A criminal investigation has begun into the death of a patient on a waiting room floor at a city-run psychiatric hospital in Brooklyn last year, the Brooklyn district attorney said on Tuesday.

The district attorney, Charles J. Hynes, said that a grand jury had begun an inquiry into the death of Esmin Green, 49, who died early on June 19, 2008, about 24 hours after arriving by ambulance at Kings County Hospital Center’s psychiatric emergency room, where doctors said she was schizophrenic and ordered her to be involuntarily committed.

According to hospital protocol, Ms. Green should have been given a medical examination before she was admitted.

Instead, she was left in the waiting room, where she eventually collapsed on the floor and died of a blood clot the next morning.

The case became a symbol of callous treatment of psychiatric patients after the New York Civil Liberties Union and other lawyers released a security video that showed Ms. Green writhing and lying on the floor while workers ignored her.

Last month, the city’s Department of Investigation issued a report that could become a template for the grand jury investigation. It named three doctors and three nurses or nurse’s aides, saying that they were complicit either in the neglect of the patient or in a cover-up over a period of four shifts.

Although the medical examiner found that Ms. Green had died of a blood clot, ruling out homicide, it is possible that the grand jury could consider lesser charges related to her death or to the falsification of hospital records. A spokesman for Mr. Hynes declined to say what charges might be considered.

The city report said that contrary to protocol, Bernardita Cabildo, the head nurse for the midnight to 8 a.m. shift on June 18, did not add Ms. Green to the “24-Hour Observation Sheet” that lists incoming patients.

Dr. Rashed Abedin told investigators, according to the report, that he had made three unsuccessful attempts to examine Ms. Green during the next shift, between 8 a.m. and 5 p.m.; he said she was uncooperative.

But investigators found that Dr. Abedin’s account was contradicted by the surveillance video and by written notes.

The city found that two other doctors, Dr. Dimitru Magardician and Dr. David Estes, who ultimately pronounced her dead, made no effort to examine Ms. Green during a third shift, and that during the fourth, Ms. Green had no contact with any doctors and little contact with nursing staff until she died at 6:35 a.m.

The city found that a senior nurse, Aida Gonzalo, made three false entries in Ms. Green’s medical records, making it appear that she had been in normal condition 45 minutes before she was discovered on the floor. A nursing aide, Royal Easton, was found to have made false entries indicating that he had checked on Ms. Green and found that she was sleeping, when in fact Mr. Easton was on a break.

There were so few patients in the waiting room during the night that the two nurses, Ms. Gonzalo and Ms. Cabildo, were taking a break at the time Ms. Green collapsed about 5:30 a.m., the report said.

Ana Marengo, a spokeswoman for the city’s Health and Hospitals Corporation, said the agency would be “fully supportive” of the investigation. She said that the three doctors and one nurse, Ms. Cabildo, were still working at the hospital.

Calls on Tuesday afternoon to the doctors at the hospital and at their homes were not immediately returned. Ms. Cabildo, reached at the hospital, declined to comment. Ms. Gonzalo did not respond to a message left on her home phone. Mr. Easton has been reassigned outside Kings County hospital, and has been recommended for firing pending disciplinary hearings, Ms. Marengo said. A woman who answered the phone at his home said he would have no comment.

Sanford Rubenstein, a lawyer for the Green family, said Ms. Green’s children were pleased that the grand jury was investigating. “The family wants anyone who committed a criminal act to be held accountable and liable criminally,” Mr. Rubenstein said Tuesday.

URL: http://www.nytimes.com/2009/07/15/nyregion/15hospital.html

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A mental health patient walked out of a Birmingham psychiatric hospital unchallenged with a door security pass belonging to a member of staff.

But West Midlands Police have revealed that the teenager was only reported missing two days later on Sunday morning.

He had used the swipe card to calmly pass through a number of electronically controlled doors and out of the intensive care unit in Edgbaston on Friday and was finally tracked down in Sparkhill by police on Monday afternoon.

Yesterday, mental health officials said they had launched an urgent investigation into the security blunder at the intensive care inpatient ward at the Oleaster Centre, near Edgbaston’s Queen Elizabeth hospital, which treats a mixture of voluntary patients and those detained under the Mental Health Act.

A source said the card belonged to a member of staff who normally had it secured to a belt. It is not clear whether it was stolen or picked up off the floor after being dropped.

The patient, thought to be in his late teens and suffering schizophrenia, used the card to open several sets of doors to exit the building, the source said.

