Archive for December, 2010

Will we ever wake up to the deadly risks of happy pills?

Tuesday, December 14th, 2010
The Daily Mail, December 13, 2010
by John Nash

As new research reveals antidepressants raise the danger of heart attacks, the disturbing cost of this modern addiction

Just as David Cameron launches his campaign to boost national happiness, along comes grim news for the 12 million Britons taking happy pills. London-based researchers have just announced that antidepressants raise the risk of fatal heart attacks.

This research is only the latest wake-up call for a nation hooked on happy pills. Might we finally heed the warnings and shake ­ourselves out of our pharmaceutical stupor?

It is high time we did: a small mountain of studies shows that antidepressant drugs are largely ineffective. But more than that, they can ruin lives by creating chronic dependency and a grinding ­hopelessness that ­sometimes leads to self-neglect and death.

The latest study, by Dr Mark Hamer, a ­public health researcher at University ­College ­London, shows that people on the older drugs — tricyclic antidepressants — are at far higher risk of cardiovascular disease than those ­taking the newer class of pills, selective ­serotonin reuptake inhibitors (SSRIs).

But if I were taking SSRIs, I would not be cheered by the findings. Tricyclics were ­discovered in the Forties and it is only now we have identified these dangerous effects.

Moreover, some SSRI drugs are known to cause serious problems such as stomach bleeding. In addition, the withdrawal ­symptoms can be so severe that patients may become dependent on them.

Dr Hamer says his findings do not only affect people with depression, because antidepressants are also prescribed to people with back pain, headache, anxiety and sleeping problems.

Last year, according to Dr ­Hamer’s ­figures, about 33 million antidepressant prescriptions were dispensed in England.

At some point, surely, there will be no one left to prescribe for. In my view, it’s fast becoming one of the greatest medical scandals of our age.

The most worrying thing about these drugs is not their side-effects, but their widespread non-effect: they just don’t work for most ­people with mild to moderate depression.

Two years ago, researchers at Hull ­University concluded that the pills only benefit ­people who are most seriously, clinically depressed. In these extreme cases, there is often a physical problem in their brain, a result of genetics or accident. But what of the rest?

There is a growing view that many people are being needlessly drugged because the natural state of feeling unhappy is viewed as an illness, rather than a ­normal part of life that we should experience and learn from.

An American study of 8,000 ­people who had been treated for depression found that a quarter of them were not clinically sick, but had just undergone a normal life event such as bereavement.

Their symptoms, it said, should be left to pass naturally (that, of course, would be a blow to the drug manufacturers, who profit so handsomely from the mass ­consumption of their mind-numbing chemicals).  For most of us, the healthiest option is to face our problems, rather than disappear down a black hole of antidepressant dependency.

One leading expert, Randolph Nesse, a psychiatry professor at Michigan University, argues that this mild form of depression is ­beneficial, often ­interjecting in life to tell us to stop what we are doing and reconsider.

This can help, he says, when something awful happens to us, such as a job loss or relationship break-up, when it makes sense to slow down to grieve, reassess and make changes.

But instead, we live in a world that tells us that when we feel out of sorts we need a pill to recover.

It is this belief that ­creates queues of patients at the doors of hard-pressed GPs, who often feel they have no option but to hand out happy pills as though they were sweeties.

Many patients later claim they couldn’t have coped without them. They will swear that ‘the drugs make me feel better, so they must be working’. But often the drugs do not actually work as chemicals. Instead, they merely reassure us — the so-called placebo effect.

In 2008, Professor Irving Kirsch at Hull University found something strange when he took a close look at some figures from drug manufacturers’ own trials of four common antidepressants.

The drugs improved patients’ sense of wellbeing. So far, so ­unremarkable.

But many of those involved in the trials were given sugar pills instead of antidepressants.

And their depression scores improved just as much as those on the real pharmaceuticals. In other words, the placebo patients put so much store by the magical (and much-promoted) power of antidepressants that they lifted their own morale without any genuine chemical intervention. Such is the life-enhancing power of human belief.

Everybody hurts: Sadness is a part of life and shouldn’t always be treated as an illness

But this phenomenon also has a dark side: the opposite of placebo, which is called the ‘nocebo’ effect.

This occurs when you convince someone that a particular thing will do them harm, and they begin to feel sick.

Talk to someone about food poisoning while they are tucking into a hearty meal and you will see the nocebo effect at work.

Sadness is a part of life and shouldn't always be treated as an illness

Something similar is happening in our pill-obsessed world. When we are convinced that we need drugs to get us out of an ­emotional crisis, we stop doing things to help ourselves.

This was clear from the latest research. Dr Hamer found that tricyclic drugs raise a person’s heart attack risk.

But that risk was dwarfed by another danger: the people ­taking the drugs often lost the will to look after themselves properly. They were more likely to smoke, be overweight and not exercise.

Dr Hamer says that if they started living more healthily they would cut their heart attack risk by three times. Exercise and weight loss would also help alleviate their depression and anxiety.

But people stuck in the role of helpless drug-munchers often ­cannot make that change for themselves.

They simply sit waiting for their questionable pills to work. And when the pills fail, they become even more demoralised. It’s a vicious cycle, and one that’s ­sucking in more and more vulnerable people.

Read more: http://www.dailymail.co.uk/health/article-1338340/Will-wake-deadly-risks-happy-pills.html#ixzz186xwdATE

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The Way Antipsychotics Are Used in Nursing Homes Called “A form of elder abuse” by Patient Advocates

Monday, December 13th, 2010

NurseWeek—Dec 13, 2010

Over-medication of dementia patients is a looming problem as the number of such patients in the U.S. continues to grow, a panel of experts told a Senate Aging Committee forum on Dec. 8.

Panelists said over-medication, sometimes with anti-psychotic drugs, frequently occurs with dementia patients because caregivers or family members may mistake complaints of physical illness for unruly behavior.

Patricia McGinnis, executive director of the California Advocates for Nursing Home Reform, said nursing homes must be “accountable” for the drugs they administer.

“The way anti-psychotic drugs are used in nursing homes is a form of elder abuse,” McGinnis told the forum. “Instead of providing individualized care, many homes indiscriminately use these drugs to sedate and subdue residents.”

By learning more about residents to understand their needs and personalities, and establishing work schedules that allow staff to consistently work with the same residents, according to panelists, nursing homes can reduce the use of drugs as a solution to unruly behavior by dementia patients.

Non-drug approaches also can be helpful for caregivers, according to panelist Laura Gitlin, PhD, director of the Jefferson Center for Applied Research on Aging and Health at Thomas Jefferson University in Philadelphia.

She said that providing at-home caregivers with specific skills training in stress reduction, communication and problem-solving techniques can reduce depression and improve self-rated health, sleep quality and overall well-being.

