Thursday, July 12, 2012

Big Pharma - Big Money (Part 2)

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State Puts Lid on Overprescribing Docs
by Andrew Conte
Saturday, March 17th, 2012
Pittsburgh Tribune
“The state’s response to Grassley was made public yesterday when the agency responded to a Right-to-Know Request filed by Ken Kramer, an investigator for Citizens Commission on Human Rights International, a group that investigates and exposes psychiatric abuse.  ”
One doctor last year gave out 6,950 prescriptions for Xanax — or more than 19 every day — at a cost of nearly $70,500.
Pennsylvania has investigated and removed some doctors who were among the top prescribers of painkillers and mental health drugs for Medicaid patients, officials said in a letter made public on Friday.
Five doctors were disqualified from participating in the program; four had their licenses suspended; two were referred to prosecutors for review; and one is under investigation, the state Department of Public Welfare told U.S. Senate investigators.
The state reported its actions in a Feb. 27 letter to Sen. Charles Grassley, R-Iowa, who has been investigating abuses nationwide of medicines such as the anti-depressant Xanax. Pennsylvania initially provided information about the top 10 prescribers of eight antipsychotic, painkiller or anti-anxiety drugs to Grassley in 2010.
“We are seeing that certain states, including Pennsylvania, are reporting that they or the state medical board has taken action against medical providers, and that’s good news,” said Jill Gerber, Grassley’s spokeswoman.
The state welfare department said it sent intervention letters to 51 other doctors, showing their patients’ drug histories. The state said its program encourages doctors to discontinue unnecessary prescriptions, reduce drug quantities or switch to other treatments.
State officials declined to identify any doctors.
“Our administration is dedicated to rooting out all waste, abuse and fraud in our programs and services,” spokeswoman Donna Kirker Morgan said in a statement.
“Although the senator’s questions are an interesting snapshot of antipsychotic drug utilization in the Medicaid system, the questions do not delve into important facts and backgrounds about patients and their current needs for such drugs and the circumstances for such prescriptions.”
Top prescribers continue to dispense many of the drugs at a high cost for taxpayers, the state’s response shows. Along with its letter, public welfare reported the top 10 prescribers for eight drugs, showing the number of prescriptions each doctor wrote and the dollar value of them.
One doctor last year gave out 6,950 prescriptions for Xanax — or more than 19 every day — at a cost of nearly $70,500. The year before, another doctor wrote 1,864 prescriptions for Seroquel, an antidepression and schizophrenia drug that can cost up to $12 per tablet. The Seroquel prescriptions cost taxpayers more than $1 million.
The state attorney general’s office could not immediately provide details about whether any of the public welfare referrals resulted in prosecution. “We aggressively pursue provider fraud, which diverts limited taxpayer resources from Medicaid recipients with legitimate needs,” spokesman Nils Hagen-Frederiksen said.
The state’s response to Grassley was made public yesterday when the agency responded to a Right-to-Know Request filed by Ken Kramer, an investigator for Citizens Commission on Human Rights International, a group that investigates and exposes psychiatric abuse.
“It’s very good to see Pennsylvania taking action,” Kramer, 55, of Clearwater, Fla., said in an email to the Tribune-Review. “There is no debate on this: Patients are overdrugged, Medicaid is overbilled and taxpayers are overburdened — all caused by the bogus prescribing of psychiatrists.”
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Are Psychiatric Medications Making Us Sicker?
By John Horgan 
March 5, 2012
Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America (Crown 2010), by the journalist Robert Whitaker, is one of the most disturbing, consequential works of investigative journalism I’ve read in a long time. Perhaps ever. Whitaker has persuaded me that American psychiatry, in collusion with the pharmaceutical industry, may be perpetrating the biggest case of iatrogenesis—harmful medical treatment–in history. I’m even more impressed by Whitaker’s research and reasoning after hearing him speak at my school, Stevens Institute of Technology, on February 29. He is the kind of science journalist who makes me proud to be a science journalist. I’m thus printing here a modified version of an article I wrote about Anatomy last fall for The Chronicle of Higher Education. I also urge you to check out Whitaker’s Psychology Today blog, where he addresses his critics.
