Harvard study found program made patients 29% more likely to stop, disrupt their meds
Restrictive prescription drug policies can cause schizophrenia patients to stop taking their medications, a Harvard Medical School study suggests.
Researchers looked at Medicare beneficiaries with schizophrenia in Maine before, during and after a policy that required patients to use an authorized medication (step treatment) before they were permitted to be prescribed drugs not on the preferred list. They were compared to Medicare beneficiaries with schizophrenia in New Hampshire, where there was no such regulation.
The study found that the Maine patients were 29 percent more likely to stop or disrupt medication when subject to the tightened policy. In addition, the restrictive drug policy -- originally designed to reduce costs -- provided only minimal savings.
READ MORE @ US NEWS & WORLD REPORT
Saturday, April 5, 2008
Friday, April 4, 2008
New Findings in Early-Onset Schizophrenia
The Treatment of Early-Onset Schizophrenia Spectrum Disorders (TEOSS) study, funded by the NIMH, was a multicenter, controlled treatment trial of children and adolescents.1 The aim of the TEOSS study was to compare the efficacy and safety of risperidone and olanzapine with that of a traditional antipsychotic agent—molindone.
In this double-blind, parallel-group study, patients were randomized to receive risperidone, olanzapine, or molindone for 8 weeks followed by a 44-week, double-blind maintenance phase for responders. A total of 119 children and adolescents were randomized in the study. The results of the study, which should be reported in the near future, will provide needed information about the safety and tolerability of antipsychotic medications in youths with schizophrenia spectrum disorders.
The clinical characteristics of this large sample were recently reported and provide important information about the demographics and severity of illness in children and adolescents with early-onset schizophrenia and schizoaffective disorder.2 The mean age of onset of illness was 11.1 years. At the time of enrollment, the mean age of the patients was 13.8 years. The sex distribution was 66% male and 34% female. The racial breakdown was 62% white, 31% African Amer-ican, 3.4% Asian, 2.5% mixed, and 0.8% Pacific Islander. The average IQ of the sample was 93. Most of the youths lived with their family, 4% were hospitalized, and 7% lived in a group home or residential facility.
READ MORE @ PSYCHIATRIC TIMES
In this double-blind, parallel-group study, patients were randomized to receive risperidone, olanzapine, or molindone for 8 weeks followed by a 44-week, double-blind maintenance phase for responders. A total of 119 children and adolescents were randomized in the study. The results of the study, which should be reported in the near future, will provide needed information about the safety and tolerability of antipsychotic medications in youths with schizophrenia spectrum disorders.
The clinical characteristics of this large sample were recently reported and provide important information about the demographics and severity of illness in children and adolescents with early-onset schizophrenia and schizoaffective disorder.2 The mean age of onset of illness was 11.1 years. At the time of enrollment, the mean age of the patients was 13.8 years. The sex distribution was 66% male and 34% female. The racial breakdown was 62% white, 31% African Amer-ican, 3.4% Asian, 2.5% mixed, and 0.8% Pacific Islander. The average IQ of the sample was 93. Most of the youths lived with their family, 4% were hospitalized, and 7% lived in a group home or residential facility.
READ MORE @ PSYCHIATRIC TIMES
Wednesday, April 2, 2008
Medication 'worsens Alzheimer's
Anti-psychotic drugs commonly given to Alzheimer's patients often make their condition worse, a UK study suggests.
Neuroleptics provided no benefit for patients with mild behavioural problems, but were associated with a marked deterioration in verbal skills.
The research focused on 165 people with advanced Alzheimer's who were living in nursing homes in four British cities.
Up to 60% of Alzheimer's patients in nursing homes are given the drugs to control behaviour such as aggression.
The study appears in the journal Public Library of Science Medicine.
The researchers, from Kings College London and the Universities of Oxford and Newcastle, found the drugs offered no long-term benefit for most patients with mild symptoms of disturbed behaviour.
But just six months of treatment was enough for patients to show a marked deterioration in their verbal fluency.
READ MORE @ BBC
Neuroleptics provided no benefit for patients with mild behavioural problems, but were associated with a marked deterioration in verbal skills.
The research focused on 165 people with advanced Alzheimer's who were living in nursing homes in four British cities.
Up to 60% of Alzheimer's patients in nursing homes are given the drugs to control behaviour such as aggression.
