April 18, 2018 by Josef Witt-Doerring, MBBS Daryl Shorter, MD & Thomas Kosten, MD | Psychiatric Times
Online Communities for Drug Withdrawal: What Can We Learn?
(Psychiatric Times) – In this age of chat rooms and social media, an ever-growing number of psychiatric patients use the internet to find their treatment community online. Interactive forums, Youtube.com, and personal blogs are now connecting psychiatric patients in ways that were never before available. One treatment focus for these online communities is complicated withdrawal from psychiatric medications. This article discusses this phenomenon in relation to the well-established forums of benzodiazepine and antidepressant withdrawal.
April 18, 2018 by Megan Findlay | YouAreUnltd.com
Calgary Researcher Investigates How Vitamins and Minerals Help Aging Brains
In an era when many people look down at their waistlines to assess nutritional health, Dr. Bonnie Kaplan, a researcher at the University of Calgary, is looking up instead.
She calls it “nutrition above the neck.” It’s a field of medical study that is seeing rapid growth, thanks to a small group of committed disruptors like herself. They’ve overcome strong resistance, particularly from the psychiatric establishment, to reveal a link between vitamins and minerals (called “micronutrients”) and improved mental health.
April 17, 2018 by Benedict Carey | The New York Times
Antidepressants and Withdrawal: Readers Tell Their Stories
(The New York Times) – In a widely read article on antidepressant withdrawal published on April 8, The New York Times invited readers to describe their experiences coming off the drugs. More than 8,800 people responded — teenagers, college students, new mothers, empty-nesters, retirees.
Dozens did write in to say the drugs had been lifesaving, literally so. “You fail to acknowledge that mood disorders can be lifelong, debilitating diseases requiring lifelong medical treatment,” wrote Rachel S., of New York.
A different kind of reader query would most likely have attracted thousands of responses of gratitude for drugs that offered relief to tens of millions of people with chronic mood problems. Some doctors chimed in, too, more than one calling our focus on withdrawal irresponsible and unduly alarming to those who might benefit from antidepressants.
The volume and diversity of the other responses painted a different picture, showing how modern antidepressants, beginning with Prozac in 1987, have percolated through our culture and have shaped public understanding of mental health. These stories traced sharp demographic fault lines: Readers of different generations came to antidepressants, and tried to quit them, for different reasons.
April 13, 2018 by Kevin J. Li; Aaron P. Greenstein; Lynn E. Delisi | Medscape
Sudden Death in Schizophrenia
Abstract and Introduction
Purpose of review: To examine the recent literature regarding sudden death in patients with schizophrenia and synthesize salient conclusions based on this evidence.
Recent findings: Sudden cardiac death (SCD) is the largest subset of sudden unexpected death (SUD), with up to 40% of SUD from cardiovascular causes. SCD has been associated with exposure to both first and second-generation antipsychotics. Clozapine [odds ratio (OR) 3.67, 95% confidence interval (CI) 1.94–6.94] confers the highest risk of SCD followed by risperidone (OR 3.04, 95% CI 2.39–3.86) then olanzapine (OR 2.04, 95% CI 1.52–2.74). SCD not associated with antipsychotic use has been correlated to several modifiable and nonmodifiable risk factors – obesity, smoking, dyslipidemia, diabetes, hypertension, age, sex, and history of cardiovascular disease. Other subsets of SUD include hematological and pulmonary causes, including agranulocytosis leading to sepsis, deep vein thrombosis leading to pulmonary embolisms, and aspiration pneumonia leading to sepsis.
Summary: There is a huge paucity in genetic and pharmacogenetic data focused on SUD in schizophrenia. Future studies should emphasize the genetic aspects as well as clarify the underlying molecular mechanisms of these pathways. Additionally, early detection of those patients at high risk for SUD and discovery of preventive measures should also be emphasized.
April 13, 2018 by Jason Fung, MD | IDMProgram.com
The Corruption of Evidence Based Medicine – Killing for Profit
(IDMProgram.com) – The idea of Evidence Based Medicine (EBM) is great. The reality, though, not so much. Human perception is often flawed, so the premise of EBM is to formally study medical treatments and there have certainly been some successes.
Consider the procedure of angioplasty. Doctors insert a catheter into the blood vessels of the heart and use a balloon like device to open up the artery and restore blood flow. In acute heart attacks studies confirm that this is an effective procedure. In chronic heart disease the COURAGE study and more recently the ORBITA study showed that angioplasty is largely useless. EBM helped distinguish the best use of an invasive procedure.
