Friday, May 27, 2011
Thursday, May 26, 2011
Drugging the Vulnerable: Atypical Antipsychotics in Children and the Elderly
Time
Pharmaceutical companies have recently paid out the largest legal settlements in U.S. history — including the largest criminal fines ever imposed on corporations — for illegally marketing antipsychotic drugs. The payouts totaled more than $5 billion. But the worst costs of the drugs are being borne by the most vulnerable patients: children and teens in psychiatric hospitals, foster care and juvenile prisons, as well as elderly people in nursing homes. They are medicated for conditions for which the drugs haven't been proven safe or effective — in some cases, with death known as a known possible outcome.
The benefit for drug companies is cold profit. Antipsychotics bring in some $14 billion a year. So-called "atypical" or "second-generation" antipsychotics like Geodon, Zyprexa, Seroquel, Abilify and Risperdal rake in more money than any other class of medication on the market and, dollar for dollar, they are the biggest selling drugs in America. Although these medications are primarily approved to treat schizophrenia and bipolar disorder, which combined affect 3% of the population, in 2010 there were 56 million prescriptions filled for atypical antipsychotics.
In a presentation this week at an American Psychiatric Association meeting, Dr. John Goethe, director of the Burlingame Center for Psychiatric Research in Connecticut, reported that over the last 10 years, more than half of all children aged 5 to 12 in psychiatric hospitals were prescribed antipsychotics — and 95% of these prescriptions were for second-generation antipsychotics.
Many of these children didn't have a condition for which the drugs have been shown to be helpful: 44% of youngsters with post-traumatic stress disorder (PTSD) and 45% of children with attention deficit hyperactivity disorder (ADHD) were treated with them. [...]
Pharmaceutical companies have recently paid out the largest legal settlements in U.S. history — including the largest criminal fines ever imposed on corporations — for illegally marketing antipsychotic drugs. The payouts totaled more than $5 billion. But the worst costs of the drugs are being borne by the most vulnerable patients: children and teens in psychiatric hospitals, foster care and juvenile prisons, as well as elderly people in nursing homes. They are medicated for conditions for which the drugs haven't been proven safe or effective — in some cases, with death known as a known possible outcome.
The benefit for drug companies is cold profit. Antipsychotics bring in some $14 billion a year. So-called "atypical" or "second-generation" antipsychotics like Geodon, Zyprexa, Seroquel, Abilify and Risperdal rake in more money than any other class of medication on the market and, dollar for dollar, they are the biggest selling drugs in America. Although these medications are primarily approved to treat schizophrenia and bipolar disorder, which combined affect 3% of the population, in 2010 there were 56 million prescriptions filled for atypical antipsychotics.
In a presentation this week at an American Psychiatric Association meeting, Dr. John Goethe, director of the Burlingame Center for Psychiatric Research in Connecticut, reported that over the last 10 years, more than half of all children aged 5 to 12 in psychiatric hospitals were prescribed antipsychotics — and 95% of these prescriptions were for second-generation antipsychotics.
Many of these children didn't have a condition for which the drugs have been shown to be helpful: 44% of youngsters with post-traumatic stress disorder (PTSD) and 45% of children with attention deficit hyperactivity disorder (ADHD) were treated with them. [...]
Expert warns national-religious educators of denial of sexual abuse
JPost
The denial and complacency within the national-religious sector regarding sexual assault of minors is wrong and harmful to the victims, an expert warned a forum of educators on Wednesday – emphasizing the danger of the belief that a rabbinic figure would not molest a child.
Speaking at the Rehovot campus of Orot Teachers’ College on their annual conference dedicated to leadership, Adi Fishman, an Education Ministry expert on preventing and treating sexual assault, specializing in the national-religious sector, said “the religious public’s feeling – as though its children are more protected from sexual assault than those of other populaces – is wrong.”
“When, indeed, nothing has yet happened, that feeling can be a convenient defense mechanism. But once a sexual assault does occur, the belief that ‘things like that don’t happen in our society’ can mar the educator or parent’s ability to assist the victimized child,” she added. “An educator must first and foremost be aware that there is a good [likelihood] that there is a sexually assaulted child in his classroom. We know that one of every four girls, and five boys, will be sexually assaulted.” [...]
The denial and complacency within the national-religious sector regarding sexual assault of minors is wrong and harmful to the victims, an expert warned a forum of educators on Wednesday – emphasizing the danger of the belief that a rabbinic figure would not molest a child.
Speaking at the Rehovot campus of Orot Teachers’ College on their annual conference dedicated to leadership, Adi Fishman, an Education Ministry expert on preventing and treating sexual assault, specializing in the national-religious sector, said “the religious public’s feeling – as though its children are more protected from sexual assault than those of other populaces – is wrong.”
“When, indeed, nothing has yet happened, that feeling can be a convenient defense mechanism. But once a sexual assault does occur, the belief that ‘things like that don’t happen in our society’ can mar the educator or parent’s ability to assist the victimized child,” she added. “An educator must first and foremost be aware that there is a good [likelihood] that there is a sexually assaulted child in his classroom. We know that one of every four girls, and five boys, will be sexually assaulted.” [...]