The study appears in the journal Public Library of Science Medicine.
The researchers, from Kings College London and the Universities of Oxford and Newcastle, found the drugs offered no long-term benefit for most patients with mild symptoms of disturbed behaviour.
But just six months of treatment was enough for patients to show a marked deterioration in their verbal fluency.
READ MORE @ BBC
Tuesday, April 1, 2008
Psychiatric drugs causing weight gain: doctors
The very drugs millions of Canadians are taking to get through their day can cause dramatic weight gain, doctors are warning.
Psychiatric drug-related weight gain "is a huge problem," says Dr. David Lau, chair of the diabetes and endocrine research group at the University of Calgary and president of Obesity Canada.
"You can see patients gaining 10, 20, 30, 40 pounds," Lau says.
Not everyone taking antidepressants, mood stabilizers or newer generation antipsychotics will gain weight, he stressed. What's more, he said new antipsychotics, so-called "atypical antipsychotics" have been "tremendous in terms of bringing back the functionality of people with schizophrenia, bipolar disorders and depression."
But Harvard University psychologist Paula Caplan warns of a vicious cycle, where patients who experience weight gain after taking psychotropic drugs are reluctant to discontinue their use.
"If they gain weight, they think 'I can avoid fast foods, or I can take smaller portion sizes or I can exercise more.' But to think, 'go off my medication that I believe is responsible for my being able to function, is too scary.'"
READ MORE@ VANCOUVER SUN
Psychiatric drug-related weight gain "is a huge problem," says Dr. David Lau, chair of the diabetes and endocrine research group at the University of Calgary and president of Obesity Canada.
"You can see patients gaining 10, 20, 30, 40 pounds," Lau says.
Not everyone taking antidepressants, mood stabilizers or newer generation antipsychotics will gain weight, he stressed. What's more, he said new antipsychotics, so-called "atypical antipsychotics" have been "tremendous in terms of bringing back the functionality of people with schizophrenia, bipolar disorders and depression."
But Harvard University psychologist Paula Caplan warns of a vicious cycle, where patients who experience weight gain after taking psychotropic drugs are reluctant to discontinue their use.
"If they gain weight, they think 'I can avoid fast foods, or I can take smaller portion sizes or I can exercise more.' But to think, 'go off my medication that I believe is responsible for my being able to function, is too scary.'"
READ MORE@ VANCOUVER SUN
Monday, March 31, 2008
Second-Generation Antipsychotics Are No Better Than First-Generation Drugs for Schizophrenia
Second-generation antipsychotic drugs are not necessarily better than the first-generation drug haloperidol at treating a first episode of schizophrenia. This is the conclusion of authors of an article published in this week's issue of The Lancet.
Second-generation drugs, introduced over a decade ago, are purported to be more effective and less likely to induce motor side effects, such as stiffness and tremors, than first-generation drugs. However, results from studies comparing the 2 types of drugs have not been reliable -- studies have over-represented men and under-represented those with other issues such as drug abuse. Moreover, these trials were often too short. The question of which drugs are more effective is an important one, as many of the newer drugs are more expensive.
READ MORE @ DOCTOR'S GUIDE
Second-generation drugs, introduced over a decade ago, are purported to be more effective and less likely to induce motor side effects, such as stiffness and tremors, than first-generation drugs. However, results from studies comparing the 2 types of drugs have not been reliable -- studies have over-represented men and under-represented those with other issues such as drug abuse. Moreover, these trials were often too short. The question of which drugs are more effective is an important one, as many of the newer drugs are more expensive.
READ MORE @ DOCTOR'S GUIDE
Sunday, March 30, 2008
Combination of Antidepressants Linked to Risk of Diabetes
The use of two types of antidepressants at the same time was associated with an increased risk for type 2 diabetes, a nested case-control study showed.
Patients taking both a tricyclic antidepressant and a selective serotonin reuptake inhibitor (SSRI) were nearly twice as likely to develop type 2 diabetes as those taking a tricyclic antidepressant alone, Jeffrey Johnson, Ph.D., of the University of Alberta, and colleagues reported in the January issue of Diabetes Research and Clinical Practice.
"If our findings are confirmed by others," they concluded, "it could be that antidepressant therapy will need to be tailored to depressed individuals' risk of developing diabetes, and that patients on combination therapy will require vigilance regarding the development of glucose intolerance."
