Severe chronic obstructive pulmonary disease appears linked to lower cognitive function in older adults, making it more difficult for them to remember and perform daily tasks, a new study finds.
Researchers at Mount Sinai School of Medicine in New York City analyzed national data on 4,150 Americans aged 50 and older, including 492 with COPD. Of those, 153 had severe COPD. On a 35-point cognition scale, scores among all COPD patients declined an average of one-point between 1996 and 2002. Further analysis showed that patients with severe COPD had significantly lower scores than those without COPD.
"Our findings should raise awareness that adults with severe COPD are at greater risk for developing cognitive impairment, which may make managing their COPD more challenging, and will likely further worsen their general health and quality of life," study author Dr. William W. Hung said in a news release.
The results suggest that patients with severe COPD have a 22 percent increase in the difficulty they experience with daily tasks.
READ MORE @ FORBES
Tuesday, July 14, 2009
Monday, July 13, 2009
Map Of Your Brain May Reveal Early Mental Illness
John Csernansky wants to take your measurements. Not the circumference of your chest, waist and hips. No, this doctor wants to stretch a tape measure around your hippocampus, thalamus and prefrontal cortex.
OK, maybe not literally a tape measure, but he does want to chart the dimensions of the many structures in the human brain. From those measurements -- obtained from an MRI scan -- Csernansky will produce a map of the unique dips, swells and crevasses of the brains of individuals that he hopes will provide the first scientific tool for early and more definite diagnosis of mental disorders such as schizophrenia. Diagnosing the beginning stage of mental disorders remains elusive, although this when they are most treatable.
The shapes and measurements of brain structures can reveal how they function. Thus, Csernansky hopes his brain maps will reveal how the brains of humans with and without major mental disorders differ from each other and the time frame over which those differences develop.
READ MORE @ SCIENCE DAILY
OK, maybe not literally a tape measure, but he does want to chart the dimensions of the many structures in the human brain. From those measurements -- obtained from an MRI scan -- Csernansky will produce a map of the unique dips, swells and crevasses of the brains of individuals that he hopes will provide the first scientific tool for early and more definite diagnosis of mental disorders such as schizophrenia. Diagnosing the beginning stage of mental disorders remains elusive, although this when they are most treatable.
The shapes and measurements of brain structures can reveal how they function. Thus, Csernansky hopes his brain maps will reveal how the brains of humans with and without major mental disorders differ from each other and the time frame over which those differences develop.
READ MORE @ SCIENCE DAILY
Sunday, July 12, 2009
Childhood-onset schizophrenia remains a mystery
A study at the National Institute of Mental Health that has already spanned 18 years may yield crucial answers to the rare disorder.
So rare is the child form of schizophrenia, it has taken researchers at the National Institute of Mental Health 18 years to diagnosis and collect data on 110 children.
"We are trying to understand schizophrenia in a comprehensive way," says Dr. Nitin Gogtay, a researcher involved with the project in Bethesda, Md. "We see the illness in a very pure form. At that age, there are no confounding factors, like alcohol or drug abuse. We feel a lot of answers will come out of this study."
The study, the largest of its kind worldwide, has already yielded clues about the disease -- the most severe mental illness. Although schizophrenia afflicts about 1% of adults, it occurs in about one of every 30,000 to 50,000 children 13 and under. The causes of the disease are a mystery, although genes are known to play a role. In young children, a brain injury at or near the time of birth may contribute to its onset.
READ MORE @ LOS ANGELES TIMES
So rare is the child form of schizophrenia, it has taken researchers at the National Institute of Mental Health 18 years to diagnosis and collect data on 110 children.
"We are trying to understand schizophrenia in a comprehensive way," says Dr. Nitin Gogtay, a researcher involved with the project in Bethesda, Md. "We see the illness in a very pure form. At that age, there are no confounding factors, like alcohol or drug abuse. We feel a lot of answers will come out of this study."
The study, the largest of its kind worldwide, has already yielded clues about the disease -- the most severe mental illness. Although schizophrenia afflicts about 1% of adults, it occurs in about one of every 30,000 to 50,000 children 13 and under. The causes of the disease are a mystery, although genes are known to play a role. In young children, a brain injury at or near the time of birth may contribute to its onset.
