The perpetrators of the crime have never been found, and that's due in part to the ease in which they were able to kill seven random people. All that was involved was taking a bottle off the shelf, opening it, inserting a number of cyanide laced capsules, then screwing the cap back on and putting it back on the shelf for the next person who came along to purchase it. In the wake of those seven deaths, an unprecedented recall was undertaken, a groundbreaking PR campaign was launched, and measures were taken that would forever change the way we consume medication.
John Green: "Why Are Americans Health Care Costs So High?" A quick, handy little overview of common misconceptions on the US healthcare system. (SLYT)
You're about to be the base doctor at Halley Research Station in Antarctica for a year. For ten months, no one gets in or out. Fourteen lives are in your hands, including your own. What do you put in your medical kit? And how do your choices differ from those of your predecessors (Eric Marshall and Edward Wilson) a century ago?
The Boston Globe reports that nursing homes in the United States continue to administer antipsychotic medications to patients who do not fit criteria for these drugs, in many cases to manage behavior considered disruptive by staff. For example, "in 21 percent of US nursing homes in 2010, at least one-quarter of the residents without illnesses recommended for antipsychotic use received the medications." Overuse of antipsychotic medications appears to correlate with nursing homes that have higher staff:patient ratios and to homes that house more people covered by Medicaid/Medicare. [more inside]
Falling STAR*D?: It is common practice for psychiatrists to switch depressive patients between different antidepressants if their current drug does not evince a symptomatic response. Despite clinical wisdom supporting this, little empirical, controlled evidence exists to direct “switching” protocols (e.g. if a patient with Z characteristics is on drug X, is it usually better to switch to drug A, B, or C? Will switching help at all?) in the psychopharmacological treatment of depression. The NIMH-funded STAR*D (Sequenced Alternatives to Relieve Depression) study aimed to address these questions of treatment direction in a very large (n>4000), “real-world” sample using a multi-phase treatment plan with different drugs (and cognitive therapy) at every step to maximize chances of eventual remission. Overall, the NIMH reported that about 67% of patients eventually achieved remission, with few differences in effectiveness between different types of treatment at each step. However, researchers and commentators have raised concerns regarding inconsistent reporting of outcomes, after-the-fact changes in study design and analysis, and other issues that may have inflated, partially invalidated, or misrepresented widely reported treatment outcomes. These inequities may also have implications for the secondary moderator analyses (i.e. does trait A predict switching to X or Y is better?) that were a major reason for the study. [more inside]
The once-secret Anti-Counterfeiting Trade Agreement (ACTA) slouches toward signing on Saturday. ACTA is expected to raise constitutional issues in the U.S., raise soverenty issues in the E.U., give copyright holders extensive powers to impose DRM and identify alleged infringers, and increase health risks worldwide. In addition, the U.S. has launched the Trans Pacific Partnership agreement (TPP) to obtain what copyright provisions were stripped from ACTA. (see michaelgeist.ca, techdirt, or slashdot) [more inside]
One in every 8 babies born in the US is premature. A new study (pdf/via) published online Wednesday in Ultrasound in Obstetrics and Gynecology indicates that vaginal progesterone gel can help women who are pregnant for the first time and at risk of premature birth extend their pregnancies, reduce potential complications and boost the health of their newborns. [more inside]
Meet the Ethical Placebo: "A provocative new study called 'Placebos Without Deception,' published on PLoS One today, threatens to make humble sugar pills something they’ve rarely had a chance to be in the history of medicine: a respectable, ethically sound treatment for disease that has been vetted in controlled trials." [Via]
Towards responsible use of cognitive-enhancing drugs by the healthy - a commentary in Nature that says, "we call for a presumption that mentally competent adults should be able to engage in cognitive enhancement using drugs". Farkesque debate here. [more inside]
Suppose you have a problem with your thinking, your mood, or your relationships. Come in, sit down, and let the internet help. Meet MoodGym and its newer sister site, e-couch. [more inside]
The Japanese Gallery of Psychiatric Art. Images from Japanese psychiatric medication advertisements: 1956-2003 (via Absent without leave)
With a newly indurated PPD in my arm, I went looking for tuberculosis resources. According to the WHO over 2 million people a year die of tuberculosis. About a third of the 40 mil. people infected with HIV worldwide are also infected with TB. Successful treatment takes 6-9 months of powerful antibiotics, but that's assuming the bacteria in your body aren't drug resistant. Epidemics of drug resistant TB are raging in some parts of Central America and in the Russian prison system. Paul Farmer is the man for treating it, and quite a good man in general. On the plus side, possibly having TB puts me in good company: Orwell, Kafka, Chekhov, Chopin, and the 70s favorite mummy, King Tut all had it. Every one of the Brontes did too, and they were all geniuses. Of course they all died of it. On a more sober note, if I do have to get treatment, but I refuse, I might be ordered to take medications by a judge.