I first took a close look at treatments for mental illness in the mid-1990s while researching an article for Scientific American. At the time, sales of a new class of antidepressants, selective serotonin reuptake inhibitors, or SSRIs, were booming. The first SSRI, Prozac, had quickly become the most widely prescribed drug in the world. Many psychiatrists, notably Peter Kramer, author of the bestseller Listening to Prozac (Viking 1993), touted SSRIs as a revolutionary advance in the treatment of mental illness. Prozac, Kramer claimed in a phrase that I hope now haunts him (but probably doesn’t), could make patients “better than well.”
Clinical trials told a different story. SSRIs are no more effective than two older classes of antidepressants, tricyclics and monoamine oxidase inhibitors. What was even more surprising to me—given the rave reviews Prozac had received from Kramer and others–was that antidepressants as a whole were not more effective than so-called “talking cures,” whether cognitive behavioral therapy or even old-fashioned Freudian psychoanalysis, according to investigators such as the psychologists Seymour Fisher and Roger Greenberg. According to these and other researchers, treatments for depression and other common ailments work—if they do work—by harnessing the placebo effect, the tendency of a patient’s expectation of improvement to become self-fulfilling. I titled my article, published in Scientific American in December 1996, “Why Freud Isn’t Dead.” Far from defending psychoanalysis, my point was that psychiatry has made disturbingly little progress since the heyday of Freudian theory.
In retrospect, my critique of modern psychiatry was probably too mild. According to Anatomy of Epidemic by Robert Whitaker, psychiatry has not only failed to progress; it may now be harming many of those it purports to help. Anatomy of an Epidemic has been ignored by most major media. I learned about it only after Marcia Angell, former editor of the New England Journal of Medicine and now a lecturer on public health at Harvard, reviewed Anatomy in The New York Review of Books last year.
As recently as the 1950s, Whitaker contends, the four major mental disorders–depression, anxiety disorder, bipolar disorder and schizophrenia–often manifested as episodic and “self-limiting”; that is, most people simply got better over time. Severe, chronic mental illness was viewed as relatively rare. But over the past few decades the proportion of Americans diagnosed with mental illness has skyrocketed. Since 1987, the percentage of the population receiving federal disability payments for mental illness has tripled; among children under the age of 18, the percentage has grown by a factor of 35.
This epidemic has coincided, paradoxically, with a surge in prescriptions for psychiatric drugs. Between 1985 and 2008, U.S. sales of antidepressants and antipsychotics multiplied almost fifty-fold, to $24.2 billion. Prescriptions for bipolar disorder and anxiety have also swelled. One in eight Americans, including children and even toddlers, is now taking a psychotropic medication. Whitaker acknowledges that antidepressants and other psychiatric medications often provide short-term relief, which explains why so many physicians and patients believe so fervently in the drugs’ benefits. But over time, Whitaker argues, drugs make many patients sicker than they would have been if they had never been medicated.
Whitaker compiles anecdotal and clinical evidence that when patients stop taking SSRIs, they often experience depression more severe than what drove them to seek treatment. A multi-nation report by the World Health Organization in 1998 associated long-term antidepressant usage with a higher rather than lower risk of long-term depression. SSRIs can cause a wide range of side effects, including insomnia, sexual dysfunction, apathy, suicidal impulses and mania–which may then lead patients to be diagnosed with and treated for bipolar disorder.
Indeed, Whitaker suspects that antidepressants—as well as Ritalin and other stimulants prescribed for attention deficit disorder—have catalyzed the recent spike in bipolar disorder. Relatively rare just a half century ago, reported rates of bipolar disorder have spiked more than 100-fold to one in 40 adults. Side effects attributed to lithium and other common medications for bipolar disorder include deficits in memory, learning ability and fine-motor skills. Similarly, benzodiazepines such as Valium and Xanax, which are among the drugs prescribed for anxiety, are addictive; withdrawal from these sedatives can cause effects ranging from insomnia to seizures, as well as panic attacks.
Whitaker’s analysis of treatments for schizophrenia is especially disturbing. Antipsychotics, from Thorazine to successors like Zyprexa, cause weight gain, physical tremors (called tardive dyskinesia) and, according to some studies, cognitive decline and brain shrinkage. Before the introduction of Thorazine in the 1950s, Whitaker asserts, almost two thirds of the patients hospitalized for an initial episode of schizophrenia were released within a year, and most of this group did not require subsequent hospitalization.