READ MORE @ LOS ANGELES TIMES
Saturday, July 11, 2009
ANALYSIS-Drug companies fight the tide, and may win
Governments on both sides of the Atlantic are fighting settlements between big pharmaceutical companies and generic firms that delay marketing of cheap versions of brand-name drugs.
But don't write off the chances of Big Pharma, which has already shown impressive clout in both the legal and political arenas.
The settlements are reached after generic companies indicate they plan to bring out cheaper copies of brand-name drugs, and the drugs' makers accuse the generics of infringement.
The U.S. Federal Trade Commission says the settlements are illegal if generic entrances are delayed in exchange for payment, but drug companies say the deals are no more than settlements of what could be expensive litigation.
EU Competition Commissioner Neelie Kroes said this week that she was determined to oppose such settlements, which she said had pushed up European consumers' bills by 20 percent between 2000 and 2007. The FTC puts the cost for U.S. consumers and insurers at an additional $3.5 billion a year.
Drug companies say the settlements can save consumers money by bringing generics to market before patents expire, while eliminating the uncertainties of court trials.
READ MORE @ FORBES
But don't write off the chances of Big Pharma, which has already shown impressive clout in both the legal and political arenas.
The settlements are reached after generic companies indicate they plan to bring out cheaper copies of brand-name drugs, and the drugs' makers accuse the generics of infringement.
The U.S. Federal Trade Commission says the settlements are illegal if generic entrances are delayed in exchange for payment, but drug companies say the deals are no more than settlements of what could be expensive litigation.
EU Competition Commissioner Neelie Kroes said this week that she was determined to oppose such settlements, which she said had pushed up European consumers' bills by 20 percent between 2000 and 2007. The FTC puts the cost for U.S. consumers and insurers at an additional $3.5 billion a year.
Drug companies say the settlements can save consumers money by bringing generics to market before patents expire, while eliminating the uncertainties of court trials.
READ MORE @ FORBES
Friday, July 10, 2009
Elderly patients boost sales of dangerous antipsychotics
Bill Wiggins believes a powerful antipsychotic medication helped save his wife, Kathye.
Helen Shields believes one of these drugs helped kill her mother, Helen Marciniszyn.
Two families, two drugs, two stories that capture the extremes of a debate about using these medicines to treat the diseases of aging when there are no other effective alternatives.
Kathye Wiggins took Johnson & Johnson's Risperdal. Marciniszyn took AstraZeneca's Seroquel. Both drugs are atypical antipsychotics, a category of psychotropic drugs that also includes Zyprexa from Eli Lilly & Co., Abilify by Bristol-Myers Squibb Co., and Pfizer Inc.'s Geodon.
The federal government approved atypicals in the 1990s to treat schizophrenia and bipolar disorder. Since then, they have become popular for treating disorders including autism and Alzheimer's, despite mixed evidence that they help and ample evidence that they hurt.
Doctors prescribe atypicals for these illnesses because they may calm people and help them sleep. Also, patients with Alzheimer's and dementia can lose touch with reality, as schizophrenics do, so, in theory, atypicals could help.
Sales of atypicals rose to $14.36 billion in 2008 from $8.4 billion in 2003, according to data provider IMS Health.
Elderly patients have been a major source of that growth. Studies suggest that 20 percent to 30 percent of nursing-home residents take an atypical, despite not having a psychosis diagnosis.
READ MORE @ PHILADELPHIA INQUIRER
Helen Shields believes one of these drugs helped kill her mother, Helen Marciniszyn.
Two families, two drugs, two stories that capture the extremes of a debate about using these medicines to treat the diseases of aging when there are no other effective alternatives.
Kathye Wiggins took Johnson & Johnson's Risperdal. Marciniszyn took AstraZeneca's Seroquel. Both drugs are atypical antipsychotics, a category of psychotropic drugs that also includes Zyprexa from Eli Lilly & Co., Abilify by Bristol-Myers Squibb Co., and Pfizer Inc.'s Geodon.