Religious dispute in New Square leads to severe burning of dissident
CBS
An orthodox Jewish father of four said he was apparently punished for worshipping his own way after an attack left him with burns covering 50 percent of his body.
CBS 2’s Dave Carlin reported a rift exploded into a fiery confrontation in Rockland County Sunday morning.
“His upper body is third-degree burns all over,” the victim’s son-in-law, Moshe Elbaum, said.
Elbaum said the top half of Aron Rottenberg’s body is covered in excruciatingly painful burn wounds. He said his father-in-law suffered the burns defending his family, confronting a man who police said was trying to fire bomb their home.
“He tried to murder people who were sleeping in the house,” Elbaum said.
Early Sunday morning, Rottenberg, 43, was sleeping in his Truman Avenue home in New Square when a family member saw an intruder in the backyard.
Rottenberg, a plumber, went outside to face the suspect, who police said had a device with flammable liquid and a long, improvised fuse. In the struggle, the device caught fire, injuring both men.
Police arrested 18-year-old Shaul Spitzer, also of New Square, and charged him with first-degree attempted arson and first-degree assault, both felonies.
An orthodox Jewish father of four said he was apparently punished for worshipping his own way after an attack left him with burns covering 50 percent of his body.
CBS 2’s Dave Carlin reported a rift exploded into a fiery confrontation in Rockland County Sunday morning.
“His upper body is third-degree burns all over,” the victim’s son-in-law, Moshe Elbaum, said.
Elbaum said the top half of Aron Rottenberg’s body is covered in excruciatingly painful burn wounds. He said his father-in-law suffered the burns defending his family, confronting a man who police said was trying to fire bomb their home.
“He tried to murder people who were sleeping in the house,” Elbaum said.
Early Sunday morning, Rottenberg, 43, was sleeping in his Truman Avenue home in New Square when a family member saw an intruder in the backyard.
Rottenberg, a plumber, went outside to face the suspect, who police said had a device with flammable liquid and a long, improvised fuse. In the struggle, the device caught fire, injuring both men.
Police arrested 18-year-old Shaul Spitzer, also of New Square, and charged him with first-degree attempted arson and first-degree assault, both felonies.
Elizabeth Smart's molester sentenced to life: In only minority of cases molester is a stranger
Foxnews
Earlier this month, Robert Steele, Mitchell's attorney, appealed to the court to lighten Mitchell’s sentencing because despite the actions of his client, “in a legal sense, the story is not the extreme psychological injury. The story is her overcoming the extreme conduct of my client.”
Mitchell’s attorney had hoped his client is detained in a federal mental facility instead of a prison.
It has been nine years since Smart’s kidnapping because the case hit a few legal hurdles after the former street preacher was declared mentally ill and unfit in to stand trial in state court.
Earlier this month, Robert Steele, Mitchell's attorney, appealed to the court to lighten Mitchell’s sentencing because despite the actions of his client, “in a legal sense, the story is not the extreme psychological injury. The story is her overcoming the extreme conduct of my client.”
Mitchell’s attorney had hoped his client is detained in a federal mental facility instead of a prison.
It has been nine years since Smart’s kidnapping because the case hit a few legal hurdles after the former street preacher was declared mentally ill and unfit in to stand trial in state court.
Wednesday, May 25, 2011
Could Conjoined Twins Share a Mind?
NYTimes
In any other set of twins, the natural conclusion about the two events — Krista’s drinking, Tatiana’s reaction — would be that they were coincidental: a gulp, a twinge, random simultaneous happenstance. But Krista and Tatiana are not like most other sets of twins. They are connected at their heads, where their skulls merge under a mass of shaggy brown bangs. The girls run and play and go down their backyard slide, but whatever they do, they do together, their heads forever inclined toward each other’s, their neck muscles strong and sinuous from a never-ending workout.
Twins joined at the head — the medical term is craniopagus — are one in 2.5 million, of which only a fraction survive. The way the girls’ brains formed beneath the surface of their fused skulls, however, makes them beyond rare: their neural anatomy is unique, at least in the annals of recorded scientific literature. Their brain images reveal what looks like an attenuated line stretching between the two organs, a piece of anatomy their neurosurgeon, Douglas Cochrane of British Columbia Children’s Hospital, has called a thalamic bridge, because he believes it links the thalamus of one girl to the thalamus of her sister. The thalamus is a kind of switchboard, a two-lobed organ that filters most sensory input and has long been thought to be essential in the neural loops that create consciousness. Because the thalamus functions as a relay station, the girls’ doctors believe it is entirely possible that the sensory input that one girl receives could somehow cross that bridge into the brain of the other. One girl drinks, another girl feels it.
