Wednesday, April 30, 2008

Parliamentary "Chemical Restraint" Report due later this month

Off-label use is the practice of prescribing drugs for a purpose outside the scope of the drug's approved label.  In the U.S. it is a criminal offense for a pharmaceutical company to promote off-label uses of drugs.  Atypical antipsychotics are not FDA approved for "Dementia".   Atypical antipsychotics have a black box warning "INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA" See FDA labels for Abilify, Geodon, Risperdal, Seroquel and Zyprexa here: http://tmap.wordpress.com/
 
WHEN David Ramsay, a former senior consultant at Guy’s hospital in London, was diagnosed with dementia in 1998, his wife fought for three years to have him taken into full-time care.

But just months after winning her battle, David’s neck twisted by 90 degrees, leaving his chin permanently fixed to his chest and forcing him to spend the rest of his life staring at the ground.

His condition, a rare neurological disorder, was a side-effect of a powerful antipsychotic drug prescribed to control the symptoms of Alzheimer’s. According to a parliamentary report, to be published later this month, his case is far from isolated.

International Concern About Doping Elderly with Antipsychotic Drugs

The Press (New Zealand)
Concern at doping of erratic elderly

Wednesday, 30 April 2008

Concern is growing about the doping of elderly rest home residents with anti-psychotic drugs.

British research shows the practice - soon to be the subject of a New Zealand study - can result in premature death.

Researchers from King's College in Britain compared the life expectancy of people with dementia and prescribed anti-psychotic medication with those not on the drugs.

They found those given anti-psychotic drugs, not designed to treat dementia but sometimes used to control aggression, died much earlier.

After 24 months on the study, more than 45 per cent of those taking anti-psychotic medication had died compared with 22% of people in the other group.

It is unknown exactly how many elderly New Zealanders with dementia or Alzheimer's disease are prescribed the psychiatric medications.

However, a group of North Island researchers will soon publish a study looking at the use of anti-psychotic medication in rest homes.

Old-age psychiatrist Matthew Croucher said far too many elderly were likely to be prescribed anti-psychotic drugs unnecessarily.

The drugs made them more likely to fall over and hurt themselves, have a stroke and in some cases die prematurely, while the benefits were modest, he said.

"Overseas there is an increasing concern about the use of anti-psychotics among the elderly. In the UK inappropriate over-medication is widespread," he said. "Here we are now looking at the issue because it is a significant one."

Croucher is one of a team of people recently charged by New Zealand's drug agency, Pharmac, to write prescription guidelines for anti-psychotic use in rest homes. He was also reviewing the North Island research.

Age Concern Canterbury chief executive Andrew Dickerson said he was disturbed by the British study, which was done by credible university academics.

He considered it abuse for people to be inappropriately medicated in rest homes, particularly if it happened because of staff shortages.

People with dementia could sometimes be difficult and required high levels of care but over-sedating them was not an appropriate response, he said.

Alzheimers New Zealand national director Lucille Ogston said it was sometimes appropriate to use anti-psychotic drugs to control intense physical or behavioural issues in people with dementia or Alzheimer's disease.

However, this was generally appropriate only in small doses and over short periods of time.

Staff shortages in rest homes and a lack of properly trained carers meant doctors were sometimes put under pressure to prescribe anti-psychotic drugs to control or sedate elderly, Ogston said.

She and Dickerson welcomed Pharmac's decision to write guidelines on the use of anti-psychotic drugs as a first step to understanding the scale of the problem in New Zealand.  

Link:  http://www.stuff.co.nz/northland/4502375a11.html

 

Monday, April 28, 2008

The Atypical Antipsychotic War

Psych Central
The Atypical Antipsychotic War
by John M. Grohol, Psy.D.
April 14, 2008

Robert Farley of the St. Petersburg Times had an excellent in-depth piece about the war to increase prescriptions of atypical antipsychotics in America. I say “war,” because it really seems like there was a concerted, although perhaps not coordinated, effort to change the thinking about the best course of treatment for people with disorders like schizophrenia. 

Typically, drug companies are happy to publish the studies that show their drugs are superior to others’, and then hand that over to their sales and marketing team to do the hard sell to the doctors and consumers (through office visits, seminars and direct-to-consumer advertising).

But in the case of atypical antipsychotics — drugs that are significantly more expensive than those they are intended to replace, yet no more effective — the drug companies went one creative step further. They organized state by state working groups stacked with experts who were either funded by the same drug companies, or had been in the past. The panels published guidelines that — surprise, surprise! — recommended the newer, more expensive atypical antipsychotics over the older, cheaper medications. Even though they didn’t work any better and had their own potential negative side effects — weight gain and diabetes . 

