psychiatry
j7uy5 | December 15, 2006Since it seems to be a big deal to the New York Times (two articles in
two days), I thought I'd comment on this. An FDA advisory
panel recently voted to expand the warnings in the product labeling for
antidepressants.
Just to put this in perspective, the FDA makes many
such changes. The most recent
href="http://www.fda.gov/medwatch/safety/2006/oct06_quickview.htm">summary
page is from October of this year, and it lists changes to
the labeling for Avastin, Chloraprep, Coumadin, Remicade, Seroquel,
Allegra, Opana, Sodium Chloride Irrigation solution, Vicoprofen,
DepaKote, Heparin,…
j7uy5 | December 11, 2006According to a study published in the medical journal, Pediatrics,
girls and young women who visit eating disorder oriented websites may
be harmed by the activity. The funny thing is, is does not
matter if the sites encourage eating disorder behavior, or discourage
it. Persons who visit such sites are more likely to end up in
the hospital for treatment of their disorder, and are more likely to
have along duration of active illness. Furthermore, they are
likely to spend less time on schoolwork.
Although it is not possible to say that the use of such sites
exacerbated the disorders, persons…
j7uy5 | December 8, 2006Just when you thought there could not possibly be any more to say about
the subject, given the uncertainties inherent in the area, there is yet
another study. This one is from analysis of a large patient
registry in Finland. A total of 15,390 patients were included
in the analysis, over a period of 3.4 years. This study
confirms the finding that antidepressant use does lead to an increase
in suicide attempts. It also finds that there is a decrease
in actual death from suicide, and a decrease in
overall mortality.
href="http://archpsyc.ama-assn.org/cgi/content/abstract/63/12/1358"…
j7uy5 | December 4, 2006This is kind of an old story, I know. Still, every once in a
while it is good to revisit these things. When the topic
first came up in 2004, it was the subject of much newspaper space and
blog commentary. But now, it has pretty much faded from the
national consciousness. Has anything more come of it?
In a recent editorial in the American Journal of Psychiatry,
Gregory E. Simon, M.D., M.P.H., reviews the largest and most
informative studies on the subject:
href="http://ajp.psychiatryonline.org/cgi/content/full/163/11/1861">
href="http://ajp.psychiatryonline.org/cgi/content/full/…
j7uy5 | December 2, 2006I have to admit, I was started to see a Consumer Reports article on the
"Best Buy" drugs for the treatment of schizophrenia and bipolar
disorder. So now
treating mental illness is like buying a toaster oven?
Seriously, at first
it seemed kind of inappropriate. After all you cannot assess
pharmaceuticals the same way you assess ordinary consumer products, can
you?
First, let me say that I like the magazine. I don't
subscribe to it, but I do look at it from time to time, and I do
consult it for certain things. For instance, in 1995, when I
went to buy a microwave oven, I first went to…
j7uy5 | October 28, 2006A while back, I wrote about the new treatment for
href="http://en.wikipedia.org/wiki/ADHD" rel="tag">ADHD
that is under
development,
href="http://www.nrpharma.com/products/NRP104.htm" rel="tag">NRP104.
The original post is
href="http://trots.blogspot.com/2005_02_27_trots_archive.html">here.
In that post, I reviewed the pharmacology of NRP104.
The basic idea is that the company took an old molecule,
href="http://en.wikipedia.org/wiki/Dextroamphetamine" rel="tag">dextroamphetamine,
and tacked a molecule of
href="http://en.wikipedia.org/wiki/Lysine">lysine
onto it. …
j7uy5 | October 27, 2006It is never easy to make decisions about the use of medication by women
who are pregnant. For the vast majority of drugs, the
manufacturer's statement says something to like this: 'Product X should
only be used if the benefit outweighs the risk.' But there is
never any specific guidance about how to weight the risks and benefits.
It is hard to do when the risks are not known.
In the case of treating maternal depression in pregnant women, the
situation is complicated by the possibility that leaving the depression
untreated could have a negative impact on both the mother and the
fetus…
j7uy5 | October 24, 2006That's the title of
href="http://www.nytimes.com/2006/10/24/health/24cons.html?ex=1319342400&en=e370af46c3a1c13b&ei=5090&partner=rssuserland&emc=rss">an
article in the New York times. It is about clusters
of illness that are discovered by people posting on the Internet.
The concern is that some of these might by "psychosomatic,"
more properly known as
href="http://psyweb.com/Mdisord/jsp/somatd.jsp">somatoform
disorders. In the article, they describe a group of
persons who believe they have
rel="tag">Morgellons Disease.
Personally, I would be skeptical of…
j7uy5 | October 13, 2006I ran across a press release (
href="http://www.eurekalert.org/pub_releases/2006-10/uoa-ltf100606.php">1
href="http://www.brightsurf.com/news/headlines/26739/LSD_treatment_for_alcoholism_gets_new_look.html">2)
pertaining to a journal article (‘Hitting Highs at
Rock Bottom’: LSD Treatment for Alcoholism,
1950–1970)
on the use of LSD for treatment of alcoholism. When I saw it,
I
thought I'd blog about it. As it happens, several people beat
me
to it.
Anyway, the topic is sufficiently compelling that I am going to post it
anyway, and try to add a little to what has already been said…
j7uy5 | October 6, 2006This is
another one of those pilot studies that may or may not go
anywhere. Even if it doesn't it might contribute to our
theoretical understanding of major depression.
One nice thing about it is that
href="http://en.wikipedia.org/wiki/Scopolamine" rel="tag">scopolamine
is old; presumably, it is not very expensive. That attraction
is offset, though, by the fact that the pilot study used intravenous
scopolamine.