Over the past half century, the rate of schizophrenia-related disability has grown by a factor of four, and schizophrenia has come to be seen as a largely chronic, degenerative disease. A decades-long study by the World Health Organization found that schizophrenic patients fared better in poor nations, such as Nigeria and India, where antipsychotics are sparingly prescribed, than in wealthier regions such as the U.S. and Europe.
A long-term study by Martin Harrow, a psychologist at the University of Illinois, found an inverse correlation between medication for schizophrenia and positive, long-term outcomes. Beginning in the 1970s, Harrow tracked a group of 64 newly diagnosed schizophrenics. Forty percent of the non-medicated patients recovered—meaning that they could become self-supporting–versus five percent of those who were medicated. Harrow contended that those who were heavily medicated were sicker to begin with, but Whitaker suggests that the medications may be making some patients sicker.
A caveat is in order here. Whitaker does NOT claim that medications have no value and that no one should take them. In his talk at my school, as in his book, Whitaker acknowledged that many people benefit from psychopharmacology, especially over the short term. But he does believe that the drugs should be administered far more sparingly.
Several possible objections to Whitaker’s case against psychiatry come to mind. First of all, the recent surge in mental disability may stem not only from iatrogenic effects of medications but from other factors, notably a decrease in the stigma associated with mental illness, which has spurred more people to seek and obtain taxpayer-supported treatment and assistance. Also, patients who are heavily medicated may not fare as well over the longer term as patients who receive fewer drugs because the former are truly sicker (as Harrow suggested). In her review, Marcia Angell called Whitaker’s book “suggestive, if not conclusive.”
Anatomy has received other recognition. It won the 2010 Investigative Reporters and Editors Award for Investigative Journalism. A review in New Scientist concluded that Whitaker’s arguments seem “far-fetched” at first but on closer examination “are worryingly sane and consistently based on evidence. They amount to a provocative yet reasonable thesis, one whose astonishing intellectual punch is delivered with the gripping vitality of a novel. Whitaker manages to be damning while remaining stubbornly optimistic in this enthralling and frighteningly persuasive book.” At the very least, Whitaker’s claims warrant further investigation. Check out his book and make up your own mind.
Image from Healingtalks.com.
About the Author: Every week, John Horgan takes a puckish, provocative look at breaking science. A former staff writer at Scientific American, he is the author of four books, including The End of Science (Addison Wesley, 1996) and The End of War (McSweeney's Books, January 2012). Follow on Twitter @Horganism.
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Top 10 Bizarre Mental Disorders
13 October 2007
Mental disorders effect millions of people in the world and can lead to years of psychotherapy. In some cases, the psychological problem suffered is extremely rare or bizarre. This is a list of the ten most bizarre mental disorders.
10. Stockholm Syndrome
Stockholm syndrome is a psychological response sometimes seen in an abducted hostage, in which the hostage shows signs of sympathy, loyalty or even voluntary compliance with the hostage taker, regardless of the risk in which the hostage has been placed. The syndrome is also discussed in other cases, including those of wife-beating, rape and child abuse.
The syndrome is named after a bank robbery in Stockholm, Sweden, in which the bank robbers held bank employees hostage from August 23 to August 28 in 1973. In this case, the victims became emotionally attached to their victimizers, and even defended their captors after they were freed from their six-day ordeal, refusing to testify against them. Later, after the gang were tried and sentenced to jail, one of them married a woman who had been his hostage.
A famous example of Stockholm syndrome is the story of Patty Hearst, a millionaire’s daughter who was kidnapped in 1974, seemed to develop sympathy with her captors, and later took part in a robbery they were orchestrating.
9. Lima Syndrome
The exact opposite of Stockholm syndrome – this is where the hostage takers become more sympathetic to the plights and needs of the hostages.
It is named after the Japanese embassy hostage crisis in Lima, Peru where 14 members of the Tupac Amaru Revolutionary Movement (MRTA) took hundreds of people hostage at a party at the official residence of Japan’s ambassador to Peru. The hostages consisted of diplomats, government and military officials, and business executives of many nationalities who happened to be at the party at the time. It began on December 17, 1996 and ended on April 22, 1997.
Within a few days of the hostage crisis, the militants had released most of the captives, with seeming disregard for their importance, including the future President of Peru, and the mother of the current President.
After months of unsuccessful negotiations, all remaining hostages were freed by a raid by Peruvian commandos, although one hostage was killed.
