Research

The decision by the National Institute of Mental Health to part company with the APA’s forthcoming DSM-5 should not be taken as evidence that biological psychiatry is entering a terminal decline. Far from it, as the Director of NIMH Thomas Insel’s blog of 29th April 2013 makes clear, the reason NIMH has opted for its own Research Diagnostic Criteria (RDoC) is because they believe psychiatric patients deserve something better.

At the University of Minnesota, the answer is apparently $1,446. If harmless clerical errors were to blame for oddities like this, that fact should be easy to clarify simply by looking at the relevant documents.  But if there are systematic issues with the administration of clinical trials that makes it possible to bill for a visit with a dead subject, those issues would be important for other universities and private trial sites as well. 

MIA blogger (and lawyer) Jim Gottstein presented a 20-minute Oral Argument in ex rel Watson v. King-Vassel in front of the US Court of Appeals for the Seventh Circuit in Chicago last Thursday. "The technical issue on appeal is a lawyer nerd question about whether expert testimony is required," said Gottstein, "but I like to think it contains a succinct and clear explanation of why even though a doctor can prescribe a drug for anything, if they prescribe one off-label to a child they are causing a False Claim (committing Medicaid Fraud) unless the use has support in at least one of the specified drug references called Compendia."

The norm in science is that there is free access to the data underpinning experiments. If free access is denied; it’s not science. In the case of branded pharmaceuticals, we do not even know what trials have been done. What is put in the public domain is not data. The selected highlights of a football game and the comments of the pundits afterwards don't change the score. The selected highlights of pharma studies and the comments of pundits routinely change the score.

At the 50th American Psychosomatic Society meeting in New York, Michael Shepherd was speaking. His topic - The Placebo. When the lecture finished, Lou Lasagna said "this paper is now open for questions." Nothing happened. Nobody said anything at all. Lasagna couldn't refrain from commenting: "There are 3 possible explanations. First, you were all asleep and therefore you heard nothing. Secondly, it was so bad that since this speaker has come 3,000 miles you didn't want to embarrass him. Third, it is genuinely so original and new that you don't quite know what to make of it. I'll leave you to decide which it was". What had Shepherd said?

Researchers in Germany, China and Australia teamed up to find, through a meta-analysis of research pertaining to 1045 patients receiving antipsychotics, that augmentation with...

Research into stigmatizing attitudes towards behavior, published in Early Intervention in Psychiatry, finds that most study subjects did not spontaneously apply diagnostic labels to...

French researchers looked at the outcomes of 467 "antipsychotic drug-naive" patients six months after a first psychotic episode (and treatment with medication), finding that...

Chinese researchers find, in a literature review for the International Journal of Endocrinology find an increased rate of osteoporosis among people with a schizophrenia...

A study of the Swedish medical birth registry, conducted by researchers from Sweden, the U.K., and the U.S.A., found a 3.3X greater risk of...

Legislation in the U.K. that empowers psychiatrists to impose treatment  on patients has lost the support of one of its key advocates. "The evidence is...

Tension mounts across the ideological divide as D-Day (DSM-5 Day) approaches. The APA has powerful allies on its side. President Obama has just launched Decade of the Brain 2 with the announcement two weeks ago that heralds the arrival of BRAIN ( Brain Research through Advances in Innovative Neurotechnologies). If that’s not enough, those who believe that science will ultimately explain madness can always rely on the media to fawn at their feet.

Some psychiatric drugs are extraordinarily effective, for instance benzodiazepines for catatonia or SSRIs for premature ejaculation. These treatments are so effective that controlled trials are an irrelevance. Every trial conducted would show a positive result. The point here is not that it is impossible for a treatment to achieve effectiveness but rather that controlled trials have little useful to contribute to the issue of effectiveness. Randomized placebo controlled trials have not shown any drug within the mental health domain is effective. If a treatment were effective virtually every RCT undertaken would show a positive result.

For the past 20 years, there has been a prevailing concern in psychiatry that psychosis is bad for the brain. When I read Anatomy of an Epidemic, this was one of my most pressing concerns; if I suggested to my patients that they pursue other treatments before starting drug treatment, was I helping or harming them?

British researchers find that a 10% increase in pain medication resulted in a dramatic reduction in the use of antipsychotic and other medications. “When...

The New York Times on Obama's $235 million initiative: "Mental health unites lawmakers Republican and Democrat, urban and rural, even those with safe seats...

Eli Lilly & Co. will pay an undisclosed amount to settle the lawsuit of the parents of a South Dakota boy who committed suicide...

Military.com reports that doctors from the Department of Veterans' Affairs are continuing to prescribe tranquilizers such as Valium and Xanax despite the VA's guidelines...

In 1956, Lou Lasagna was on his way to being the most famous doctor in the United States; an advocate for controlled clinical trials of both the safety and effectiveness of medication, as well as for a revision to the Hippocratic Oath to include a holistic and compassionate approach to medicine. Then, caught in the nexus of reason, regulation, and the pharmaceutical machine, his star fell.

Pfizer may face lawsuits regarding improper marketing of Neurontin after a Boston court reinstated lawsuits that had been denied class-action status by lower courts....

Journalist/humorist Jon Ronson’s TED talk “Strange Answers To The Psychopath Test” addresses the DSM, diseasing normality, faking mental illness, and the psychopathy of former CEO “Chainsaw” Al Dunlap. The Huffington Post, for their TED Weekends section, asked me for a reaction to Ronson’s talk—but then refused to print my blog because, a Huffington Post staffer emailed me, “the TED Weekends team said that the wording of the post was too strong.” Below is the original post.

In these days of sequestrations, budget cliffs, and congressional gridlock, everyone is feeling pressured to cut back, cut corners and find the most inexpensive way to accomplish anything and everything. For those of us who have been working so hard over the past decades, this leads to the obvious question, "can we afford recovery?" I mean, after all, it is usually cheaper to just give someone a drug than to invest in the time and effort needed to bring human spirits back alive to strive and thrive. So I decided to look at this question, from the vantage point of my own singular life.

The Cochrane Library reports that "many older people with Alzheimer's dementia and NPS (neuropsychiatric symptoms) can be withdrawn from chronic antipsychotic medication without detrimental effects...

The invitation from the London Review of Books to review Ben Goldacre’s Bad Pharma™ reads: “We were unsure, at first, what a review could add that isn’t already in the book – scrappy summaries and bits of praise are not for us. The book is of sufficient importance that the main thing is to get someone who knows what they’re talking about to present the material confidently... frame the discussion”. My head said it was inconceivable that the LRB wouldn’t take a review, even if it was at odds with the invitation to praise Bad Pharma. But my gut told me the inconceivable was about to take flesh.

Pete Early, author of Crazy, traces the history of NAMI, including its "complicated love-hate relationship with Dr. E. Fuller Torrey" and shift from his...