GPs under 'pressure' to issue neuroleptics, claims professor

15/01/2009
Gavin Atkin

GP leader Professor Steve Field has claimed GPs are under great pressure from nursing home staff to prescribe neuroleptics for agitated patients.

Following publication of new data in The Lancet showing increased mortality in Alzheimer’s disease patients receiving neuroleptic treatments, Royal College of General Practitioners chairman Professor Field said the drugs could be extremely dangerous.

They should be prescribed only when absolutely necessary and only after a thorough assessment, and even then patients should only be given the treatment for a very short time. The treatment should also be reviewed regularly.

“Doctors can come under great pressure from staff in nursing and rest homes to prescribe these drugs to agitated patients,” he said.

“But we know doctors across the country are being vigilant and doing everything they can to avoid prescribing these drugs except as a last resort.”

The new mortality results come from long-term follow up of the DART-AD study of the effect of neuroleptics on cognitive decline and neuropsychiatric symptoms in patients with Alzheimer’s disease living in care facilities.

Survival over 12 months was 70 per cent in the treated group compared with 77 per cent in the placebo group. The difference between the two groups was more pronounced over time, with survival at 46 per cent and 71 per cent respectively at 24 months, and 30 per cent and 59 per cent at 36 months.

The authors said the results highlighted the need for less harmful long-term treatments for neuropsychiatric symptoms in these patients.

source: Chemist+Druggist

Law suits relating to psychotic drugs and ECT

(they are giving me heart attack)

ELECTROSHOCK
Lawsuits relating to ECT and the damage it causes. (also see: http://www.ect.org)

Landmark decision: jury awards $635,711 damages for memory loss from electroshock
http://www.ahrp.org/infomail/05/07/08.php

Shock machine company pays up
http://www.ect.org/news/suit.html

Shock therapy patients to sue
http://www.ect.org/news/sue.html

UK settlement
http://www.ect.org/news/leeds.html

Electric shock suit condemns hospital
http://www.ect.org/news/sanfransuit.html

Woman says electric shock treatment destroyed her life
http://www.ect.org/news/woman.html

Ontario lawsuit
http://www.ect.org/news/ontsuit.html

Soldier sues
http://www.ect.org/news/soldiersuit.html

DRUGS
Stewart v. The Johns Hopkins Hospital: A 21-year-old student was prescribed the antidepressant Desipramine for “depression.” The doctor failed to monitor the level of the drug in her blood and she subsequently developed cardiac problems, collapsed and died. Her surviving family was awarded $2.5 million (€1.9 million).

Weaver v. Myers: A 26-year-old man was awarded $1.5 million (€1.2 million) after being prescribed an antipsychotic that caused Tardive Dyskinesia, a side effect he had not been warned of.

Muss v. Goldstein Cohen: A 43-year-old woman was misdiagnosed with bipolar and prescribed an off-label drug resulting in Stevens-Johnson Syndrome, a severe allergic drug reaction that resulted in epidermal necrosis (skin loss) and death. The jury determined that the doctor had failed to warn the patient of the side effect and, therefore, violated her informed consent, awarding $3.4 million (€2.7 million) to her surviving family.

Liss v. Doeff: Elizabeth Liss, a 45-year-old factory worker, was diagnosed with “bipolar” disorder by psychiatrist Jan W. Doeff and prescribed the antipsychotic drug Risperdal as well as Lithium. Liss complained about side effects from the Risperdal, but Doeff insisted she continue it. Both Liss and her husband noticed and complained of Liss’s facial twitches, tightening of the facial muscles, pain in the neck and jaw area, and other similar symptoms. A neurologist confirmed Liss had developed Tardive Dyskinesia. Liss was awarded $6.7 million (€5.3 million).

Snider v. Harding Hospital: A 35-year-old teacher was prescribed an antipsychotic drug, which caused Tardive Dyskinesia. The plaintiff did not sign any informed consent forms, nor did the medical records reflect any warnings. She was awarded $800,000 (€630,269).

Mennell v. Bradley: California psychiatrist Cecil Bradley was found liable for failing to prevent a crime. For five years Bradley treated a patient who repeatedly expressed a compulsive desire to hurt others with his truck. California regulations require doctors and mental health professionals to notify the Department of Motor Vehicles when a patient is incapable of driving safely. Bradley did not do this even when the patient had used his truck to ram a vehicle in the psychiatrist’s parking lot. Eventually the patient drove up onto a sidewalk, killing one and severely injuring another. The jury found in favor of the surviving victim, awarding him over $11 million (€8.7 million) — $8.6 million (€6.8) of which Bradley was held responsible for.

INVOLUNTARY COMMITMENT
In January 2004, Robert Lee Marion of Manhattan was awarded nearly $1 million in damages for being involuntarily committed to Bellevue Hospital. In 1998, Marion admitted himself to Bellevue for a minor treatment of diabetes, was told he wasn't scheduled for the operation and was involuntarily committed when he objected.