Test Kids on ADHD drugs for Heart Problems, per American Heart Association

The American Heart Association recommends heart tests for kids on Ritalin.
 
Guess who protests this?   Psychiatrists of course!   They say -  Testing for heart problems "might deter people from seeking treatment."  
 

 
Heart screening urged before kids get ADHD drugs
April 21, 2008

NEW YORK (AP) -- Children should be screened for heart problems with an electrocardiogram before getting drugs such as Ritalin to treat hyperactivity and attention-deficit disorder, the American Heart Association recommended Monday.

art.heart.model.jpg

Stimulant drugs can increase blood pressure and heart rate. For most children, that isn't a problem. But in those with heart conditions, it could make them more vulnerable to sudden cardiac arrest -- an erratic heartbeat that causes the heart to stop pumping blood through the body -- and other heart problems.

About 2.5 million American children and 1.5 million adults take medication for attention-deficit hyperactivity disorder, or ADHD, according to government estimates. Stimulant drugs, like Ritalin, Adderall and Concerta, help children with ADHD to stay focused and control their behavior.

The medications already carry warnings of possible heart risks in those with heart defects or other heart problems, which some critics said were driven more by concerns of overuse of the drugs than their safety.

The heart group is now recommending a thorough exam, including a family history and an EKG, before children are put on the drugs to make sure that they don't have any undiagnosed heart issues.

"We don't want to keep children who have this from being treated. We want to do it as safely as possible." said Dr. Victoria Vetter, a pediatric cardiologist at the University of Pennsylvania School of Medicine and head of the committee making the recommendation.

The label warnings were added after a review by the Food and Drug Administration of its databases found reports of 19 sudden deaths in children treated with ADHD drugs and 26 reports of other problems including strokes and fast heart rates between 1999 and 2003. There were also reports of heart problems in adults; the committee didn't look at adults.

An EKG can detect abnormal heart rhythms that can lead to sudden cardiac arrest. Children who are already on ADHD drugs should also be tested, Vetter said. If problems are found, the child should be sent to a pediatric cardiologist. With careful monitoring, Vetter said. children with heart problems can take the medicines if needed.

 

Antipsychotic Makers: "The British Are Coming! The British Are Coming!"

Neil Hunt, of the Alzheimer's Society, said: "It is absolutely disgraceful that the widespread abuse of people with dementia has been allowed to continue despite safety warnings on anti-psychotics."    Safe alternatives to anti-psychotics are available, Mr Hunt said. 
 
Daily Mail
More than 100,000 dementia patients are given anti-psychotic drugs that 'may kill'

BY JENNY HOPE
28th April 2008

Thousands of dementia patients are being given dangerous anti-psychotic drugs just to keep them quiet, an official report has found.

The medication, which could increase the risk of premature death, is prescribed to control agitation, delusions, sleep disturbance and aggression. It is not licensed to treat Alzheimer's.

Like a zombie: Lily Frost
Like a zombie: Lily Frost

But an official investigation has found that care-home staff are using the drugs as a first resort to control the behaviour of difficult patients with dementia.

A report from the all-party parliamentary group on dementia warns that almost three-quarters of those taking the drugs, up to 105,000, are given them inappropriately - at a cost of more than £60million a year.

elderly dignity campaign

There is also evidence that side effects can double the risk of users dying prematurely.

The report, called A Last Resort, says there is no regulation of their use and urges the Government to stop their over-prescription.

MPs are calling for three-monthly checks on Alzheimer's patients taking "dangerous" anti-psychotic drugs, to review their condition.

Link: http://www.dailymail.co.uk/pages/live/articles/news/news.html?in_article_id=562425&in_page_id=1770

   records@psychsearch.net  with "UNSUBSCRIBE ME" in the subject line.

More: British Legislators Do the Right Thing: "The Government must end this needless abuse" Antipsychotic Drugging of Elderly

BBC News
Members of Parliament  urge cut in dementia drug use

MPs have urged the government to stop the "dangerous over-prescribing" of antipsychotic drugs to people in care homes with dementia.

The All Party Parliamentary Group on Dementia said the drugs should only be used as a last resort.

Elderly man

Research published earlier this month said the drugs had no benefits, and could even worsen patients' condition.

Alzheimer's groups said safeguards should be introduced to ensure the drugs were used only when essential.

There are currently 700,000 people with dementia in the UK, but that figure is predicted to soar to well over 1.7m by 2051.

The recent study, by experts from Kings College London and Oxford and Newcastle Universities, found the drugs provided no benefit for patients with mild behavioural problems, but were associated with a significant deterioration in verbal skills.

Side effects previously cited include excessive sedation, dizziness social withdrawal, accelerated cognitive decline and severe sensitivity reactions.

There have also been suggestions that use of two of the drugs, risperidone and olanzapine, can increase the risk of stroke.