Gitlin described an occupational program at her university that developed meaningful activities for dementia patients based on their capabilities. The program cost $941.63 per family per year, compared with $1,825 for drug treatment programs. The program also saved caregivers about five hours a day in time they would have otherwise spent in hands-on care.

http://news.nurse.com/article/20101213/NATIONAL02/112130006/-1/frontpage

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Texas Doctors Prescribe $47 Million Worth of Antipsychotic & Anti-Anixety Drugs, Primarily for Kids—One Child Psychiatrist Alone Wrote 27,000 Prescriptions For Xanax

Sunday, December 12th, 2010

The Star Telegram – Dec 12, 2010

By Darren Barbee

The boy, 20 months old, is a maelstrom of tears and self-abusive behavior. Simply holding him sets off hours of crying, banging of his head or biting himself. His mother used drugs during her pregnancy. Clinical notes recommend he receive potent antipsychotic medication, one for adults suffering bipolar disorder and schizophrenia.State medical records

With little oversight and apparent carte blanche, a relative handful of Texas physicians wrote $47 million worth of Medicaid prescriptions for powerful antipsychotic and anti-anxiety drugs over the past two years, according to a Star-Telegram analysis.

The top five doctors alone wrote $18 million worth.

Most of the drugs have gone to children and adolescents, although prescribing the drugs to children, such as a toddler, is considered “off-label” — uses not approved by the federal Food and Drug Administration.

Now the state’s Medicaid program is among others under scrutiny, after Sen. Charles Grassley, R-Iowa, began investigating the use of mental-health drugs this year. Grassley, the ranking member of the Senate Finance Committee, told federal health officials to keep a better watch on top prescribers. His conclusion: Either some physicians have specialized expertise or the number of prescriptions suggests “overutilization or even health care fraud,” according to an October letter sent to the Health and Human Services Department.

Some advocates are concerned that the drugs are unsafe for children, who make up nearly 75 percent of Texas Medicaid’s 3.2 million recipients. In a 16-state study, Texas had the maximum rate of prescribing multiple mental-health drugs to youths in foster care. Although the number of prescriptions had dropped 19 percent by 2007, Texas was still tops, according to the June study.

John Breeding, a psychologist concerned that the drugs may cause permanent neurological and metabolic damage, told the state, “That so many of our very young children, younger than 4 or even 3 years old, are being given these drugs is so very sad and upsetting.”

And some doctors churn out prescriptions for children and others at an alarming rate. Antipsychotic drugs prescribed to children under 6 grew by 20 percent from 2007 to 2009, according to a November report by the Texas Health and Human Services Commission.

About 1.7 percent of children on Medicaid received antipsychotic drugs in fiscal 2009, state officials said.

Some children are overmedicated: One area doctor routinely prescribes five potent mental-health drugs simultaneously, said one of the state’s top prescribers. He said he tries to scale back the number of drugs the children are on.

Some experts believe that medication has pushed aside talk therapy, which might be effective and reduce medication needs.

“I do think that a lot of people receive medication without any therapy,” said Tami Mark, a researcher with Thomson Reuters in Washington, D.C. “Most of the literature suggests that therapy is effective and can improve the effectiveness of the medication. So it’s better to get both.”

Top prescribers

The child, 31/2, suffers from shaken baby syndrome. When stressed, he pulls at his ventilator hoses and tracheotomy tube so much that his hands must be tied to the bed. He is prescribed antipsychotics because other sedatives could suppress the breathing centers of the brain.

Grassley asked Texas and other states for the top 10 prescribers who billed Medicaid for certain drugs. The Star-Telegram used prescriber numbers to identify the doctors, then sorted and tallied the drugs they were prescribing. Also reviewed was information on other mental-health drugs that have cost taxpayers about $1.3 billion during the past five years.

The analysis and research found:

In the past two years, 72 Medicaid providers wrote 186,992 prescriptions, an average of 2,597 each.

The state’s top prescriber, child psychiatrist G.K. Ravichandran of Houston’s Shamrock Psychiatric clinic wrote 27,000 scripts for the anti-anxiety drug Xanax in the past two years. The next-closest physician wrote 6,300.

Under his license, 44,138 prescriptions for antipsychotic drugs were written, at a cost to Medicaid of $6.4 million.

Ravichandran did not respond to repeated requests for comment.

Dr. Fernando Siles, a child psychiatrist in Greenville, is the second most prolific Medicaid prescriber. He sees children from across North Texas, including Tarrant County.

In the past two years, Siles’ medical license was used to write 13,601 antipsychotic prescriptions at a cost of $4.6 million.

Siles, who treats solely Medicaid recipients, some as young as 3, has three nurse practitioners who also write prescriptions under his license, he said.

Many children referred to him are already on multiple antipsychotic drugs, and he tries to cut back, he said. “Fifty percent of the medications I prescribe, I did not start them on the medicine,” he said. “They came from other doctors.”

There may be other physicians who are also prescribing high volumes of antipsychotic drugs but aren’t as easily detected, state officials say.

Some physicians use a clinic to hide the volume of their prescribing, said Stephanie Goodman, spokeswoman for the Texas Health and Human Services Commission, which oversees Medicaid.

“To be quite honest, we feel like single doctors have started to bill under clinics to maybe hide that, to make it look like it’s not a single doctor prescribing all these,” she said.

State sanctions

The 13-year-old girl suffered depression and post traumatic stress disorder. She cut her arms and stomach. Her stepfather molested her, and then beat her when she refused to have sex. She cannot sleep at night for the nightmares of being locked in a closet. Prescribed an antipsychotic off label, she begins to have fewer flashbacks and nightmares.

Another top prescriber, Dr. Adolphus Lewis of Fort Worth, is a family physician who also treats the elderly. In one year ending in 1994, he wrote 61 prescriptions for one male patient, including enough Vicodin and Valium to pop seven pills a day.

The state medical board accused Lewis of prescribing “medically excessive” numbers of pills to a woman who later died, court documents show. Her death, which was due to respiratory failure, implicated three drugs, including two that Lewis previously prescribed, according to the documents.

Lewis did not respond to multiple requests for comment.

About 40 percent of the 72 top Medicaid prescribers among certain antipsychotic drugs have been disciplined by the state medical board. By comparison, last year the state disciplined less than 1 percent of the state’s 62,521 doctors.

In 2002, the Texas Medical Board restricted Ravichandran’s license for five years for “unprofessional or dishonorable conduct that is likely to deceive or defraud the public or injury the public.” The restriction, which was not related to prescriptions, was lifted within three years.

