Schizophrenia is one of the most debilitating of the major psychiatric disorders, and is also one of the most difficult to treat. Although numerous antipsychotic treatments are available, they can cause significant side effects and many patients experience only a partial relief of their symptoms and up to 30% no relief at all. In a new study scheduled for publication in the December 15th issue of Biological Psychiatry, Marder and colleagues examined the efficacy and safety of a new psychotropic agent for the treatment of schizophrenia in a 6-week, randomized, placebo-controlled trial.
The authors studied paliperidone extended-release (ER) tablets, an investigational drug which orally delivers the active metabolite of the drug risperidone, which is an already established efficacious antipsychotic. The authors recruited 444 patients who were experiencing an acute episode of schizophrenia and, after evaluating the severity of their symptoms, administered one of four treatments for 6 weeks: 6 mg or 12 mg/day of paliperidone ER, 10 mg/day of olanzapine (the active comparator), or placebo. During the six weeks of treatment, the investigators monitored the patients for side effects and assessed their symptom improvement.
READ MORE @ EUREKALERT
Friday, December 14, 2007
Thursday, December 13, 2007
British Psychiatrists Criticize Rise Of Bipolar Disorder In Adults, Children
David Healy and his colleague Joanna Le Noury have a new paper out, which examines the rise of bipolar disorder in both adults and children and puts it all in some kind of historical context. It's a lengthier examination of what Healy calls disease mongering than his PLoS paper of 2006. If you want to avoid my summary of this new piece, which I think is a withering attack on just about everyone in the mental health industry, then read their paper here (it's a .pdf file).
This is a lengthy post, but I think it's worth laying out the authors' key points since they are pushing back against some powerful forces in our culture and, at the end, asking if the bipolar child paradigm isn't a new form of Munchausen’s syndrome. I should also note that this site makes an appearance by inference in the article, which was published in the International Journal of Risk & Safety in Medicine.
READ MORE @ FURIOUS SEASONS
This is a lengthy post, but I think it's worth laying out the authors' key points since they are pushing back against some powerful forces in our culture and, at the end, asking if the bipolar child paradigm isn't a new form of Munchausen’s syndrome. I should also note that this site makes an appearance by inference in the article, which was published in the International Journal of Risk & Safety in Medicine.
READ MORE @ FURIOUS SEASONS
Wednesday, December 12, 2007
Possible Markers For Mental Illness Discovered
Researchers have discovered natural genetic differences that might help predict the most effective antipsychotic drugs for particular patients with mental disorders such as schizophrenia, Parkinson's and drug addiction.
They found the differences in the gene for a molecule called the dopamine D2 receptor (DRD2), a protein present on brain cells that are sensitive to the neurotransmitter dopamine.
The receptor is known to play a key role in memory and in a variety of mental illnesses. Most antipsychotic drugs work at least in part by blocking this protein, but scientists don't yet understand how this helps patients. Nor can they explain why some people respond well to certain antipsychotic drugs and others respond poorly.
READ MORE @ SCIENCE DAILY
They found the differences in the gene for a molecule called the dopamine D2 receptor (DRD2), a protein present on brain cells that are sensitive to the neurotransmitter dopamine.
The receptor is known to play a key role in memory and in a variety of mental illnesses. Most antipsychotic drugs work at least in part by blocking this protein, but scientists don't yet understand how this helps patients. Nor can they explain why some people respond well to certain antipsychotic drugs and others respond poorly.
READ MORE @ SCIENCE DAILY
Tuesday, December 11, 2007
How moods affect our health
HAVING AN ARGUMENT
As your irritation mounts, you can feel your blood pressure rising. And that's exactly what is happening to your body when you have an argument. The effects, it seems, can be lasting. In the week after the irritating incident, you just need to think about the argument and your blood pressure will rise again, according to research published in the International Journal of Psychophysiology. So if you've recently experienced a dispute, a seething irritation or a simple frustration, you could be best off forgetting about it.
A half-hour argument with your lover can also slow your body's ability to heal by at least a day. In couples who regularly argue, that healing time is doubled again. Researchers at Ohio State University discovered this by testing married couples with a suction device that created tiny blisters on their arm. When couples were then asked to talk about an area of disagreement that provoked strong emotions, the wounds took around 40 per cent longer to heal. This response, say researchers, was caused by a surge in cytokines – immune-molecules that trigger inflammation. Chronic high levels of these are linked to arthritis, diabetes, heart-disease and cancer.