The increased risk of diabetes in depressed patients is well-documented, the researchers said, but the mechanisms are unknown.
READ MORE @ MEDPAGE TODAY
Patients taking both a tricyclic antidepressant and a selective serotonin reuptake inhibitor (SSRI) were nearly twice as likely to develop type 2 diabetes as those taking a tricyclic antidepressant alone, Jeffrey Johnson, Ph.D., of the University of Alberta, and colleagues reported in the January issue of Diabetes Research and Clinical Practice.
"If our findings are confirmed by others," they concluded, "it could be that antidepressant therapy will need to be tailored to depressed individuals' risk of developing diabetes, and that patients on combination therapy will require vigilance regarding the development of glucose intolerance."
The increased risk of diabetes in depressed patients is well-documented, the researchers said, but the mechanisms are unknown.
READ MORE @ MEDPAGE TODAY
Friday, March 28, 2008
Study Hints of Gene Link to Risk of Schizophrenia
A new study has found that rare and previously undetectable genetic variations may significantly increase the risk that a person will develop schizophrenia.
Experts said the study, while not identifying the cause of the disorder, provided a striking demonstration of how new gene-scanning technology can open a new frontier in the quest to understand the biology of mental disorders.
Until now, researchers had focused on finding common and known genetic variations that, when acting in some combination, might increase the risk for schizophrenia. They have had little success. The new analysis, being published Friday in the journal Science, detected extremely rare and unknown mutations that turned up three to four times as often in people with schizophrenia as in those without it.
The findings point scientists to previously unappreciated developmental problems that may help them develop more effective treatments, experts said.
READ MORE @ NY TIMES
Experts said the study, while not identifying the cause of the disorder, provided a striking demonstration of how new gene-scanning technology can open a new frontier in the quest to understand the biology of mental disorders.
Until now, researchers had focused on finding common and known genetic variations that, when acting in some combination, might increase the risk for schizophrenia. They have had little success. The new analysis, being published Friday in the journal Science, detected extremely rare and unknown mutations that turned up three to four times as often in people with schizophrenia as in those without it.
The findings point scientists to previously unappreciated developmental problems that may help them develop more effective treatments, experts said.
READ MORE @ NY TIMES
Thursday, March 27, 2008
Clozapine Better Than "High-Dose" Olanzapine for the Treatment of Adolescents With Schizophrenia
The results of a 12-week, double-blind, randomised study published in the March issue of Biological Psychiatry suggest that clozapine is more effective than "high-dose" olanzapine for the treatment of children and adolescents with schizophrenia who do not respond to standard, first-line antipsychotic treatment.
There is a wealth of scientific literature available on the treatment of adults with schizophrenia. However, there is a paucity of data to guide the treatment of children and adolescents with schizophrenia.
"Although the US Food and Drug Administration has recently approved the use of aripiprazole and risperidone for adolescents with schizophrenia, few controlled data are available to help guide clinicians regarding the management of children and adolescents with schizophrenia who fail to respond to these standard 'first-line' antipsychotic treatments," according to Dr. Sanjiv Kumra, University of Minnesota, Minneapolis, Minnesota, one of the authors of the study.
READ MORE @ DOCTOR'S GUIDE
There is a wealth of scientific literature available on the treatment of adults with schizophrenia. However, there is a paucity of data to guide the treatment of children and adolescents with schizophrenia.
"Although the US Food and Drug Administration has recently approved the use of aripiprazole and risperidone for adolescents with schizophrenia, few controlled data are available to help guide clinicians regarding the management of children and adolescents with schizophrenia who fail to respond to these standard 'first-line' antipsychotic treatments," according to Dr. Sanjiv Kumra, University of Minnesota, Minneapolis, Minnesota, one of the authors of the study.
READ MORE @ DOCTOR'S GUIDE
Wednesday, March 26, 2008
Drug bill would give doctors unbiased details on medication
Imagine our doctors getting an unbiased education on the medications they prescribe instead of having to rely on drug company sales reps to tell them what's on the market and how well it works.
That's already happening in other countries -- Australia, England, the Netherlands and some provinces of Canada. It's happening -- or about to -- in some parts of the United States, too, including Maine, Pennsylvania, South Carolina, Vermont and Washington, D.C.