Read the rest of the article here: http://www.star-telegram.com/2010/12/11/2697798/some-doctors-handing-out-prescriptions.html#tvg#ixzz17uj9SWtQ

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Girl, 2, had twice the amount of anti-psychotic drug in her system as adult dosage

Friday, December 10th, 2010

Note from CCHR:  Though this toddlers death is being investigated as an accidental ingestion of the drug, as hard as it is to  comprehend, this is fact—the prescribing of psychiatry’s most powerful drugs,  antipsychotics,  to infants and toddlers has become commonplace. These drugs are so strong they can cause brain atrophy (shrinkage), tardive dyskinesia (involuntary muscle spasms that can be permanent), diabetes, cardiac events,  and death.   CCHR’s Drug Database contains the adverse reactions to psychiatric drugs that have been filed with the US FDA by doctors, pharmacists, health care providers and others over a 4 year period.  For just this one antipsychotic drug alone (Haldol), the database contains 45 reports of adverse reactions for children 3 years old and under, 41 of which were reported to the FDA by medical doctors.  One antipsychotic.  There are many others.  Keep in mind that by the FDA’s  own admission, only 1-10% of side effects are ever reported to them.    See the reports here: http://www.cchrint.org/psychdrugdangers/medwatch_psych_drug_adverse_reactions.php

Grand Rapids Press – December 10. 2010

by John Tunisun

Awtumn Minnema, 2, and her father, Nathan Minnema

WALKER — Awtumn Minnema, the 2-year-old who died Nov 15 from a prescription drug overdose, had twice the amount of an anti-psychotic drug in her system as a single adult dose, a pathologist said today.

Dr. Stephen Cohle, who performed the autopsy on Awtumn, said toxicology reports showed the girl died from too much haloperidol, sold as Haldol, in her system.

Haldol is anti-psychotic drug most often used to treat schizophrenia.

Awtumn was with her mother at a relative’s birthday party on Three Mile Road NW when she apparently ingested the drug.

Her father, Nathan Minnema, was not at the party but was told later that family members tried to make the girl vomit on the belief she had swallowed pills that fell from a broken shelf to the floor. She did not vomit, however, and was put in bed.

She was discovered early the next afternoon in her crib, not breathing.

Walker police say the investigation is open and say they do not know whether anyone will face criminal charges.

Cohle, a forensic pathologist at Spectrum Health Blodgett hospital, said Haldol is generally safe for adults. But it could cause the heart to slow or stop and impaired breathing in a child, he said.

http://www.mlive.com/news/grand-rapids/index.ssf/2010/12/girl_2_had_twice_the_amount_of.html


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Anti-Depressant Blamed For Woman’s Suicide—Investigation Launched into the Drug

Thursday, December 9th, 2010

International Drug Regulatory Agencies Warn Antidepressants Cause Suicidal Ideation

TopNews  December 9 2010

by Cindy Tweed

After a mother of two committed suicide because of being increasingly dependent on an anti-depressant, an investigation has been started into the drug.

Last year, on October 25, Yvonne Woodley, 42, was discovered by her husband Kevin hanging in the loft of the family home in Solihull, West Midlands. Before six months of her death, her Citalopram’s dosage was increased by six GPs she consulted.

The drug had a reversed affect. It made her more disturbed and she often used to express her wish to die.

On Monday, during an inquest, it was heard that Woodley consulted six GPs at Solihull’s Yew Tree Medical Centre last year, who increased the dosage of her anti-depressant that resulted into worsening of her mental health.

Experts of such as Professor David Healy raised their apprehensions over the adverse effects of the drug and have blamed the same for the death of the woman that led the Birmingham coroner Aiden Cotter to call for an investigation into the drug.

The drug made her daughter zombie, as expressed by Vera Sansbury, mother of Woodley.

She said, “She was like a zombie. The eyes were blank and flat and there was no emotional response. Yvonne displayed every single side-effect of the drug”.

http://topnews.us/content/230039-anti-depressant-blamed-woman-s-suicide

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To see all  international drug regulatory warnings and studies on antidepressants causing suicide, including  newer and older antidepressants (SSRIs, Tricyclics) as well as brand name drugs (Prozac, Zoloft, Paxil etc) visit CCHR’s Psychiatric Drug Side Effects Database:  http://www.cchrint.org/psychdrugdangers/drug_warnings.php

To read

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Once Again Psychiatrists Top the List of Top Prescribers—And Are Heavily Funded by Pharma

Wednesday, December 8th, 2010

Note from CCHR:   The reason why we repeatedly see psychiatrists on the list of top drug prescribers is pretty simple.  It’s so easy to prescribe psychiatric drugs to patients. Think about it.  It’s not like cancer or diabetes, or even high cholesterol where there’s a test to show some disease or imbalance requiring “medication” to treat it.   Sure there are medical conditions that may not have a “test” to prove anything is wrong.  There are some.  But there are no tests to prove anyone has a mental disorder.  Not one.  So psychiatrists can make a killing when it comes to writing unnecessary prescriptions.  Literally.   All while raking in the bucks from Pharma.

San Diego Union Tribune – December 8, 2010

By Christina Jewett

Three San Diego doctors who prescribe medications at the same time they are paid by drug companies as experts on the products figure into a broader national debate about whether playing both roles poses a conflict.

California Watch, a project of the independent, nonprofit Center for Investigative Reporting, compared two sets of data at the center of the debate — one a database of payments by drug companies to doctors nationwide and the other a list of the top antipsychotic prescribers in California’s Medi-Cal program for the poor and disabled.

Among California’s top prescribers, three accepted more than $20,000 in educational or speaker’s fees from the company that makes the drug they prescribe to Medi-Cal patients. All three practice in San Diego County.

Accepting drug company payments and then prescribing the products to patients is not illegal or even unethical, in and of itself. But some inside the profession and out are concerned such marketing could induce over-prescription of drugs or otherwise corrupt the process.

Two of the San Diego-area psychiatrists share a La Mesa office — Samuel O. Etchie and John W. Allen.

Allen was among the state’s top prescribers of Zyprexa, an antipsychotic drug. Allen dispensed 418 prescriptions at a cost to the state of $346,569. This year and last, the drug’s maker, Eli Lilly and Co., paid him about $27,000 to educate other medical professionals.

Allen said he conducts speeches about Zyprexa for Lilly based on information contained in the FDA-approved literature that comes with the drug. He said he speaks for a variety of drugmakers if he has done research and treated patients with the medication.

“I think it’s unfortunate that there’s in implication in articles that we’re robots for drug companies,” Allen said. “We have to have our own experience with medications and find out what works best. We’re not 5-year-olds in front of TV watching cereal and toy commercials.”

Allen said the prescribing numbers reflect the many bipolar and schizophrenic patients he treats in his practice. He said he prescribes a wide variety of medications, new and old.

“Whatever works for the patient is most important,” Allen said.

