Friday, November 05, 2010

Alienist Investigation Continues

 

It started with the high prescribing Miami alienist* (see end) who wrote 284,908 prescriptions over the past six years which cost

Florida taxpayers $43 million.  See here: http://www.cchrflorida.org/blog/tag/dr-fernando-mendez-villamil/

 

Newspapers in other states are now publishing articles on high prescribers in their own zone.   (See below links for stories)

 

Now an Alabama newspaper is calling for their new Governor to force Alabama Medicaid to release psych drug data.

Quotes: "It is important because, as it turns out, some doctors are writing far more prescriptions for psychiatric drugs than are their colleagues. Not only does this add to the strain on Medicaid and Medicare, but it may indicate that some patients are being over-medicated. …Grassley, a member of the Senate Finance Committee, wrote to state Medicaid agencies earlier this year, asking them

to list their top 10 prescribers of eight drugs commonly used in psychiatry."

 

Alabama - Why are doctors writing so many prescriptions?

http://www.tuscaloosanews.com/article/20101105/NEWS/101109818/1012?p=1&tc=pg

 

Connecticut

http://blogs.courant.com/connecticut_insurance/2010/11/senator-grassley-cites-connect.html

 

Pennsylvania

http://www.pittsburghlive.com/x/pittsburghtrib/news/regional/s_706831.html

 

Arizona

http://azstarnet.com/news/local/article_fd365674-cb88-5b00-95ba-a2f9b2961883.html

 

West Virginia:

http://www.herald-dispatch.com/opinions/x1769794505/Senator-asks-good-questions-about-prescription-drugs

 

Minnesota:

http://www.startribune.com/lifestyle/health/105576013.html?elr=KArks:DCiUHc3E7_V_nDaycUiD3aPc:_Yyc:aUbPi87EK_g:D_vqnH_nchO7DU

 

 

*Alienist - psychiatrist; derivation: mid-19th century < French aliƩniste < Latin alienare "estrange, make irrational"

 (Encarta World English Dictionary)

 

 

Monday, November 01, 2010

Psychobabble

Millions of people around the world will crack a smile today as they watch the 33 Chilean miners finally being hoisted back to life. But Those Who Know Better, the overlords of the therapy industry, see something different: not a happy ending to a two-month nightmare, but the start of an even longer nightmare of ill-health, craziness and PTSD for these unfortunate creatures from the dark. According to the experts, what we’re really witnessing in Chile today is a volcanic eruption of human instability, as 33 ticking timebombs of emotional frailty are raised to the surface.

One psycho-expert, echoing an army of others, told Fox News that the rescue of the men will release a ‘cauldron of emotions’; apparently ‘molten, churning reservoirs of emotion are about to emerge from that mine’. And there’s no telling what this geyser of two months worth of repressed feelings will give rise to. Fox’s fortune-teller says it could spawn ‘divorces, violence, terrible despondency, panic attacks, plays for celebrity that fall short and lead to suicide, addiction to alcohol and illicit drugs and gambling, and wild allegations levelled by one miner against another’. For the mental-health lobby, it seems, every silver lining has a cloud.

How will these men who coped remarkably well in a 32 degrees Celsius underground cavern for more than two months now cope with the temptation to descend into a drug-addled world of violence and backstabbing? On this question, the experts are unanimous: as one of them sums it up, the freed 33 will require ‘all the skill of the very best mental-health professionalsavailable’. Is it just me or does this look like a brazen job-creation scheme? At a time of recession and cutbacks, I guess even the mental-health lobby has to find ways to earn a crust - even if that means cynically re-presenting 33 fairly hard, robust miners as men on the verge of a nervous breakdown who will need professional help for the rest of their lives.

The most startling thing about the various psycho-pronouncements being made about the miners is not their undiluted miserabilism, their ability to see future suicides where most of us see a moment of joy, but their ignorance of the facts of the past two months. Because the inconvenient truth is that the 33 miners survived underground not as a result of psychological advice and intervention but by sometimesrebelling against the psychologists who kept a watchful eye on their every move. The real story of the Chilean miners, for anyone who cares to look, is that the interventions of the various wings of the trauma industry often make things worse rather than better, and people are mostly happier and healthier without them.

