Psychiatric Drugs

New York Times columnist, Nicholas Kristof, relates the story of Andrew Francesco, a boy who began taking Ritalin at age five and died from complications with Seroquel when he was fifteen. His father, a former pharmaceutical industry executive, reveals the industry’s greed in his memoir “Overmedicated and Undertreated.” Now the industry is pushing for a first-amendment right to market its drugs for off-label uses.

The National Institute of Mental Health (NIMH) is increasingly shifting its research emphasis toward attempting to uncover biomarkers for “mental diseases,” which may have dramatic consequences for research and training in clinical psychology. In an article to be published in next month’s Professional Psychology: Research and Practice, Marvin Goldfried outlines how the shift in funding priorities for psychological research is tied to the needs of pharmaceutical companies and the biological model in psychiatry.

In 2014, then National Institute of Mental Health (NIMH) director, Thomas Insel, speculated that ketamine “might be the most important breakthrough in antidepressant treatment in decades.” A recent review of the research suggests that while ketamine may produce a rapid short-term improvement in depression, the effect is short-lived and the potential for addiction and dependence warrants considerable caution.

At Alternet, Jay Syrmopoulos of The Free Thought Project discusses new research on the use of medical marijuana as a treatment for ADHD within the context of the ongoing debate over the validity of the ADHD diagnosis.

I was a psychiatrist who participated in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP). Although I welcomed the positive headlines that heralded the study's results, the reports left me with mixed feelings. What happened to render the notion that talking to people about their experiences and helping them find jobs or go back to school is something novel?

A new study on the depression symptoms of over three-thousand patients challenges the criteria used for diagnosing major depression with the latest Diagnostic and Statistical Manual (DSM-5). Current diagnostic systems are based on an assumption that the symptoms of depression point to a common underlying “illness," but research suggests that this framework may be outdated and oversimplified.

A small study of 30 participants in Germany claims that cannabis can be used to treat “ADHD” because it increases the availability of dopamine. "This then has the same effect but is a different mechanism of action than stimulants like Ritalin and dexedrine amphetamine, which act by binding to the dopamine and interfering with the metabolic breakdown of dopamine." According to the report, 22 of the 30 participants opted to discontinue their prescriptions in favor of medical marijuana.

Robert Neugeboren, who “spent most of his adult life in institutions, often subject to isolation, physical punishment and numbing medication,” was “a celebrity of sorts in the world of the mentally ill: a survivor of the horrors of mistreatment, a case history for those who point to the positive effects of kindness and talk therapy, and, perhaps most of all, the embodiment of the bottomless mystery of the human mind.”

The UK Independent reports that Ireland is moving toward a policy of decriminalizing small amount of drugs like heroin, cocaine, and cannabis in what amounts to a “radical cultural shift.” While it would remain a crime to profit from the sale of these substances, users will have specially designated areas for safe use. The chief of Ireland’s National Drugs Strategy told the paper: “I am firmly of the view that there needs to be a cultural shift in how we regard substance misuse if we are to break this cycle and make a serious attempt to tackle drug and alcohol addiction.”

A Quebec City pharmacy claims it accidentally mixed antipsychotic drug pills into a candy basket that was distributed to trick-or-treating children.

Marcia Angell in the New York Review of Books writes about the inherent conflict in clinical trials between “the search for scientific answers," on one hand, and “the rights and welfare of human subjects,” on the other.

In an op-ed for the Guardian, cardiologist Aseem Malhotra writes: “Corporate greed and systematic political failure have brought healthcare to its knees. There are too many misinformed doctors and misinformed patients. It’s time for greater transparency and stronger accountability, so that doctors and nurses can provide the best quality care for the most important person in the consultation room – the patient.”

New research suggests that more frequent in-person contact lessens the risk of depression in older adults. The study, published in this month’s issue of the Journal of the American Geriatric Society, found that in Americans over fifty the more face-to-face contact they had with children, family and friends, the less likely they were to develop depressive symptoms.