The federal government approved atypicals in the 1990s to treat schizophrenia and bipolar disorder. Since then, they have become popular for treating disorders including autism and Alzheimer's, despite mixed evidence that they help and ample evidence that they hurt.
Doctors prescribe atypicals for these illnesses because they may calm people and help them sleep. Also, patients with Alzheimer's and dementia can lose touch with reality, as schizophrenics do, so, in theory, atypicals could help.
Sales of atypicals rose to $14.36 billion in 2008 from $8.4 billion in 2003, according to data provider IMS Health.
Elderly patients have been a major source of that growth. Studies suggest that 20 percent to 30 percent of nursing-home residents take an atypical, despite not having a psychosis diagnosis.
READ MORE @ PHILADELPHIA INQUIRER
Thursday, July 9, 2009
Delirium in hospitalized adults: Situation critical, no relief available
Every year as many as seven million adults in the United States experience delirium during hospitalization. In a systematic review of the scientific literature on delirium prevention and treatment, investigators from Indiana University School of Medicine, the Regenstrief Institute and Wishard Health Services found that despite the significant health and financial burdens of delirium for hospitalized adults, no effective way to prevent or treat the condition has been identified.
"Having delirium prolongs the length of a hospital stay, increases the risk of post-hospitalization transfer to a nursing home and doubles the risk of death. We need to identify a safe and effective drug to prevent and treat delirium. With our review we are challenging the scientific community to come up with new therapeutic options," said Malaz Boustani, M.D., senior author of the study which appears in the July 2009 issue of the Journal of General Internal Medicine. Dr. Boustani is a Regenstrief Institute investigator and associate professor of medicine at the IU School of Medicine.
Delirium, experienced by a significant number of older patients in surgical and critical care units and over half of older adults who are hospitalized for broken hips, is a state of confusion in which the individual has undergone a sudden alteration of mental status. Delirium is not dementia, but individuals with dementia are more susceptible to developing delirium during hospitalization than individuals without dementia.
The researchers found that only 13 randomized controlled studies on promising drugs for delirium were conducted from January 1966 to October 2008. These studies identified and evaluated 15 drugs including first and second generation antipsychotics, the drugs currently prescribed by most physicians for patients with delirium. The researchers found that neither older agents nor newer, more expensive medications were effective in preventing delirium. The study also found no difference between antipsychotics in treating delirium. To date, there are no U.S. Food and Drug Administration approved drugs to prevent or manage delirium according to Dr. Boustani.
READ MORE @ EUREKALERT
"Having delirium prolongs the length of a hospital stay, increases the risk of post-hospitalization transfer to a nursing home and doubles the risk of death. We need to identify a safe and effective drug to prevent and treat delirium. With our review we are challenging the scientific community to come up with new therapeutic options," said Malaz Boustani, M.D., senior author of the study which appears in the July 2009 issue of the Journal of General Internal Medicine. Dr. Boustani is a Regenstrief Institute investigator and associate professor of medicine at the IU School of Medicine.
Delirium, experienced by a significant number of older patients in surgical and critical care units and over half of older adults who are hospitalized for broken hips, is a state of confusion in which the individual has undergone a sudden alteration of mental status. Delirium is not dementia, but individuals with dementia are more susceptible to developing delirium during hospitalization than individuals without dementia.
The researchers found that only 13 randomized controlled studies on promising drugs for delirium were conducted from January 1966 to October 2008. These studies identified and evaluated 15 drugs including first and second generation antipsychotics, the drugs currently prescribed by most physicians for patients with delirium. The researchers found that neither older agents nor newer, more expensive medications were effective in preventing delirium. The study also found no difference between antipsychotics in treating delirium. To date, there are no U.S. Food and Drug Administration approved drugs to prevent or manage delirium according to Dr. Boustani.
READ MORE @ EUREKALERT
Wednesday, July 8, 2009
Antidepressants aid electroconvulsive therapy in treating severe depression
Combining antidepressant drugs with electroconvulsive therapy (ECT) does a better job of reducing symptoms of severe depression and causes less memory loss than using ECT alone, according to a new study by researchers at Wake Forest University School of Medicine and colleagues.