Ohio and the rest of the nation could see the same thing if a couple of U.S. senators get their way.
Democrats Herb Kohl of Wisconsin and Dick Durbin of Illinois are writing a bill that would provide accurate and objective drug information to any doctor in America who wants it.
Government-funded pharmacists and nurses who've studied the drugs -- all of them, even generics and over-the-counter ones -- and who understand their pros and cons would prepare the information and present it to doctors interested in having it. And the information would be available to consumers, those of us who end up having to take this stuff.
READ MORE @ THE PLAIN DEALER
That's already happening in other countries -- Australia, England, the Netherlands and some provinces of Canada. It's happening -- or about to -- in some parts of the United States, too, including Maine, Pennsylvania, South Carolina, Vermont and Washington, D.C.
Ohio and the rest of the nation could see the same thing if a couple of U.S. senators get their way.
Democrats Herb Kohl of Wisconsin and Dick Durbin of Illinois are writing a bill that would provide accurate and objective drug information to any doctor in America who wants it.
Government-funded pharmacists and nurses who've studied the drugs -- all of them, even generics and over-the-counter ones -- and who understand their pros and cons would prepare the information and present it to doctors interested in having it. And the information would be available to consumers, those of us who end up having to take this stuff.
READ MORE @ THE PLAIN DEALER
Tuesday, March 25, 2008
The Increasing Use Of Antidepressants: Some Reasons For Concern
Two articles in the March issue of the European Journal Psychotherapy and Psychosomatics raise serious concern about the increasing use of antidepressant medications. In the first article, David Healy and collaborators (University of Cardiff) formulate a critique of many studies which try to support the use of antidepressants on the basis of variations in suicide rates.
The Authors compare suicide rates in the Nordic countries with autopsy and ill-defined death rates, and antidepressant sales, during the period 1961 through to 2003, finding a close correlation between suicide rates and both autopsy and ill-defined death rates.The Authors conclude that the role of autopsies and other factors in the registration of a death as a suicide appear to need further clarification.
In another article Mojtabai and collaborators analyze the increase in antidepressant medication in the US in the past decade in two US general population surveys.
READ MORE @ MEDICAL NEWS TODAY
The Authors compare suicide rates in the Nordic countries with autopsy and ill-defined death rates, and antidepressant sales, during the period 1961 through to 2003, finding a close correlation between suicide rates and both autopsy and ill-defined death rates.The Authors conclude that the role of autopsies and other factors in the registration of a death as a suicide appear to need further clarification.
In another article Mojtabai and collaborators analyze the increase in antidepressant medication in the US in the past decade in two US general population surveys.
READ MORE @ MEDICAL NEWS TODAY
Monday, March 24, 2008
Know Suicide's Warning Signs - More people likely to take their lives in the spring, doctors say
While many people view spring as a time of renewal and hope, the greatest number of suicides in the United States occur each year in April and May, notes the American College of Emergency Physicians.
It's not clear why suicide rates spike in the spring, said ACEP President Dr. Linda L. Lawrence. But "we do know that suicide is the 11th leading cause of death for all ages in the United States, with one suicide occurring every 16 minutes or about 11 suicides per 100,000 people," she said in a prepared statement.
"Moreover, suicide is the second leading cause of death among 25- to 34-year-olds and the third leading cause of death among 15- to 24-year-olds. Men take their own lives nearly four times more often than women, with men ages 75 and older having the highest rate of suicide, although over a lifetime, women attempt suicide two to three times as often as men," Lawrence said.
READ MORE @ US NEWS & WORLD REPORT
It's not clear why suicide rates spike in the spring, said ACEP President Dr. Linda L. Lawrence. But "we do know that suicide is the 11th leading cause of death for all ages in the United States, with one suicide occurring every 16 minutes or about 11 suicides per 100,000 people," she said in a prepared statement.
"Moreover, suicide is the second leading cause of death among 25- to 34-year-olds and the third leading cause of death among 15- to 24-year-olds. Men take their own lives nearly four times more often than women, with men ages 75 and older having the highest rate of suicide, although over a lifetime, women attempt suicide two to three times as often as men," Lawrence said.
READ MORE @ US NEWS & WORLD REPORT
Sunday, March 23, 2008
Seriously Depressed Teens Respond to Combined Therapy
"If at first..." Many high-risk teenagers with depression show improvement on treatment combining medication with cognitive-behavioral therapy.