So, why do prominent physicians call EBM mostly useless? The 2 most prestigious journals of medicine in the world are The Lancet and The New England Journal of Medicine. Richard Horton, editor in chief of The Lancet said this in 2015
“The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue”
Dr. Marcia Angell, former editor in chief of NEJM wrote in 2009 that,
“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor”
April 10, 2018 by Nancy A. Melville | Medscape
Few Psychiatrists Recommend Exercise for Anxiety Disorders
(Medscape) WASHINGTON — Although short, intensive bouts of exercise and aerobic exercise of longer duration can have significant benefits for patients with anxiety disorders, few psychiatrists take the time to talk about or recommend these effective interventions, new research suggests.
Several studies on exercise were presented here at the Anxiety and Depression Association of America (ADAA) Conference 2018.
In one, 29 psychiatrists and psychiatry residents in Illinois responded anonymously to a survey conducted from November 2015 to February 2016.
“We found that only about 20% of patients being treated for depression received discussion about exercise from their psychiatrist,” reported lead author Dawn C. Roberts, PhD, associate professor of psychology at Bradley University, Peoria, Illinois.
Key predictors of not recommending exercise were psychiatrists themselves rarely having time for exercise or spending more days exercising moderately instead of vigorously.
April 9, 2018 by Liam Davenport | Medscape
Sleep Disturbances Affect the Majority of Schizophrenia Patients
(Medscape) FLORENCE, Italy — A large proportion of schizophrenia patients suffer from a range of sleep disturbances — a finding that shines a light on an underexamined area in major psychiatric disorders.
In a study that included more than 5000 psychiatric patients and 8000 healthy control persons, investigators found that among schizophrenia patients, particularly those aged 18 to 40 years, rates of sleep disturbances were much higher than in the general population.
Led by Minna Torniainen-Holm, PhD, National Institute for Health and Welfare, University of Helsinki, Finland, the researchers found that “disturbed sleep is very common” in patients with schizophrenia; 75% of such patients report having a sleep disturbance of one kind or another.
“They were sleeping long, they were tired, and they had difficulties falling asleep and staying asleep,” said Torniainen-Holm.
The findings were presented here at the Schizophrenia International Research Society (SIRS) 2018 Biennial Meeting.
April 7, 2018 by BENEDICT CAREY & ROBERT GEBELOFF | The New York Times
Many People Taking Antidepressants Discover They Cannot Quit
Victoria Toline would hunch over the kitchen table, steady her hands and draw a bead of liquid from a vial with a small dropper. It was a delicate operation that had become a daily routine — extracting ever tinier doses of the antidepressant she had taken for three years, on and off, and was desperately trying to quit.
“Basically that’s all I have been doing — dealing with the dizziness, the confusion, the fatigue, all the symptoms of withdrawal,” said Ms. Toline, 27, of Tacoma, Wash. It took nine months to wean herself from the drug, Zoloft, by taking increasingly smaller doses.
“I couldn’t finish my college degree,” she said. “Only now am I feeling well enough to try to re-enter society and go back to work.”
Long-term use of antidepressants is surging in the United States, according to a new analysis of federal data by The New York Times. Some 15.5 million Americans have been taking the medications for at least five years. The rate has almost doubled since 2010, and more than tripled since 2000.
Nearly 25 million adults, like Ms. Toline, have been on antidepressants for at least two years, a 60 percent increase since 2010.
April 6, 2018 by Bob Nikkel, MSW | Breggin.com
Richard Scarry and Lessons from a State Mental Health Commissioner
At my grandson’s first birthday party, I saw laying around on the floor a very well-worn children’s book that my own two children had nearly devoured—Richard Scarry’s What Do People Do All Day? It shows in colorful pictures of a great many occupations: firefighters, teachers, doctors, nurses and about 50 others. Nowhere, however, does it mention state mental health commissioners—one of my occupations. And I began to realize, Richard Scarry couldn’t have been much help in introducing children to that job—nor could anyone else—except someone like me who’s done it.
April 3, 2018 by Courtney Armstrong | PsychotherapyNetworker.org
Breaking Free from the Limits of Our Medical Treatment Model
As therapists, we’re taught to be master detectives, methodically investigating our clients’ symptoms in search of a culprit—the source of their pain. But if we spend too much time preoccupied with our clients’ symptoms, we’re likely to miss important clues to their hidden strengths. Over the years, I’ve learned that turning a symptom into a client’s ally, rather than a nemesis, can transform the whole experience of psychotherapy for both the therapist and client.
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