“He was able to pass through a number of doors with a swipe card that had been stolen from a nurse. He went through three or four doors without being challenged,” said the source. “No one could believe how it happened.”

The teenager was not a danger to the public and categorised as low risk.

Ros Alstead, the Trust’s executive director of nursing, said: “The safety of our patients is paramount and we take any breach of security extremely seriously.

“We have instigated a full and urgent investigation into the circumstances surrounding this incident, to ensure that we can prevent reoccurrence and learn from it.”

URL: http://www.birminghampost.net/news/west-midlands-health-news/2009/02/04/patient-used-security-card-to-leave-psychiatric-hospital-65233-22848806/

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By Anne Harding

Susan Craig’s brother Roger died of a pulmonary embolism in 2007, at age 38. Diagnosed with bipolar disorder in high school, he had been on antipsychotic drugs for years. At the time of his death, he was carrying 280 pounds on his 6-foot-4-inch frame.

Craig, a public relations specialist who works at Columbia University in New York City, knew that Roger’s medications could cause weight gain. But she had never been told that the drugs he was taking might be harming his heart.

“We were never counseled by his psychiatrist or his primary care provider to watch for symptoms of heart disease or any risk of sudden death at all,” Craig says. There’s no evidence that Roger’s medications caused his death, but his family might have been able to get him help sooner if they had known about the risks, Craig explains.
New research published Wednesday in the New England Journal of Medicine shows that antipsychotic drugs are not risk free, and the study’s authors are urging much more caution in their use. The drugs are associated with a risk of sudden cardiac death, particularly at higher doses. Health.com 10 best foods for your heart

Craig’s brother was taking haloperidol, which belongs to an older class of drugs called typical antipsychotics, which have long been known to increase the risk of sudden death due to cardiac causes. He was also on risperidone, a member of a newer class of drugs called atypical antipsychotics, which had been considered safer.

Doctors prescribe these newer medications, originally developed to treat schizophrenia, for a wide variety of problems — from conduct disorder in kids to aggressive behavior in Alzheimer’s patients. In fact, they’ve become so popular that three of them — olanzapine, risperidone, and quetiapine — are among the 10 top-selling drugs worldwide, with $14.5 billion in sales in 2007.

The new study suggests that among patients taking high doses of atypical antipsychotics, there are about 3.3 cases of sudden cardiac death per 1,000 patients per year, which an editorial characterizes as a risk that’s “between ‘moderate’ and ‘low,’ but not ‘rare.’” Health.com: Heart drug may be a cancer fighter

About 325,000 people in the United States each year die of sudden cardiac death, which has an incidence of 0.1 to 0.2 percent per year in adults.

“[The drugs] have potentially very serious side effects,” says Wayne A. Ray, Ph.D., the director of the division of pharmacoepidemiology at Vanderbilt University School of Medicine, in Nashville. “So whenever a decision is made to use one, consideration of potential side effects needs to be made.” Ray and his colleagues found that atypical antipsychotics doubled the risk of sudden death from heart-related causes, most likely by causing disturbances in heart rhythms.

First introduced in the mid-nineties, atypical antipsychotics were praised for having none of the troublesome side effects of their predecessors, including frequent, involuntary movements of the face and mouth that were in some cases irreversible.

But the new study shows that the increased risk of sudden cardiac death seen with the older drugs is nearly identical to that of the newer medications. There had been suspicions that the drugs were risky, especially when used in older patients, but the current study is the first to systematically investigate their association with sudden cardiac death.

Ray and his colleagues reviewed data on Tennessee Medicaid patients, comparing 44,218 people using older typical antipsychotics and 46,089 taking the newer atypical antipsychotics to 186,600 people who had never used the drugs. People with schizophrenia may have a higher rate of cardiac problems, due to smoking and other factors. To account for this, researchers also compared antipsychotic drug users without schizophrenia to non-drug users who had characteristics (in most cases, mood disorders) that made them likely candidates for the drugs.

Overall, people taking typical antipsychotics were at 1.99-times greater risk of sudden cardiac death, while the risk for those on atypical antipsychotics was increased 2.26 times. The increased risk was greater for people on higher doses of the drugs. People who had used the drugs in the past but stopped weren’t at greater risk of sudden cardiac death.

“The drugs are still very effective for conditions that there’s proven evidence for,” says Jeffrey A. Lieberman, M.D., a professor and chair of psychiatry at Columbia University, in New York City, and the director of the New York State Psychiatric Institute, who was not involved with Ray’s research. “They clearly need to still be able to be used. I think this [study] really underscores the need to be very judicious about how these medications are used and whom they’re given to.”

