Antipsychotics

The results of epidemiological studies of the prevalence of hallucinations strongly imply that psychosis exists on a spectrum, according to the Scientific American. This suggests “that the standard treatment for a psychotic episode might be due for an overhaul.”

ServiceNet, a mental health and human service agency in western Massachusetts, received a three year, two million dollar grant to launch a program designed to support young adults who have recently experienced their first episode of psychosis. The Prevention and Recovery Early Psychosis (PREP) program is funded by the Massachusetts department of mental health and is designed to treat psychosis as a symptom, not an illness, resulting from other illnesses, substance abuse, trauma, or extreme stress.

In the third major verdict of its kind, drug giant Johnson & Johnson was ordered to pay a Maryland man who grew female breasts while taking the antipsychotic Risperdal. The company failed to warn doctors, patients, and regulators of the risk of abnormal breast development in young males and now faces about 5,400 lawsuits involving the drug.

The Washington Examiner reports that the manufacturer of the antipsychotic Abilify is seeking FDA approval for new digitized pills that would alert doctors if patients fail to take their drugs on schedule.

The German news agency DW features a video report on whether cannabidiol, an active substance derived from marijuana, can help relieve the symptoms of schizophrenia.

I was a psychiatrist who participated in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP). Although I welcomed the positive headlines that heralded the study's results, the reports left me with mixed feelings. What happened to render the notion that talking to people about their experiences and helping them find jobs or go back to school is something novel?

Robert Neugeboren, who “spent most of his adult life in institutions, often subject to isolation, physical punishment and numbing medication,” was “a celebrity of sorts in the world of the mentally ill: a survivor of the horrors of mistreatment, a case history for those who point to the positive effects of kindness and talk therapy, and, perhaps most of all, the embodiment of the bottomless mystery of the human mind.”

A Quebec City pharmacy claims it accidentally mixed antipsychotic drug pills into a candy basket that was distributed to trick-or-treating children.

In a Science Update, the National Institute of Mental Health (NIMH) reports that Medicaid services is already taking steps to implement “coordinated specialty care” (CSC) in response to the RAISE study released last week. “The RAISE initiative has shown that coordinated specialty care for first episode psychosis is better than the standard care offered in community clinics. However, covering the cost of coordinated specialty care can be challenging. When Medicaid agrees to pay for effective treatment programs, patients in need benefit.”

The percentage of seniors in the United States prescribed potentially deadly antipsychotic drugs increases with age. A new study reveals that in the face of serious risks of strokes, fractures, kidney injuries, and death, over seventy-five percent of seniors given antipsychotics do not have a diagnosis for a mental disorder.

At CounterPunch, Joseph Natoli connects Big Pharma, mass shootings, and rampant inequality. He writes: “The Brave New World soma strategy to deal with a population that, were they not doped up, might violently disrupt that brave new world, is useful if a society is ‘creatively destroying’ a growing number of its population each day. While the poor have daily evidence of their poverty, a collapsing middle class live in the illusion that they are middle class and just a short distance, not from ruin, but from fame and fortune. They are, in short, heading for a catastrophic break-down. Big Pharma is already set to give us all a ‘soft landing.’”

Dr. Mickey Nardo adds to the ongoing discussion about the RAISE study results. He writes: “If there is ‘spin’ in the reporting of this study, we need to know about it. I personally think that it’s more important for RAISE to be reported completely and honestly than whether it comes out like they [or I] want it to come out. We don’t need some sanitized version of RAISE to tell us we need to turn our attention to a full bodied approach to the treatment of First Episode psychotic patients. We all already know that. What we do need is to have our confidence restored in our research community – that they will honestly and clearly report their findings whether they are clean as a whistle or an unholy mess.”

Neuroskeptic weighs in on the controversy over the lack of antipsychotic dose data in the RAISE study and the misleading media coverage. He points out that one of the treatment interventions was a computerized medication management system called COMPASS, which recommends doctors use lower doses than they otherwise might.

Last Tuesday, The New York Times and several other outlets (including Mad In America) reported on the highly-touted results of a study on psychosocial treatment for patients diagnosed with schizophrenia. Now, claims made about the study, which the ‘Times called “the most rigorous trial to date,” are coming under increased scrutiny.

This week the drug monitoring and patients' rights website, RxISK, launched the Centre for Medication Withdrawal, a page dedicated to establishing what causes dependence and how to treat it.

Writing on his 1 Boring Old Man blog, Dr. Mickey Nardo reflects on the media frenzy around the RAISE study and asks why the prescription data has not been released. He adds skepticism about the political motives of the potentially overblown results, which he sees as a clear push for increased mental health funding.

A California jury ruled that Johnson & Johnson’s Janssen Pharmaceutical and a psychiatrist were responsible for the death of 25-year-old Leo Liu. During a clinical trial for Risperdal, Liu died of a heart injury that was “further complicated” by the drug and ignored by the study doctors. Janssen was found 70% responsible for Liu’s death and ordered to pay $5.6 million to the family.

Yesterday, the New York Times reported that schizophrenia patients in an experimental treatment program (RAISE) who experienced better outcomes had been on lower doses of antipsychotics than normal. However, the article published in the American Journal of Psychiatry on Tuesday did not divulge any data on the varying antipsychotic drug doses in the different study groups.

Results of a large government-funded study call into question current drug heavy approaches to treating people diagnosed with schizophrenia. The study, which the New York Times called “by far the most rigorous trial to date conducted in the United States,” found that patients who received smaller doses of antipsychotic drugs with individual talk therapy, family training, and support for employment and education had a greater reduction in symptoms as well as increases in quality of life, and participation in work and school than those receiving the current standard of care.

Johnson & Johnson is exposed to personal injury and product liability lawsuits over the failure to warn about Risperdal gynecomastia side effects in boys.

The University of Minnesota recently announced that it is ending the controversial practice of recruiting study participants from patients involuntarily being held in their psychiatric unit. In a commentary for Minnesota’s Star Tribune, bioethicist and MIA contributor Carl Elliot reports that the university has still not apologized to the patient who spoke out against this practice. Instead, “the university has done its best to discredit him.”

The Psychiatric Advisor reports on new research from King’s College London that suggests that antipsychotics can cause serious harm to people with Parkinson’s.

After the 2009 suicide of a seven-year-old foster kid who had been on two “black box” medications intended for adults, Florida updated its policies to protect vulnerable children from over-prescription. Unfortunately, according to a report by Orlando Weekly, “foster children are still being put on psychotropic medications without caregivers following proper procedures.”

The University of Minnesota announced a change to its research ethics policies this month after coming under criticism “following the recruitment of a schizophrenia...

New research published in the July issue of The Journal of Clinical Psychiatry found that the use of mood stabilizers, antipsychotics, antidepressants, and hypnotics during pregnancy is associated with increased health risks to the infant.