Posts Tagged ‘JAMA’

Huffington Post: Poor Kids far more likely to be prescribed psychiatric drugs

Thursday, May 20th, 2010

Huffington Post
By Bruce E. Levine
May 20, 2010

Children covered by Medicaid are far more likely to be prescribed antipsychotic drugs than children covered by private insurance, and Medicaid-covered kids have a higher likelihood of being prescribed antipsychotics even if they have no psychotic symptoms. This is reported in the May19, 2010 Journal of American Medical Association (JAMA) article, “Studies Shed Light on Risks and Trends in Pediatric Antipsychotic Prescribing.”

Researchers at Rutgers University and Columbia University found that children and adolescents covered by Medicaid were four times as likely as those with private insurance to receive an antipsychotic in 2004. Among those aged six to 17 years who were covered by Medicaid, 4.2 percent were prescribed at least one antipsychotic drug. In contrast, among those in this same age group who had private insurance, less than 1 percent were prescribed an antipsychotic. Nearly half of these Medicaid-covered pediatric patients receiving antipsychotic drugs had nonpsychotic diagnoses of attention deficit hyperactivity disorder (ADHD) or some other disruptive behavior disorder. In contrast, of the privately insured pediatric patients receiving antipsychotics, about one fourth were diagnosed with ADHD or some other disruptive behavior disorder.

The current issue of JAMA also reports another troubling study published earlier this year in the journal Pediatrics. This study, conducted by Robert Penfold of the Department of Population Medicine at Harvard Medical School and the Harvard Pilgrim Health Care Institute, examined the use of the antipsychotic Geodon (ziprasidone) in pediatric patients covered by Medicaid in Michigan in 2001. Of the pediatric patients who had been diagnosed with a psychiatric disorder and had received Geodon, only 53.3 percent actually had a diagnosis of psychosis. The other children who received Geodon had one or more of the following diagnoses: 24.1 percent were diagnosed with explosive personality disorder, 17.6 percent were diagnosed with depressive disorder, and 13.1 percent of these kids who were prescribed Geodon had oppositional defiant disorder (ODD). What exactly does it take to get an ODD diagnosis?

Read entire article:  http://www.huffingtonpost.com/bruce-e-levine/psychiatric-drugs-and-poo_b_583568.html

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Psychiatrists And Pharma: Undue Influence? Concern about corruption increasing…

Friday, March 26th, 2010

Pharmalot
By Ed Silverman
March 25, 2010

Two essays published in separate periodicals this week raise troubling questions about the extent to which psychiatrists may be unduly influenced by the pharmaceutical industry, and how this relationship may effect public trust in psychiatry. The upshot? The concern about corruption, or at least the appearance of corruption is palpable. Sigmund Freud would not be pleased. Interestingly, one of the authors is Tom Insel, the director of the National Institute of Mental Health.

For instance, Lisa Cosgrove and Harold Bursztajn write in Psychiatric Times that they looked at the two philanthropic arms of the American Psychiatric Association – the American Psychiatric Foundation and the American Psychiatric Institute for Research and Education – and found that APF’s 15-member board includes four high-level pharma execs that either make meds recommended by APA or are developing products targeted to treat mental disorders. Other board members include two more with industry ties and a senior vp at Fleishman Hillard, the public relations firm whose clients include six drugmakers.

APF’s corporate advisory council lists drugmakers, they continue, that contribute “significant funding” to APF and that make meds recommended in the APA’s clinical practice guidelines. Although it was not possible to discern the total amount of industry funding given to APF, in fiscal year 2008 APF lists 11 pharmaceutical companies and 1 medical device manufacturer that contributed monies; 6 of the companies are listed as giving $40,000 “and above” per year.

They go on to write that APIRE, like APF, doesn’t require disclosure of financial conflicts of interests, and that nine of 16 APIRE board members have ties to drugmakers. They also note current disclosure policies don’t require reporting of pooled industry money to academic departments, units, hospitals, and med schools. And because there is no independent monitoring of industry ties, they maintain “underreporting is very likely a problem. For example, one board member who reported ‘no disclosure’ in an APA publication was found to be on the speakers’ bureau of multiple pharmaceutical companies.”

Read entire article:  http://www.pharmalot.com/2010/03/psychiatrists-and-pharma-undue-influence/

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In the wake of U.S. Senator Charles Grassley investigations, Medical Editors Push for Ghostwriting Crackdown

Friday, September 18th, 2009

Natasha Singer and Duff Wilson
The New York Times
September 17, 2009

The scientific integrity of medical research has been clouded in recent years by articles that were drafted by drug company-sponsored ghostwriters and then passed off as the work of independent academic authors.

Yet the leading medical journals have continued to rely largely on an honor system of disclosure to detect such potential bias, asking authors to voluntarily report any industry ties or contributors to their manuscripts.

But now, in light of recently released evidence that some drug makers have gone to great lengths to turn scientific articles into marketing vehicles for their products, some influential medical editors are cracking down on industry-financed ghostwriting. And they are getting help from some members of Congress.

Read entire article: http://www.nytimes.com/2009/09/18/business/18ghost.html?_r=1&hp

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