Five-point plan

The committee looked at the prescription of antipsychotics to care home residents.

It concluded that around 70% of prescriptions are inappropriate, equating to around 105,000 people with dementia.

Link: http://news.bbc.co.uk/2/hi/health/7366416.stm

 

British Legislators Do the Right Thing: "The Government must end this needless abuse" Antipsychotic Drugging of Elderly

Stop drugging dementia patients, urges report
April 28, 2008

Ministers should step in to stop inappropriate prescriptions of powerful antipsychotic drugs for Alzheimer's patients, an influential group of MPs [Members of Parliament] said today.

Up to 105,000 people with dementia in Britain are wrongly being treated with the drugs, which are used to control behavioural symptoms such as aggression, they claim. Research has shown that the medications have side effects which can accelerate mental decline, triple the risk of stroke, and double the chances of premature death.

They are intended for psychotic patients suffering from delusions, paranoia and hallucinations. Yet the drugs continue to be used as a first resort to address the challenging behaviour of people suffering from Alzheimer's disease and other types of dementia, according to the MPs. A report from the all-party parliamentary group (APPG) on dementia demanded Government action on the problem and urged the National Institute for Health and Clinical Excellence (Nice), the health watchdog, to carry out a review.

The report, A Last Resort, points out that no audit or regulation of such prescriptions exists. Jeremy Wright, the group's chairman, said: "Antipsychotics can double risk of death and triple the risk of stroke in people with dementia, (can) heavily sedate them, and (can) accelerate cognitive decline.

"The Government must end this needless abuse. Safeguards must be put in place to ensure antipsychotics are always a last resort. We need to include families in decisions, give people with dementia regular reviews, and equip care staff with specialist training."

The inquiry was told that 150,000 people with dementia were prescribed antipsychotic drugs in British care facilities. Psychiatric experts said 70 per cent of these prescriptions were inappropriate.

Neil Hunt, the chief executive of the Alzheimer's Society, said more than 70 per cent of dementia patients exhibited challenging behaviour.

"More often than not this is an expression of unmet need, not a symptom of dementia, and there is no excuse for reaching for the medicine cabinet," he said.

Link: http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/04/28/ndementia128.xml

 

Friday, April 18, 2008

St. Pete Times Exposes BILLION DOLLAR PSYCH DRUG SCAM

St. Petersburg Times 
Drug research: To test or to tout?  
In the 1990s, drug companies trumpeted a new class of drugs, atypical antipsychotics: better treatment, fewer shakes. They wanted the Food and Drug Administration to let them say their drugs were safer and more effective than Haldol. But the FDA said no.  
By Robert Farley
 
In the mental institution in One Flew Over the Cuckoo's Nest, Nurse Ratched is obsessed with keeping order on the ward. She dispenses pills that sedate the residents into near zombies.

The novel was published in the 1960s, when Haldol and Thorazine were the drugs of choice to fight schizophrenia. They calm patients but also can cause uncontrollable shakes.

In the 1990s, drug companies trumpeted a new class of drugs, atypical antipsychotics, that they billed as a dream solution: better treatment, fewer shakes. 

Atypical antipsychotic drugs: left to right, ZyPREXA, SeroQUEL, ABILIFY and RISPERDAL.
[Martha Rial  - Times]
Atypical antipsychotic drugs: left to right, Zy prexa, Seroquel, Abilify and Risperdal

They wanted the Food and Drug Administration to let them say their drugs were safer and more effective than Haldol. But the FDA said no, because the drug companies had submitted biased studies, according to documents obtained by the St. Petersburg Times.

It happened when Eli Lilly and Co. asked for approval of Zyprexa, and again when Janssen asked for approval for Risperdal.

The FDA said Risperdal could come to market. But there was a caveat: "We would consider any advertisement or promotion labeling for Risperdal false, misleading or lacking fair balance ... if there is a presentation of data that conveys the impression that (Risperdal) is superior to haloperidol (generic for Haldol) or any other marketed antipsychotic drug product with regard to safety or effectiveness."

Believing they had invented better drugs, not to mention the opportunity for outsized profits, the drug companies were undaunted by the FDA's red light.

Prohibited from touting their drugs as better? No problem. They paid academics and doctors who said it for them.

The companies funded study after study that found — little surprise — the new drugs were better and safer. State by state, the companies funded committees that set treatment guidelines that decreed atypicals should be the drugs of choice.

Despite the FDA ostensibly reining them in, the drug companies remade the marketplace.

Atypicals have become the overwhelming drug of choice, and not just for schizophrenia and bipolar disorder, the crippling illnesses they were approved for. Doctors commonly prescribe them to treat anxiety, depression and ADHD in children. They're even given as sleep aids.