Etchie, who shares and office with Allen, prescribed Seroquel more than 1,000 times in 2009 at a cost of $449,000 to the state, according to Medi-Cal records collected by the Pro Publica news organization and provided to California Watch. The drug’s maker paid him $25,350 this year to speak to health professionals.

Etchie said he’s been paid by drug companies to give talks for about 10 years, and sees it as a way to keep himself informed about new and approved uses for medications and to share that information with colleagues who may be too busy to keep track of the research themselves. He said his presentations on Seroquel are an overview of the research drugmaker AstraZeneca has given the FDA about the medication.

“Whatever I do in the area of medicine, I want to get paid,” he said. “But my motive in doing this is to keep my knowledge base current and then to pass on that information to colleagues. Whether a doctor prescribes a medication or not is none of my business. I’m not a salesman.”

The third San Diego-area doctor is Harinder Grewal, a child psychiatrist who sees patients throughout the county.

According to Medi-Cal records, she issued nearly 3,000 prescriptions for antipsychotic medications in 2009, half of them for the drug Seroquel. This year AstraZeneca, that company that sells the drug, paid her $21,600 to educate other health workers.

Grewal did not return calls from California Watch or The San Diego Union-Tribune.

Grewal was also among the state’s top prescribers of the antipsychotic medication Geodon. That drug’s maker, Pfizer, spent $3,750 to compensate Grewal for leading an educational forum.

The three doctors showed up on a list provided by Medi-Cal officials to Sen. Charles Grassley, R-Iowa, who is reviewing prescribing rates of psychiatric and pain medications nationwide.

Grassley’s investigation comes on the heels of numerous government lawsuits that have accused pharmaceutical companies of illegally marketing drugs beyond their approved uses. California authorities who provided the information to Grassley’s office warned against viewing the data as a sign of wrongdoing.

Read the rest of the article here:  http://www.signonsandiego.com/news/2010/dec/06/paid-drug-experts-also-prescribe-products/

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Psychiatrist Asks, “Why Are People So Divided When It Comes To Children’s Mental Health?” We’ve Got the Answer…

Tuesday, December 7th, 2010

20 million kids are being prescribed dangerous mind-altering drugs

By CCHR

Today’s Huffington Post features an article from psychiatrist Harold Koplewicz, frequently seen in the press leading the cheer for more psychiatric diagnosing and drugging of children.   In today’s article, Koplewicz makes a plea to ‘Stop the Stigma’ which is preventing children from being diagnosed mentally ill.   Pretty catchy slogan isn’t it? “Stop the Stigma.”  It ought to be, it’s a brilliant marketing campaign, brought to you by Big Pharma, via the National Alliance on Mental Illness (NAMI), a group that  masquerades as a “patient’s rights group for the mentally ill”  but receives tens of millions in Pharma funding.

But here’s the real rub—What entity is most responsible for stigmatizing millions of children? What group has pathologized childhood behavior and repackaged a list of behaviors into a “disease” called ADHD?  Psychiatry and Pharma.   You can’t be a kid anymore.  If you display child-like behaviors you can be  branded mentally ill for life. And its not just us saying this.  Consider that the former Chairman of the American Psychiatric Association’s DSM task force,  psychiatrist Allen Frances, stated “Our country is in the midst of a fifteen year ‘epidemic’ of Attention Deficit Disorder (ADD). There are six potential causes for the skyrocketing rates of ADD—but only five have been real contributors. The most obvious explanation is by far the least likely – that the prevalence of attention deficit problems in the general population has actually increased in the last 15 years. Human nature is remarkably constant and slow to change, while diagnostic fads come and go with great rapidity. We don’t have more attention deficit than ever before-we just label more attentional problems as mental disorder.”

He  also talked about “stigma,” but sourced the industry creating it—psychiatry: “The ‘epidemic’ of childhood Bipolar Disorder has created a public health dilemma” and that it is  “based on much hype and very little scientific evidence. The label Bipolar Disorder also carries considerable stigma, implying that the child will have a lifelong illness requiring lifetime treatment.”

Exactly.

The title of Dr. Koplewicz’s article is “Why Are People So Divided When It Comes to Children’s Mental Health?” so we’d like to answer that question, as it’s pretty simple —Some of us are for children’s rights and putting their best interests above all else, while others are for Psycho/Pharma and putting their best interests above all else.

That’s the short version.  Here is a bit more detailed answer;

Point 1) Millions of children have been stigmatized with bogus psychiatric “labels” that are based solely on opinion, and not one shred of medical evidence that there’s anything physically wrong with them.  No blood tests, brain scans, X-rays, MRIs or any proof whatsoever they are “mentally ill” and require drugs euphemistically being called “medicine.”    Unlike real medical diseases which are discovered in labs, psychiatric diagnoses are invented by psychiatrists in committee, by  the following “scientific” process;  Cluster a number of behaviors into a nice little package, give it a name and add “disorder” on the tail end of it,  then take a vote.  Majority wins.   That’s about it. And that’s why mental disorders can be here one day and gone the next, because of majority opinion — namely, psychiatry’s.   So while psychiatrists talk about the “amazing progress” they’ve made, and how “close” they’ve come to proving mental disorders are “real medical conditions,” we’d like to point out the obvious—they haven’t.   They couldn’t prove mental disorders were physical/medical conditions 50 years ago, and can’t prove it today despite billions in government funding.    No progress.  Whatsoever.   Zippo.  Nada.    So understandably, Dr. Koplewicz,, as people become more educated about this ludicrous subjective process of disorders made to order, they are concerned about the lack of real science to psychiatric “diagnoses” particularly where their children are concerned.

Point 2) The majority of psychiatrists within the American Psychiatric Association that “decide” on what will and will not be a mental “disorder” are funded by Pharma.  That’s called a Conflict of Interest.  A serious, egregious conflict of interest.  No “conspiracy” here Dr. Kopelwicz, just some facts about your colleagues and their incentives for developing more mental disorders.

Point 3) Due to these subjective, invented mental disorders,  20 million children are currently taking mind-altering, life-threatening drugs, acknowledged by international drug regulatory agencies to cause future drug dependence, stunted growth, mania, psychosis, violence, aggression, hallucinations, heart attack, stroke, sudden death and suicidal ideation.  All international studies and warnings on psychiatric drugs along with all the reports filed with the U.S. FDA’s Medwatch by doctors, pharmacists and healthcare providers reporting suicidal ideation and death from psychiatric drugs given to toddlers, young children and teenagers can be found here:  http://www.cchrint.org/psychdrugdangers/

Point 4) While Koplewicz has the audacity to call the “over-drugging” of children “a myth”,  consider that the Government Accountability Office has launched a federal investigation into the massive increase of drugging children in foster care.  “The investigators will attempt to account for estimates in the hundreds of millions of dollars of possible fraud arising from prescriptions for drugs explicitly barred from Medicaid coverage.  The GAO is collecting data from six states to search for patterns of abuse.  According to a number of foster care experts who spoke with Politics Daily, children in foster care, who are typically concurrently enrolled in Medicaid, are three or four more times as likely to be on psychotropic medications than other children on Medicaid. Alarmingly, many of these drugs are medically prohibited for minors and dangerous to the children taking them.”