READ MORE @ THE INDEPENDENT
As your irritation mounts, you can feel your blood pressure rising. And that's exactly what is happening to your body when you have an argument. The effects, it seems, can be lasting. In the week after the irritating incident, you just need to think about the argument and your blood pressure will rise again, according to research published in the International Journal of Psychophysiology. So if you've recently experienced a dispute, a seething irritation or a simple frustration, you could be best off forgetting about it.
A half-hour argument with your lover can also slow your body's ability to heal by at least a day. In couples who regularly argue, that healing time is doubled again. Researchers at Ohio State University discovered this by testing married couples with a suction device that created tiny blisters on their arm. When couples were then asked to talk about an area of disagreement that provoked strong emotions, the wounds took around 40 per cent longer to heal. This response, say researchers, was caused by a surge in cytokines – immune-molecules that trigger inflammation. Chronic high levels of these are linked to arthritis, diabetes, heart-disease and cancer.
READ MORE @ THE INDEPENDENT
Monday, December 10, 2007
Brain Differences Identified In Adolescents With Mental Illness
Puberty may have an impact on areas of the brain that contribute to bipolar disorder or schizophrenia in youth, according to a study presented December 7 at the annual meeting of the American College of Neuropsychopharmacology (ACNP).
Researchers studying the brains of youth with bipolar disorder (also known as manic depressive illness) and schizophrenia found that these children have size differences in some brain areas between these disorders and between genders. These changes exist in key areas of the brain that are involved in reward, motivation, sensory input, emotion and memory, and researchers say examining these areas can help researchers understand developmental processes that occur around the time mental disorders develop.
The brains of children with bipolar disorder are different from the brains of children with schizophrenia, and there are brain differences between boys and girls, and investigators say such findings can help them better understand gender's role in brain processes, and how it affects the development of mental illness. Additionally, they could help lay the foundation for identifying different possible treatment approaches to these illnesses in boys and girls.
READ MORE @ SCIENCE DAILY
Researchers studying the brains of youth with bipolar disorder (also known as manic depressive illness) and schizophrenia found that these children have size differences in some brain areas between these disorders and between genders. These changes exist in key areas of the brain that are involved in reward, motivation, sensory input, emotion and memory, and researchers say examining these areas can help researchers understand developmental processes that occur around the time mental disorders develop.
The brains of children with bipolar disorder are different from the brains of children with schizophrenia, and there are brain differences between boys and girls, and investigators say such findings can help them better understand gender's role in brain processes, and how it affects the development of mental illness. Additionally, they could help lay the foundation for identifying different possible treatment approaches to these illnesses in boys and girls.
READ MORE @ SCIENCE DAILY
Sunday, December 9, 2007
Research finds link between depression
Findings suggest patterns of risk in co-occurring conditions
Depression nearly triples the risk of death following a heart attack, even when accounting for other heart attack risk factors, according to research presented today at the American College of Neuropsychopharmacology (ACNP) annual meeting, which showed that among 360 depressed, post myocardial infarction patients followed for more than six years, those who did not recover from their depression in the first six months were more than twice as likely to die.
This study was one of several presented at a panel which examined the links between depression and vascular disease. “There is an unequivocal link between depression and heart disease, but it is not clear what causes this link,” said Alexander Glassman, M.D., Professor of Psychiatry at Columbia University, College of Physicians and Surgeons and ACNP member. “There is a whole series of factors that link depression and heart disease and we are just beginning to understand how antidepressants act in people who have these conditions together.” Additional risk factors that tend to be major medical predictors of death from a heart attack include the severity of the heart attack and variability in various measures of heart function during recovery.
READ MORE @ EUREKALERT
Depression nearly triples the risk of death following a heart attack, even when accounting for other heart attack risk factors, according to research presented today at the American College of Neuropsychopharmacology (ACNP) annual meeting, which showed that among 360 depressed, post myocardial infarction patients followed for more than six years, those who did not recover from their depression in the first six months were more than twice as likely to die.