What actually happens in moments like the one I witnessed is, at this point, theoretical guesswork of the most fascinating order. No controlled studies have been done; because the girls are so young and because of the challenges involved in studying two conjoined heads, all the advanced imaging technology available has not yet been applied to their brains. Brain imaging is inscrutable enough that numerous neuroscientists, after seeing only one image of hundreds, were reluctant to confirm the specific neuroanatomy that Cochrane described; but many were inclined to believe, based on that one image, that the brains were most likely connected by a live wire that could allow for some connection of a nature previously unknown. A mere glimpse of that attenuated line between the two brains reduced accomplished neurologists to sputtering incredulities. “OMG!!” Todd Feinberg, a professor of clinical psychiatry and neurology at Albert Einstein College of Medicine, wrote in an e-mail. “Absolutely fantastic. Unbelievable. Unprecedented as far as I know.” A neuroscientist in Kelowna, a city in British Columbia near Vernon, described their case as “ridiculously compelling.” Juliette Hukin, their pediatric neurologist at BC Children’s Hospital, who sees them about once a year, described their brain structure as “mind-blowing.” [...]
In any other set of twins, the natural conclusion about the two events — Krista’s drinking, Tatiana’s reaction — would be that they were coincidental: a gulp, a twinge, random simultaneous happenstance. But Krista and Tatiana are not like most other sets of twins. They are connected at their heads, where their skulls merge under a mass of shaggy brown bangs. The girls run and play and go down their backyard slide, but whatever they do, they do together, their heads forever inclined toward each other’s, their neck muscles strong and sinuous from a never-ending workout.
Twins joined at the head — the medical term is craniopagus — are one in 2.5 million, of which only a fraction survive. The way the girls’ brains formed beneath the surface of their fused skulls, however, makes them beyond rare: their neural anatomy is unique, at least in the annals of recorded scientific literature. Their brain images reveal what looks like an attenuated line stretching between the two organs, a piece of anatomy their neurosurgeon, Douglas Cochrane of British Columbia Children’s Hospital, has called a thalamic bridge, because he believes it links the thalamus of one girl to the thalamus of her sister. The thalamus is a kind of switchboard, a two-lobed organ that filters most sensory input and has long been thought to be essential in the neural loops that create consciousness. Because the thalamus functions as a relay station, the girls’ doctors believe it is entirely possible that the sensory input that one girl receives could somehow cross that bridge into the brain of the other. One girl drinks, another girl feels it.
What actually happens in moments like the one I witnessed is, at this point, theoretical guesswork of the most fascinating order. No controlled studies have been done; because the girls are so young and because of the challenges involved in studying two conjoined heads, all the advanced imaging technology available has not yet been applied to their brains. Brain imaging is inscrutable enough that numerous neuroscientists, after seeing only one image of hundreds, were reluctant to confirm the specific neuroanatomy that Cochrane described; but many were inclined to believe, based on that one image, that the brains were most likely connected by a live wire that could allow for some connection of a nature previously unknown. A mere glimpse of that attenuated line between the two brains reduced accomplished neurologists to sputtering incredulities. “OMG!!” Todd Feinberg, a professor of clinical psychiatry and neurology at Albert Einstein College of Medicine, wrote in an e-mail. “Absolutely fantastic. Unbelievable. Unprecedented as far as I know.” A neuroscientist in Kelowna, a city in British Columbia near Vernon, described their case as “ridiculously compelling.” Juliette Hukin, their pediatric neurologist at BC Children’s Hospital, who sees them about once a year, described their brain structure as “mind-blowing.” [...]
Psychiatrists who offer public comments about public figures
NYTimes
Of course, it’s only natural for the media to seek comment from experts. But as a psychiatrist, I cringe at statements like these, for they cross an ethical line that goes back to a presidential campaign nearly half a century ago.
Just before the 1964 election, a muckraking magazine called Fact decided to survey members of the American Psychiatric Association for their professional assessment of Senator Barry Goldwater of Arizona, the Republican nominee against President Lyndon B. Johnson.
Ralph Ginzburg, the magazine’s notoriously provocative publisher, had heavily advertised the issue in advance, saying it would call Mr. Goldwater’s character into question.
A.P.A. members were asked whether they thought Mr. Goldwater was fit to be president and what their psychiatric impressions of him were. It was not American psychiatry’s finest hour. [...]
Of course, it’s only natural for the media to seek comment from experts. But as a psychiatrist, I cringe at statements like these, for they cross an ethical line that goes back to a presidential campaign nearly half a century ago.
Just before the 1964 election, a muckraking magazine called Fact decided to survey members of the American Psychiatric Association for their professional assessment of Senator Barry Goldwater of Arizona, the Republican nominee against President Lyndon B. Johnson.
Ralph Ginzburg, the magazine’s notoriously provocative publisher, had heavily advertised the issue in advance, saying it would call Mr. Goldwater’s character into question.
A.P.A. members were asked whether they thought Mr. Goldwater was fit to be president and what their psychiatric impressions of him were. It was not American psychiatry’s finest hour. [...]
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