The new drugs can cost 20 times as much as the old, so taxpayers pay a small fortune in Medicaid expenses. In Florida alone in the past five years, taxpayers spent more than $1.1-billion on the new antipsychotic drugs.

The drug companies, meantime, enjoy billions in profits.

• • •

Allen Jones knew the instant he was destined to be a whistle-blower. He says it was when his boss told him: "Quit being a salmon. Quit swimming against the stream with the pharmaceutical case."

It was a fluke that the case landed on his desk, and it was a fluke that he was even working in the office of the Inspector General in Pennsylvania.

Twice divorced, a single dad with custody of his kids, he had been swinging a hammer, doing rehab work on houses and flipping them. He figured signing on with the state would give him financial security and early retirement.

But life has a way of veering from script, and in 2002, he happened to draw a case where the state's chief pharmacist reportedly was earning money on the side — from a pharmaceutical company.

Jones learned that the chief pharmacist headed a government panel that would decide which drugs doctors should reach for first to treat severe mental illnesses in Pennsylvania. All of the drugs being touted as front-line were brand new, patented, and therefore exceptionally expensive. Yet some experts that Jones talked to said the new drugs were no better than the old ones.

"It didn't pass the smell test," he said. "There was too much opportunity for fraud."

He suspected that pharmaceutical companies promoting their new drugs were "buying off" state officials in positions to influence the prescription practices of doctors across Pennsylvania. Taxpayers were paying the freight for these high-priced drugs.

That's when Jones says his boss told him not to play the part of the salmon. Drop it, the politicians will never stand for a real investigation: "I was told point-blank, 'These pharmaceutical companies write checks on both sides of the aisle.' "

Jones ended up taking his concerns to the press. It wasn't long before a security guard escorted him from the building and into the ranks of the unemployed.

 More:  http://www.tampabay.com/news/health/article454391.ece

Thursday, April 17, 2008

3,000 children were given unlicensed anti-psychotic drugs despite safety fears

The Times
3,000 children were given unlicensed anti-psychotic drugs despite safety fears
April 7, 2008
By Ben Quinn
 
The number of British children being given controversial anti-psychotic drugs has increased sharply, according to research.
 
As many as 3,000 children were administered the unlicensed drugs between 1996 and 2005, despite concerns from experts that they could cause long-term harm and even death.
 
Doctors gave out twice as many prescriptions for the medication in 2005 as in 1992, even though they are not licensed to be given to children.
 
The number of prescriptions for children in the 7 to 12 age group trebled, the largest area of expansion, according to findings by Ian Wong, a Professor of Paediatric Medicines Research at the London School of Pharmacy.
 
In most cases, the drugs have been given to children with behavioural and personality disorders, autism and hyperactivity.
 
The research is to be published in the US journal Pediatrics next month. David Healy, Professor of Psychological Medicine at Cardiff University gave warning that the drugs could cause heart, circulatory and breathing problems.
 
"There is a real question over whether the drugs can kill, for a number of reasons," he told The Guardian. "One is that all anti-psychotics act on the \ dopamine." Professor Healy said that dopamine was known to have a role in cardiovascular regulation.
 
 

Anti-psychotics may speed Alzheimer's

USA TODAY
Anti-psychotics may speed Alzheimer's decline

By Kathleen Fackelmann
April 7, 2008

Anti-psychotic drugs frequently used in nursing homes to treat aggression in Alzheimer's patients don't provide any benefit and seem to lead to a marked decline in verbal ability, a report says.

The study, published in the April issue of the journal Public Library of Science Medicine, adds to a long line of evidence suggesting such drugs aren't safe in elderly patients and don't work very well when used off-label.

The Food and Drug Administration warned doctors in 2005 that some anti-psychotic drugs could increase the risk of death when given to older patients in nursing homes.

Yet the drugs are widely prescribed. An estimated 30% to 60% of nursing home patients in the USA are given the drugs, and many of the patients have Alzheimer's, a progressive brain disease that sometimes leads to aggressive behavior, says Ralph Nixon, a spokesman for the Alzheimer's Association.

Doctors often prescribe these drugs because they act as sedatives for difficult patients, says researcher Robin Jacoby, a geriatric psychiatrist at the University of Oxford in England.

Often an underlying medical problem, such as an untreated urinary tract infection, causes an Alzheimer's patient to behave aggressively, Jacoby says.

 

 

U.S. Sen. Grassley Knocks Psychiatrist's Funding

Sen. Grassley Knocks Psychiatrist’s Funding from AstraZeneca
April 7, 2008
by Sarah Rubenstein

A University of Cincinnati psychiatrist who was the lead author of a 2002 study that concluded kids did well on AstraZeneca’s antipsychotic Seroquel has received hundreds of thousands of dollars from the company since then, according to Sen. Charles Grassley (R-Iowa). 
 