This study was one of several presented at a panel which examined the links between depression and vascular disease. “There is an unequivocal link between depression and heart disease, but it is not clear what causes this link,” said Alexander Glassman, M.D., Professor of Psychiatry at Columbia University, College of Physicians and Surgeons and ACNP member. “There is a whole series of factors that link depression and heart disease and we are just beginning to understand how antidepressants act in people who have these conditions together.” Additional risk factors that tend to be major medical predictors of death from a heart attack include the severity of the heart attack and variability in various measures of heart function during recovery.
READ MORE @ EUREKALERT
Saturday, December 8, 2007
Flawed Studies Underscore Need for More Rigorous PTSD Research
Despite PTSD's prominence in a trauma-ridden world, therapies for the disorder rest on some very slim reeds, says the Institute of Medicine.
"Significant gaps" in the evidence underlying nearly all treatments for posttraumatic stress disorder make it impossible to judge their value, according to a study released in October by the Institute of Medicine (IOM).
Poorly designed and executed studies have failed to include enough veterans or account for important comorbidities like depression, substance abuse, or traumatic brain injury, said the IOM committee that conducted the study.
READ MORE @ PSYCHIATRIC NEWS
"Significant gaps" in the evidence underlying nearly all treatments for posttraumatic stress disorder make it impossible to judge their value, according to a study released in October by the Institute of Medicine (IOM).
Poorly designed and executed studies have failed to include enough veterans or account for important comorbidities like depression, substance abuse, or traumatic brain injury, said the IOM committee that conducted the study.
READ MORE @ PSYCHIATRIC NEWS
Friday, December 7, 2007
Antipsychotics, Nursing Homes And Abuse
Keeping them quiet down on the farm. That’s the tone of one story after another these days about how nursing homes increasingly give antipsychotics to patients, whether they need them or not. And of course, the tab is often picked up, unnecessarily by Medicaid, for instance. A couple of weeks ago, The St. Petersburg Times ran such a piece in which Barbara Hengstebeck, executive director of the Coalition to Protect America’s Elders in Tallahassee, Fla., offered an explanation: “A lot of people feel like the elderly in nursing homes are expendable.”
The latest spend-a-gram comes from The Wall Street Journal, which notes that the Centers for Medicare & Medicaid Services says nearly 21 percent of nursing-home patients who don’t have a psychosis diagnosis are on antipsychotic drugs. The use comes amid a wider debate about how to care for the rising numbers of seniors, many of whom have behavior problems stemming from dementia. And a big question, the paper writes, is whether to use a medical model - administering these meds as the way to alleviate distressing symptoms or trying to find other ways to help these patients.
READ MORE @ PHARMALOT
The latest spend-a-gram comes from The Wall Street Journal, which notes that the Centers for Medicare & Medicaid Services says nearly 21 percent of nursing-home patients who don’t have a psychosis diagnosis are on antipsychotic drugs. The use comes amid a wider debate about how to care for the rising numbers of seniors, many of whom have behavior problems stemming from dementia. And a big question, the paper writes, is whether to use a medical model - administering these meds as the way to alleviate distressing symptoms or trying to find other ways to help these patients.
READ MORE @ PHARMALOT
Wednesday, December 5, 2007
Newly-identified Exercise Gene Could Help With Depression
Boosting an exercise-related gene in the brain works as a powerful anti-depressant in mice--a finding that could lead to a new anti-depressant drug target, according to a Yale School of Medicine report in Nature Medicine.
"The VGF exercise-related gene and target for drug development could be even better than chemical antidepressants because it is already present in the brain," said Ronald Duman, professor of psychiatry and senior author of the study.
Depression affects 16 percent of the population in the United States, at a related cost of $83 billion each year. Currently available anti-depressants help 65 percent of patients and require weeks to months before the patients experience relief.
Duman said it is known that exercise improves brain function and mental health, and provides protective benefits in the event of a brain injury or disease, but how this all happens in the brain is not well understood. He said the fact that existing medications take so long to work indicates that some neuronal adaptation or plasticity is needed.
READ MORE @ SCIENCE DAILY
"The VGF exercise-related gene and target for drug development could be even better than chemical antidepressants because it is already present in the brain," said Ronald Duman, professor of psychiatry and senior author of the study.
Depression affects 16 percent of the population in the United States, at a related cost of $83 billion each year. Currently available anti-depressants help 65 percent of patients and require weeks to months before the patients experience relief.