While atypical antipsychotics have been used to ease aggressive behavior for patients with Alzheimer’s disease, for example, they are not approved for this purpose by the U.S. Food and Drug Administration; in fact, in 2005, the FDA issued a warning that these drugs increased the risk of death among elderly people, extending the warning to all antipsychotic drugs last year, notes Sebastian Schneeweiss, M.D., Sc.D., an associate professor of medicine at Harvard Medical School, in Boston, who coauthored an editorial accompanying the current study. Health.com: How is depression in the elderly different from dementia?

Given the lack of better alternatives, these drugs are still widely used in patients with dementia despite the warnings, he adds. But while there’s anecdotal evidence that they will “cool these patients down” and reduce their aggressive behaviors, there’s no scientific evidence that they really help patients or their caregivers, Dr. Schneeweiss says.

In his editorial, Dr. Schneeweiss and coauthor Jerry Avorn, M.D., also of Harvard, call for patients to undergo an electrocardiogram before and shortly after being placed on atypical antipsychotics, to determine if the drugs are causing any heart rhythm disturbances.

For people who must be on these medications, Ray says, it’s essential for their doctors to treat any other conditions, such as high blood pressure, that can harm the heart. “Sudden cardiac death usually occurs when multiple risk factors are present,” he explains. “When you add one, it’s kind of like the straw that broke the camel’s back.”

“Absolutely the lowest dose that works should be used, because we found a strong dose response,” Ray says.

Jamaison Schuler, a spokesperson for Eli Lilly and Company, the maker of Zyprexa, says, “Although the study appears to have important limitations, it provides additional information for practicing physicians to consider as they decide how to treat very complex diseases such as schizophrenia and bipolar disorder.”

The FDA has approved atypical antipsychotics for treating bipolar disorder, Ray adds. But the researcher recommends that physicians first try safer alternatives, such as the mood stabilizer lithium. “That’s a very serious illness, and it has important consequences for patients’ quality of life and relationships,” Ray notes. “If the mood stabilizer doesn’t work, I think it’s very reasonable to consider an antipsychotic, but…other drugs should be considered first.”

Finally, he says, a patient should never stop taking any drug without consulting his or her physician. Nevertheless, anyone taking an atypical antipsychotic for a non-FDA-approved use should consult his physician. “I think off-label use should be undertaken very cautiously, and its frequency should be much less than it is currently,” Ray says. Health.com: Superfoods that can save your health

For Susan Craig, the new research makes it clear that treating serious mental illness must go far beyond just prescribing pills. “We need to be supporting these people in a better, more systematic way,” she says. “There’s no magic pill. It’s treating the whole person.”

URL: http://www.cnn.com/2009/HEALTH/01/15/healthmag.antipsychotic.sudden.death/

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Jan 9 (Reuters) – Vanderbilt University will team up with Johnson & Johnson to develop new drugs to treat schizophrenia, according to a media report.

The Tennessee university will receive about $10 million from J&J over the next three years, plus as much as $100 million in additional payments if it meets certain research milestones, the Wall Street Journal said.

The deal is scheduled to be announced Friday, the paper said.
Researchers unconnected with the project told the paper that the Vanderbilt-J&J partnership appears to be more extensive than historical university-industry collaborations.

Under the agreement, Vanderbilt’s researchers won’t just identify promising molecules, but will develop drugs to the stage where they are ready for human testing, working, for example, to make a prospective medicine less toxic, according to the paper.

Johnson & Johnson and Vanderbilt University could not be immediately reached for comment by Reuters. (Reporting by Ajay Kamalakaran in Bangalore; Editing by Kim Coghill)

URL: http://www.reuters.com/article/marketsNews/idUSBNG12204220090109

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Right after its number one pill, the Purple Performer Nexium?

Can anyone say disease mongering?

For years, AstraZeneca has tried to convince depressed people they are really bipolar and need to take the atypical antipsychotic Seroquel (quetiapine fumarate) which is only approved for schizophrenia or bipolar disorder.

“Is It Really Depression or Could It Be Bipolar Disorder?”  trumpet the ads, urging unaware victims to take a Symptom Quiz and find out how sick they really are.

Full color spreads run in general interest magazines showing a rampaging woman her mouth contorted – think female Dark Knight – asking readers is this you?

“Are there periods of time when you have racing thoughts? Fly off the handle at little things? Spend out of control? Need less sleep? Feel irritable? You may need treatment for bipolar disorder.”

Now the FDA says AstraZeneca can not – repeat not – market Seroquel for depression.