This finding could alleviate one of the primary concerns about ECT – that it causes memory loss, said W. Vaughn McCall, M.D., M.S, professor and chairman of the Department of Psychiatry and Behavioral Medicine and the principal investigator for the study's Wake Forest Baptist site.
The full study appears in the current issue of the Archives of General Psychiatry, published today.
ECT uses an electrical stimulus to the brain to induce seizures. It is prescribed for patients with crisis-level severe depression – who are catatonic (people who are so slowed down that they stop moving, talking and eating) or suicidal – or for patients with major depression who have not responded to medication. Electrodes attached to the head deliver the stimulus and patients are anesthetized and receive muscle relaxants during the procedure.
Patients receiving ECT often experience some memory loss that usually improves within days of treatment.
Researchers wanted to find a way to increase the effectiveness of ECT while reducing the side effects of memory loss.
READ MORE @ EUREKALERT
This finding could alleviate one of the primary concerns about ECT – that it causes memory loss, said W. Vaughn McCall, M.D., M.S, professor and chairman of the Department of Psychiatry and Behavioral Medicine and the principal investigator for the study's Wake Forest Baptist site.
The full study appears in the current issue of the Archives of General Psychiatry, published today.
ECT uses an electrical stimulus to the brain to induce seizures. It is prescribed for patients with crisis-level severe depression – who are catatonic (people who are so slowed down that they stop moving, talking and eating) or suicidal – or for patients with major depression who have not responded to medication. Electrodes attached to the head deliver the stimulus and patients are anesthetized and receive muscle relaxants during the procedure.
Patients receiving ECT often experience some memory loss that usually improves within days of treatment.
Researchers wanted to find a way to increase the effectiveness of ECT while reducing the side effects of memory loss.
READ MORE @ EUREKALERT
Tuesday, July 7, 2009
To predict the severity of mental disease, consider the family
We've all been asked at routine visits to the doctor to record our family's history with medical problems like cancer, diabetes or heart disease. But when it comes to mental disorders, usually mum's the word.
New findings by researchers at the Duke Institute for Genome Sciences & Policy (IGSP) make a strong case for changing that status quo. They have found that 30 minutes or less of question-and-answer about the family history of depression, anxiety, or substance abuse is enough to predict a patient's approximate risks for developing each disorder and how severe their future illness is likely to be.
"There are lots of kids with behavior problems who may outgrow them on their own without medication, versus the minority with mental illnesses that need treatment," said Terrie Moffitt, a professor of psychology and neuroscience in the IGSP. "Family history is the quickest and cheapest way to sort that out."
Researchers who are on the hunt for genes responsible for mental disorders might also take advantage of the discovery, added Avshalom Caspi, an IGSP investigator and professor of psychology and neuroscience. "It suggests they may be better off selecting people with more serious illness or, better still, collecting family history information directly," he said.
That mental illnesses tend to run in families is certainly no surprise. In fact, psychiatric conditions are some of the most heritable of all disorders. But the link between family history and the seriousness of psychiatric disease has been less certain.
Moffitt, Caspi and their colleagues looked to 981 New Zealanders born at a single hospital in 1972 or 1973, who are participants in what is known as the Dunedin Study. Researchers have been tracking the physical and mental health and lifestyles of those enrolled in the longitudinal study since they were 3 years old.
READ MORE @ EUREKALERT
New findings by researchers at the Duke Institute for Genome Sciences & Policy (IGSP) make a strong case for changing that status quo. They have found that 30 minutes or less of question-and-answer about the family history of depression, anxiety, or substance abuse is enough to predict a patient's approximate risks for developing each disorder and how severe their future illness is likely to be.
"There are lots of kids with behavior problems who may outgrow them on their own without medication, versus the minority with mental illnesses that need treatment," said Terrie Moffitt, a professor of psychology and neuroscience in the IGSP. "Family history is the quickest and cheapest way to sort that out."
Researchers who are on the hunt for genes responsible for mental disorders might also take advantage of the discovery, added Avshalom Caspi, an IGSP investigator and professor of psychology and neuroscience. "It suggests they may be better off selecting people with more serious illness or, better still, collecting family history information directly," he said.