Duman said it is known that exercise improves brain function and mental health, and provides protective benefits in the event of a brain injury or disease, but how this all happens in the brain is not well understood. He said the fact that existing medications take so long to work indicates that some neuronal adaptation or plasticity is needed.
READ MORE @ SCIENCE DAILY
Monday, December 3, 2007
Mental illness and drug addiction may co-occur due to disturbance in part of the brain
Why do mental illness and drug addiction so often go together" New research reveals that this type of dual diagnosis may stem from a common cause: developmental changes in the amylagda, a walnut-shaped part of the brain linked to fear, anxiety and other emotions. A full report on why these “comorbid” disorders may develop appears in the December Behavioral Neuroscience, published by the American Psychological Association (APA).
Dual diagnosis is common yet difficult to treat. Addiction of all types – to nicotine, alcohol and drugs – is often found in people with a wide variety of mental illnesses, including anxiety disorders, unipolar and bipolar depression, schizophrenia, and borderline and other personality disorders. Lead author Andrew Chambers, MD, cites clinical reports that at least half the people who seek help with addiction or mental-health treatment have co-occurring disorders. Epidemiological data says that from two to five of every 10 anxious or depressed people, and from four to eight of every 10 people with schizophrenia, bipolar disorder, or antisocial personality, also have some type of addiction.
READ MORE @ EUREKALERT
Dual diagnosis is common yet difficult to treat. Addiction of all types – to nicotine, alcohol and drugs – is often found in people with a wide variety of mental illnesses, including anxiety disorders, unipolar and bipolar depression, schizophrenia, and borderline and other personality disorders. Lead author Andrew Chambers, MD, cites clinical reports that at least half the people who seek help with addiction or mental-health treatment have co-occurring disorders. Epidemiological data says that from two to five of every 10 anxious or depressed people, and from four to eight of every 10 people with schizophrenia, bipolar disorder, or antisocial personality, also have some type of addiction.
READ MORE @ EUREKALERT
Sunday, December 2, 2007
One Gene Variant Puts Stressed Women At Risk For Depression; Has Opposite Effect In Men
A common variation in genes puts women who are under chronic stress at risk for increased depressive symptoms, but has the exact opposite effect in men, according to new findings from Duke University Medical Center researchers.
The researchers analyzed two independent samples of healthy individuals for the presence of a genetic variant that regulates levels of serotonin — a neurotransmitter that is linked to health in numerous ways, including emotion regulation.
One version of the gene puts women who are under chronic stress at risk for more severe depressive symptoms. But among men, the same gene variant appeared to be protective against depression. In fact, men with the opposite gene variant were the ones who experienced more depressive symptoms when under chronic stress.
READ MORE @ SCIENCE DAILY
The researchers analyzed two independent samples of healthy individuals for the presence of a genetic variant that regulates levels of serotonin — a neurotransmitter that is linked to health in numerous ways, including emotion regulation.
One version of the gene puts women who are under chronic stress at risk for more severe depressive symptoms. But among men, the same gene variant appeared to be protective against depression. In fact, men with the opposite gene variant were the ones who experienced more depressive symptoms when under chronic stress.
READ MORE @ SCIENCE DAILY
Saturday, December 1, 2007
Novel Antidepressant Agomelatin Targets Melatonin and Serotonin Receptors: Presented at CPA
The soon-to-be-available antidepressant agomelatin offers excellent efficacy with great tolerability and sleep improvements to boot.
Raymond W. Lam, MD, Professor and Head of Clinical Neuroscience, Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, Canada, presented the latest findings on this agent here at the 57th Annual Conference of the Canadian Psychiatric Association (CPA).
Agomelatin is a new antidepressant with a novel mechanism of action. It acts as an agonist to both the melatonin receptors MT1 and MT2. It is also an antagonist to the 5HT2C serotonin receptor. It also appears to have no other action in any other receptor site, and over 80 sites have been studied so far, said Dr. Lam.
Both the M1 and M2 receptors are known to be involved in regulation of circadian rhythms. Stimulation of M1 has a positive effect on sleep by attenuating the alerting signal produced by the suprachiasmatic nucleus (SCN) in the brain. M2 has a phase-shifting effect on circadian rhythms. Antagonism of the 5HT2C increases the activity of dopamine and noradrenalin in the frontal cortex, which can have both anxiolytic and antidepressant effects. It also promotes slow wave sleep or deep, restorative sleep.