Over half of adolescents who don't respond to a first antidepressant improve when switched to a combination of a different antidepressant and cognitive-behavioral therapy (CBT). This is a key finding of an NIMH-funded clinical trial, the Treatment of SSRI-Resistant Depression in Adolescents (TORDIA).
Previous trials have shown that SSRI antidepressants or CBT or the combination can produce an adequate clinical response in up to 60 percent of treated adolescents, the authors noted, but, "There are no empirical studies to guide clinicians regarding the management of adolescents with depression not responsive to an initial treatment with an SSRI."
Previously, the Treatment of Adolescent Depression Study (TADS) demonstrated a similar benefit for combined therapy, but it tested a treatment-naïve group of depressed adolescents. TORDIA differed in two ways from TADS. It was aimed at youth who had not responded to a first round of treatment, and it included more chronically depressed adolescents (averaging two years) and more with suicidal ideation (59 percent)—groups often excluded from clinical trials, said lead author David Brent, M.D., in an interview with Psychiatric News.
READ MORE @ PSYCHIATRIC NEWS
Over half of adolescents who don't respond to a first antidepressant improve when switched to a combination of a different antidepressant and cognitive-behavioral therapy (CBT). This is a key finding of an NIMH-funded clinical trial, the Treatment of SSRI-Resistant Depression in Adolescents (TORDIA).
Previous trials have shown that SSRI antidepressants or CBT or the combination can produce an adequate clinical response in up to 60 percent of treated adolescents, the authors noted, but, "There are no empirical studies to guide clinicians regarding the management of adolescents with depression not responsive to an initial treatment with an SSRI."
Previously, the Treatment of Adolescent Depression Study (TADS) demonstrated a similar benefit for combined therapy, but it tested a treatment-naïve group of depressed adolescents. TORDIA differed in two ways from TADS. It was aimed at youth who had not responded to a first round of treatment, and it included more chronically depressed adolescents (averaging two years) and more with suicidal ideation (59 percent)—groups often excluded from clinical trials, said lead author David Brent, M.D., in an interview with Psychiatric News.
READ MORE @ PSYCHIATRIC NEWS
Saturday, March 22, 2008
Practicing Patients
Todd Small was stuck in quicksand again. It happened, as always, on the floor of the Seattle machine shop where he worked. His shift complete, Small was making the 150-yard walk from his workstation to his car, when he realized that his left leg was sinking deep in the stuff. Though this had happened before — it happened nearly every day now — he stopped and glanced down at his feet. His Nikes looked normal, still firmly planted on the shop’s concrete floor. But he was stuck, just the same. His brain was sending an electrical pulse saying “walk,” but as the signal streaked from his cerebellum and down his spinal cord, it snagged on scar tissue where the myelin layer insulating his nerve fibers had broken down. The message wasn’t getting to his hip flexors or his hamstrings or his left foot. That connection had been severed by his multiple sclerosis. And once again, Small was left with the feeling that, as he described it, “I’m up to my waist in quicksand.”
For the 400,000 Americans with multiple sclerosis, Todd Small’s description will most likely ring true. Muscle stiffness is a hallmark of the disease, and “foot drop” — the term for Small’s quicksand feeling — is a frequent complaint. The condition is usually treated, as it was in Small’s case, with baclofen, a muscle relaxant that works directly on the spinal cord. Every day for 14 years, he took a single 10-milligram pill. “My neurologist always told me if you take too much it will weaken your muscles. So I never wanted to go over 10 milligrams.” It didn’t seem to have much effect, but he carried on as best he could.
Small would have continued just as he was had he not logged on last June to a Web site called PatientsLikeMe. He expected the sort of online community he’d tried and abandoned several times before — one abundant in sympathy and stories but thin on practical information. But he found something altogether different: data.
READ MORE @ NY TIMES
For the 400,000 Americans with multiple sclerosis, Todd Small’s description will most likely ring true. Muscle stiffness is a hallmark of the disease, and “foot drop” — the term for Small’s quicksand feeling — is a frequent complaint. The condition is usually treated, as it was in Small’s case, with baclofen, a muscle relaxant that works directly on the spinal cord. Every day for 14 years, he took a single 10-milligram pill. “My neurologist always told me if you take too much it will weaken your muscles. So I never wanted to go over 10 milligrams.” It didn’t seem to have much effect, but he carried on as best he could.