That mental illnesses tend to run in families is certainly no surprise. In fact, psychiatric conditions are some of the most heritable of all disorders. But the link between family history and the seriousness of psychiatric disease has been less certain.
Moffitt, Caspi and their colleagues looked to 981 New Zealanders born at a single hospital in 1972 or 1973, who are participants in what is known as the Dunedin Study. Researchers have been tracking the physical and mental health and lifestyles of those enrolled in the longitudinal study since they were 3 years old.
READ MORE @ EUREKALERT
Monday, July 6, 2009
How does direct to consumer advertising affect the cost of medications
When one looks at television, a newspaper or a magazine it is impossible not to be inundated with ads for various prescription drug medications. This was not always the case. In fact, not until 1997, when the FDA issued its guidelines for direct to consumer advertising, did this massive pharmaceutical advertising expenditure begin.
It might interest some to know that only 2 countries in the world allow our brand of direct to consumer advertising of prescription drugs: the United State and New Zealand.
The amounts of money involved are staggering. A study done by the Kaiser Family Foundation in 2006 found that for every dollar a drug company spent on advertising, it earned $4 in additional sales. Doesn’t sound like much, does it?
But the real numbers put the impact in prospective. In 1999, just two years after the FDA permitted direct to consumer advertising in its current form, Pfizer spent 55 million advertising it’s cholesterol lowering drug, Lipitor. Sales of Lipitor jumped 56% that year to almost $2.6 billion.
As advertising spending went up, the amount of control exercised by the FDA fell. According to the New England Journal of Medicine, the FDA sent 142 violations letters to pharmaceutical companies in 1997. By 2006 the FDA sent only 21 violation letters.
READ MORE @ EXAMINER.COM
It might interest some to know that only 2 countries in the world allow our brand of direct to consumer advertising of prescription drugs: the United State and New Zealand.
The amounts of money involved are staggering. A study done by the Kaiser Family Foundation in 2006 found that for every dollar a drug company spent on advertising, it earned $4 in additional sales. Doesn’t sound like much, does it?
But the real numbers put the impact in prospective. In 1999, just two years after the FDA permitted direct to consumer advertising in its current form, Pfizer spent 55 million advertising it’s cholesterol lowering drug, Lipitor. Sales of Lipitor jumped 56% that year to almost $2.6 billion.
As advertising spending went up, the amount of control exercised by the FDA fell. According to the New England Journal of Medicine, the FDA sent 142 violations letters to pharmaceutical companies in 1997. By 2006 the FDA sent only 21 violation letters.
READ MORE @ EXAMINER.COM
Sunday, July 5, 2009
Schizophrenia genetically linked to other psychiatric disorders
A huge international study has discovered the first common genetic mutations involved in schizophrenia. The results show that schizophrenia shares some genetic links with other psychiatric problems, including bipolar disorder.
Three research consortia analysed the DNA of 15,000 people with schizophrenia and 50,000 health control subjects, to find differences between those with and without the disease. Their findings are published in Nature, the journal
Schizophrenia, which affects about 1 per cent of adults, tends to run in families. This tripartite study has uncovered a vast array of genetic variation that is estimated to account for about a third of the disease's total heritability.
"Each individual gene has a small effect, raising the [risk] of schizophrenia from 1 per cent to 1.2 per cent at most," said David Collier, of the Institute of Psychiatry, London.
While the findings do not provide any astonishing revelations, the international collaboration has been a "spectacular success", according to Dr Collier. It will lead soon to a better understanding of the biology of schizophrenia, though new diagnostic tests and treatments lie further in the future.
READ MORE @ FINANCIAL TIMES
Three research consortia analysed the DNA of 15,000 people with schizophrenia and 50,000 health control subjects, to find differences between those with and without the disease. Their findings are published in Nature, the journal
Schizophrenia, which affects about 1 per cent of adults, tends to run in families. This tripartite study has uncovered a vast array of genetic variation that is estimated to account for about a third of the disease's total heritability.
"Each individual gene has a small effect, raising the [risk] of schizophrenia from 1 per cent to 1.2 per cent at most," said David Collier, of the Institute of Psychiatry, London.