READ MORE @ DOCTOR'S GUIDE
Raymond W. Lam, MD, Professor and Head of Clinical Neuroscience, Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, Canada, presented the latest findings on this agent here at the 57th Annual Conference of the Canadian Psychiatric Association (CPA).
Agomelatin is a new antidepressant with a novel mechanism of action. It acts as an agonist to both the melatonin receptors MT1 and MT2. It is also an antagonist to the 5HT2C serotonin receptor. It also appears to have no other action in any other receptor site, and over 80 sites have been studied so far, said Dr. Lam.
Both the M1 and M2 receptors are known to be involved in regulation of circadian rhythms. Stimulation of M1 has a positive effect on sleep by attenuating the alerting signal produced by the suprachiasmatic nucleus (SCN) in the brain. M2 has a phase-shifting effect on circadian rhythms. Antagonism of the 5HT2C increases the activity of dopamine and noradrenalin in the frontal cortex, which can have both anxiolytic and antidepressant effects. It also promotes slow wave sleep or deep, restorative sleep.
READ MORE @ DOCTOR'S GUIDE
Friday, November 30, 2007
Lifespan link to depression drug
An antidepressant drug lengthens tiny worms' lives and offers hope of humans living longer too, US scientists say.
In the study, detailed in journal Nature, nematode worms were exposed to 88,000 chemicals in turn and mianserin extended lifespan by almost a third.
The drug seems to mimic the effects on the body of the only known animal long-life regime - virtual starvation.
Experts said the findings might point to there being genes in humans that could be targeted to increase lifespan.
READ MORE @ BBC
In the study, detailed in journal Nature, nematode worms were exposed to 88,000 chemicals in turn and mianserin extended lifespan by almost a third.
The drug seems to mimic the effects on the body of the only known animal long-life regime - virtual starvation.
Experts said the findings might point to there being genes in humans that could be targeted to increase lifespan.
READ MORE @ BBC
Wednesday, November 28, 2007
Hormonal Changes And Depression: What Is The Connection?
Women are more susceptible to mood disorders and depression during hormonal transitions, such as pregnancy, postpartum and perimenopause, according to a new report by the Society for Women's Health Research, a Washington, D.C.-based advocacy organization, released at a media briefing held at the Palace Hotel in New York City.
The report summarizes a June 2007 thought leaders' roundtable of eight national experts convened by the Society and the National Institute of Mental Health to discuss current efforts to understand the effects of hormonal transitions on mood disorders in women and to make recommendations for future research.
READ MORE@MEDICAL NEWS TODAY
The report summarizes a June 2007 thought leaders' roundtable of eight national experts convened by the Society and the National Institute of Mental Health to discuss current efforts to understand the effects of hormonal transitions on mood disorders in women and to make recommendations for future research.
READ MORE@MEDICAL NEWS TODAY
Tuesday, November 27, 2007
Brain scans 'may detect OCD risk'
Brain scans may be able to reveal which people are at genetic risk of developing obsessive compulsive disorder (OCD), researchers say.
Individuals with OCD and their close relatives have distinctive patterns in their brain structure, a team at Cambridge University found.
The genes responsible remain unknown, but it appears they change the brain's anatomy, which may aid diagnosis.
The study is published in the latest edition of the journal Brain.
OCD is an anxiety disorder in which the person is compelled by irrational fears and thoughts to repeat seemingly needless actions over and over again.
It can manifest itself in repetitive behaviours, such as excessive hand washing, cleaning or repeated checking, affects 2%-3% of the population and is known to run in families.
READ MORE @ BBC
Individuals with OCD and their close relatives have distinctive patterns in their brain structure, a team at Cambridge University found.
The genes responsible remain unknown, but it appears they change the brain's anatomy, which may aid diagnosis.
The study is published in the latest edition of the journal Brain.
OCD is an anxiety disorder in which the person is compelled by irrational fears and thoughts to repeat seemingly needless actions over and over again.
It can manifest itself in repetitive behaviours, such as excessive hand washing, cleaning or repeated checking, affects 2%-3% of the population and is known to run in families.
READ MORE @ BBC
Monday, November 26, 2007
Transcranial Magnetic Stimulation Repels Severe Depression
Transcranial magnetic stimulation significantly reduces acute symptoms of major depression and offers an alternative to conventional therapy, investigators in a multicenter trial have concluded.