In December the FDA denied approval of Seroquel for major depressive disorder and asked the company instead for more information in a complete response letter (CRL).

Oops.

Of course to be AstraZeneca’s number two pill, Seroquel must be used by more than the nation’s schizophrenia and bipolar disorder patients who number only 8 million.

Almost half of Seroquel’s 2006 sales were for off label uses says Bloomberg news including depression, autism and hyperactivity in adolescents and dementia, insomnia and Alzheimer’s disease in the elderly.

Which wouldn’t be so bad if Seroquel were safe.

But AstraZeneca faces nine thousand lawsuits – 15,026 plaintiffs – alleging the company failed to adequately warn patients about Seroquel side effects like severe weight gain, diabetes and pancreatitis.

Even as AstraZeneca vowed to defend the suits on their merits and not capitulate like Lilly with its $1.48 billion settlement with 32 states over similar drug Zyprexa this year, more bad ink spilled.

Documents surfaced in December that showed AstraZeneca knew as far back as 2000 about Seroquel’s dangerous side effects at a pretrial hearing in a Tampa, Florida federal court for an upcoming Seroquel trial.

There was “reasonable evidence to suggest Seroquel therapy can cause” diabetes and related conditions documents show Wayne Geller, AstraZeneca’s Global Safety Officer wrote after analyzing available studies and internal trials says Bloomberg news.

Created in 1988 and approved for schizophrenia in 1997, Seroquel had an “efficient” journey from R&D to sales.

But in 2005 an article in the New England Journal of Medicine found Seroquel and other atypical antipsychotics except one had no advantage over the older antipsychotics like Haldol and Thorazine. Including the reduction in rigidity and tremors which was sold as their advantage over the old drugs!

The same year, an article in the British Medical Journal found Seroquel and a similar atypical antipsychotic were ineffective in reducing agitation among Alzheimer’s patients and actually made cognitive functioning worse.

And in AstraZeneca’s own clinical trials, 2.4 percent of people who began treatment with normal blood sugar became technically diabetic after 52 weeks on Seroquel plaintiff lawyer Paul Pennock testified at the Tampa pretrial hearing – almost a 70 percent increase over those not taking the drug.

Nor can AstraZeneca claim it has marketed Seroquel legally and for approved uses only.

On Thursday, January 3, 2008, an AstraZeneca sales rep “made an unsolicited sales call to a physician at his office” and “stated that Seroquel was approved for treatment of Major Depressive Disorder (MDD),” charges a letter sent to James L. Gaskil, Pharm.D., Director of AstraZeneca’s Promotional Regulatory Affairs from FDA Regulatory Review Officer Amy Toscano, Pharm.D. in December.

When the physician asked for written information, the rep sent a mailing with “information about Seroquel and Seroquel XR’s use for MDD, and included summaries of eight clinical trials with referenced citations. This mailing was not the result of an unsolicited request by the physician, but rather was prompted by the sales representative’s statements,” charges the FDA.

AstraZeneca reps were even coached to sell product using the Winnie the Pooh figures Tigger – bipolar! – and Eeyore – depressed! – reports the pharma site Pharmalot.

The characterizations could come in handy.

In December AstraZeneca sought approval from the FDA for its ulcer drug Nexium for the “overlooked GERD population” of “patients ages 0 to 1 year old.”

Yes, infants!

“While some reflux and regurgitation are normal in infants and may not require medical treatment,” says Marta Illueca, MD, AstraZeneca’s Nexium Brand Medical Director, “Close medical supervision is key in the appropriate diagnosis and choice of treatment for these infants.”

They may have bipolar disorder too.

Martha Rosenberg is a columnist and cartoonist, who writes about public health

To comment on this story, email to comment@newsblaze.com

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Eli Lilly sells a drug that can cause diabetes and then turn a profit on the drugs that treat the condition that they may have caused in the first place! Zyprexa is the product name for Olanzapine,it is Lilly’s top selling drug.It was approved by the FDA in 1996 ,an ‘atypical’ antipsychotic a newer class of drugs without the motor side effects of the older Thorazine.

Zyprexa has been linked to causing diabetes and pancreatitis. Zyprexa, which is used for the treatment of psychiatric disorders, such as schizophrenia and bipolar disorder, accounted for 32% of Eli Lilly’s $14.6 billion revenue last year.Did you know that Lilly made nearly $3 billion last year on diabetic meds, Actos,Humulin and Byetta? Yes! They sell a drug that can cause diabetes and then turn a profit on the drugs that treat the condition that they may have caused in the first place!