While the findings do not provide any astonishing revelations, the international collaboration has been a "spectacular success", according to Dr Collier. It will lead soon to a better understanding of the biology of schizophrenia, though new diagnostic tests and treatments lie further in the future.
READ MORE @ FINANCIAL TIMES
Saturday, July 4, 2009
Hoopla, and Disappointment, in Schizophrenia Research
The journal Nature held a big press conference in London Wednesday, at the World Conference of Science Journalists, to unveil three large studies of the genetics of schizophrenia. Press releases from five American and European institutions celebrated the findings, one using epithets like “landmark,” “major step forward,” and “real scientific breakthrough.” It was the kind of hoopla you’d expect for an actual scientific advance.
It seems to me the reports represent more of a historic defeat, a Pearl Harbor of schizophrenia research.
The defeat points solely to the daunting nature of the adversary, not to any failing on the part of the researchers, who were using the most advanced tools available. Still, who is helped by dressing up a severely disappointing setback as a “major step forward”?
The principal news from the three studies is that schizophrenia is caused by a very large number of errant genes, not a manageable and meaningful handful.
READ MORE @ NY TIMES
It seems to me the reports represent more of a historic defeat, a Pearl Harbor of schizophrenia research.
The defeat points solely to the daunting nature of the adversary, not to any failing on the part of the researchers, who were using the most advanced tools available. Still, who is helped by dressing up a severely disappointing setback as a “major step forward”?
The principal news from the three studies is that schizophrenia is caused by a very large number of errant genes, not a manageable and meaningful handful.
READ MORE @ NY TIMES
Friday, July 3, 2009
Long-Acting Risperidone Shows Benefits in Recent-Onset Schizophrenia: Presented at WCBP
Risperidone long-acting injectable (RLAI) is effective and well tolerated for the treatment of recent-onset schizophrenia, researchers stated here on June 30 at the 9th World Congress of Biological Psychiatry (WCBP).
Little is known about the use of long-acting injectable antipsychotics in recent-onset schizophrenia, and new atypical long-acting injectable psychotropic medications like RLAI may be a viable treatment option in this population, according to the researchers.
"Long-acting injectable antipsychotics have been traditionally reserved for treating poorly compliant, uncooperative, and severely ill patients with chronic schizophrenia," the authors noted in their poster presentation.
"Early in the course of illness, there are sound clinical reasons for using these agents," they wrote. For example, incomplete adherence to antipsychotics is common with high rates of relapse and incomplete symptom remission. Also, the early phase of illness can be a critical period since an aggressive relapsing course may produce accruing morbidity and persistent deficits, they added.
READ MORE @ DOCTOR'S GUIDE
Little is known about the use of long-acting injectable antipsychotics in recent-onset schizophrenia, and new atypical long-acting injectable psychotropic medications like RLAI may be a viable treatment option in this population, according to the researchers.
"Long-acting injectable antipsychotics have been traditionally reserved for treating poorly compliant, uncooperative, and severely ill patients with chronic schizophrenia," the authors noted in their poster presentation.
"Early in the course of illness, there are sound clinical reasons for using these agents," they wrote. For example, incomplete adherence to antipsychotics is common with high rates of relapse and incomplete symptom remission. Also, the early phase of illness can be a critical period since an aggressive relapsing course may produce accruing morbidity and persistent deficits, they added.
READ MORE @ DOCTOR'S GUIDE
Thursday, July 2, 2009
Olanzapine Effective for Bipolar Disorder in Naturalistic Setting: Presented at WCBP
Olanzapine, as monotherapy or combination therapy, significantly improves symptoms in patients with manic or mixed episodes of bipolar affective disorder, according to data reported here at the 9th World Congress of Biological Psychiatry (WCBP) on June 29.
Pavel Vohlidka, MD, Eli Lilly and Company, Basingstoke, United Kingdom, presented 12-week outcomes in 251 patients who received olanzapine as acute-phase treatment either alone or in tandem with other antipsychotics, anticonvulsants and/or lithium, and antidepressants.
All patients were being treated for manic or mixed episodes of bipolar affective disorder and were enrolled in the 24-month Mania and Olanzapine Treatment (MANOLA) study, which examined patterns of clinical use of olanzapine in a natural setting over a recent 4-year period.