One
interesting aspect of this study is that scopolamine is an
ingredient in nightshade, jimson weed, mandrake, and henbane.
It blocks a family of cholinergic receptors:…
j7uy5 | October 5, 2006Imagine what kind of money you could make, if you had a $15,000 device
that could slow the progression of Alzheimer disease. The
following clip is from a Medscape news article. (Free
registration is required to view it, but that is better than the
original journal article, which requires a subscription.)
Vagus
Nerve Stimulation Shows Promise as Alzheimer Disease Treatment
By Will Boggs, MD
NEW YORK (Reuters Health) Sept 28 - Vagus nerve stimulation (VNS) is
safe and beneficial for some patients with Alzheimer disease, according
to a report in the August Journal of Clinical Psychiatry…
j7uy5 | October 2, 2006This is from the journal Menopause. The
link goes to the abstract; a subcription is required for full access.
It is a pilot study with results that are not robust enough
to use in routine clinical decision-making, but it does indicate a
possible benefit to supplementation of venlafaxine (Effexor) with HRT
in depressed postmenopausal women.
href="http://www.menopausejournal.com/pt/re/menopause/abstract.00042192-200613020-00011.htm;jsessionid=Fg9ZyB1TT5h1lKGn52MG1XLKMd3v4rT7knF02TDQV2jRY25S6tvX%211096339265%21-949856144%218091%21-1">Menopause
2006 Mar-Apr;13(2):202-11.
Efficacy of…
j7uy5 | September 20, 2006I find it interesting that one of the recipients of a Lasker Clinical
Research Award this year was
href="http://en.wikipedia.org/wiki/Aaron_Beck" rel="tag">Aaron
Beck. Dr. Beck is a psychiatrist. He is
widely regarded as the originator of cognitive therapy.
The rationale is outlined in the NYT
href="http://www.nytimes.com/2006/09/17/health/17lasker.html?ex=1316145600&en=f2f082f5fbdc459b&ei=5090&partner=rssuserland&emc=rss">article
on the awards:
The psychiatrist, Dr. Aaron T. Beck, 85, of the
University of Pennsylvania, won the Lasker clinical research award. Dr…
j7uy5 | September 11, 2006There is a lot of
information about
href="http://en.wikipedia.org/wiki/Vagus_nerve_stimulation"
rel="tag">vagus nerve stimulation as a treatment
for depression, that you can get from the latest New York Times article
(
href="http://www.nytimes.com/2006/09/10/business/yourmoney/10cyber.html?ex=1315540800&en=7877734ab451d64f&ei=5090&partner=rssuserland&emc=rss">Battle
Lines in Treating Depression, permanent link) on the subject.
Unfortunately, most of the good information is found by
following links. The article itself is pretty bad.
The author launched into a…
j7uy5 | September 10, 2006Today is suicide prevention day. Dr. Serani has the details
href="http://drdeborahserani.blogspot.com/2006/09/world-suicide-prevention-day-91006.html">here.
j7uy5 | August 24, 2006There is nothing mystical about the act of understanding.
Sometimes it may seem like it, when one has an Aha! moment,
or when understanding emerges in the context of meditation or spiritual
reflection, but there really is nothing supernatural about it.
Understanding, after all, is merely an act of description. It
arises from the collation of observations.
To understand something is to be able to describe that thing on all
pertinent levels of abstraction. In the case of mental
illness, that means description on levels from the molecular to the
sociocultural. At least at this time. It…
j7uy5 | August 17, 2006For decades, corporate influences, primarily in the media, have
pressured women to have poor body images. This has spurred
growth of entire industries in fashion, weight loss, etc. No
doubt, billions of dollars have been made in this way. The
only price to society has been the epidemic of eating
disorders.
However, the marketing impact has largely been limited to women.
Now, it appears, men are increasingly affected.
A study by Dr. Tracy
Tylka, presented at the annual American Psychological
Association meeting this year, provides the details:
href="http://www.medicalnewstoday.com/…
j7uy5 | August 10, 2006This is no big surprise, although I did not expect the magnitude of the
effect:
href="http://www.eurekalert.org/pub_releases/2006-08/bsj-vaw080806.php">Violence
at work significantly boosts clinical depression risk
Work-related violence and threats and the risk of
depression and stress disorders
Employees subjected to real or threatened violence at work run a major
risk of becoming clinically depressed, indicates research in the
Journal of Epidemiology and Community Health.
The magnitude of the risk was in direct proportion to the amount of
workplace violence experienced, the…
j7uy5 | August 5, 2006About 15 years ago, I was giving a lecture on psychiatric medication to
a group of MSW
students. One student asked a question that was intended to
be
provocative. She asked, "how can you justify giving
medication to
treat a problem that is obviously psychological in origin, like
posttraumatic stress disorder?"
What she was referring to, was a paradigm that was commonly held at the
time. Specifically, there was this notion that some problems
were
psychological, and others were biological, in origin. It was
thought, by some, that there was a clear distinction between the two
kinds of…
j7uy5 | August 2, 2006I just finished reading a news release pertaining to a finding in
psychiatric genetics. I was prepared to be irritated, but was
pleased instead.
href="http://www.med.umich.edu/opm/newspage/2006/ocd.htm">New
genetic findings add to understanding of obsessive-compulsive disorder
Kara Gavin
July 26, 2006
ANN ARBOR, MI – Obsessive-compulsive disorder tends to
run in families, causing members of several generations to experience
severe anxiety and disturbing thoughts that they ease by repeating
certain behaviors. In fact, close relatives of people with
rel="tag"
href="http://www.…