Where Eli Lilly’s negligence comes in,is their KNOWING and not informing consumers (black box warning) until the FDA demanded it. Lilly’s incentive not to readily disclose is they had billions coming in from state medicaid scripts.

Daniel Haszard http://www.zyprexa-victims.com

URL: http://www2.islandpacket.com/blogs/post/33276

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Roger Dobson reports
Tuesday, 3 June 2008

Spending too much time on the internet? Worried about a low sex drive, shyness or lack of social skills? Or do you lose your temper too easily, blush too readily or spend too much time and money shopping?

Time was when such behaviours might have been regarded as individual differences, or put down to lack of self control and restraint. But not any more. Increasing numbers of behavioural conditions are being treated with drug therapy. Bereavement issues, blushing, low sex drive, high sex drive, sex addiction, lack of orgasm, gambling, fear of public speaking, stealing, domestic violence and phobias are all being targeted with drugs that are either in clinical trials or already available.

For drug companies, this market is potentially huge. It’s claimed, for example, that almost half of women have a sexual problem. Nearly 8 per cent of adults, it seems, have intermittent explosive disorder, while another 8 per cent are compulsive shoppers. Thirteen to 15 per cent – around 10 million of us in Britain – are said to be social phobics, and up to 10 per cent have a fear of public speaking. On top of that are the gamblers, the phobics and the depressed – all suitable cases for treatment.

But critics argue that some of these treatments amount to medicalisation of individual differences and traits. Unlike physiological diseases such as cancer, behaviour disorders are a grey area, with no clear boundary between normality and illness. While there is no doubt that people at the extreme end do need treatment, others who may have symptoms may not.

Another problem is defining symptoms of some conditions. Take intermittent explosive disorder, the definition of which seems to defy even people in the field. “It is a vaguely defined condition for which effective treatments have not been identified,” say researchers at Chicago University who have been involved in one drug trial.

One of the major areas for trials of new drugs is sexual problems. Reports have suggested that one in three women have low sex drive – and one drug trial has involved women whose symptoms include failure to achieve orgasm in half of their sexual encounters.

Professor Graham Hart, of the University of Glasgow, co-author of a paper on this issue in the British Medical Journal, says that the imperative now is for more and better sexual gratification. “Celibacy is the new deviance,” he says. “The problem with such an overly medical approach to sexual behaviour is that social and interpersonal dynamics may be ignored.

“People choose one another for their uniqueness. The last century saw a considerable increase in acceptance of diversity of sexual expression – it would be a shame if this century saw diversity replaced by uniform expectations of performance and desire.”

At the University of East Anglia, Dr Ray Crozier, an expert on shyness, makes a similar case about the medicalisation of blushing. He argues that, in many cases, there is nothing inherently wrong, painful or unhealthy about blushing, yet it is treated both with surgery and drugs. More often than not, he says, the problem is in the eye of the perceiver.

“Shame and embarrassment are powerful experiences that lead people to find a way to escape from them. But anxiety about blushing is not caused by inherent properties of the blush, and something important would be lost if blushing were eradicated.”

Bereavement

An eight-week drug treatment for newly bereaved people is about to start a clinical trial. Researchers carrying out the trial hope that at least half of those taking part, all of whom must have lost a first-degree relative, will show improvement after taking the drug, duloxetine. One of the aims is to assess the effect of treatment in patients with bereavement-associated depression. A second is to look at its effects on health status, pain and other symptoms. “We expect substantial reductions in measures of grief and bereavement, with improvements in measures of pain, symptom burden and functional status,” according to researchers at Cooper Green Mercy Hospital and the Jefferson Clinic in the US.

Internet use

There have been some reports of success in treating this problem, which is defined as time spent on the internet at the expense of occupational, relationship and social activities. Research at Mount Sinai School of Medicine, New York, showed after treatment with an antidepressant called escitalopram, internet use dropped from an average of 36.8 hours a week to 16.5 hours. But in a second part of the research, the same results were achieved with a placebo.

Temper

Losing your temper could lead to a diagnosis of intermittent explosive disorder (IED), a condition that is acquiring its own family of drug and other therapies. Just what IED includes, and excludes, is not clear, but Mayo Clinic doctors say: “Road rage. Domestic abuse. Angry outbursts or temper tantrums that involve throwing or breaking objects. Sometimes such erratic eruptions can be caused by a condition known as intermittent explosive disorder.” Some 8 per cent of adults suffer from IED, and doctors at Chicago University are using divalproex sodium, a drug used for epilepsy and bipolar disorder, to treat it.

