The trial of former California police officer Anthony Orban for rape goes to closing arguments today. Orban is pleading “not guilty by reason of unconsciousness,” claiming that Zoloft rendered him unaware of his actions. “I knew exactly what it was. It was the medication,” Orban told a California CBS news affiliate.
Johnson & Johnson has agreed to pay $2.2 billion to settle probes by the U.S. government of its marketing of Risperdal and other medications, the second-largest settlement of its kind in history. Additional cases with individual states are ongoing, for which J&J is setting aside an additional $600 million.
Oxytocin, which has “shown promise as a novel antipsychotic in multiple clinical trials,” improved cognition in a small sample (n=15) of people with schizophrenia diagnoses. Results appear online today in Schizophrenia Research.
Writing in Neuron that antipsychotics’ “functional consequences and the subcellular sites of their accumulation in nervous tissue have remained elusive,” researchers from Germany and Denmark find that antipsychotics accumulate in synaptic vesicles where, having reached sufficient concentration, are expelled into synaptic spaces when neurons are excited. The authors theorize that this period of accumulation accounts for “the slow development of the full therapeutic action of the drugs” which theoretically occurs within the same 4-6 week time range.
Prozac, Effexor, and/or carbamazepine induce gene expression patterns in the brains of fathead minnows that mimic those thought to be associated with autism in humans, according to a study published yesterday (June 6, 2012) in PLoS One. The study found that the pattern of gene expression was specific to idiopathic (heredity x environment) autism, but not other autism diagnoses associated with specific mutations. The authors write that the findings are consistent with a theorized role of elevated serotonergic neurodevelopmental perturbations during pregnancy that may be associated with a dramatic increase of idiopathic autism.
Researchers from Switzerland, the U.K., Belgium, Denmark, Canada, Italy, Austria and the U.S. review the current evidence linking antidepressants to loss of bone mineral density and osteoporosis in an article released online May 30 by the journal Bone. They find that depression itself increases the risk for fractures, and that use of SSRIs and tricyclics increases fracture risk by as much as twofold in a dose-response relationship. The increased risk is greatest in the early stages of treatment, and diminishes to baseline in the year after discontinuation.
Senator Chuck Grassley continues his pursuit of questionable financial ties between the pharmaceutical companies and research by asking the National Institutes of Health (NIH) why it has awarded $400,000 for medical research to Charles Nemeroff. Nemeroff, who had been banned from NIH funding for failure to disclose a $1.2 million financial relationship with GlaxoSmithKline (the maker of Paxil) while leading a $9 million study on the treatment of depression, remains under investigation by the Inspector General for the Department of Health and Human Services. The decision to award the grant “risks sending the wrong message to physicians seeking or performing federally funded research,” Grassley said.
Research from Australia shows that “remained pervasive” in 70% of a sample of 83 patients medicated with antipsychotics and other medications, and concludes that antipsychotics are “not an appropriate substitute for other sleep interventions” because “antipsychotic medication only marginally improves, but does not normalise, sleep.” The research was published online June 1, 2012 in Schizophrenia Research.
An Israeli study of 10,621 women found that those taking an SSRI more than 80% of the time were 1.4 times more likely to experience bone fractures or to initiate treatment for osteoporosis. The study appeared online in CNS Drugs on May 21, 2012.
Researchers in Barcelona, Spain retrospectively reviewed the use of antipsychotics in 117,811 patients, of whom 9,855 were given combinations of antipsychotics and 13,763 were given unspecified combinations of drugs. The researchers found that “the scant evidence available regarding the efficacy of combining different antipsychotics contrasts with the high number and variety of combinations prescribed to outpatients.” The study appears in BMC Psychiatry.
A study published online today (May 26, 2012) in Current Psychiatry Reports recommends Zyprexa as “elusive” pharmacologic solution to anorexia nervosa. On the basis of four randomized clinical trials, the study finds Zyprexa superior to placebo, Thorazine and Abilify in its ability to promote “weight gain and/or reduction in obsessional symptoms.”
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.
A study released online today by the British Journal of Psychiatry shows that the clinical profile of neuroleptic malignant syndrome (NMS) is similar in 1st- v. 2nd-generation antipsychotics. Patients presenting with NMS from 2nd generation are younger, with less rigidity and a lower mortality rate.
A study from the Netherlands found that outcomes for 598 patients in treatment for mild to moderate depression were significantly less in practice than in meta-analyses for antidepressants, psychotherapy, or a combination of the two. Outcomes from the STAR*D trial were as poor as in routine practice. Results appeared online in Psychotherapy and Psychomatics May 11, 2012.
Analysis of 10,568 critically ill patients’ records by Beth Israel Deaconess Medical Center and MIT finds that those on antidepressants were almost twice as likely to die, though the correlation is not explained by the study. The research will be presented at this week’s American Thoracic Society International Conference in San Francisco.
“… 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.”
Data from the National Health and Nutrition Examination Surveys (2005-2008) show that 11% of Americans 12 and over take antidepressants. 60% of those have taken them 2 years or longer; 14% 10 years or more. Less than 1/3 of those taking one antidepressant and less than 1/2 of those taking multiple antidepressants have seen a mental health professional in the previous year.
Robert Whitaker, author of Anatomy of an Epidemic, discusses the disturbing effects of psychotropic drugs prescribed for children. Such medications, used for ADHD, depression, and anxiety, for example, have become commonplace over the past 30 years. This practice profoundly alters the lives of the children, and so now we, as a society, urgently need to address this question: do the medications help the children thrive and grow up into healthy adults? Or does this practice do more harm than good over the long term. Robert Whitaker emphasizes two things: first, the need for an objective, evidence-based approach to evaluating these drugs; and second, the need for better public understanding of how these medications work.
Senators Chuck Grassley of Iowa, Herb Kohl of Wisconsin and Richard Blumenthal of Connecticut filed an amendment to the Food and Drug Administration Safety and Innovation Act yesterday in the United States Senate, “intended to empower (nursing home) residents and their loved ones in the decisions about the drugs prescribed for them.” The amendment calls for education regarding non-pharmacological interventions along with possible risks and side effects of medication.
Drexel University researchers found that methylphenidate (Ritalin) administered to juvenile rats produced significant depressive effects on pyramidal neurons. The authors conclude that “the juvenile prefrontal cortex is supersensitive to methylphenidate, and the accepted therapeutic range for adults is an overshoot. Juvenile treatment with MPH may result in long-lasting, potentially permanent, changes to excitatory neurons function in the prefrontal cortex of juvenile rats.” The study will appear in Biological Psychiatry.
Researchers assessed 55 first-episode drug-naive people with schizophrenia diagnoses in New Delhi, India for the predictive value of symptoms on quality of life (QOL). They found that negative symptoms have a greater impact than positive on subjective quality of life, while antipsychotics focus on primary positive and negative symptoms. “There is a need to develop a holistic approach (target non-psychotic symptoms intensively) in the disease management to prevent further long-term impairment of QOL.” The study appears in the Nordic Journal of Psychiatry.
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George Zimmerman, accused of killing unarmed Trayvon Martin while communicating with police dispatchers who tried to restrain him, was prescribed Adderall (a stimulant) and Temazepam (a benzodiazepine) prior to the incident. Adderall’s label warns users to watch for “new or worsening mental or mood problems (eg, aggression, agitation, anxiety, delusions, depression, hallucination, hostility.)” The prescribing doctor had noted that it was “imperative” that Zimmerman be evaluated by a psychologist.