On June 16, 2003, Roy E. Lund of Pennsylvania was awarded $1.1 million for being falsely imprisoned in a psychiatric facility, Northwest Medical Center in Oil City, Penns. The jury found the hospital had been “grossly negligent” in its violation of the state’s Mental Health Procedures Act, which was with reckless indifference to Mr. Lund.

source: Citizen Commission on Human Rights 

Non-existence of biological tests to support existance of mental illness

Psychiatric abuse survivor videos

Posted here are some videos from psychiatric survivor patients. More can be found on Youtube. I welcome more links

Oppositional Defiant Disorder and Malaysian politicians

IMHO frankly speaking many of our Malaysian's politicians exhibit symptoms of ODD and should be drugged for our country's sake. FYI:

Diagnostic criteria for Oppositional Defiant Disorder (313.81, DSM-IV)

A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four (or more) of the following are present:

1. often loses temper
   
2. often argues with adults
   
3. often actively defies or refuses to comply with adults' requests or rules
   
4. often deliberately annoys people
   
5. often blames others for his or her mistakes or misbehavior
   
6. is often touchy or easily annoyed by others
   
7. is often angry and resentful
   
8. is often spiteful or vindictive
   

What say you?

Note: DSM = Diagnostic and Statistical Manual of Mental Disorders (download here)

FDA warning on antidepressants and suicidal behavior

Dear fellow psychiatrists,

The U.S. Food and Drug Administration (FDA) today proposed that makers of all antidepressant medications update the existing black box warning on their products' labeling to include warnings about increased risks of suicidal thinking and behavior, known as suicidality, in young adults ages 18 to 24 during initial treatment (generally the first one to two months).

Source:
US Food and Drug Administration

More videos/news article:
FDA Orders Antidepressant Warning
FDA: Antidepressant Warning Suicide Watch
FDA seeks new antidepressant warning

Do I smell something fishy here? Well, as usual silence is golden

Validity of chemical imbalance

More articles examining the validity of Chemical Imbalance model in so-called mentally ill patients: (source: Citizens Commission on Human Rights)

Excerpt from Psychiatry and your child's future: “Chemical imbalance” is often the rationale behind the psychiatric community's emphasis on drugs. Many professionals disagree:

• “We know that the chemical imbalance model for mental illness has never been scientifically proven.”- Ty C. Colbert, PhD, clinical psychiatrist
• “There are no tests available for assessing the chemical status of a living person’s brain.” - Dr. Elliot Valenstein, Professor Emeritus of Psychology, University of Michigan
  

Other links

• Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature
  
• BLAMING THE BRAIN The ‘Chemical Imbalance’ Fraud
  

Psychiatry: No Science, No Cures

I've stumbled upon some interesting videos regarding psychiatry that are worth sharing


http://www.youtube.com/watch?v=b30iwhEw9ho

Psychiatry: An industry of death (short version)

http://www.youtube.com/watch?v=hsfH_ap2Wgg

For longer version click here: http://video.google.com/videosearch?q=psychiatry&emb=0&aq=f&dur=3#

Frankly speaking these videos are rather disturbing (and I would prefer NOT to let my patients know)... I'll be losing alot businesses if Malaysians were to know about these stuff (affects my car installments etc u know...)

Off-label treatment for insonmia

I have many patients who complain about insonmia and often I prescribe Seroquel for them. Works like charm ;)

"Seroquel causes certain rare and fatal side effects. One of them is neuroleptic malignant syndrome (NMS). Symptoms of this syndrome include nausea, vomiting, anxiety, agitation, insomnia, sore throat, blurred vision, stiff muscles, excessive sweating, jerky muscle movements, and sudden numbness in the muscles and decreased hunger. Certain patients using Seroquel also develop hypertension and diabetes. Another serious side effect with Seroquel is tardive dyskinesia (TD), an incurable neurological disorder characterized by uncontrollable movements of the face, tongue and other parts of the body. Tardive dyskinesia occurs due to prolonged usage of Seroquel. It is important to consult the physician when one observes any of the above symptoms."

http://www.scumdoctor.com/medicine/dangerous-medicine/

I still prescribe Seroquel to my patients anyway. You don't really have to inform them about TD (most patients never ask anyway). It just works.

About me

ex-President of the Malaysian Psychiatric Association

Qualifications: MB, BS(Malaya),DPM, MRCPsych

I am currently offering psychiatric services at the following location:

Lot 1-B, Ground Floor
CMH Medical Centre
106 Jalan Pudu
55100 Kuala Lumpur

03-20783126

Please feel free to drop by! When you are feeling down or mental...

http://pharmagossip.blogspot.com/2008/09/astrazeneca-seroquel-here-we-go-again.html

Dr Chin Cheuk Ngen

Hello and good day, I'm trying out blogging as my part time hobby...
Meantime please enjoy reading the articles I've posted here regarding psychiatry...
Hopefully you would find my articles useful and informative

In case you are wondering... it's lobotomy, a psychiatric practice used for treating various disorders such as schizophrenia, depression, anxiety disorders and etc

Sounds barbaric?

Well... let's just say times have changed and now we have ECTs (electroconvulsive therapy) and plenty of drugs such as antipsychotics, antidepressants, anticonvultants (plenty of anti-stuff here ;) anxiolytics, benzodiazepines etc... chemical lobotomy, perhaps?

For your amusement: 10 most insane medical practices in history