Small would have continued just as he was had he not logged on last June to a Web site called PatientsLikeMe. He expected the sort of online community he’d tried and abandoned several times before — one abundant in sympathy and stories but thin on practical information. But he found something altogether different: data.
READ MORE @ NY TIMES
Friday, March 21, 2008
Frank Berger, 94, Miltown Creator, Dies
Dr. Frank M. Berger, who helped start the modern era of drug development with his invention of Miltown, the first mass-market psychiatric drug and a forerunner of medical and cultural phenomena like Valium and Prozac, died on Tuesday in Manhattan. He was 94.
The cause was cardiac arrest after a fall, said his wife, Alma Christine Spadi Berger.
Dr. Berger was working at a Yorkshire, England, laboratory, trying to find a preservative for penicillin, when he noticed that a chemical agent he was working with had a calming effect on laboratory animals including mice, rats and guinea pigs.
He described this “tranquilizing” action in a now classic 1946 article in The British Journal of Pharmacology.
He was intrigued, he said later, by the way that anxiety seemed to come and go in people without apparent reason: “These people are not insane; they simply are overexcitable and irritable, and create crisis situations over things that are unimportant. What is the physiological basis of this overexcitability?”
READ MORE @ NY TIMES
The cause was cardiac arrest after a fall, said his wife, Alma Christine Spadi Berger.
Dr. Berger was working at a Yorkshire, England, laboratory, trying to find a preservative for penicillin, when he noticed that a chemical agent he was working with had a calming effect on laboratory animals including mice, rats and guinea pigs.
He described this “tranquilizing” action in a now classic 1946 article in The British Journal of Pharmacology.
He was intrigued, he said later, by the way that anxiety seemed to come and go in people without apparent reason: “These people are not insane; they simply are overexcitable and irritable, and create crisis situations over things that are unimportant. What is the physiological basis of this overexcitability?”
READ MORE @ NY TIMES
Thursday, March 20, 2008
A pioneer in psychiatry
Dr. Frank J. Ayd Jr., a Baltimore psychiatrist who pioneered the field of psychopharmacology when he began treating schizophrenics with Thorazine in the early 1950s, died in his sleep Monday at Lorien Mays Chapel Health Care Center. He was 87.
At a time when the psychiatric establishment rejected the notion that mental illness was rooted in biology, Dr. Ayd championed the use of medications to adjust brain chemistry and, in so doing, relieve a patient's suffering.
"He was a biological psychiatrist, one of the important kinds of people who in spite of - and against - the establishment had the guts to stand up and really do things," said Dr. Thomas Ban, an emeritus professor of psychiatry at Vanderbilt University in Nashville, Tenn.
"Many people claim pioneering, but he really was. He entered the field when the whole thing started."
Dr. Philip G. Janicak, a Chicago psychiatrist and editor of International Drug Therapy Newsletter, said, "Dr. Ayd was one of the founding fathers of modern psychiatry. He changed the direction of psychiatry."
Dr. Janicak added: "He saw the potential value of medications to treat serious psychiatric disorders."
READ MORE @ BALTIMORE SUN
At a time when the psychiatric establishment rejected the notion that mental illness was rooted in biology, Dr. Ayd championed the use of medications to adjust brain chemistry and, in so doing, relieve a patient's suffering.
"He was a biological psychiatrist, one of the important kinds of people who in spite of - and against - the establishment had the guts to stand up and really do things," said Dr. Thomas Ban, an emeritus professor of psychiatry at Vanderbilt University in Nashville, Tenn.
"Many people claim pioneering, but he really was. He entered the field when the whole thing started."
Dr. Philip G. Janicak, a Chicago psychiatrist and editor of International Drug Therapy Newsletter, said, "Dr. Ayd was one of the founding fathers of modern psychiatry. He changed the direction of psychiatry."
Dr. Janicak added: "He saw the potential value of medications to treat serious psychiatric disorders."
READ MORE @ BALTIMORE SUN
Wednesday, March 19, 2008
Antidepressant linked to worsening white matter in elderly
The results of a study employing serial cranial MRI suggest that elderly adults who use tricyclic antidepressants may be at increased risk for progression of white matter lesions, which have been linked with late-life depression by previous studies.