 
Grassley (pictured) raised the issue in a floor statement last week in support of a bill he’s co-sponsoring that would require drug and device makers with annual revenues of more than $100 million to disclose to the federal government on a quarterly basis anything of value given to physicians, such as payments, gifts, or travel expenses.

“Today, I am going to report on the actions of one physician to explain how industry payments to medical experts can affect medical practice,” Grassley said by way of introducing his remarks. Grassley then reviewed the funding for Melissa DelBello, who had reported to the University of Cincinnati that she had received $100,000 from AstraZeneca in 2003, the year after the study’s publication in the Journal of the American Academy of Child & Adolescent Psychiatry. She reported another $80,000 in 2004. The payments covered lectures, consulting fees, service on advisory boards and reimbursements for travel-related costs, Grassley said.

DelBello, who also has received NIH grants, also reported $100,000 in outside income between 2005 and 2007. But when Grassley asked AstraZeneca directly, the total value of its payments to DelBello during those three years came to $238,000.

“The fact that a physician can promote a drug to other doctors and receive NIH funding, while hiding a very clear conflict of interest, is disturbing,” Grassley concluded.

More here:
http://tmap.wordpress.com/2008/04/07/sen-grassley-knocks-psychiatrist%e2%80%99s-funding-from-astrazeneca/

 

Tranquillisers putting children's lives at risk. Anti-psychotics may cause long-term harm, say critics


The Guardian
Tranquillisers putting children's lives at risk· Anti-psychotics may cause long-term harm, say critics
Youngsters under 6 being given unlicensed drugs

By Sarah Boseley
April 7 2008

New evidence has shown children's lives are being put at risk by a surge in the use of controversial tranquillising drugs which are being prescribed to control their behaviour, the Guardian has learned.

The anti-psychotic drugs are being given to youngsters under the age of six even though the drugs have no licence for use in children except in certain schizophrenia cases, the report says.

The number of children on the drugs has doubled since the early 1990s as the UK begins to follow a trend started in the US, but critics say they are a "chemical cosh" that could cause premature death.

The first comprehensive analysis, carried out by Ian Wong, professor of paediatric medicines research at the London School of Pharmacy, suggests the number of children on the drugs has surged sharply.

His analysis, to be published next month in the US journal Pediatrics, shows that between 1992 and 2005, 3,000 UK children were given anti-psychotics.

Twice as many prescriptions were given to children for the drugs in 2005 as in 1992, with the biggest increase in the seven to 12 age group, where the number of anti-psychotics prescribed trebled. The largest category of use by far is in cases of behavioural disorders and personality disorders, including bipolar disorder (manic depression), autism and hyperactivity.

The increase follows a huge rise in the use of the drugs in children in the US. Yet nobody knows how the drugs affect a growing child's body or what may happen in the long term. The increase has come at a time when former psychiatric best-sellers Prozac and its class of anti-depressants have gone out of patent. Wong says children on anti-psychotic medication are more likely to die earlier - something which may not be caused by the drug but which gives cause for concern. "The mortality rate is much higher. It could be some underlying problem of the brain. It doesn't show the drug is causing any deaths, but there is this inequality." 
 

2.5m children on drugs in US

April 07 2008

Antipsychotic drugs for children have taken off in the US on the back of a willingness to diagnose those with behavioural problems as having manic depression. Even children barely out of babyhood are getting a diagnosis of bipolar disorder, the modern term for the condition.

The chief symptoms are mood swings, which, however, are common in children of any age.

David Healy, an expert on bipolar disorder, said there were now 2.5 million American children on antipsychotics. However, the UK guidelines on the disorder, from the National Institute for Health and Clinical Excellence, urge caution.

One drug which prompted concern was Risperdal, originally to be sold for children with "irritability" or difficult behaviour in autism. It was reviewed by experts for the Medicines and Healthcare products Regulatory Agency because of "concern about the potential misuse of [it] as ... long-term chemical control". The drug's maker, Janssen-Cilag, though it won a licence for it, withdrew its application, citing differences with the authority.

Sami Timimi, a child psychiatrist, criticises the "social trend of using powerful, largely ineffective medicines to control the behaviour of [children] who have never had a say in what is imposed on them".

More here:
http://tmap.wordpress.com/2008/04/07/25m-children-on-drugs-in-us/

 

Wednesday, April 16, 2008

Fire that psychiatrist!


