Overtreatment

From the Globe and Mail In medicine,sometimes it's better to do nothing

In the seminal work of satire The House of God, author Samuel Shem provided a list of commandments for good medical care. The infamous 13th Law of the House of God was: “The delivery of good medical care is to do as much nothing as possible.” Yet, since the book’s publication in 1978, overtreatment has reached such tragicomic proportions that the satire has melted away, leaving only age-old wisdom. It’s as if we have come full circle back to Hippocrates, who said: “To do nothing is sometimes a good remedy

Are you there Agent? It's me, Mother.

I know this excuse is getting old, fast, but the reason why I'm merely passing on information these days is because I continue to work on edits on Holistic Recovery from Schizophrenia: A Mother and Son Journey. It's been exactly three months since I sent the book proposal to the agent.

               Surely some revelation is at hand;
               Surely the Second Coming is at hand.

In the meantime, I blog, I edit, I Twitter, but I'd prefer some solid evidence from an agent that my memoir has a universal appeal.


ABILIFY = DISABILIFY Thanks to Bristol Myers Squibb for a "wonder drug" that may only be better than a placebo. Andy Behrman, a former spokesman for Abilify and Bristol Myers Squibb, and author of ElectroBoy: A Memoir of Mania, discusses his side effects from Abilify, the "wonder drug" of Bristol Myers Squibb. From YouTube

Are Psychiatric Medications Making Us Sicker? Read yet another article on this subject here.

Louise Gillett recounts her reaction when she went to a Rethink meeting recently in London.She raises some interesting questions about how independent these organizations really are, and how little objection was raised during the meeting to the medications. But I have the feeling that a lot of sufferers and their families are accepting the label and the medication because they come with the safety net of the benefits. 

The selling of OxyContin

From: The National Post (thanks to Liz for passing this along)

It was a pleasant, informative break from the grind for a crowd of local doctors: lunch and a series of lectures at Vancouver’s chic Four Seasons Hotel, all presented free by Purdue Pharma, which had just rolled out a new pain drug called OxyContin.

The specialists Purdue paid to speak at the 1997 forum, including Toronto’s Dr. Brian Goldman, who now hosts a popular CBC-Radio show, encouraged doctors to overcome fear of such “opioid” medicines and consider them even for patients with chronic non-cancer pain.

Similar, Purdue-sponsored talks were held across the country in the following months and years, while sales reps fanned out to visit family doctors and others, promoting the drug’s continuous-release convenience and its supposedly low potential for abuse

Read the rest here.

More about fish oil

Fish Oil May Aid Against Manic DepressionStudy Attributes Dramatic Improvement in Patients to Omega-3 Fatty Acids in Supplements
By Marc Kaufman
Washington Post Staff Writer
Tuesday, April 27, 1999; Page Z07
Scientists believe they have found a surprising new ally in their efforts to understand and treat the sharp mood swings of manic depression--the fatty acids of fish oil.
A Harvard University clinical trial of 44 patients suffering from manic, or bipolar, depression had such positive results with fish oil that the experiment was stopped after four months and all patients were put on a treatment of 14 capsules per day.
"The group taking the fish oil was performing strikingly better than the placebo group, including significantly longer periods of remission," said Andrew L. Stoll, director of the Psychopharmacology Research Laboratory at Harvard Medical School/McLean Hospital. "A decision was made to stop the trial on ethical grounds."
Based on those promising findings, Stoll said, the National Institutes of Health (NIH) has given preliminary approval for a larger fish oil trial starting this summer. That trial, at McLean and Baylor College of Medicine in Houston, would include 120 people suffering from manic depression and would last for three years.
"If this works, it would be one of the most exciting findings in psychiatry in the past 20 years," said Jerry Cott, chief of the psychopharmacology research program at the National Institute of Mental Health. "This is the first time we would be testing a nutritional supplement that appears to be having efficacy about to the degree of a synthetic medication."
"This could give us real insight into what is the basis of this psychiatric disorder," Cott said. "Right now, we have no clue what it's really about."
In the Harvard study, all the patients continued on their other medications. About half were also treated with fish oil capsules, while the others got olive oil as a placebo. According to Stoll, 11 of the 15 patients taking the fish oil improved after four months, and only two had a recurrence. Six of 20 on the placebo responded positively, he said, and 11 had a relapse. Some patients were not counted because the trial was stopped before they had completed their four-month treatment.
Details of the study will be published in May in a major medical journal.