8. Diogenes Syndrome
Diogenes was an ancient Greek philosopher, who lived in a wine barrel and promoted ideas of nihilism and animalism. Famously, when he was asked by Alexander the Great what he wanted most in the world, he replied, “For you to get out of my sunlight!”
Diogenes syndrome is a condition characterised by extreme self neglect, reclusive tendencies, and compulsive hoarding, sometimes of animals. It is found mainly in old people and is associated with senile breakdown.
The syndrome is actually a misnomer since Diogenes lived an ascetic and transient life, and there are no sources to indicate that he neglected his own hygiene.
7. Paris Syndrome
Paris syndrome is a condition exclusive to Japanese tourists and nationals, which causes them to have a mental breakdown while in the famous city. Of the millions of Japanese tourists that visit the city every year, around a dozen suffer this illness and have to be returned to their home country.
The condition is basically a severe form of ‘culture shock’. Polite Japanese tourists who come to the city are unable to separate their idyllic view of the city, seen in such films as Amelie, with the reality of a modern, bustling metropolis.
Japanese tourists who come into contact with, say, a rude French waiter, will be unable to argue back and be forced to bottle up their own anger which eventually leads to a full mental breakdown.
The Japanese embassy has a 24hr hotline for tourists suffering for severe culture shock, and can provide emergency hospital treatment if necessary.
You can read a much more indepth article on Paris syndrome here.
6. Stendhal Syndrome
Stendhal Syndrome is a psychosomatic illness that causes rapid heartbeat, dizziness, confusion and even hallucinations when an individual is exposed to art, usually when the art is particularly ‘beautiful’ or a large amount of art is in a single place. The term can also be used to describe a similar reaction to a surfeit of choice in other circumstances, e.g. when confronted with immense beauty in the natural world.
It is named after the famous 19th century French author Stendhal who described his experience with the phenomenon during his 1817 visit to Florence, Italy in his book Naples and Florence: A Journey from Milan to Reggio.
5. Jerusalem Syndrome
The Jerusalem syndrome is the name given to a group of mental phenomena involving the presence of either religiously themed obsessive ideas, delusions or other psychosis-like experiences that are triggered by, or lead to, a visit to the city of Jerusalem. It is not endemic to one single religion or denomination, but has affected Jews and Christians of many different backgrounds.
The condition seems to emerge while in Jerusalem and causes psychotic delusions which tend to dissipate after a few weeks. Of all the people who have suffered this spontaneous psychosis, all have had a history of previous mental illness, or where deemed not to have been ‘well’ before coming to the city.
You can read a much more indepth article on Jerusalem syndrome here.
4. Capgras Delusion
The Capgras delusion is a rare disorder in which a person holds a delusional belief that an acquaintance, usually a spouse or other close family member, has been replaced by an identical looking impostor.
It is most common in patients with schizophrenia, although it occur in those with dementia, or after a brain injury.
One case report said the following:
Mrs. D, a 74-year old married housewife, recently discharged from a local hospital after her first psychiatric admission, presented to our facility for a second opinion. At the time of her admission earlier in the year, she had received the diagnosis of atypical psychosis because of her belief that her husband had been replaced by another unrelated man. She refused to sleep with the impostor, locked her bedroom and door at night, asked her son for a gun, and finally fought with the police when attempts were made to hospitalize her. At times she believed her husband was her long deceased father. She easily recognized other family members and would misidentify her husband only.
The paranoia induced by this condition has made it a common tool in science fiction books and films, such as Invasion of the Body Snatchers, Total Recall and The Stepford Wives.
3. Fregoli Delusion
The exact opposite of the Capgras delusion – the Fregoli delusion is a rare disorder in which a person holds a delusional belief that different people are in fact a single person who changes appearance or is in disguise.
The condition is named after the Italian actor Leopoldo Fregoli who was renowned for his ability to make quick changes of appearance during his stage act.
It was first reported 1927 by two psychiatrists who discussed the case study of a 27 year old woman who believed that she was being persecuted by two actors whom she often went to see at the theatre. She believed that these people “pursued her closely, taking the form of people she knows or meets.”
2. Cotard Delusion
The Cotard delusion is a rare psychiatric disorder in which a person holds a delusional belief that he or she is dead, does not exist, is putrefying or has lost their blood or internal organs. Rarely, it can include delusions of immortality.