Still, the progression of these lesions may be the indication for use, or certain side effects, such as hypotension, may be directly responsible.
Late-life depression has been tied to white matter lesions on MRI. The contribution of the various antidepressant agents to this finding has been unclear. Prior research has suggested that selective serotonin reuptake inhibitors (SSRI) inhibit platelet aggregation, which might be expected to slow progression of these lesions.
Dr. David C. Steffens, from Duke University Medical Center in Durham, North Carolina and associates addressed this topic by comparing the initial and five-year follow-up MRI scans in 1829 adults, 65 years or older, who were not using antidepressants at baseline.
The use of an antidepressant from any class during the study period hastened the progression of white matter disease, according to the report in the March issue of Stroke.
READ MORE @ MEDICEXCHANGE
Still, the progression of these lesions may be the indication for use, or certain side effects, such as hypotension, may be directly responsible.
Late-life depression has been tied to white matter lesions on MRI. The contribution of the various antidepressant agents to this finding has been unclear. Prior research has suggested that selective serotonin reuptake inhibitors (SSRI) inhibit platelet aggregation, which might be expected to slow progression of these lesions.
Dr. David C. Steffens, from Duke University Medical Center in Durham, North Carolina and associates addressed this topic by comparing the initial and five-year follow-up MRI scans in 1829 adults, 65 years or older, who were not using antidepressants at baseline.
The use of an antidepressant from any class during the study period hastened the progression of white matter disease, according to the report in the March issue of Stroke.
READ MORE @ MEDICEXCHANGE
Tuesday, March 18, 2008
Solving The US Drug Price Crisis, Experts Propose Solution
The mounting U.S. drug price crisis can be contained and eventually reversed by separating drug discovery from drug marketing and by establishing a non-profit company to oversee funding for new medicines, according to two MIT experts on the pharmaceutical industry.
Stan Finkelstein, M.D., senior research scientist in MIT's Engineering Systems Division, and Peter Temin, Elisha Gray II Professor of Economics, present their research and detail their proposal in their new book, "Reasonable Rx: Solving the Drug Price Crisis."
Finkelstein and Temin address immediate national problems--the rising cost of available medicines, the high cost of innovation and the 'blockbuster' method of selecting drugs for development--and predict worsening new ones, unless bold steps are taken.
"Drug prices in the United States are higher than anywhere else in the world. Right now, the revenues from those drugs finance research and development of new drugs. We propose to reduce prices, not at the expense of innovation, but by changing the way innovation is financed," said Temin, also the author of "Taking Your Medicine: Drug Regulation in the US."
READ MORE @ SCIENCE DAILY
Stan Finkelstein, M.D., senior research scientist in MIT's Engineering Systems Division, and Peter Temin, Elisha Gray II Professor of Economics, present their research and detail their proposal in their new book, "Reasonable Rx: Solving the Drug Price Crisis."
Finkelstein and Temin address immediate national problems--the rising cost of available medicines, the high cost of innovation and the 'blockbuster' method of selecting drugs for development--and predict worsening new ones, unless bold steps are taken.
"Drug prices in the United States are higher than anywhere else in the world. Right now, the revenues from those drugs finance research and development of new drugs. We propose to reduce prices, not at the expense of innovation, but by changing the way innovation is financed," said Temin, also the author of "Taking Your Medicine: Drug Regulation in the US."
READ MORE @ SCIENCE DAILY
Monday, March 17, 2008
Military Mental Health Policies Examined
Chris Scheuerman believes the military he served for 20 years failed his Army son Jason, who shot himself to death in his Iraq barracks almost three years ago.
Carefully choosing his words before a hushed congressional audience Friday, the father spoke of how the 20-year-old private's superiors largely ignored the soldier's signs of distress and his family's expressions of alarm in the days leading up to his suicide.
"I do not believe there is a safety net right now for those who fall through," Scheuerman, a veteran with service in Army medicine, told a House Armed Services subcommittee.
Scheuerman was one of several people who testified about their experiences with the military's mental health system. Military personnel, facing prolonged warfare and lengthy deployments, are under particular stress these days.
Army Chief Warrant Officer Richard Gutteridge, an Iraq war veteran treated for post-traumatic stress disorder, spoke of the military's prejudices toward service members with mental health problems. "PTSD sufferers are lepers without lesions," he said.
