorders are caused by some of the same genes.

"These findings say that [schizophrenia and bipolar disorder] are related, above all, for genetic reasons," says lead study author Paul Lichtenstein, a genetic epidemiologist at the Karolinska Institutet in Stockholm, Sweden. "[Therefore] it might not be a good idea to view these disorders as separate entities."

Lichtenstein and his colleagues (researchers from both the U.S. and Sweden) scoured the entire Swedish population for anyone with schizophrenia or bipolar disorder by reviewing psychiatric discharge data from all Swedish hospitals between 1973 and 2004.

READ MORE @ SCIENTIFIC AMERICAN

Sunday, January 18, 2009

No Long-Term Harm From Short-Term Placebo in Adolescent Depression Trials

Delaying active therapy for teens with major depression didn't impair long-term outcomes in the context of a clinical trial.

Patients on placebo for 12 weeks before switching to antidepressants or cognitive behavioral therapy showed no difference in 36-week response rate (82% versus 83%) compared with those on active treatment from the start of a large randomized trial, said Betsy D. Kennard, Psy.D., of the University of Texas Southwestern Medical Center at Dallas, and colleagues.

The 12-week delay in active therapy also had little impact on rates of suicidal events and symptom worsening, the researchers reported online in the American Journal of Psychiatry.

Although these findings support placebo treatment as an ethical course of action in a well-run pediatric clinical trial, Dr. Kennard emphasized that its use was not simply a matter of "wait and see" if a teen gets better.

READ MORE @ MEDPAGE TODAY

Friday, January 16, 2009

Study Finds Drug Risks With Newer Antipsychotics

The popular drugs known as atypical antipsychotics, prescribed for an array of conditions, including schizophrenia, autism and dementia, double patients’ risk of dying from sudden heart failure, a study has found.

The finding is the latest in a succession of recent reports contradicting the long-held assumption that the new drugs, which include Risperdal, Zyprexa and Seroquel, are safer than the older and much less expensive medications that they replaced.

The risk of death from the drugs is not high, on average about 3 percent in a person being treated at least 10 years, according to the study, published Thursday in The New England Journal of Medicine. Nor was the risk different from that of the older antipsychotic drugs.

But it was significant enough that an accompanying editorial urged doctors to limit their prescribing of antipsychotic drugs, especially to children and elderly patients,who can be highly susceptible to the drugs’ side effects, including rapid weight gain.

READ MORE @ NY TIMES

Thursday, January 15, 2009

Lilly to Pay Biggest Fine Ever to End Zyprexa Probe (Update7)

Eli Lilly & Co. will plead guilty to a charge of promoting its antipsychotic drug Zyprexa for unapproved uses and pay $1.42 billion, including the largest criminal fine ever imposed by the U.S. on an individual company.

The company admitted its marketing of Zyprexa was illegal in a civil and criminal settlement announced jointly today in a statement by Acting U.S. Attorney Laurie Magid and Attorney General Michael Mukasey. Lilly will also submit to U.S. monitoring against future lawbreaking.

Lilly resolved federal and state probes into how it marketed the drug and will make its guilty plea in U.S. District Court in Philadelphia in the next few weeks, the Indianapolis- based drugmaker said in a statement. Lilly said it promoted Zyprexa in elderly people to treat dementia, a use not approved by the Food and Drug Administration, between September 1999 and March 2001, a criminal violation of the Food, Drug and Cosmetic Act.

“Eli Lilly completely ignored the law” and made “hundred of millions of dollars” from its illegal promotion of Zyprexa, Magid said at a press conference in Philadelphia today. “We’re holding a company responsible for putting thousands and thousands of patients at risk.”

READ MORE @ BLOOMBERG

Wednesday, January 14, 2009

New Study: Antidepressants Help Patients with Fibromyalgia

Drugs traditionally used to treat depression are also effective in easing widespread pain, sleep disturbances and dismal moods associated with fibromyalgia syndrome (FMS), according to a large-scale analysis published today in JAMA The Journal of the American Medical Association. The study confirms earlier research about the meds' effect on symptoms associated with this mysterious disease.

Fibromyalgia, an often overlooked disorder believed to cause widespread muscle pain, sleep disturbances, depression and fatigue, affects up to 12 million people (4 percent of the U.S. population), nearly 11 million of them women. The degree of debilitation caused by the disease ranges "from very little to total," says Roland Staud, a professor of medicine at the University of Florida College of Medicine in Gainesville, adding that he has known some patients who have been bedridden for as long as a year because of symptoms, which typically appear between ages 40 and 60 and may last for the remainder of sufferers' lives.

Researchers do not know the cause of FMS and there is currently no cure. But psychiatrist Leslie Arnold, director of the Women's Health Research Program at the University of Cinncinnati's College of Medicine, says that both genetics and stress appear to play a role. Only two drugs have been approved by the U.S. Food and Drug Administration (FDA) to treat fibromyalgia—Cymbalta made by Eli Lilly (one of the antidepressants reviewed in this study) and Pfizer's Lyrica, an Rx to control seizures and pain.