Point 5) Senate investigations this past year revealed that some of the “leading” psychiatrists touting the wonders of diagnosing and drugging kids, and largely responsible for massive increases in kids unnecessarily placed on dangerous psychiatric drugs, were on Pharma’s payroll, and failed to disclose this.  Psychiatrists such as Joseph Biederman, who was being paid millions of dollars by the Pharmaceutical companies while skewing the results of drug trials to show false benefits for kids, in order the launch a nationwide campaign to get children diagnosed as “bi-polar.”

And he’s not the only one: Here are some of the “leading” psychiatrists exposed by Senate investigations:

Melissa DelBello, Associate Professor of Psychiatry and Pediatrics at the University of Cincinnati, was exposed in 2007 by the Senate Finance Committee for concealing $180,000 she received from AstraZeneca in 2003 and 2004.  DelBello’s studies of the antipsychotic Seroquel, made by AstraZeneca, in children helped to fuel the widespread pediatric use of antipsychotic drugs.

In 2008, Joseph Biederman, a leading Harvard child psychiatrist whose work helped fuel an explosion in the use of powerful antipsychotic drugs in children, was exposed for withholding earning at least $1.6 million in consulting fees from drug makers between 2000 and 2007.

Alan Schatzberg, president-elect of the APA, and Professor and Department of Psychiatry Chair of Stanford University was also investigated in 2008 by the Senate Finance Committee.  Schatzberg was forced to step down as principal investigator in an NIH funded research project into a drug called Mifeprestone, to treat “psychotic depression.” Senate investigators found that Schatzberg failed to report $4.8 million worth of stock in Corcept Therapeutics, a drug company which he co-founded and acted as lead researcher on a drug development project for until he was forced to surrender that role after being exposed.

A Senate investigation found Charles Nemeroff, Professor of Psychiatry and Behavioral Sciences and Chairman of Psychiatry and Behavioral Sciences, Emory University School of Medicine had concealed $2.8 million he earned from drug companies. He was forced to step down as Chairman of Psychiatry and Behavioral Sciences at Emory due to being exposed for his hidden pharmaceutical pay and attempted cover up.

In December 2009, Sen. Charles Grassley filed a complaint about Fernando Mendez-Villamil to federal authorities for his excessive prescribing of antipsychotics to children that were not approved by the FDA.  This cost taxpayers $43 million over six years.  Mendez-Villamil is apparently also currently under investigation by the Medicaid program.  Mid 2009, the Florida Agency for Health Care Administration reported that that Mendez Villamil is the top Medicaid prescriber of mental health drugs in the state—for all ages.  It was calculated that he wrote more than 150 prescriptions a day, seven days a week for six years

So to summarize, we don’t have an epidemic of mentally ill children, we have an epidemic of psychiatry stigmatizing children with mental disorders that cannot be medically/scientifically proven to exist.  We have an epidemic of children prescribed dangerous and potentially lethal psychiatric drugs, including infants and toddlers.  And we have the real source of stigmatization—the Psychiatric/Pharmaceutical industry.

To read Koplewicz’s article, click here

http://www.huffingtonpost.com/dr-harold-koplewicz/mental-health-being-openminded_b_791706.html

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Nation of Pill Poppers: 19 Potentially Dangerous Drugs Pushed By Big Pharma

Tuesday, December 7th, 2010
AlterNet — December 6, 2010
by Martha Rosenberg
Here are some of the dicey drugs many Americans are hooked on,
thanks to greedy pharmaceutical companies.

Since direct-to-consumer drug advertising was legalized 13 years ago, Americans have become a nation of pill poppers — choosing the type of drug they desire like a new toothpaste, sometimes whether or not they need it.

But if patients want the drugs, doctors and pharma executives want them to have the drugs and media gets full page ads and huge TV flights (when many advertisers have dried up), is the national pillathon really a problem?

Yes, when you consider the cost of private and government insurance and the health of patients who take potentially dangerous drugs like these.

Seroquel, Zyprexa, Geodon, atypical antipsychotics

Even though the antipsychotic Seroquel surpasses 71 drugs on the FDA’s January quarterly report with 1766 adverse events, even though it’s linked to eight corruption scandals, even though military parents blame Seroquel for unexplained troop deaths, it is the fifth biggest-selling drug in the world and netted AstraZeneca almost $5 billion last year.

Atypicals were originally promoted to replace side-effect prone drugs like Thorazine but soon became pharmaceutical Swiss Army Knives for depression, anxiety, insomnia, bipolar and conduct disorders and other off label uses — and betrayed the same side effects as older antipsychotics. (Especially tardive dyskinesia-linked Abilify.)

Foisted disproportionately on the young, poor and disadvantaged, atypicals cause such weight gain and metabolic derangement — 16 percent of Zyprexa patients gain 66 pounds and some gain over 100 — manufacturer Lilly Eli Lilly agreed to pay the state of Alaska $15 million in 2008 for the Medicaid costs of Zyprexa patients who developed diabetes.

Atypicals carry warnings of death in demented patients but are widely used in nursing homes. And even though Risperdal maker Johnson & Johnson, Geodon maker Pfizer, Abilify maker Bristol-Myers Squibb, Lilly and AstraZeneca have all entered into government settlements that acknowledge fraudulent or wrongful atypical marketing, FDA rewarded atypical makers by approving Zyprexa and Seroquel for children last year. And approved a new atypical antipsychotic, Latuda, in October. Maybe the FDA is bipolar.

Ritalin, Concerta, Strattera, Adderall and ADHD drugs

When it comes to the epidemic of 5.3 million US children between 3 and 17 diagnosed with ADHD, suspicions of pharma pushing the disorder are exceeded only by pharma’s admissions thereof.

During an August conference call with financial analysts, Shire specialty pharmaceuticals president Mike Cola credited the “very dynamic ADHD market” to Shire’s globalization efforts and “investments we have made in new uses for our existing products.”

Those uses, a.k.a. diagnoses, for Shire products like stimulants Adderall, Vyvanse and Intuniv include adult ADHD, cognitive impairment, depression and excessive daytime sleepiness.

Still, Cola says despite the 10 percent ADHD “new starts” that are helping Shire “grow the market,” and the “co-administration market” of add-on prescription drug$, the ADHD franchise suffers from patients who drop out when they quit seeing their pediatrician. “We don’t see those patients show up again until their mid-to-late 20s,” laments Cola.