At the same time, Gutteridge and others cited improvements in the military's responses to the high levels of mental health problems and brain injuries among those serving in Iraq and Afghanistan.
Dr. S. Ward Casscells, assistant defense secretary for health affairs, and the surgeons general of the Army, Navy and Air Force also efforts to help address psychological issues. Steps include recruiting more mental health professionals, providing prompt care and extending outreach programs to military personnel and their families.
READ MORE @ ASSOCIATED PRESS
Carefully choosing his words before a hushed congressional audience Friday, the father spoke of how the 20-year-old private's superiors largely ignored the soldier's signs of distress and his family's expressions of alarm in the days leading up to his suicide.
"I do not believe there is a safety net right now for those who fall through," Scheuerman, a veteran with service in Army medicine, told a House Armed Services subcommittee.
Scheuerman was one of several people who testified about their experiences with the military's mental health system. Military personnel, facing prolonged warfare and lengthy deployments, are under particular stress these days.
Army Chief Warrant Officer Richard Gutteridge, an Iraq war veteran treated for post-traumatic stress disorder, spoke of the military's prejudices toward service members with mental health problems. "PTSD sufferers are lepers without lesions," he said.
At the same time, Gutteridge and others cited improvements in the military's responses to the high levels of mental health problems and brain injuries among those serving in Iraq and Afghanistan.
Dr. S. Ward Casscells, assistant defense secretary for health affairs, and the surgeons general of the Army, Navy and Air Force also efforts to help address psychological issues. Steps include recruiting more mental health professionals, providing prompt care and extending outreach programs to military personnel and their families.
READ MORE @ ASSOCIATED PRESS
Sunday, March 16, 2008
Statement from Eli Lilly and Company: Response to Today's New York Times Article, 'Lilly E-Mail Discussed Off-Label Drug Use'
See Friday, March 14, 2008 post.
Eli Lilly and Company today called the assertions in a New York Times online article 'flat out wrong.' The Times report in question focused on the State of Alaska v. Eli Lilly and Company trial that is underway and attempted to interpret a 2003 email from John C. Lechleiter, Ph.D., currently Lilly's president and chief operating officer. About this email and the Times report, the company makes the following statement:
READ MORE @ EARTHTIMES
Eli Lilly and Company today called the assertions in a New York Times online article 'flat out wrong.' The Times report in question focused on the State of Alaska v. Eli Lilly and Company trial that is underway and attempted to interpret a 2003 email from John C. Lechleiter, Ph.D., currently Lilly's president and chief operating officer. About this email and the Times report, the company makes the following statement:
READ MORE @ EARTHTIMES
Saturday, March 15, 2008
Pharmaceuticals found in US drinking water - Trace quantities could endanger wildlife, humans
An array of pharmaceuticals - including antibiotics, anticonvulsants, mood stabilizers, and sex hormones - have been found in the drinking water supplies of at least 41 million Americans, an Associated Press investigation found.
The concentrations of these pharmaceuticals are tiny, measured in quantities of parts per billion or trillion, far below the levels of a medical dose. And utilities insist that their water is safe.
But the presence of so many prescription drugs - and over-the-counter medicines like acetaminophen and ibuprofen - in so much of our drinking water is heightening worries among scientists of long-term consequences to human health.
In the course of a five-month inquiry, the AP discovered that drugs have been detected in the drinking water supplies of 24 major metropolitan areas - from southern California to northern New Jersey, from Detroit to Louisville, Ky.
Water providers rarely disclose results of pharmaceutical screenings, unless pressed, the Associated Press found.
READ MORE @ BOSTON GLOBE
The concentrations of these pharmaceuticals are tiny, measured in quantities of parts per billion or trillion, far below the levels of a medical dose. And utilities insist that their water is safe.
But the presence of so many prescription drugs - and over-the-counter medicines like acetaminophen and ibuprofen - in so much of our drinking water is heightening worries among scientists of long-term consequences to human health.
In the course of a five-month inquiry, the AP discovered that drugs have been detected in the drinking water supplies of 24 major metropolitan areas - from southern California to northern New Jersey, from Detroit to Louisville, Ky.
Water providers rarely disclose results of pharmaceutical screenings, unless pressed, the Associated Press found.
READ MORE @ BOSTON GLOBE
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