Pornography addiction

According to researchers at the Mayo Clinic in the US, naltrexone, a drug prescribed for alcoholism, interferes with the brain chemical dopamine. They say the drug has been successfully used for “suppressing a euphorically compulsive and interpersonally devastating addiction to internet pornography”.

Gambling

A number of drugs have been in trials for the treatment of compulsive gambling. In one pilot study, nine out of 15 patients who took topiramate, a drug used for the treatment of seizure disorders, achieved full remission of gambling behaviour. The drug is thought to work by reducing the arousal that comes with gambling. Yale University has a trial of memantine ongoing for the same purpose.

Compulsive buying

As many as one in 12 of us have this disorder, according to psychiatrists at the University of Iowa, although it is mainly found in developed countries with market-based economies. They say some antidepressants help to ease the compulsion, and doctors at the Clinical Hospital Centre Zagreb-Croatia have successfully used fluvoxamine.

Public speaking

Speaking in public is an effort for many, but could taking a drug used for schizophrenia, psychosis and similar conditions help those with severe cases? A pilot study has been under way at the University of Minnesota, where quetiapine is being given to individuals with reported fear of public speaking. “We hypothesise that individuals will react with less self-reported anxiety,” say researchers.

Low sex drive

Also know as hypoactive sexual disorder, it involves a distressing absence of sexual fantasies, thoughts and desire for sexual activity, and it affects up to 30 per cent of women and 10 per cent of men. Around 900 women aged over 18 are taking parts in a trial of the drug flibanserin, a compound that has an effect on brain chemicals related to mood. Sponsored by Boehringer Ingelheim Pharmaceuticals, trial inclusion criteria say that women who take part must be willing to try to have sexual activity at least once a month.

Female orgasmic disorder

Also known as inhibited female orgasm, it is claimed to be a disorder that affects one in three women at some time in their lives. Symptoms are said to include persistent delay in, or absence of, orgasm following sex. A study at King’s College found that introverted women were 2.5 times more likely to have this problem. A trial has been under way in the States, sponsored by GlaxoSmithKline, where the drug bupropion is being used. One study found that it increased the incidence of orgasm as soon as 28 days after starting treatment. Exactly who might benefit is not clear, but one clue is that the trial inclusion criteria say women wishing to take part should have had an orgasm in less than half of sexual encounters.

Stealing

People diagnosed with kleptomania have been taking part in an eight-week treatment programme with the drug naltrexone. “The hypothesis is that naltrexone will be effective in reducing the urges to steal in patients with kleptomania. The proposed study will provide needed data on the treatment of a disabling disorder that currently lacks a clearly effective treatment,” say the Minnesota University researchers.

Social phobia

More than 60 clinical trials and more than a dozen drugs are currently being tested for a condition that interferes with the lives of up to 13 per cent of people, according to the Institute of Psychiatry. Anxiety disorder is characterised by a fear of social or performance situations, and sufferers are often concerned that they will do or say something embarrassing. One of the trials involves children aged eight and over.

But therapy has its critics: “Shyness has become an unhealthy state of mind for individuals living in contemporary Western societies,” according to a University of Sussex report. “Insofar as its behavioural symptoms imply a failure to achieve certain cultural values, such as assertiveness, self-expression and loquacious vocality, shyness is increasingly defined as a problem for which people can, and should, be treated.”

Poor social skills

Have difficulty understanding social cues? Can’t read facial expressions? Fear not – help may soon be at hand. Researchers at Zurich University have shown that they can improve the ability of healthy people to read social cues in the eyes of others by giving them oxytocin, a hormone that plays a major role in establishing maternal behaviour. One treatment session was enough to improve the recognition of social cues in pairs of eyes on a computer screen.

Domestic violence

Self-control used to be a key message for violent partners, but a pill may be more effective. Men and women who have been violent to their partners, with or without the involvement of alcohol, are being prescribed Prozac in a clinical trial sponsored by the US National Institutes of Health. While treatments have concentrated on anger management, there’s some evidence that the drug can reduce acts of aggression.

“We will evaluate whether fluoxetine (Prozac), used together with traditional psychotherapy, can reduce aggression in people who are physically violent towards their spouses or significant others,” they say.