ADHD drugs, in addition to “robbing kids of their right to be kids, their right to grow, their right to experience their full range of emotions, and their right to experience the world in its full hue of colors,” as Anatomy of an Epidemic author Robert Whitaker puts it, can also be deadly.

A 2009 article in the American Journal of Psychiatry called Sudden Death and Use of Stimulant Medications in Youths found 1.8 percent of youthful stimulant users died sudden deaths from cardiac dysrhythmia or unexplained causes versus 0.4 percent who were not on stimulants. Though it helped fund the study, the FDA said the results proved no “real risk” and kids should keep taking their meds.

Meanwhile, says Robert Whitaker, kids on ADHD meds “are told they are going to be on these drugs for life. And next thing they know, they’re on two or three or four drugs,” a phenomenon also known as the co-administration market.

Prozac, Paxil, Zoloft, SSRIs

Selective serotonin reuptake inhibitor (SSRIs) antidepressants like Prozac, Paxil, Zoloft and Lexapro probably did more to inflate pharma profits in the last decade than direct-to-consumer advertising and Viagra put together, no pun intended: over 60 million prescriptions were filled in the US in 2007 with many patients reporting their depression lifted.

But some critics say for mild depression, SSRIs don’t work at all and are no better than placebo.

And others say they can add aggression, bizarre behavior, self-harm and suicidal thoughts to depression. In fact, there are 4,200 published reports of SSRI-related violence, aggression, bizarre behavior, self-harm and suicide since the drugs were introduced in 1988 including the well known gun massacres at Columbine (1999), Red Lake (2005), NIU and likely, Virginia Tech (2007).

SSRIs have non-behavioral perks both sides agree on: life-threatening serotonin syndrome when taken with migraine drugs, gastrointestinal bleeding when taken with aspirin, Aleve or Advil and the bone condition, osteoporosis.

Paxil can reduce or abolish the effect of tamoxifen in breast cancer patients and increase deaths says British Medical Journal. It’s linked to a two-fold increased risk of cardiac birth defects in infants according to its own manufacturer, GSK.

And sex? SSRIs are so linked to dysfunction even the pharma-identified web site WebMD admits many will experience impotence, delayed ejaculation or no orgasm. But there is a solution (besides going off SSRIs) says WebMD: Add another antidepressant that’s not an SSRI, like Wellbutrin!

Effexor, Cymbalta, Pristiq, SNRIs

Selective norepinephrine reuptake inhibitors (SNRIs) are like their SSRIs chemical cousins except their norepinephrine effects can modulate pain, which has ushered in your-depression-is-really-pain, your-pain-is-really-depression and other crossover marketing. But the problem with giving a psychoactive drug for pain is that you’re giving a psychoactive drug for pain. “After three months of taking Savella [another SNRI], I started self-destructing and cutting myself,” writes a 40 year old woman on askapatient.com. “I don’t know why or anything, but it does similar to Prozac where it makes you think and do weird things.”

And Cymbalta, approved this fall for chronic back pain and osteoarthritis?

Cymbalta was the drug healthy 19-year-old volunteer Traci Johnson was testing when she hung herself in an Eli Lilly dorm in 2005. It was the drug Carol Anne Gotbaum killed herself on at Phoenix’s Sky Harbor airport in 2007.

SNRI’s are also harder to quit than SSRIs, especially Effexor. 25-year-old Chicagoan David F. told AlterNet he stood at the top of an 8-story parking lot contemplating jumping every day for weeks after quitting. It’s also the drug Andrea Yates was on when she drowned her five children in 2001.

But not all SNRI side effects are behavioral. The FDA would not approve Pristiq, a newer version of Effexor, when Wyeth/Pfizer tried to market it for vasomotor symptoms, because it caused heart attacks, coronary artery obstruction and hypertension in clinical trials. That’s similar to another SNRI, the diet pill Meridia, which was just withdrawn from the market for causing heart problems. Pristiq is still available.

Read the rest of the article here: http://www.alternet.org/story/149078/nation_of_pill_poppers_19_dangerous_drugs_shamelessly_pushed_by_big_pharma?page=entire

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Nursing homes are seeking to end the psychiatric drug stupor

Sunday, December 5th, 2010

Note from CCHR: The wholesale psychiatric drugging of the elderly in both private and public nursing homes has reached epidemic levels, with the use of antipsychotics, antianxiety drugs (tranquilizers) and antidepressants  skyrocketing and patients being harmed and killed as a direct result.  These drugs are highly dangerous when prescribed to anyone, but when prescribed to the elderly the risks for diabetes, stroke and sudden death are greatly increased.    As stated in the article below, ” Instead of looking for causes of disruptive behavior among dementia patients, doctors typically prescribe drugs to mask the symptoms… because it’s the easy thing to do. … That’s true in hospitals, in clinics and in nursing homes.” It is for this reason we feel the more humane non-drug approach being undertaken by this particular chain of nursing homes in treating elderly patients  suffering from dementia should not only be commended, but employed by all nursing homes caring for the elderly.

The Star Tribune – Dec 4, 2010

by Warren Wolfe

Instead of treating behavioral problems with antipsychotic drugs, the Ecumen chain of 15 homes is using strategies including aromatherapy, massage, music, games, exercise and good talk. The state is helping out.

The aged woman had stopped biting aides and hitting other residents. That was the good news.

But in the North Shore nursing home’s efforts to achieve peace, she and many other residents were drugged into a stupor — sleepy, lethargic, with little interest in food, activities and other people.

“You see that in just about any nursing home,” said Eva Lanigan, a nurse and resident care coordinator at Sunrise Home in Two Harbors, Minn. “But what kind of quality of life is that?”

Working with a psychiatrist and a pharmacist, Lanigan started a project last year to find other ways to ease the yelling, moaning, crying, spitting, biting and other disruptive behavior that sometimes accompany dementia.

They wanted to replace drugs with aromatherapy, massage, games, exercise, personal attention, better pain control and other techniques. The entire staff was trained and encouraged to interact with residents with dementia.

Within six months, they eliminated antipsychotic drugs and cut the use of antidepressants by half. The result, Lanigan said: “The chaos level is down, but the noise is up — the noise of people laughing, talking, much more engaged with life. It’s amazing.”

Now the home’s operator, Shoreview-based Ecumen, has started a project called Awakenings throughout its 15 long-term care nursing homes. It’s based on Lanigan’s work and funded with a two-year, $3.7 million state grant.

“We saw what Eva was doing — something everybody in the industry talks about — and we were impressed,” said Mick Finn, an Ecumen vice president. “We said, ‘Hey, this is real. Can we all do this?’ ”

The dangers of drugs

Powerful antipsychotic drugs have been used for years to reduce agitation, hallucinations and other debilitating symptoms among people with mental illnesses.