 
Rajiv Tandon,  Chief Psychiatrist, State of Florida,  needs to be fired as an employee of the State.   Check out the story http://tinyurl.com/49v62c in the St. Pete Times and then write a letter.  Tandon received undisclosed amounts of money from every atypical antipsychotic maker. As the "Chief Psychiatrist" Tandon  invited only those psychiatrists  who had been funded by atypical antipsychotic makers to a meeting where it was decided which antipsychotics to use in Florida. He neglected to invite anyone such as Yale professor, Dr. Robert Rosenheck, who said "There was never any evidence that warranted the amount of money we spend on atypicals," he said. "If you look at it independently, it is very clear the results say there is no benefit'' to atypicals (newer antipsychotics) over typicals. (older antipsychotics)  The cost to Florida taxpayers for these new atypical antipsychotic drugs over the last 5 years?  $1.1 BILLION. These "new" antipsychotics at $8 per pill are no more "effective" than the older antipsychotic drugs such as Haldol and Thorazine at 5 cents per pill  and have just as many horrendous side effects. 
 
Fire that Psychiatrist!
 
1. Send your letter to the editor: letters@sptimes.com
 
2 Then send the message to Florida Governor Charlie Crist:  Charlie.Crist@eog.myflorida.com   and cc  Bob Butterworth Bob_Butterworth@dcf.state.fl.us , Secretary of  
the Florida Department of Children and Families.  
 
 

Antipsychotic Drugs Increase Pneumonia In Elderly

 
ScienceDaily
Antipsychotic Drugs Increase Risk Of Developing Pneumonia In Elderly
Apr. 15, 2008

 
Elderly patients who use antipsychotic drugs have a 60 percent increased risk of developing pneumonia compared to non-users. This risk is highest in the first week following prescription and decreases gradually thereafter. Antipsychotic drugs are frequently used in elderly patients for the treatment of psychosis and behavioral problems associated with dementia and delirium. This study is the first to show that the development of pneumonia is associated with antipsychotic drug use.

“The risk of developing pneumonia is not associated with long-term use, but is the highest shortly after starting the drug,” say Drs. Rob van Marum and Wilma Knol, authors of the study. They caution that “all antipsychotic drugs may be associated with pneumonia in elderly patients.”

In nursing homes, up to 40 percent of residents may be prescribed antipsychotics, according to the study. It has been suggested that, for residents of nursing homes who receive antipsychotic therapy, more than half are prescribed for inappropriate reasons.

Although literature shows limited efficacy and effectiveness for antipsychotic drug use in the treatment of behavioral problems in dementia patients, these drugs are frequently used for this purpose. In the last few years it has become clear that the use of antipsychotic drugs in elderly patients is also associated with an increased risk of death and morbidity.

The underlying mechanism for the association remains unclear. The authors stress that clinicians may need to monitor patients for sedation after initiation of antipsychotic medication and that a careful weighing of the possible risks is recommended before starting antipsychotic treatment in elderly people.

This study is published in Journal of the American Geriatrics Society.
  
 
 
 

Saturday, April 12, 2008

A steady trickle of reports emanating from around the US?

teens-and-pills.jpgOver the past several months, there has been a steady trickle of reports emanating from around the US that indicate antipsychotics have been prescribed to children, even when appropriate regulatory approval has been lacking. Now, a forthcoming study suggests the same trend has been occurring in the UK, The Guardian reports.

The number of children on the drugs has doubled since the early 1990s, according to the first comprehensive analysis, which was conducted by Ian Wong, a professor of pediatric medicines research at the London School of Pharmacy. His analysis, which will be published next month in Pediatrics, shows that between 1992 and 2005, 3,000 UK children were given antipsychotics, the paper writes.

Moreover, twice as many scrips were written for children in 2005 as in 1992, with the biggest increase in the 7-to-12 age group, where the number of antipsychotics prescribed tripled. The largest category of use was in cases of behavioral and personality disorders, including bipolar disorder (manic depression), autism and hyperactivity.

Wong says children on antipsychotics are more likely to die earlier - something which may not be caused by the drug but which gives cause for concern. “The mortality rate is much higher. It could be some underlying problem of the brain. It doesn’t show the drug is causing any deaths, but there is this inequality,” he tells The Guardian. He adds, however, that some children had underlying, incurable conditions such as AIDS, so it is hard to establish whether the drugs played any part in those deaths.

Manhattan Shrink Exposed

By C.J. SULLIVAN and JEREMY OLSHAN

PSYCHED OUT: Beverly and Madison Wilhelm, say they were tricked by their shrink, who works at this Westchester clinic.
PSYCHED OUT: Beverly and Madison Wilhelm, say they were tricked by their shrink, who works at this Westchester clinic.
 
April 8, 2008 -- A Manhattan shrink practiced a perverse version of couple's therapy, a bombshell lawsuit charges - messing with the husband's head while trying to just plain mess around with the wife.

Beverly and Madison Wilhelm, of Georgia, say psychiatrist Jonathan Lauter nearly destroyed their marriage by preying on Beverly's emotional confusion and seducing her.