URL: http://www.independent.co.uk/life-style/health-and-wellbeing/features/
behavioural-problems-are-drugs-really-the-answer-838793.html

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Fish oil is commonly known as Omega-3. It contains EPA or eicosapentaenoic acid and DHA or docosahexaenoic acid. The key stabilizing element in fish oil is EPA. Taking fish oil in supplement form may be healthier than consuming it through fish because all of the toxins of a fish are taken away when the fish oil liquid or capsules are created. Many people don´t eat enough fish or like it so supplementation is preferred.

If you decide to take a daily supplement of fish oil capsules or tablets then you should know how much is okay to take. Just like any other vitamin, if you take too much of it then you won´t receive a benefit from the supplement but it could cause problems. It is recommended that people take 1.5 to 3.5 grams of Omega-3 daily. You should take it with food also. Higher amounts of fish oil have shown to cause oxidative stress. Some doctors also recommend taking vitamin C and E along with Omega-3 to balance the benefits.

Through extensive research and studies, fish oil may be used to treat people suffering from disorders like bipolar, depression, diabetes, allergies, macular degeneration, and as a mood stabilizer. Omega-3 has may even help to have dramatic results for people suffering from severe depression.

In countries along coastlines where fish is primarily consumed it is proven they have lower rates of depression than places who don´t consume much fish at all. People suffering from disorders like schizophrenia and bipolar have also benefited from taking Omega-3 to help stabilize their moods and normalize them.

The primary reason the fish oil works so well with stabilizing the mood is because it is a fatty acid that the brain needs. The brain is primarily made up of fats and it needs the fatty acids to properly function. When the brain doesn´t have the appropriate fatty acids and vitamins it needs then things like depression and disorders occur in the brain. Omega-3 may help the brain function properly because it is believed it provides a stabilizing effect.

Fish oil through vitamins or eating plenty of fish and seafood is healthy for you. These supplements help create a stable mood and uplift your attitude and the way that you feel. People suffering from depression and other mood disorders may benefit from taking a daily dosage of fish oil. However, everyone should be sure they have the appropriate amount of fatty acids for normalizing the brain function.

Fish consumption and supplementation had become popular in recent years because of the research and even doctors recommending it.

Another positive benefit that may result in consuming omega 3´s is on ADHD/ADD to assist in concentration. It has been said that kids and adults suffering from this disorder may have less essential fatty acids than normal.

It is advised to always to work with your doctor about the appropriate medicine or alternative approach.

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

Lori Matthews studies health, nutrition and wellness. She enjoys writing articles on health for both people and pets. Please visit omega 3 fish oil supplements for more information.

URL: http://www.americanchronicle.com/articles/63631

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Problem is, Invega isn’t much different than one of J&J’s best-selling drugs, the antipsychotic Risperdal. In late June, Risperdal is scheduled to lose its U.S. patent protection, clearing the way for competing generic copies that are cheaper than Invega, which could further diminish Invega sales, already characterized as a disappointment by J&J.

“I don’t think they have a strong case to make,” says Lieberman, chairman of the psychiatry department at Columbia University’s medical school. “It’s basically a me-too drug, and the company hasn’t done the studies that would be required to really distinguish it.”

Lieberman’s skepticism is shared by health insurers and points to a rising challenge for drug makers: a tougher market for so-called follow-on drugs. As a result, some companies – including Wyeth (WYE) and Shire PLC (SHPGY) – are setting prices lower or emphasizing improved dosing for the newer drugs to help overcome any skepticism that they’re not much more effective than the older drugs set to lose patent protection.

The growing disdain for follow-on drugs also should reinforce the need for drug makers to come up with truly innovative products, not just marginally better ones, industry watchers say.

Drug companies have used follow-on drugs to try to offset some of the revenue lost when older, top-selling drugs lose patent protection and become exposed to generic knockoffs. The goal is to convince patients, doctors and drug plans to switch to the newer drug that carries a brand-name price and patent protection for years.

A successful example was AstraZeneca PLC’s (AZN) promotion of the Nexium heartburn pill when its older drug, Prilosec, became exposed to U.S. generic competition in 2002. Nexium went on to become a huge blockbuster despite being chemically similar to Prilosec, which became available as both a cheaper generic and over-the-counter product.

Such tactics, however, might not work as well in today’s environment, in which drug-benefit plans are demanding steeper discounts and pushing use of generic drugs in order to lower costs and bolster profit margins.

“We don’t think those opportunities are really going to fly,” Deutsche Bank pharmaceutical analyst Barbara Ryan said. “I think managed-care sees them for what they are, extending the franchise.”

