Thursday, January 22, 2009

People With Schizophrenia Say Bias Is Part of Their Lives

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

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

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

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

READ MORE @ WASHINGTON POST

Wednesday, January 21, 2009

Antidepressant Has Modest Benefits in Anxious Older Patients

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

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

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

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

READ MORE @ MEDPAGE TODAY

Tuesday, January 20, 2009

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

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

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

READ MORE @ U.S. NEWS & WORLD REPORT

Monday, January 19, 2009

New study: Bipolar disorder and schizophrenia are genetically linked

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

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

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

READ MORE @ SCIENTIFIC AMERICAN

Sunday, January 18, 2009

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

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

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

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

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

READ MORE @ MEDPAGE TODAY

Friday, January 16, 2009

Study Finds Drug Risks With Newer Antipsychotics

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

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

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

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

READ MORE @ NY TIMES

Thursday, January 15, 2009

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

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

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

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

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

READ MORE @ BLOOMBERG

Wednesday, January 14, 2009

New Study: Antidepressants Help Patients with Fibromyalgia

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

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

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

READ MORE @ SCIENTIFIC AMERICAN

Tuesday, January 13, 2009

UPDATE 3-US lets drugmakers advise doctors on unapproved uses

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

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

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

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

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

READ MORE @ REUTERS

Monday, January 12, 2009

Women-only gene link to dementia

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

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

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

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

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

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

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

READ MORE @ BBC

Sunday, January 11, 2009

Economy prompts more calls to suicide hotlines

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

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

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

READ MORE @ USA TODAY

Saturday, January 10, 2009

One flew into the cuckoo's nest

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

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

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

READ MORE @ THE GUARDIAN

Friday, January 9, 2009

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

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

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

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

READ MORE @ DOCTOR'S GUIDE

Thursday, January 8, 2009

Genetic Determinants Of ADHD Examined

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

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

READ MORE @ SCIENCE DAILY

Wednesday, January 7, 2009

Deep Brain Stimulation Helps Those With Advanced Parkinson's Study found both physical function and quality of life improved

The largest study of its kind finds that deep brain stimulation improves both physical function and quality of life after six months in patients with Parkinson's disease.

Deep brain stimulation (DBS) performed better than currently available drug treatments, but it did carry some risks, including one death, according to a study in the Jan. 7 issue of the Journal of the American Medical Association.

"This basically corroborates what has largely emerged over the last decade from literature and clinical experience showing pretty dramatically the potential benefit of DBS for Parkinson's," said Dr. Fred Marshall, medical director of the deep brain stimulation program at the University of Rochester Medical Center, in New York.

Despite abundant clinical experience, there have been few controlled trials on the topic, added colleague Dr. Irene Richard, an associate professor of neurology and psychiatry at the University of Rochester Medical Center. "This is corroborative, that surgery is helpful, but it is associated with more risk."

READ MORE @ U.S. NEWS & WORLD REPORT

Monday, January 5, 2009

Brain scans may aid anxious

U.S. researchers suggest brain scans may help predict how anxiety disorders patients react to drug therapy.

"Hopefully we'll be able to use that eventually to determine what kind of treatment to provide to people," lead author Jack Nitschke, of the University of Wisconsin-Madison School of Medicine and Public Health said in a statement.

The study, published in the American Journal of Psychiatry, used functional magnetic resonance imaging to examine patients with generalized anxiety disorder and found high levels of amygdala activity -- a part of the brain involved in memory of emotional reactions

This response in a "safe" lab settings was a disproportionately large response to the idea that something negative might happen, Nitschke said.

READ MORE @ UPI

Sunday, January 4, 2009

Drug companies seek a cure for their ailing research. With costs and regulation rising, a new way of developing blockbuster treatments is needed.

THERE was warm applause for Lord [James] Black last month when the veteran drug developer stepped up in front of an 800-strong audience of business leaders and VIPs in the City to collect an award. The Nobel prize winner was being honoured by Medical Futures, a healthcare interest group, for his contribution to medical research — he is responsible for developing beta blockers, among other significant breakthroughs.

However, Black wonders whether, if he had been in his professional prime in today’s environment, his various discoveries would have happened. He argues that a safety-first approach is hindering the development of the next generation of blockbuster drugs.

“The problem, in my recent experience of trawling new products round big pharma’s R&D divisions, is that they are only comfortable in well-recognised fields,” he said.

READ MORE @ TIMES ONLINE UK

Saturday, January 3, 2009

Preemies face some risk of psychiatric disorders

Results of a Swedish population-wide study hint that children born prematurely have some risk of developing anxiety, depression or other psychiatric disorder in adolescence and young adulthood.

Children born "preterm" should therefore be watched more closely for these disorders, the investigators suggest.

Among 545,628 Swedish residents born in the 1970s and followed up until 23 to 29 years of age, Dr. Karolina Lindstrom from Sachs Children's Hospital, Stockholm, and colleagues observed a stepwise increase in psychiatric hospital admissions with an increasing degree of preterm birth.

READ MORE @ REUTERS

Friday, January 2, 2009

Researchers Look for Link Between Brain Injury, Psychiatric Illness

A range of psychiatric symptoms can follow combat-related head injuries, but establishing cause and long-term effect awaits longitudinal research.

Traumatic brain injury, the hallmark wound of the war in Iraq, may cause a number of neurological and psychiatric disorders, but more prospective research is needed to understand its long-term effects, a committee of the Institute of Medicine (IOM) reported in December 2008.

"There is a paucity of information in the scientific literature regarding the sequelae of blast injury, and there is a need for prospective, longitudinal studies to confirm reports of long-term effects of exposure to blasts," said the report, commissioned by the Department of Veterans Affairs and based on an analysis of 1,900 peer-reviewed studies.

READ MORE @ PSYCHIATRIC NEWS

Thursday, January 1, 2009

Novartis spent almost $1.4 million lobbying in 3Q

Swiss pharmaceutical maker Novartis AG spent nearly $1.4 million lobbying the U.S. government in the third quarter, according to a recent disclosure form.

Novartis (nyse: NVS - news - people ) lobbied on bills designed to ensure the government has a sufficient stockpile of influenza vaccine in case of an outbreak, and that the government helps pay for vaccines for seniors, children and uninsured adults. The company makes flu vaccine, as well as vaccines against rabies, meningitis and several childhood illnesses.

Novartis also lobbied on the Defense Department's budget and another bill involving the military's Tricare program, which insures about 9 million current and retired service members and dependents. The company, which makes two anti-rejection drugs, Neoral and Myfortic, lobbied to provide comprehensive coverage for immune-suppressing drugs for kidney transplant patients.

READ MORE @ FORBES