Patients treated with transcranial magnetic stimulation had almost a twofold higher remission rate at six weeks compared with patients who received sham therapy in the randomized study, John P. O'Reardon, M.D., of the University of Pennsylvania, and colleagues reported in the Dec. 1 issue of Biological Psychiatry.
As many as 40% of patients with major depression do not get adequate improvement in symptoms with medication and psychotherapy, the investigators noted. Depression may progress into treatment-resistant illness for which transcranial magnetic stimulation could be useful.
Transcranial magnetic stimulation involves discharge of a time-varying current from an insulated coil placed on the scalp surface. The discharge generates a brief dynamic magnetic field that induces current flow when reaching a conductive medium, such as neural tissue. The current offers the potential to modulate neural circuitry in a therapeutic fashion.
Patients treated with transcranial magnetic stimulation had almost a twofold higher remission rate at six weeks compared with patients who received sham therapy in the randomized study, John P. O'Reardon, M.D., of the University of Pennsylvania, and colleagues reported in the Dec. 1 issue of Biological Psychiatry.
As many as 40% of patients with major depression do not get adequate improvement in symptoms with medication and psychotherapy, the investigators noted. Depression may progress into treatment-resistant illness for which transcranial magnetic stimulation could be useful.
Transcranial magnetic stimulation involves discharge of a time-varying current from an insulated coil placed on the scalp surface. The discharge generates a brief dynamic magnetic field that induces current flow when reaching a conductive medium, such as neural tissue. The current offers the potential to modulate neural circuitry in a therapeutic fashion.
Sunday, November 25, 2007
Ritalin: The scandal of kiddy coke
When he was in the throes of his worst tantrums, Daniel Fletcher would rip wallpaper off the walls at home and hit and kick anyone who came near him.
Once, he put his pet mouse in the microwave. On another occasion he jumped out of a moving car.
He was first diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD) at the age of two, and just three years later the little boy was prescribed the amphetamine-like drug Ritalin.
The effect, says his mother Hayley, was a loss of appetite but no difference in his behaviour.
"So the doctor kept upping the doses until he was on six times the normal dose, yet he was still hyperactive."
Eight months ago, Daniel, now 14, was put on Risperdal - an antipsychotic drug usually given to schizophrenics.
"It was as if my son had been replaced by a doped-up zombie,' says Hayley, 35, who took him off it a month later.
READ MORE @ DAILY MAIL
Once, he put his pet mouse in the microwave. On another occasion he jumped out of a moving car.
He was first diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD) at the age of two, and just three years later the little boy was prescribed the amphetamine-like drug Ritalin.
The effect, says his mother Hayley, was a loss of appetite but no difference in his behaviour.
"So the doctor kept upping the doses until he was on six times the normal dose, yet he was still hyperactive."
Eight months ago, Daniel, now 14, was put on Risperdal - an antipsychotic drug usually given to schizophrenics.
"It was as if my son had been replaced by a doped-up zombie,' says Hayley, 35, who took him off it a month later.
READ MORE @ DAILY MAIL
Saturday, November 24, 2007
Trials in Obsessive Compulsive Disorder Highlight Group Therapy, Escitalopram, and Anticonvulsants: Presented at CPA
The latest research on the management of obsessive compulsive disorder (OCD) suggests that cognitive behaviour therapy (CBT) can be as effective in groups and in the office as it is in one-on-one sessions and in the home. Also, the antidepressant escitalopram and anticonvulsants topiramate and lamotrigine may play a more important therapeutic role than has previously been recognised.
Pratap Chokka, MD, Associate Clinical Professor, University of Alberta, Psychiatrist, Grey Nuns Hospital, Edmonton, Canada, presented the latest findings on the management of OCD here on November 17 at the 57th Annual Conference of the Canadian Psychiatric Association (CPA).
Currently, CBT is a mainstay of treatment for OCD. As a stand-alone treatment, it has been found in some studies to be as effective as antidepressants. While one-on-one CBT therapy was believed until recently to be the most effective option, 2007 data has revealed that, in fact, both individual and group therapy are effective. While response rates were faster with individual therapy, overall response rates were similar with both modalities. This is an important finding for a real world setting, where patients are often on waiting lists to receive CBT, said Dr. Chokka.