In a Science Update, the National Institute of Mental Health (NIMH) reports that Medicaid services is already taking steps to implement “coordinated specialty care” (CSC) in response to the RAISE study released last week. “The RAISE initiative has shown that coordinated specialty care for first episode psychosis is better than the standard care offered in community clinics. However, covering the cost of coordinated specialty care can be challenging. When Medicaid agrees to pay for effective treatment programs, patients in need benefit.”

The percentage of seniors in the United States prescribed potentially deadly antipsychotic drugs increases with age. A new study reveals that in the face of serious risks of strokes, fractures, kidney injuries, and death, over seventy-five percent of seniors given antipsychotics do not have a diagnosis for a mental disorder.

At CounterPunch, Joseph Natoli connects Big Pharma, mass shootings, and rampant inequality. He writes: “The Brave New World soma strategy to deal with a population that, were they not doped up, might violently disrupt that brave new world, is useful if a society is ‘creatively destroying’ a growing number of its population each day. While the poor have daily evidence of their poverty, a collapsing middle class live in the illusion that they are middle class and just a short distance, not from ruin, but from fame and fortune. They are, in short, heading for a catastrophic break-down. Big Pharma is already set to give us all a ‘soft landing.’”

Dr. Mickey Nardo adds to the ongoing discussion about the RAISE study results. He writes: “If there is ‘spin’ in the reporting of this study, we need to know about it. I personally think that it’s more important for RAISE to be reported completely and honestly than whether it comes out like they [or I] want it to come out. We don’t need some sanitized version of RAISE to tell us we need to turn our attention to a full bodied approach to the treatment of First Episode psychotic patients. We all already know that. What we do need is to have our confidence restored in our research community – that they will honestly and clearly report their findings whether they are clean as a whistle or an unholy mess.”

Neuroskeptic weighs in on the controversy over the lack of antipsychotic dose data in the RAISE study and the misleading media coverage. He points out that one of the treatment interventions was a computerized medication management system called COMPASS, which recommends doctors use lower doses than they otherwise might.

Despite safety concerns, a new study reveals that there has been no change in the use of benzodiazepines in the elderly from 2001 to 2010.

In a bellwether case, plaintiffs allege that Pfizer did not adequately warn patients that Zoloft (sertraline) would cause birth defects. The case is scheduled in Federal Court in March, and the verdict will have significant implications for future suits.

PsychCentral presents a new study from the Center for Disease Control and Prevention (CDC) that found that foster care children are three times more likely than other children on Medicaid to receive a diagnosis of ADHD. Overall, more than one in four children in foster care receive such a diagnosis. CDC statistician Melissa Danielson interpreted these results as revealing a “substantial need” for more medical and behavioral services for kids in foster care.

The UK Times reports that pharmaceutical companies are actively lobbying to limit the release of clinical trial data to the public. Rather than limiting results and data to medical journals, new transparency initiatives are pushing for making the information publically available. The push for transparency comes in the wake of the reanalysis of the Study 329 data on paroxetine (marketed as Seroxat and Paxil), which found that the industry study had misconstrued its results.

Results of a new study reveal that sixty-nine percent, or more than two-thirds, of patients prescribed antidepressant drugs have never, in their medical history, met the criteria for major depression. The study, published in the Journal of Clinical Psychiatry this month, also found that several demographic factors, like race and gender, were associated with the prescription of antidepressants.

Over at CounterPunch, Carl Boggs takes on the knee-jerk mental illness response that pervades the airwaves after every mass shooting. He writes: “What the mental-health fixation lacks is any semblance of historical or social context. Given the persistence of U.S. imperialism and militarism — and mounting fascination with combat and guns in a society transfigured by its warfare state — Washington remains a thriving center of global violence: repeated armed interventions abroad have found their domestic parallel in the world’s largest prison system, a deepening gun culture, home-bred terrorism, police atrocities, and a media culture filled with spectacles of warfare and bloodshed.”

Last Tuesday, The New York Times and several other outlets (including Mad In America) reported on the highly-touted results of a study on psychosocial treatment for patients diagnosed with schizophrenia. Now, claims made about the study, which the ‘Times called “the most rigorous trial to date,” are coming under increased scrutiny.