They also are widely used “off label” to quell disruptive behavior among people with Alzheimer’s disease and other forms of dementia.

Medicare spends more than $5 billion a year on those drugs for its beneficiaries, including about 30 percent of nursing home residents. Several studies have concluded that more than half are prescribed inappropriately. The drugs are especially hazardous to older people, raising the risk of strokes, pneumonia, confusion, falls, diabetes and hospitalization.

“There’s a bunch of problems, not least of which is those drugs can kill you,” said Dr. Mark Kunik at Baylor College of Medicine in Houston who spoke last month at the Gerontological Society of America’s annual meeting in New Orleans.

Instead of looking for causes of disruptive behavior among dementia patients, doctors typically prescribe drugs to mask the symptoms, he said, because “It’s the easy thing to do. … That’s true in hospitals, in clinics and in nursing homes.”

Federal regulators are cracking down on homes that don’t routinely reassess residents on psychotropic drugs. But use remains widespread.

“Whether you have Alzheimer’s or not, there’s a reason people get frustrated or upset — pain, urinary tract infections, hunger, fear of strangers or loud noises or strange settings, maybe drug interactions,” Kunik said. “If you figure that out, you likely can find a safer, nonpharmacologic treatment.”

Treating loss with love

About 150 miles south of Two Harbors, Bernice Brockelman, 91, was snacking on cookies last Wednesday beside the Christmas tree at Ecumen Parmly LifePointes, a nursing home in Center City — all the while alternating quickly from calm to worry to calm.

“Can I stay here tonight? I don’t know where to go. Can I stay with you?” she asked Christy Johnson, the home’s therapeutic recreation director. Though Johnson reassured her, she asked the question again — and again and again.

In an effort to calm her while preparing to wean her from pills, the Parmly staff invited Brockelman into a game of Bingo and to recite the Polish phrases she learned from her immigrant parents. Then she spotted a male visitor.

“Hey, is he married?” she asked with a sparkle in her eye.

“When she’s feeling good, Mom’s an outrageous flirt and she can be really funny,” said her daughter, Judy Balthazor of Center City. “But often there is the repetitive questions, the worry, sometimes just being washed out. I can’t wait for them to get her off her drugs.”

Until the Awakenings project, few at the home knew Brockelman’s whole story — the loss of both parents when she was in high school, of her husband at age 46, then two sons, a close friend and a nephew. Found to have psychosis and dementia, she “just shut down because she had so many losses,” Balthazor said.

Now, the Parmly staff is gaining deeper knowledge of 15 residents who are on psychotropic drugs and who frequently are agitated or upset. They are about to start weaning the residents from the drugs, but they’ve already started a range of activities tailored to each.

Some say nursing homes cannot afford to replace drugs with personal attention because it requires too much staff time.

“Our guess is that it will take the equivalent of two extra people at each home, spread across all job categories,” said Finn, Ecuman’s vice president. “Can we afford it? We think we have to, because it’s the right thing.”

Brockelman, who lived nearly all of her life in northeast Minneapolis, loved to bake, so now she helps make bread and cookies. She danced and was physically active, so she walks with an aide and taps her toes to polka music. A devout Catholic, she attends several weekly church services. She plays Bingo with aide Jenna Miller and sometimes other residents.

“When [you] understand who Beatrice has been in the past, you know her a lot better in the present,” Miller said. “With the Awakenings project, I have permission to spend the time I need with Bernice so she feels safe and loved.”

http://www.startribune.com/lifestyle/health/111326224.html?page=1&c=y

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5 Myths About Depression Treatments

Friday, December 3rd, 2010

COUNTER PUNCH, December 3, 2010

By Bruce E. Levine,
Clinical Psychologist

A warning: for people satisfied with their standard depression treatments, debunking myths about them may be troubling. However, for critically thinking depression sufferers who have not been helped by antidepressants, psychotherapy, or other standard treatments, discovering truths about these treatments can provide ideas about what may actually work for them.

Critical thinkers have difficulty placing faith in any depression treatment because science tells them that these treatments often work no better than placebos or nothing at all, and if one lacks faith in a depression treatment, it is not likely to be effective. In fact, it is belief and faith—or what scientists call “expectations” and the “placebo effect”—that is mostly responsible for any depression treatment working. Critical-thinkers can find a way out of depression when their critical thinking about depression treatments is validated and respected, and they are challenged to think more critically about their critical thinking.

Myth 1: Antidepressants Are More Effective than Placebos

Many depressed people report that antidepressants have been effective for them, but do antidepressants work any better than a sugar pill? Researcher Irving Kirsch (professor of psychology at the University of Hull in the United Kingdom as well as professor emeritus at the University of Connecticut and author of The Emperor’s New Drugs) has been trying to answer that question for a significant part of his career.

In 2002, Kirsch and his team at the University of Connecticut examined 47 depression treatment studies that had been sponsored by drug companies on the antidepressants Prozac, Paxil, Zoloft, Effexor, Celexa, and Serzone. Many of these studies had not been published, but all had been submitted to the Food and Drug Administration (FDA), so Kirsch used the Freedom of Information Act to gain access to all the data. He discovered that in the majority of the trials, antidepressants failed to outperform sugar pill placebos.

“All antidepressants,” Kirsch reported in 2010, “including the well-known SSRIs [selective serotonin reuptake inhibitors], had no clinically significant benefit over a placebo.” While in aggregate, antidepressants slightly edge out placebos, the difference is so unremarkable that Kirsch and others describe it as “clinically negligible.”

Why are so many doctors unaware of the lack of superiority of antidepressants as compared to placebos? The answer became clear in 2008 when researcher and physician Erick Turner (currently at the Department of Psychiatry and Center for Ethics in Health Care, Oregon Health and Science University) discovered that antidepressant studies with favorable outcomes were far more likely to be published than those with unfavorable outcomes. Analyzing published and unpublished antidepressant studies registered with the FDA between 1987-2004, Turner found that 37 of 38 studies having positive results were published; however, Turner reported, “Studies viewed by the FDA as having negative or questionable results were, with 3 exceptions, either not published (22 studies) or published in a way that, in our opinion, [falsely] conveyed a positive outcome (11 studies).”

Myth 2: If the First Antidepressant Fails, Another Antidepressant Will Likely Succeed

In The Noonday Demon, the popular 2001 book about depression, writer and depression sufferer Andrew Solomon repeated the then urban legend that “more than 80 percent of depressed patients are responsive to medication.” Solomon accurately cites a journal article that states this statistic; however, following the “reference trail,” I discovered that the journal article that Solomon cited refers to a second article for evidence of this statistic, but this second journal article mentions nothing about 80 percent of depressed patients responding to some medication.