The skepticism around Invega has contributed to a financial disappointment for J&J. The New Brunswick, N.J., healthcare giant hasn’t broken out Invega sales but acknowledges they’ve been below expectations. Invega’s share of U.S. antipsychotic prescriptions was only around 2% for the week ended May 9, according to Verispan, a drug-data marketer. In comparison, Risperdal, which had 2007 sales of more than $4 billion, held a 21% market share.

Insurer Pressure

Some insurers aren’t putting certain follow-on drugs on their lists of preferred drugs, or they’re requiring members to pay higher out-of-pocket costs for these drugs than for other branded and generics.

“It’s a marketing scheme that is not looking at improving healthcare, it’s looking at maintaining their revenues coming in,” said Mirta Millares, in commenting on the industry’s follow-on drug strategy.

Millares is manager of drug information services at Kaiser Permanente, a California health insurer that doesn’t include Invega on its list of preferred drugs. The active ingredient of Invega is derived from that of Risperdal, Millares noted, though it was different enough to get a new patent and regulatory approval.

Minneapolis-based UnitedHealth Group Inc. (UNH), the nation’s largest health insurer by revenue, has Invega on the “third tier” of its preferred drug list, which means members have to pay higher copays than if they were to use other schizophrenia drugs on the first and second tiers. The insurer deemed Invega clinically similar to other atypical antipsychotics.

Clinical studies supporting Invega’s December 2006 Food and Drug Administration approval primarily compared it with a fake drug, or placebo, but not with Risperdal. In 2007, J&J released data showing Invega improved symptoms over AstraZeneca’s Seroquel antipsychotic, which is the market leader for U.S. antipsychotic prescriptions. Also, J&J touts Invega’s long-acting formulation and once-daily dosing.

J&J says it’s not encouraging patients who are stable on Risperdal to switch to Invega. But it had hoped for Invega’s performance to be better by now, making Risperdal’s loss of U.S. market exclusivity next month less painful. “We need to do a better job at drawing a differentiation in a difficult-to-treat population, ” David Norton, J&J’s group chairman of pharmaceuticals, said earlier this month.

Norton said J&J should have ensured Invega had more favorable coverage by drug plans at the time of market launch. Still, he noted that new antipsychotics have historically taken a while to gain acceptance.

J&J has said it plans to seek FDA approval for Invega as a treatment for bipolar disorder, which could bolster sales. It also has applied for FDA approval of a long-acting, injectable version of Invega.

New Marketing Strategies

Despite the challenges, drug-company marketing remains a powerful tool, and it might be too early to write off follow-on campaigns such as that for Invega. The real test may come when Risperdal goes off patent, and J&J reduces its active promotion of Risperdal, leaving sales reps to focus on Invega.

“There are plenty of studies showing physicians are susceptible to marketing practices in their prescribing patterns,” said Aaron Kesselheim, an instructor in medicine at Harvard Medical School who researches drug marketing. “My perception is that hasn’t changed substantially.”

A new marketing campaign that might be meeting with more success is underway at Shire, Basingstoke, U.K., which last year began selling a new drug for attention deficit hyperactivity disorder, Vyvanse. Shire’s top drug, Adderall XR for ADHD, will face generic competition beginning next year.

So far, Vyvanse has captured about 7% of U.S. ADHD drug prescriptions, according to Verispan, which Chief Executive Matthew Emmens calls good progress. Although Shire recently said it expected 2008 Vyvanse sales to come in at the lower end of its forecast range of $350 million to $400 million, Emmens said in an interview he was confident that Vyvanse’s market share will eventually surpass Adderall XR’s peak market share of about 26%.

Emmens noted that Vyvanse is a different chemical entity than Adderall XR, and he thinks its pricing is attractive to health insurers. “In a general nature, the market has become more price sensitive in the last 10 years,” he said. Not incidentally, in the 1990s, Emmens headed the AstraZeneca partnership with Merck & Co. (MRK) that marketed Prilosec and he was involved in the planning for Nexium’s marketing.

The next test of the drug-switch campaign?

Wyeth, Madison, N.J., recently began selling Pristiq, an antidepressant that is chemically similar to Wyeth’s older antidepressant Effexor XR, which is expected to face limited generic competition this year. Deutsche Bank’s Ryan thinks the odds of Pristiq’s success are slim because it appears to offer few benefits beyond those of Effexor.

Wyeth has said Pristiq is effective at treating depression, offers a convenient dose regimen for most patients, and is being priced at a 20% discount to Effexor.

-Peter Loftus; Dow Jones Newswires; 215-656-8289; peter.loftus@dowjones.com

Url: http://money.cnn.com/news/newsfeeds/articles/djf500/
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