READ MORE @ SCIENTIFIC AMERICAN

Tuesday, January 13, 2009

UPDATE 3-US lets drugmakers advise doctors on unapproved uses

U.S. health officials finalized guidelines that allow pharmaceutical companies to tell doctors about unapproved uses of their medicines, a practice opposed by critics of industry marketing.

The Food and Drug Administration (FDA) guidelines allow manufacturers such as Pfizer Inc (PFE.N) and Merck & Co (MRK.N) to distribute copies of medical journal articles that describe unapproved uses. The action could help companies expand the markets for medicines and medical devices.

The move, announced a week before Republican President George W. Bush leaves office, puts in place a policy that drew objections from congressional Democrats and drug-industry critics when it was proposed last year. Opponents say it will allow promotion of uses without adequate testing.

By law, manufacturers are prohibited from marketing their medicines for uses not approved by the FDA. But doctors can prescribe drugs for any use they see fit, a practice known as "off-label" use.

Distribution of medical literature suggesting a drug may have merit for an unapproved use is a marketing area that has been in dispute for years.

READ MORE @ REUTERS

Monday, January 12, 2009

Women-only gene link to dementia

Scientists have found a genetic risk factor for late onset Alzheimer's disease which is only carried by women.

The discovery is the first evidence to suggest that genetics may partly explain why more women than men tend to develop the disease.

The key variant was found in a gene on the X chromosome, of which females have two copies, but males only one.

The study, by the Mayo Clinic College of Medicine, features in the journal Nature Genetics.

The Mayo team carried out a detailed genetic analysis of patients with Alzheimer's diease.

They identified a particular variant of a gene called PCDH11X which appeared to be closely linked to a higher risk of the disease.

However, further analysis showed that the association was almost entirely restricted to women.

READ MORE @ BBC

Sunday, January 11, 2009

Economy prompts more calls to suicide hotlines

Many mental-health crisis and suicide hotlines are reporting a surge in calls from Americans feeling despair over financial losses.

It's unknown if the economic meltdown will lead to more suicides, says Lanny Berman, executive director of the Washington-based American Association of Suicidology. "Maybe the fact that so many are calling is a positive sign. They're seeking help."

Although suicides spiked during the Great Depression, they didn't increase in subsequent recessions, which lasted an average of 10 months, according to the suicidology group's website. The current recession is 13 months long and counting.

READ MORE @ USA TODAY

Saturday, January 10, 2009

One flew into the cuckoo's nest

First she posed as a man. Now Norah Vincent has gone under cover as a 'loony'. Alexander Linklater is intrigued by the result

To produce her first book, Self-Made Man, lesbian author Norah Vincent embarked on an adventure in "immersion journalism", spending a year disguised as a man. She emerged with a bestselling account of American masculinity and some unresolved mental-health issues. Though she does not clarify whether the strain of adopting a fake identity was a trigger, she suffered a depressive collapse towards the end of her research and wound up in a locked psychiatric ward.

Where Self-Made Man ended, her new book, Voluntary Madness, begins. After her breakdown, Vincent decided to re-enter the psychiatric system as a journalist, posing as a patient with a serious mental disorder. Unsurprisingly, as her immersion-narrative deepens, the distinction between Vincent as journalist and Vincent as patient dissolves. It turns out she has long suffered from depressive episodes that date back to a childhood trauma, the precise nature of which is revealed towards the end of her story.

READ MORE @ THE GUARDIAN

Friday, January 9, 2009

Antipsychotic Use in Elders With Alzheimer's Leads to Large Increase in Mortality

There is a large increased long-term risk of mortality in patients with Alzheimer's disease (AD) who are prescribed antipsychotic medication, according to the long-term follow-up results of the Dementia Antipsychotic Withdrawal Trial (DART-AD) published early online and in the February edition of The Lancet Neurology.

While there is evidence of modest short term benefits of antipsychotic treatment for the neuropsychiatric symptoms of AD, there is also clear evidence of an increase in adverse effects. However, all the data regarding mortality so far relate to short term follow-up of 12 weeks or less.

Clive Ballard, MD, Wolfson Centre for Age-Related Diseases, King's College London, London, United Kingdom, and colleagues have provided the first long-term follow-up data for AD patients given antipsychotic drugs.

READ MORE @ DOCTOR'S GUIDE

Thursday, January 8, 2009

Genetic Determinants Of ADHD Examined

A special issue of American Journal of Medical Genetics (AJMG): Part B: Neuropsychiatric Genetics presents a comprehensive overview of the latest progress in genetic research of Attention Deficit/Hyperactivity Disorder (ADHD). The issue covers major trends in the field of complex psychiatric genetics, underscoring how genetic studies of ADHD have evolved, and what approaches are needed to uncover its genetic origins.

ADHD is a complex condition with environmental and genetic causes. It is characterized by developmentally inappropriate levels of inattention, hyperactivity and impulsivity that has an onset in childhood. It is one of the most common psychiatric diseases, affecting between 8-12 percent of children worldwide. The drugs used to treat ADHD are highly effective, making ADHD one of the most treatable psychiatric disorders.

READ MORE @ SCIENCE DAILY