Prozac Found in Britain's Drinking Water. Norman Baker, environment spokesman for the Liberal Democrats, said it looked "like a case of hidden mass medication upon the unsuspecting public." Or possibly something less alarming, like the recycled leftovers from the public waste... either way, very disturbing.
Nootropics ("smart" drugs) - all wish to be smarter, correct ? And - while exercise, nutrition, learning, travel, and social interaction (the last 3 via release of neurotrophins) effectively do this, Nootropic drugs have been researched since the 1950's and have been shown to cause at least short term cognitive function enhancement. Piracetam, the first of this drugs, shows promise in the treatment of Alzheimer's and Attention deficit Disorder. Alas, as with poor little Algernon, the effect seems temporary. Nootropics can be a little difficult to acquire in the US. Beer is not a nootropic, but sex on the other hand.....
Pills for Problems: The British have taken steps to restrict the use of some antidepressants. Breggin and others have been warning us for some time now about the many problems with medicating behavior. The Big Picture: Aren't "medications" (legal or not) used for behavioral problems just an excuse for us not controlling ourselves?
The war on drugs is unfairly targeting doctors who prescribe legal pain medication to their patients who suffer from chronic pain, according to a spokeswoman of the Association of American Physicians and Surgeons. She was speaking at a press conference of patient and physician advocacy groups, sponsored by the Pain Relief Network, in support of Dr. William Hurwitz. Dr. Hurwitz has been indicted and imprisoned for prescribing high doses of opioid pain relievers, as have other pain-management doctors. But these crackdowns may end up doing more harm than good to patients in chronic pain. [More inside.]
The American Gallery of Psychiatric Art. 'Sanity For Sale: 1960-2000'. Magazine advertisements for psychiatric medications in the latter half of the twentieth century.
Is forcing a prisoner on death row to take antipsychotic medication to make him sane enough to execute cruel and unusual punishment? (NYT link) A federal appeals court ruled that officials in Arkansas can force a prisoner on death row to take antipsychotic medication to make him sane enough to execute. The problem is that the American Medical Association's ethical guidelines prohibits precisely that. To make the case more surreal, a representative of the Arkansas attorney general's office who argued for the state later said: "The ethical decisions involving doctors are difficult ones, but they are not ones for the courts". Does this mean that COs -Correction Officers- are to figure out for themselves which medication to administer? Do they also call the shots when deciding if the "waiting" patient is sane enough???
Inside the JFK medical files. Very interesting article from Sunday's NY Times (reg. req'd) about the long-term health of John F. Kennedy, from World War II to his death. Corresponding Yahoo News item here also. [more inside...]
Move over, Jared... there's going to be a hot new way to lose weight. Scientists have "found the chemical pathways that muscle cells use to build strength and endurance," making it possible to have a fitness pill.
President Lincoln narrowly avoids insanity. Had he not changed his medication early in his presidency, Lincoln might have conducted the war very differently.
As if you weren't depressed enough, now the world knows you're taking Prozac