When Mrs. Wilhelm confessed to her doctor that she had developed feelings for him - a psychological phenomenon known as "erotic transference" - Lauter, rather than dispel these notions or refer her to another psychiatrist, chose to employ a "talking cure" that involves phone sex, the suit alleges.

"I would love to make love to you," Lauter replied, according to the lawsuit. "I have always been attracted to you. I saw doors opening when you told me how you felt."

With Mr. Wilhelm, meanwhile, Lauter is accused of playing up the psychological damage done by the infidelity of a previous wife.

Lauter could not be reached for comment at his Upper West Side home, or at the clinic at the Stony Lodge Hospital in Ossining, Westchester County, where he treats adolescent substance abusers.

The Lauters moved to New York from Georgia in 2006, because of his wife's job as an attorney for the Anti-Defamation League, sources said. The move had nothing to do with the case.

Lauter admitted to the Atlanta Journal-Constitution that Wilhelm confessed her feelings to him, but insisted that he himself had done nothing wrong.

"I have no idea what this is all about," he said.

Even though Lauter never actually managed to get Beverly Wilhelm into the sack, he continued his unethical behavior even months after he left Georgia, said the couple's attorney, William Quinn.

"He can truthfully say, 'We never had sex.' And to some people that might seem like 'no harm, no foul,' but this clearly goes against all standards of practice," Quinn said.

Lauter's behavior seems to have been somewhat premeditated.

The couple initially brought their 4-year-old son to Lauter because he was having great difficulty adjusting to the birth of a sibling. Lauter determined that there was nothing clinically wrong with the boy, but suggested taking on the parents as patients, both as individuals and as a couple, according to the lawsuit.

The couple wasted countless hours and thousands of dollars on therapy that was not only worthless, but destructive, Quinn said.

Cellphone records show Lauter continued to obsessively call Beverly Wilhelm long after he and his wife moved to New York, and as a result she started drinking heavily.

Despite Lauter's best efforts, he could not convince Wilhelm to come up to New York to consummate the twisted affair.

Instead he had to settle for progressively more graphic phone conversations, the suit charges.

"As the sexualized nature of the telephone calls became more overt, the defendant on a number of occasions specifically told the plaintiff that he wanted to make love to her, or 'f- - -' her," the suit says.

Wilhelm, who remained conflicted about her feelings throughout, even tried changing her cellphone number to end their contact. But the calls continued.

Nearly "suicidal," she finally broke the news to her husband after drinking the better part of a bottle of wine, Quinn said.

"Rather than strengthen her marriage, and increasing her self-esteem, the defendant caused the plaintiff to feel unworthy, depressed, isolated, and at times suicidal," the lawsuit states.

Quinn would not say what monetary award the couple is seeking.

Reached at their Alpharetta home, the couple declined to comment.

 

Friday, April 04, 2008

Psych Sued in Child (4 year old Rebecca Riley) Drugging Case

4 year old Rebecca Riley died from an overdose of Seroquel - an antipsychotic drug and a variety of other psychiatric drugs.    Unfortunately, she is becoming the poster child  against antipsychotic drugging of children.  Her case has been reported widely in the media.  
 
"They made her a 4-year-old zombie," said Meyer, whose Boston law firm Lubin & Meyer specializes in medical malpractice cases. 

Boston Globe
Doctor is sued in death of girl, 4
Her psychiatrist treated her with powerful drugs

By Shelley Murphy
April 4, 2008

The parents of 4-year-old Rebecca Riley are awaiting trial on charges that they killed her in December 2006 with an overdose of psychiatric drugs.

A medical malpractice suit filed yesterday asserts that a Tufts Medical Center psychiatrist who diagnosed the girl as bipolar when she was 28 months old and then treated her for two years with a regimen of powerful drugs is to blame for her death.
 

"This child was subject to mostly telephone prescriptions and a slipshod diagnosis," said Boston lawyer Andrew C. Meyer Jr., who represents Rebecca Riley's estate and filed the suit against Dr. Kayoko Kifuji in Suffolk Superior Court.

Six weeks before Rebecca Riley was found dead on Dec. 13, 2006, in a Hull house shared by her parents and other relatives, a nurse at her Weymouth preschool warned Kifuji that she suspected the child was overmedicated because she was often too tired to participate in school activities and appeared like a "floppy doll," according to Meyer. Kifuji did not reduce her medication after examining the child, he said.
 
"They made her a 4-year-old zombie," said Meyer, whose Boston law firm Lubin & Meyer specializes in medical malpractice cases. "We don't believe that she did suffer from bipolar or that this was the appropriate medication."
"The primary responsibility falls on this doctor," Meyer said. "The failure of this doctor to respond to the warnings she was given and to thoroughly investigate the symptoms that her medication was causing ended with this very sad result here of a young girl dying."
 
