The killing of 20 children and six adults in Newtown has triggered a search for some way of preventing these kinds of tragedies. The focus has been on gun control, video game violence and a registry of persons diagnosed with … Full Article →
The Journal of ECT, looking at the question of whether antidepressant medications at the start of ECT reduced post-ECT relapse in a sample of 319 patients, notes that 50% of the patients relapsed and 16.4% dropped out; leaving 33.6% in remission after 6 months. ”Relapse rates after ECT are substantial despite intensive pharmacology,” the authors note.
Pleading guilty to marketing Depakote for behavioral problems in dementia patients, a purpose for which the drug was not approved, a federal judge has assessed Abbott pharmaceuticals a criminal fine of $500 million, forfeiture of $198.5 million, and a payment of $1.5 million to Virginia’s Medicaid Fraud Control Unit.
Researchers from Tufts and Harvard find in a review of 233 medical charts of psychiatrically hospitalized youth at three points in time (1991, 1998 and 2008) that rates of psychotropic medication use rose over time, while rates of hospitalization for youth with more severe psychiatric disorders stayed the same. Results appear online in Psychiatric Quarterly.
The authors of an article in Journal of Psychosocial Nursing reviewed the literature on psychotropic PRN medications in order to respond to a request to clarify the best protocol for nurses at St. Vincent’s hospital in Sydney, Australia. They found “considerable variation in nursing practices related to administration of PRN medication. In an area of practice that is undertaken with such regularity and with considerable potential impact on consumers, these findings point to the need for further research to establish best practices.”
A touching article in the Las Vegas Sun follows one child from abandonment through foster placements, polypharmacy, suicidality, delinquency and homelessness to stability off medication and with close support. The article weaves this story together with recent efforts to curb the use of medications in foster care.
Rising prescriptions for psychiatric medications are partly a result of longer-term treatment and increasing population, according to an article by Joanna Moncrieff and Stephen Ilyas in the May, 2012 issue of British Journal of Psychiatry. Psych meds were an increasing proportion of all prescriptions in England between 1998 and 2010. Antipsychotics in particular, both costly and prescribed for uses beyond severe mental illness, are making an increasing contribution to total drug costs.
“… Absence of clear practice guidelines for psychotropic medication use in children with ASD” leads to a range of drugs for depression, anxiety, psychosis and hyperactivity, say the authors of an NIMH study of 1,420 children with an autism diagnosis. There are no drugs approved to treat the symptoms or causes of the disorder, but some suggest that “there has been a relative under-appreciation of psychiatric co-morbidity in individuals, especially younger individuals with autism spectrum disorders.”
Researchers publishing in the Journal of Clinical Psychiatry argue that broadening the diagnostic criteria for bipolar disorder would result in a greater increase in “false positives” than in “true” diagnoses, while there are no controlled studies demonstrating the efficacy of mood stabilizers in treating “subthreshold” bipolar disorder. They also assert that an increase in “false positive” diagnoses would go undetected because the absence of future manic/hypomanic episodes would “incorrectly be considered evidence of the efficacy of treatment, and the unnecessary medications that might cause medically significant side effects would not be discontinued.”
Ruling that health care providers, while important, “are not entitled to an elevated status in tort law that would categorically immunize them from liability when their negligent prescriptions cause physician injury to nonpatients,” the Utah Supreme Court overruled a lower court’s decision for the defendants in the case of David Ragsdale, who shot his estranged wife to death after being prescribed a mix of psychotropic drugs and steroids by a nurse practitioner. “Prescribing medication is not an exact science, especially when it comes to mental health,” said a lawyer for the defendants, “physicians have to play the odds.”
Abbott Laboratories has pled guilty to civil and criminal charges of illegally marketing Depakote for the control of agitation and aggression in elderly patients with dementia (referred to as “elder abuse” by one U.S. attorney), as well as for the treatment of schizophrenia. Abbott will undergo court-supervised probation and reporting obligations by Abbott’s CEO and board of directors.
The effects of antidepressants and mood stabilizers on young people’s psychosexual development receive little attention or research, says Kaitlin Bell Barnett (author of “Dosed: The Medication Generation Grows Up”). She attributes the “shocking lack of studies” to a puritanical attitude toward teenage sexuality, and writes about the “shortsighted” approach to the lasting effects on young peoples’ development and psyches.
Research from Germany finds that people with schizophrenia or schizoaffective diagnoses given multiple medications – an antipsychotic plus a benzodiazepine or more than one other psychotropic medication – faired more poorly than people given one antipsychotic. The authors note that the direction of causality is not established. It is not known whether multiple medications made people worse or merely fail to help people who were doing worse to do better. Results appear in Acta Psychiatrica Scandinavica.
Denis Bay had high levels of prescription drugs used to treat schizophrenia and bipolar illness in his blood on February 3, when he shot and killed his wife, two children and himself, say toxicology reports released yesterday. 911 dispatchers described his subdued and mellow attitude while informing them that he had just shot his family, then shooting himself.
An article in January’s American Journal of Psychiatry weighs the relative risk of mortality associated with various antipsychotics and mood stabilizers used in the treatment of 33,604 patients with dementia. An accompanying editorial in the same issue points out that the least risky options were also the least effective in curbing aggression.
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Dutch researchers write in the Journal of Clinical Psychopharmacology that, in a prospective study of 7415 persons with diagnoses of schizophrenia, use of a first-generation antipsychotic and use of a mood stabilizer were associated with higher mortality rates.
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Australian researchers look at the literature on the effect of psychotropics on falls in the elderly; largest effect of any randomized trial was achieved by discontinuation of psychotropics.
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On October 23, the New York Times ran a very nice feature story about a Los Angeles woman, Keris Myrick, who, even though she has a diagnosis of schizoaffective disorder and obsessive-compulsive disorder, thrives today as CEO of Project Return … Full Article →
When I first interviewed Brandon Banks, in the spring of 2008, while researching Anatomy of an Epidemic, he had recently entered Elizabethtown Community College in Kentucky, with dreams of becoming a journalist. Given his medical history, which included multiple psychiatric … Full Article →