The on-site psychology team at the San Jose mine treated the trapped men with extraordinary mean-spiritedness. Driven by the conviction that they, as one headline put it, ‘know best’, and backed up by the dime-a-dozen profferings of every headline-hungry psychologist and therapist around the globe, the psychologists saw it as their duty to police the men’s thoughts and even to censor letters from their families in case they triggered ‘problematic emotions’. Such petty authoritarianism is the end result of the deep-rooted idea that life is way too hard and complicated to be negotiated without the words of wisdom of the therapy lobby.

One of the medical experts at San Jose - part of a team of 300 people that oversaw the men’s health and needs - said there was a ‘daily arm wrestle’ between the miners and the psychology team. That isn’t surprising. The mental-health experts overground used a system of ‘prizes and punishments’ to try to control the men’s behaviour - for their own good, of course. So when the men assented to hour-long phone calls with the mental-health team, as they did when they were first found to be alive 17 days after getting trapped, they were rewarded with prizes such as access to TV shows. But when they refused to talk to the psychologists, as they started to do in mid-September when their health and body weight were improving as a result of sent-down food and they insisted that ‘we are well’, the psychology team would deprive them of luxuries. As one on-site doctor put it: ‘We have to say, “OK, you don’t want to speak with psychologists? Perfect. That day you get no TV, there is no music - because we administer these things.”’

 

More: http://www.spiked-online.com/index.php/site/article/9785/

 

Blame Anna Nicole's death on her psychiatrist

Anna Nicole Smith's psychiatrist was convicted of conspiring to fake names on prescriptions. Psychiatrist Dr. Khristine Eroshevich was convicted of conspiring with Howard K. Stern to fraudulently prescribe Vicodin. 

 

http://www.sacbee.com/2010/10/28/3140863/jury-acquits-smiths-doctor-in.html

GlaxoSmithKline criminal charges

GlaxoSmithKline has agreed to pay an eye-popping $750 million and will plead guilty to a criminal charge to settle a U.S. government investigation of manufacturing deficiencies at a former plant in Puerto Rico. The investigation largely concerned the manufacture of defective pills including the Paxil antidepressant at Glaxo’s plant in Cidra, Puerto Rico, between 2001 and 2005. U.S. authorities found that some tablets could split apart or had inappropriate amounts of active ingredient, posing safety risks. 

[http://blogs.wsj.com/law/2010/10/27/gsk-to-pay-750m-to-settle-charges-over-adulterated-drugs/?blog_id=14&post_id=35066]

 

Significant portion of children received antipsychotic for conditions that have no published evidence supporting their use

A significant proportion of children younger than 18 years in at least 1 state Medicaid population received a second-generation antipsychotic for conditions that have no published evidence supporting their use. "Clearly, behavioural problems, including oppositional and conduct disorders and hyperkinetic-hyperactivity symptoms, were frequently seen among the children treated with second-generation antipsychotics," the investigators write. [http://www.medscape.com/viewarticle/717544]

 

atypical antipsychotics (AAPs) increases the risk of significant weight gain

More research appears to confirm recent results of a large, prospective cohort study that the use of atypical antipsychotics (AAPs) increases the risk of significant weight gain and varied metabolic changes in children and adolescents with mental illness and behavioral disturbances. According to Dr. Panagiotopoulos, a growing body of evidence in adults demonstrating that AAPs cause significant weight gain, hyperlipidemia, and insulin resistance has raised concerns among the medical community in general, and the psychiatric community in particular, about whether these drugs may increase the risk of premature cardiovascular disease in children and adolescents. [http://www.medscape.com/viewarticle/712079]

 

antipsychotic use in children and adolescents is associated with rapid and significant weight gain

October 29, 2009 — First-time, second-generation antipsychotic use in children and adolescents is associated with rapid and significant weight gain as well as varied adverse metabolic changes, new research shows. "These medications are not benign and can have side effects that can have potential long-term complications that are associated with endocrine and cardiovascular illness," said principal investigator Christoph U. Correll, MD.[http://www.medscape.com/viewarticle/711526]