 
 

Thursday, April 03, 2008

British Legislator says Antipsychotic Drugs are Killing Elderly

You can comment side by side with the Brits here: http://tinyurl.com/2cn5ba

BBC
Drugs 'kill 23,000 Alzheimer's victims a year'

By Sarah Womack, Social Affairs Correspondent
01/04/2008

More than 23,000 elderly people with Alzheimer's could be dying prematurely in care homes each year after being given drugs to keep them quiet, a report claims today.

Anti-psychotic drugs, which are not licensed to treat dementia but are prescribed to control agitation, sleep disturbance and aggression, are being given to 100,000 elderly people to keep them "quiet and manageable", says a report by Paul Burstow, the Liberal Democrat MP and a campaigner for the rights of elderly people.

Some elderly folks simply prefer to keep busy, scoff at antipsychotic drugs such as Risperdal  and shoo away shrinks.

Despite studies that show the drugs can increase the risk of strokes and have other harmful side effects, the report claims the Government has failed to act to stem their use.

The report comes as research by three universities says long-term use of anti-psychotics offers "no long-term benefit for most patients".

The claims in the report will fuel the debate over the use of powerful drugs, dubbed "chemical coshes" because of their strong sedative effect, on care home residents.

Mr Burstow cited a yet-to-be published study by King's College London that gave a placebo to one group of Alzheimer's patients and anti-psychotics to another for 12 months.

The study, funded by the Alzheimer's Research Trust, found that after 24 months, the placebo group had a 78 per cent survival rate compared with 54.5 per cent for the rest; after 42 months the survival rates were 60 per cent versus 28 per cent.

Mr Burstow said: "There are around 244,000 people with dementia living in care homes, and the Alzheimer's Society estimates 100,000 are being given anti-psychotic drugs. Of those, I am saying that 23.5 per cent could be dying prematurely as a result of being prescribed anti-psychotic drugs - or 23,500 people a year."

More here:
http://tmap.wordpress.com/2008/04/01/drugs-kill-23000-alzheimers-victims-a-year/

You can find the legislator's report here: http://tinyurl.com/2ytdku

 

Wednesday, April 02, 2008

Talking Head Psych who did Studies for Lilly - Banned From Practising In Britain

Telegraph
BBC psychiatrist Tonmoy Sharma is struck off
By Lucy Cockcroft
01/04/2008

A psychiatrist who regularly appeared as an expert on the BBC has been struck off the medical register after he lied about his academic qualifications and performed unethical drugs tests on mentally ill patients.

Tonmoy Sharma, who was a senior lecturer at the Institute of Psychiatry in London, has been exposed as a fraud who repeatedly referred to himself as a "professor" when records show that he had never completed a PhD thesis.

Tonmoy Sharma has been struck off the medical register
Tonmoy Sharma was found guilty of serious professional misconduct

Despite this, Sharma, who was registered at the Clinical Neuroscience Research Centre in Dartford, Kent, regularly used the letters PhD after his name and managed to deceive the NHS and some of the world's largest pharmaceutical companies.

He also appeared on the BBC2 series Mind of a Murderer in 2000 and was often used as an expert commentator on BBC News Online stories.

A General Medical Council panel yesterday found Sharma guilty of "serious failings of personal integrity" after hearing that he recruited mentally ill patients to test drugs without seeking proper approval.

Andrew Popat, chairman of the panel, told Sharma: "Your persistent and wide-ranging dishonesty and untruthfulness, spanning a number of years, together with your lack of insight, is so serious that it is fundamentally incompatible with your continuing to be a registered medical practitioner."

Mr Popat said Sharma, the author of several books on mental illness, had "contributed significantly towards the advancement of medical science" and was highly regarded by his colleagues.

However, after a 10-month hearing, the GMC Fitness to Practise panel found Sharma guilty of serious professional misconduct and struck him off the medical register.

The 42-year-old, who trained in India, was found to have acted unprofessionally in relation to five major studies between 1997 and 2003, involving four leading pharmaceutical companies including Eli Lilly and the Janssen Research Foundation.

He also misled the companies when he chose to use identical patients in different studies, subjecting them to MRI scans and tests that had not been approved by an ethics committee. In 2003, he recruited mental health patients in unsolicited telephone calls and without consent from their doctors. He then failed to give them proper information about the trials - one schizophrenic was simply handed a leaflet.

His misconduct was first uncovered by the drugs company Sanofi, and a complaint resulting in his temporary suspension was made to the Institute of Psychiatry in 2001, prompting an investigation.

Sharma, who represented himself at the hearing, denied the claims and insisted that he "believed in ethics in medicine".