In the current analysis, about one-third of patients received olanzapine as monotherapy and about two-thirds received the agent as part of combination therapy. The groups were similar in terms of baseline demographic and clinical characteristics.
The primary objective of the analysis was to evaluate changes in mania symptoms in both groups on the Clinical Global Impression-Bipolar Disorder (CGI-BP) scale: overall, mania, depression, hallucinations, delusions.
READ MORE @ DOCTOR'S GUIDE
Pavel Vohlidka, MD, Eli Lilly and Company, Basingstoke, United Kingdom, presented 12-week outcomes in 251 patients who received olanzapine as acute-phase treatment either alone or in tandem with other antipsychotics, anticonvulsants and/or lithium, and antidepressants.
All patients were being treated for manic or mixed episodes of bipolar affective disorder and were enrolled in the 24-month Mania and Olanzapine Treatment (MANOLA) study, which examined patterns of clinical use of olanzapine in a natural setting over a recent 4-year period.
In the current analysis, about one-third of patients received olanzapine as monotherapy and about two-thirds received the agent as part of combination therapy. The groups were similar in terms of baseline demographic and clinical characteristics.
The primary objective of the analysis was to evaluate changes in mania symptoms in both groups on the Clinical Global Impression-Bipolar Disorder (CGI-BP) scale: overall, mania, depression, hallucinations, delusions.
READ MORE @ DOCTOR'S GUIDE
Wednesday, July 1, 2009
Depression, Anxiety Bad for the Heart
Two new studies show that problems with the mind can play a significant role in problems of the heart.
One study found that anxiety and depression can increase the incidence of angina, the chest pain that sends many people to the doctor, said Dr. Mark Sullivan, professor of psychiatry and behavioral sciences at the University of Washington, and senior author of one of the reports in the June 29 online issue of Circulation.
"The overwhelming focus in the United States has been on ischemia," the blockage of heart arteries, Sullivan said. "That is pretty unique in the world. The rest of the world takes a much more multi-modal approach to chest pain. Ischemia is not the only or most important cause of what patients are feeling."
Stress tests and similar measures are properly used to assess ischemia in people with angina, Sullivan said. "But in addition to the kind of diagnostic studies done with stress tests, patients who have a lot of angina should be screened for anxiety and depression, because they could be very cost-effective targets for intervention," he said.
To prove that point, Sullivan and his colleagues studied 191 people with known ischemia who underwent stress testing and heart imaging. They found that 36 percent reported no angina in the previous month, with 35 percent reporting monthly incidents.
Of the 30 percent who had daily or weekly angina, psychological assessments, including a self-reporting anxiety and depression questionnaire, showed that 44 percent had significant anxiety and two-thirds had significant depression.
READ MORE @ ATLANTA JOURNAL CONSTITUTION
One study found that anxiety and depression can increase the incidence of angina, the chest pain that sends many people to the doctor, said Dr. Mark Sullivan, professor of psychiatry and behavioral sciences at the University of Washington, and senior author of one of the reports in the June 29 online issue of Circulation.
"The overwhelming focus in the United States has been on ischemia," the blockage of heart arteries, Sullivan said. "That is pretty unique in the world. The rest of the world takes a much more multi-modal approach to chest pain. Ischemia is not the only or most important cause of what patients are feeling."
Stress tests and similar measures are properly used to assess ischemia in people with angina, Sullivan said. "But in addition to the kind of diagnostic studies done with stress tests, patients who have a lot of angina should be screened for anxiety and depression, because they could be very cost-effective targets for intervention," he said.
To prove that point, Sullivan and his colleagues studied 191 people with known ischemia who underwent stress testing and heart imaging. They found that 36 percent reported no angina in the previous month, with 35 percent reporting monthly incidents.
Of the 30 percent who had daily or weekly angina, psychological assessments, including a self-reporting anxiety and depression questionnaire, showed that 44 percent had significant anxiety and two-thirds had significant depression.
READ MORE @ ATLANTA JOURNAL CONSTITUTION
Thursday, June 18, 2009
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
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
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
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
"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
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
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