The National Institute of Mental Health (NIMH) was aware that there was no research to back up the assertion that 80 percent of depressed patients improve if they keep trying different medications, so NIMH funded “Sequential Treatment Alternatives to Relieve Depression” (STAR*D), the largest ever study of sequential depression treatments. STAR*D results were published in 2006.

In Step One of STAR*D, all depressed patients were given the antidepressant Celexa, and in Step Two, patients who failed to respond to Celexa were divided into different groups and received other treatments (mostly different drug treatments) in place of or in addition to Celexa. If their second treatment failed, there was a third and, if necessary, a fourth treatment step.

In every STAR*D treatment step, remission rates were either equal to or significantly lower than the customary placebo performance in other antidepressant studies, but to the exasperation of many scientists, there was no placebo control in this $35 million U.S. taxpayer funded STAR*D study. (STAR*D researchers disclosed receiving consulting and speaker fees from the pharmaceutical companies which manufacture the antidepressants studied in STAR*D.)

In March 2006, NIMH triumphantly announced that 50 percent of depressed people saw remission of symptoms after the first two STAR*D steps. However, NIMH failed to mention in its press release that in the same time it took to complete these first two steps—slightly over 6 months—previous research shows that depressed people receiving no treatment at all have a spontaneous remission rate of 50 percent.

In November 2006, following the completion of all four STAR*D steps, STAR*D authors claimed a 67 percent cumulative remission rate, which again exasperated many scientists because this number failed to incorporate STAR*D’s extremely high relapse and dropout rates. In an American Journal of Psychiatry editorial that accompanied STAR*D authors’ report, J. Craig Nelson, M.D, stated, “I found a cumulative sustained recovery rate of 43 percent after four treatments, using a method similar to the authors but taking relapse rates into account.” However, even 43 percent turns out to be an inflated rate.

Separate analyses of STAR*D in 2010 by psychologist Ed Pigott and medical reporter Robert Whitaker revealed that STAR*D researchers had inflated remission numbers by switching mid-study to a more lenient measurement, and also by including patients who were not depressed enough at baseline to meet study criteria. But even taking the STAR*D data as is, Pigott’s analysis revealed that less than 3 percent of the entire group of depressed patients who began the STAR*D study can be ascertained as having a sustained remission (i.e., actually participated in the final assessment without relapsing and/or dropping out).

Myth 3: Electroconvulsive Treatment (ECT) is an Effective Last Resort

Andrew Solomon in The Noonday Demon alsostates, “ECT seems to have some significant impact between 75 and 90 percent of the time. About half of those who have improved on ECT still feel good a year after treatment.” Is ECT really that effective?

In 2004, researcher Joan Prudic, M.D. and her team at New York State Psychiatric Institute conducted a major study of ECT, which involved 347 patients at seven hospitals. Reported were both the immediate outcomes and the outcomes over a 24-week follow-up period. With respect to immediate outcomes, Prudic reported: “In contrast to the 70 to 90 percent remission rates expected with ECT, remission rates, depending on criteria, were 30.3 to 46.7 percent.” Even worse for ECT advocates, Prudic noted that, “10 days after ECT, patients had lost 40 percent of the improvement.”

There are also studies comparing ECT with a placebo (called “sham ECT”). In sham ECT, patients receive muscle-relaxing and anesthetizing drugs that routinely accompany ECT, and they are hooked up to the ECT apparatus, but they receive no electric voltage. Psychiatrist Colin Ross reports, “No study has demonstrated a significant difference between real and placebo (sham) ECT at 1 month post-treatment.”

Myth 4: Cognitive Behavior Therapy (CBT) is the Best Psychotherapy for Depression

First, the good news about CBT. The only non-drug treatment examined in STAR*D was a form of cognitive therapy (which was not fully detailed by STAR*D authors and only administered in Step Two). Among those who failed Celexa in the first step, three groups in Step Two switched from Celexa to one of three antidepressants, and their remission rates ranged from 25 to 26.6 percent; but one group in Step Two switched from Celexa to cognitive therapy, and its remission rate was 41.9 percent. STAR*D researchers did not assess whether any differences in treatment effectiveness were statistically significant.

Another group in Step Two maintained Celexa and added cognitive therapy, and this “Celexa plus cognitive therapy” group’s remission rate was 29.4 percent, not as high as the group that received cognitive therapy without medication. This begs the question: Is it also a myth that “antidepressants plus psychotherapy” works better than either treatment alone? Research psychologist David Antonuccio at the University of Nevada School of Medicine reports, “Combined psychotherapy and drug treatment do not appear to be superior to therapy or drug treatment alone.”

What psychotherapy is best for depression? While Americans hear most about CBT, it turns out that CBT or some form of cognitive therapy is no more effective for depression than any of several other types of psychotherapy. In 2008, psychologists Pim Cuijpers and Annemicke van Straten at the University of Amsterdam reported on a meta-analysis of 53 studies, each of which compared two or more different types of psychotherapy for depression. Included were varieties of “cognitive-behavior therapy,” “psychodynamic therapy,” “behavioral activation therapy,” “social skills training,” “problem-solving therapy,” “interpersonal therapy,” and “nondirective supportive therapy.” The major finding? “No large differences in efficacy between major psychotherapies for mild to moderate depression.”

So, if psychotherapy technique is not all that important, what is? Psychologist Bruce Wampold at the University of Wisconsin reviewed the psychotherapy outcome literature, examining hundreds of studies and meta-analyses, for his book The Great Psychotherapy Debate. Wampold unequivocally states that outcome effectiveness does not depend on the specific techniques of psychotherapy but instead depends on so-called “non-specific” factors such as the nature of the alliance between therapist and their client, and clients’ confidence in the therapy and in their therapist. “Simply stated,” Wampold concludes, “the client must believe in the treatment or be led to believe in it.”

Myth 5: No Treatment for Depression Works

In April 2002, an NIMH-funded study on the antidepressant Zolof, the herb St. John’s wort, and a placebo had some curious results. The findings were that 32 percent of placebo-treated patients experienced remission, better than the 25 percent remission for the Zoloft-treated patients or the 24 percent remission for the St. John’s wort-treated patients. Most scientists would say that this study shows that neither Zoloft nor St. John’s wort worked, but those subjects who had positive outcomes with these two treatments would disagree. So, does this study show that antidepressants and St. John’s wort are not helpful, or does it show that “expectations,” belief,” and “faith” are the likely factors that make all treatments work?

When assessing whether a specific treatment is effective, scientists are trained to rule out the effect of expectations. Researchers evaluate a depression treatment as effective if, in a controlled study, the treatment outcome is significantly better than a placebo. However, the reality of depression treatments is that expectations, faith, belief, and the placebo effect are—far and away—the most important reasons why anything works.

Read the rest of the article here: http://www.counterpunch.org/levine12032010.html

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