Earlier this year, Ronald Pies and Allen Frances wrote a series of blogs that collectively might be titled: “Why Robert Whitaker is Wrong about Antipsychotics.” In regard to reviewing the “evidence” on that question, Pies did most of the heavy lifting, but he also told of drawing on the expertise of E. Fuller Torrey, Joseph Pierre and Bernard Carroll. Given the prominence of this group, it could be fairly said that Pies’ review reflects, to a large degree, the collective “thoughts” of American psychiatry. And with that understanding in mind, therein lies an opportunity, one not to be missed.
A systematic review published this week in the British Journal of Clinical Pharmacology found that patients taking antipsychotic drugs were at nearly twice the risk of a heart attack compared to non-users. "Our findings provide important information about the safety of antipsychotic drugs," Bing Ruan, a lead author of the study, wrote. "Clinicians should prescribe them only for patients with a clear need."
Here I was, 15 years old and already in a long-term treatment facility. I was, on paper: crazy! This entire time, all the adults in my life had been speaking for me. I never felt like I was any of the things they said, but I went along with it. What else could I have done? Every time I rebelled, it only confirmed to my mother what she thought of me.
The US FDA has issued a new warning for the atypical antipsychotic Olanzapine, also known by the brand names Zyprexa and Symbyax. The agency warns that new evidence shows that the drug can lead to a rare but serious skin condition known as Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). The condition can be progressive and can lead to the injury of internal organs and even death. There are currently no specific treatments for DRESS.
The FDA has rejected the drug/device combination designed to monitor patient adherence with Abilify from Otsuka Pharmaceutical and Proteus Digital Health. Just last week the FDA issued an additional warning that Abilify (aripiprazole), an atypical antipsychotic, could lead to compulsive and dangerous behaviors.
Yesterday, the US Food and Drug Administration (FDA) released a warning that the antipsychotic drug aripiprazole or Abilify is associated with compulsive and uncontrollable urges. Research suggests that the drug may cause urges to gamble, binge eat, shop, and have sex but that the urges often stop when the drug is withdrawn or the dose is reduced.
For the New York Times, Cornell psychiatrist Richard Friedman proposes new regulations to make direct-to-consumer drug ads reveal the relative price and effectiveness information that is currently hidden. “Drug companies might legitimately complain that there are many reasons a drug might fail to outperform a placebo besides ineffectiveness: quirks in the design of a trial; patients who were not typical of those with the disease; a dosage that was too low. But then the company should be happy to explain this to the public, since the goal is education, right?”
Professionals are paid to share their wisdom with those who are, typically, less informed. But, when dealing with mental health professionals in the psychiatric arena, it is wise to retain a degree of skepticism about the words spoken by the doctors and nurses commissioned to help reduce human misery and suffering.
New data reveals that the majority of care homes in British Columbia, Canada are giving out prescriptions for antidepressants and antipsychotics without a diagnosis. According to a report by the Times Colonist, “there are a whopping 54 homes in which 40 percent of the residents are taking antipsychotics without a diagnosis.”
As we have reported at MIA, new research indicates that Parkinson's disease patients who are given antipsychotics to treat dementia and psychosis may be more likely to die early.
A new study in JAMA Neurology finds that the use of antipsychotic drugs more than doubled the risk of death in patients with Parkinson’s disease. Use of antipsychotics is common in Parkinson’s patients who exhibit symptoms of dementia or psychosis, and the researchers call for increased caution when prescribing these drugs and for the development of non-drug approaches to managing psychiatric symptoms.
Over the past two months, Ronald Pies and Allen Frances, in response to a post I had written, wrote several blogs that were meant to serve as an “evidence-based” defense of the long-term use of antipsychotics. As I read their pieces, I initially focused on that core argument they were presenting, but second time through, the aha moment arrived for me. Their blogs, when carefully parsed, make a compelling case that their profession, in their use of antipsychotics as a treatment for multiple psychotic disorders, has done great harm, and continues to do so today.
When I was born, everyone was expecting me to have arms. The doctor’s mind raced; how am I going to tell this mother and the father that their son has hands but not arms? If he’s missing so much in his extremities, mustn’t he also be missing a mind? My mom looked into my eyes and knew – in a way that only mothers know – that I had a mind, and spirit.
