Psychiatric Drugs

When Wilda White recovered from a manic episode triggered by her ADHD medication, she had lost her relationship, her home, and her dream job as a public interest lawyer. She reached a turning point when, she told Seven Days newspaper, "in the course of trying to figure out what had happened to me, I went on the website Mad in America.” Through the site, she connected with a job listing from Vermont Psychiatric Survivors, a non-profit dedicated to empowering and protecting the rights of people labeled “mentally ill.” She is now their executive director.

Amid growing criticism about the over-prescription of psychotropic medication in foster care, Pennsylvania commissioned PolicyLab to conduct an analysis of the use of psychiatric drugs among all of the state’s Medicaid-enrolled children. The report, released in June, found that the rate of psychotropic prescriptions among youth in Medicaid and foster care was higher than previously reported.

Antipsychotics are currently the predominant treatment for individuals diagnosed with schizophrenia, but there is an accumulating body of research that links the use of these drugs to structural abnormalities in the brain. A recent meta-analysis suggests that gray matter loss in the brain may depend on the dose and class of the antipsychotic.

Antipsychotics are being prescribed to people who may have challenging behaviors but no mental disorder, according to new research published in this month’s issue of BMJ. “Excessive use of psychotropic drugs has individual and systemic implications,” the researchers write. “Antipsychotics, in particular, are associated with several adverse side effects that can impair quality of life and lead to deleterious health outcomes.”

New research finds that brain matter loss in patients diagnosed with schizophrenia is correlated with antipsychotic use, according to Psych Central. The analysis suggests that the continued use of antipsychotics is linked with progressive cortical gray matter loss.

This month’s issue of JAMA Psychiatry ran an editorial commenting on recent research revealing that the majority of youth prescribed antipsychotics have not been diagnosed with a mental disorder.

In the September issue of The Journal of the American Medical Association (JAMA) three FDA advisory committee members describe the convergence of factors that made the committee’s recommendation to approve flibanserin especially challenging and politically charged.

On Tuesday, NPR told the story of DeAngelo Cortijo. DeAngelo became a foster kid at age 3 after his mother attempted suicide. He was “diagnosed with bipolar and anxiety disorders, attachment disorder, intermittent explosive disorder or posttraumatic stress disorder,” and was prescribed “a combination of antipsychotics, antidepressants and stimulants, and was told that taking them was his only hope of being normal.” Through equine therapy, DeAngelo was eventually able to get off all of his medication. Now, California is hoping to pass reforms that would prevent foster kids, like DeAngelo, from being “prescribed antipsychotic drugs at double to quadruple the rate of that not in foster care.”

In addition to hosting the Panorama programs and The Famous Grouse history of Study 329, Study329.org has a comprehensive timeline on the origins of concerns about the SSRIs and the risk of suicide, initially with Prozac and subsequently with Paxil/Seroxat. The hope is to provide a comprehensive repository for anyone who wants to study SSRIs, RCTs, and Study 329 in particular.

"CNN's Carol Costello explores Operation Tohidu, an experimental rehabilitation program to help veterans with PTSD." Operation Tohidu founder, Dr. Mary Vieten claims PTSD is not a mental illness and "there is no reason to medicate someone who has been traumatized by their war experience." When asked what percentage of soldiers returning with PTSD do not need drugs she responds, "100%."

MedPageToday reports that Janssen Pharmaceuticals omitted data from a 2003 study that connected Risperdal with serious side effects. Janssen was previously sued by the FDA for marketing Risperdal for off-label uses and settled for $2.2 billion in 2013. Earlier this year, a man with autism was awarded $2.5 million after growing breasts while on Risperdal. According to MedPage, documents from this latest case reveal missing data tables from a 2003 study “designed to ferret out potential adverse effects of long-term risperidone use.” The missing tables were related to elevated prolactin levels and side effects, including gynecomastia in men.

An editorial in the Guardian discusses the fact that the number of people with intellectual or learning disabilities “who are being treated with psychotropic drugs far exceeds those with mental illness.” The authors of a new study examining the overuse of psychotropic drugs on people with learning disabilities, published this month in BMJ, argue: “If people without mental illness are given psychotropic drugs… it is probably to control their behavior.”

Writing for Forbes, Matthew Herper documents the FDA’s increasing drug approval rates. “In 2008, BioMedTracker says the FDA approved 20 new molecular entities (NMEs) and rejected 20, for an approval rate of 50%.” So far this year, he writes, “the FDA approval rate is more like 96%.”

The International Business Times covers a new study showing “trials for new antidepressant medications may not be applicable to the population at large.” “The finding, published in the Mayo Clinic Proceedings, shows recent trials are less generalizable than the prior studies, as researchers excluded most depressed patients from drug company-sponsored treatment studies.”

On Tuesday, the U.S. Food and Drug Administration (FDA) approved Flibanserin (Addyi) to treat low sexual desire in women despite concerns about the drug's limited efficacy and doubts over its clinical relevance. That the drug is being called the "pink Viagra" can be misleading as Viagra treats erectile dysfunction by improving blood flow while Flibanserin targets the brain, and must be taken daily.

“When people with early-stage symptoms took omega-3 supplements for three months, they had much lower rates of progression than those who did not,” according to research out of Australia covered in this month’s issue of the New Scientist.

Seniors are twice as likely to receive psychotropic prescriptions than younger adults but are much less likely to receive mental health care from psychiatrists or to receive psychotherapy, according to a recent study published in the Journal of the American Geriatrics Society. "Our findings suggest that psychotropic medication use is widespread among older adults in outpatient care, at a far higher rate than among younger patients," the study’s lead author Dr. Maust said in a press release. “In many cases, especially for milder depression and anxiety, the safer treatment for older adults who are already taking multiple medications for other conditions might be more therapy-oriented, but very few older adults receive this sort of care."

The majority of children, adolescents and young adults prescribed antipsychotic medications have not been diagnosed with a mental disorder, according to a recent study published in JAMA Psychiatry.

Fox 5 Atlanta featured a back to school story about the growing percentage of preteens and teens being prescribed antipsychotic medication for ADHD.  They report:...

US Food and Drug Administration scientists want to better evaluate side effects of sexual dysfunction associated with antidepressant drugs.

-HealthNewsReview.org looks at the research and concludes there's little evidence that women experience loss of executive functions during menopause, or that an ADHD drug could help if they did.

-Psychiatry Advisor reports on psychiatrist James Rucker's campaign for more research into the therapeutic potentials of psychedelic drugs, and on critics who point to the risks.

A Molecular Psychiatry study found that people who had recurrent depression developed smaller hippocampi and antidepressants protected against that effect -- except insofar as the study evidence seemed to show the opposite of what the media reported on it.

-A presentation at the International Parkinson and Movement Disorder Society Congress, that showed a doubling and tripling of the risk of dying within 6 months for people with Parkinson's if they were taking antipsychotics.

A Johns Hopkins Bloomberg School of Public Health survey of 1000 US primary care physicians found that many do not understand basic medical facts about the addictive nature of the opioids they are prescribing.