READ MORE @ DOCTOR'S GUIDE
Pratap Chokka, MD, Associate Clinical Professor, University of Alberta, Psychiatrist, Grey Nuns Hospital, Edmonton, Canada, presented the latest findings on the management of OCD here on November 17 at the 57th Annual Conference of the Canadian Psychiatric Association (CPA).
Currently, CBT is a mainstay of treatment for OCD. As a stand-alone treatment, it has been found in some studies to be as effective as antidepressants. While one-on-one CBT therapy was believed until recently to be the most effective option, 2007 data has revealed that, in fact, both individual and group therapy are effective. While response rates were faster with individual therapy, overall response rates were similar with both modalities. This is an important finding for a real world setting, where patients are often on waiting lists to receive CBT, said Dr. Chokka.
READ MORE @ DOCTOR'S GUIDE
Thursday, November 22, 2007
Dementia relief, with a huge side effect
The off-label use of some drugs is helping elderly patients, but may be killing thousands.
Two years ago, federal regulators sounded a dire warning: Elderly people with dementia who take drugs like Seroquel, Risperdal and Zyprexa could suffer the ultimate side effect.
They could die.
Yet today, about one in four nursing home residents still take these antipsychotic drugs. Sales to the elderly continue to rise, generating a total of $13-billion in revenues for their manufacturers this year.
The disconnect between government warnings about the increased risk of death and physician prescribing practices led a prominent Food and Drug Administration safety expert to make a stunning estimate.
Dr. David Graham, who had blown the whistle on the dangers of Vioxx, was back before a congressional panel in February. He testified that Zyprexa and other antipsychotics kill about 15,000 nursing home residents each year.
His pronouncement did not spark any followup investigations; it did not prompt government-sponsored research for safer alternatives. Instead, there was resounding silence.
READ MORE @ ST. PETERSBURG TIMES
Two years ago, federal regulators sounded a dire warning: Elderly people with dementia who take drugs like Seroquel, Risperdal and Zyprexa could suffer the ultimate side effect.
They could die.
Yet today, about one in four nursing home residents still take these antipsychotic drugs. Sales to the elderly continue to rise, generating a total of $13-billion in revenues for their manufacturers this year.
The disconnect between government warnings about the increased risk of death and physician prescribing practices led a prominent Food and Drug Administration safety expert to make a stunning estimate.
Dr. David Graham, who had blown the whistle on the dangers of Vioxx, was back before a congressional panel in February. He testified that Zyprexa and other antipsychotics kill about 15,000 nursing home residents each year.
His pronouncement did not spark any followup investigations; it did not prompt government-sponsored research for safer alternatives. Instead, there was resounding silence.
READ MORE @ ST. PETERSBURG TIMES
Wednesday, November 21, 2007
Study Questions 'Real World' Benefits of Newer Antipsychotics
The second-generation antipsychotics may not change the compromised neurobiology that underlies cognitive deficits.
Are the cognitive benefits claimed by manufacturers of second-generation antipsychotics an artificial result of repetitive practice in test conditions?
That's what a randomized trial of risperidone and olanzapine comparing cognitive improvements among first-episode schizophrenia patients and healthy controls suggests. Risperidone is marketed by Janssen Pharmaceutica as Risperdal, and olanzapine is marketed by Eli Lilly and Co. as Zyprexa.
The study, reported in the October Archives of General Psychiatry, found that the cognitive improvements among patients were consistent in magnitude with the "practice effects"—the effects of exposure, familiarity, and procedural learning that naturally occur in test conditions—seen in healthy patients.
READ MORE @ PSYCHIATRIC NEWS
Are the cognitive benefits claimed by manufacturers of second-generation antipsychotics an artificial result of repetitive practice in test conditions?
That's what a randomized trial of risperidone and olanzapine comparing cognitive improvements among first-episode schizophrenia patients and healthy controls suggests. Risperidone is marketed by Janssen Pharmaceutica as Risperdal, and olanzapine is marketed by Eli Lilly and Co. as Zyprexa.
The study, reported in the October Archives of General Psychiatry, found that the cognitive improvements among patients were consistent in magnitude with the "practice effects"—the effects of exposure, familiarity, and procedural learning that naturally occur in test conditions—seen in healthy patients.
READ MORE @ PSYCHIATRIC NEWS
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