Canada's Global News reports that "A couple of years after a national initiative began to reduce the use of anti-psychotic medication, some people are saying the move has had an even more positive effect in Alberta than first expected ... 'Lots of teams said, ‘We didn’t realize how much pain [patients] might have been in, and so they were acting out, or having these responsive behaviors' ... 'So when we took down the antipsychotics and gave them more Tylenol … their behaviours are way calmer.'”
Chicago Psychiatrist Michael Reinstein received a sentence of nine months in prison for taking an estimated $600,000 in kickbacks from pharmaceutical companies in exchange for prescribing their drugs to patients. Reinstein dangerously prescribed the antipsychotic Clozapine to thousands of elderly patients in area nursing homes and hospitals. “At one point in the early 2000s, he was the largest prescriber of Clozapine to Medicaid recipients in the county,” the Chicago Sun Times reports.
A new study to be published in the next issue of Schizophrenia Research examines patients suffering from a first-episode of psychosis who stop taking any antipsychotic drugs. The researchers attempt to identify variables that may predict the successful discontinuation of antipsychotics. They find, for example, that those who discontinue the drugs have, on average, the same outcomes as those who stay on them, and that those who have better social integration are more likely to discontinue without relapse.
For a long time I have felt that there just isn’t a good enough and long enough study on the pros and cons of long-term antipsychotic treatment versus reduction and discontinuation in people who have psychotic disorders, including those who are classified as having schizophrenia. Moreover, there are increasing reasons to be worried about the effects of long-term treatment with antipsychotics. I put this case to the UK’s National Institute of Health Research recently, and proposed that they fund a trial to assess the long-term outcomes of a gradual programme of antipsychotic reduction compared with standard ‘maintenance treatment.’ The NIHR agreed that this was an important issue, and that a new trial was urgently needed. The RADAR (Research into Antipsychotic Discontinuation And Reduction) study officially started in January 2016.
Vermont Governor Shumlin recently suggested a change to state law that would accelerate the process under which a person could be forced to take antipsychotic drugs against her will. The House Human Services Committee reviewed this proposal and I was asked to testify. What follows are my comments.
A new study found that patients treated with the antipsychotic clozapine experienced gastrointestinal side-effects. “The study findings may help explain morbidity and mortality from GI complications (eg, bowel obstruction) related to clozapine therapy.”
The Santa Cruz Sentinel reports on legislation being passed in California to go after physicians who overprescribe psychiatric drugs to foster youth. The proposed legislation also targets government agencies that fail to offer nondrug alternative therapies to help foster youth recover from traumatic childhoods.
A pathbreaking new study out of Finland suggests that early intervention programs for youth experiencing psychotic-like symptoms may see the greatest improvement when treatment works within the home rather than in a hospital setting. The research, to be published in next month’s issue of Psychiatry Research, found greater improvement in functioning, depression, and hopelessness among teens in a new need-adapted Family and Community oriented Integrative Treatment Model (FCTM) program.
Benedict Carey of the New York Times reports on the success of new schizophrenia and psychosis programs that provide family counseling and job and educational supports and treat patients as equals in decisions about care. “One way to think about it is to ask, if this program were a drug, would we pay for it? And the answer is yes.”
“Two Scots whose lives have been ravaged by prescription drugs are battling for recognition of the devastating withdrawal issues as well as proper support for victims,” the Daily Record reports. “Health Secretary Shona Robison has now agreed to ask chief medical officer Catherine Calderwood to investigate the claims.”
The case of “Beth” depicts, almost innocently, the trials and tribulations of a well-adjusted, talented 15-year-old who developed depression, paranoia, panic attacks, and self-injurious and homicidal behavior, and “bipolar disorder” after being prescribed antidepressants, and then antipsychotics. After Beth decided – on her own – to discontinue psychotropic medications in favor of hormone therapy, she remained free of psychiatric symptoms.
In a study published yesterday, researchers from the Nippon Medical School in Tokyo bring attention to a condition known as neuroleptic-induced deficit syndrome (NIDS) brought on by the adverse mental effects of antipsychotic drugs. They express concern that NIDS can resemble the negative symptoms associated with schizophrenia and psychosis, leading to misdiagnosis and ineffective treatments.
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