One case study said the following:
[The patient's] symptoms occurred in the context of more general feelings of unreality and being dead. In January, 1990, after his discharge from hospital in Edinburgh, his mother took him to South Africa. He was convinced that he had been taken to hell (which was confirmed by the heat), and that he had died of septicaemia (which had been a risk early in his recovery), or perhaps from AIDS (he had read a story in The Scotsman about someone with AIDS who died from septicaemia), or from an overdose of a yellow fever injection. He thought he had “borrowed my mother’s spirit to show me round hell”, and that he was asleep in Scotland.
It is named after Jules Cotard, a French neurologist who first described the condition, which he called “le délire de négation” (“negation delirium”), in a lecture in Paris in 1880.
1. Reduplicative Paramnesia
Reduplicative paramnesia is the delusional belief that a place or location has been duplicated, existing in two or more places simultaneously, or that it has been ‘relocated’ to another site. For example, a person may believe that they are in fact not in the hospital to which they were admitted, but an identical-looking hospital in a different part of the country, despite this being obviously false, as one case study reported:
A few days after admission to the Neurobehavioural Center, orientation for time was intact, he could give details of the accident (as related to him by others), could remember his doctors’ names and could learn new information and retain it indefinitely. He exhibited, however, a distinct abnormality of orientation for place. While he quickly learned and remembered that he was at the Jamaica Plain Veterans Hospital (also known as the Boston Veterans Administration Hospital), he insisted that the hospital was located in Taunton, Massachusetts, his home town. Under close questioning, he acknowledged that Jamaica Plain was part of Boston and admitted it would be strange for there to be two Jamaica Plain Veterans Hospitals. Nonetheless, he insisted that he was presently hospitalized in a branch of the Jamaica Plain Veterans Hospital located in Taunton. At one time he stated that the hospital was located in the spare bedroom of his house.
The term ‘reduplicative paramnesia’ was first used in 1903 by the Czechoslovakian neurologist Arnold Pick to describe a condition in a patient with suspected Alzheimer’s disease who insisted that she had been moved from Pick’s city clinic, to one she claimed looked identical but was in a familiar suburb. To explain the discrepancy she further claimed that Pick and the medical staff worked at both locations
Contributor: JT
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Personality Disorder Test
This test, sponsored by 4degreez.com, is meant to help determine whether or not you have a personality disorder. It is not meant to be used as a diagnostic tool, but rather as a tool to give you insight into a potential disorder that may be having a negative impact on your life. If you believe you may be suffering from a personality disorder or any other disorder, you should ask your family doctor to recommend a therapist in your area to meet with.
In addition to this personality test we have psychology forums to discuss issues with other visitors.
First, what is a personality disorder?
A personality disorder is basically a set of traits that combine to negatively affect your life. They have a wide range of causes and some are easier to treat than others. This test is set up to look for the ten recongized personality disorders which are Paranoid, Schizoid, Schizotypal, Antisocial, Borderline, Histrionic, Narcissistic, Avoidant, Dependent, and Obsessive-Compulsive.
Once again, this test is not meant to be used as a diagnostic tool. Only a trained professional can properly diagnose a personality disorder.
Finally, be honest! This test is completely anonymous, so please be honest otherwise you will not get the proper results. Go to: http://www.4degreez.com/misc/personality_disorder_test.mv
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Also See:
Big Pharma and the American Gestapo Working Together!
18 April 2012
http://arcticcompass.blogspot.ca/2011/04/big-pharma-and-american-gestapo-working.html
and
Misuse and Abuse in Psychological Testing?
07 March 2011
http://arcticcompass.blogspot.ca/2011/03/misuse-and-abuse-in-psychological.html
and
Big Pharma is King! FDA bows!
10 January 2011
http://arcticcompass.blogspot.ca/2011/01/big-pharma-is-king-fda-bows.html
and
Politics and Prescription Drugs
20 July 2010
http://arcticcompass.blogspot.ca/2010/07/dea-politics.html
and
 FDA - Drugs, Vaccines & Vitamin Supplements
(Part 2)
03 May 2009
http://arcticcompass.blogspot.ca/2009/05/fda-drugs-vaccines-vitamin-supplements.html
and
Big Pharma - Big Money
(Part 1)
25 Febuary 2008
http://arcticcompass.blogspot.ca/2008/02/oxycontin.html
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