Read the rest here.

The Brain Bio Centre
Food for the Brain

At the Brain Bio Centre, the best results we’ve seen in helping those with schizophrenia or other psychotic disorders are achieved by investigating a number of possible avenues. These include:
• Blood sugar problems made worse by excess stimulant and drug use
• Essential fat imbalances
• Too many oxidants and not enough antioxidants
• Niacin (Vitamin B3) therapy
• Methylation problems helped by B12 and folic acid
• Pyroluria and the need for zinc
• Food allergies
Quite apart from these nutritional factors, having good psychological support and a stable home environment make a major impact upon those with mental health problems.

Thanks to Duane Sherry for suggesting these links.

Gut and Psychology Syndrome (GAPS)

Words fail me

Child Cholesterol Tests Are Urged

By THE ASSOCIATED PRESS

Published: November 11, 2011   

Every child should be tested for high cholesterol as early as age 9, surprising new advice from a government panel that suggests screening children in grade school for a problem more common in middle age. The panel urges cholesterol screening between ages 9 and 11 — before puberty, when cholesterol temporarily dips — and again between ages 17 and 21. The panel also suggests diabetes screening every two years starting as early as age 9 for children who are overweight and have other risks for Type 2 diabetes.

Astonishing modification to McGorry study

This article appeared in The Psychiatric Times on Oct. 28, 2011. Treating Mental Illness Before it Strikes details the efforts of the psychiatric community throughout the twentieth century and the beginnings of this century to identify and treat young adults before they become psychotic. Most recently we have heard about the debate on the proposed insertion of a new category of disorder —psychosis risk syndrome — into the Diagnostic and Statistical Manual of Mental Disorders (DSM V), and of Dr. Allan Frances's outspoken views on this subject. Some of us have also read about the proposed McGorry medical trial in Australia, which was heavily critized on ethical grounds because the trial involved putting youth as young as age 15 (most of whom would never go on to develop psychosis) on antipsychotics if there was evidence of a family background of psychosis.

In June 2011, a number of Australian newspapers reported that a high-profile medical trial targeting psychosis in young adults would not go ahead. It was to be conducted by Prof. Patrick McGorry, who had been Australian of the year (an honorary and mostly symbolic title bestowed by the Australian government on an unusually deserving citizen advocating worthy causes). In the proposed trial, youths as young as age 15 would receive Seroquel (quetapine) when they were first diagnosed, not with psychosis but with attenuated psychosis syndrome (previously called psychosis risk syndrome). Treating young adults with this syndrome would nip the danger in the bud—their potential psychosis would be treated before it even arose. The trial was to have been sponsored by the drug’s manufacturer, AstraZenaca, which, like many pharmaceutical companies, was probably eager to test its medication on a younger age group to expand the market for its medications. What could be wrong with such a commendable initiative?

The final paragraph of the article reveals that

Dr McGorry has introduced a slight modification to his study, which will now go ahead. Instead of Seroquel, he will now test the efficacy of fish oil.

Slight modification? This is huge! To favor conducting a medical trial with fish oil rather than with Quetiapine (Seroquel) is astonishing, not least because the drug manufacturer is now out of the picture.  Fish oil is becoming popular for its purported benefits in preventing schizophrenia (and depression). Will fish oil be found to do all that its proponents claim it does or will it be found to be ineffective in preventing psychosis? Wouldn't a rather simple solution be to study the prevalence of schizophrenia in Inuit populations where the diet is high in fish oil? Studies show that rates of schizophrenia are pretty much the same (about 1%) in any culture in any part of the world, with some anomalies due to e.g. migration of certain populations. Will this new McGorry trial be properly executed? I have read that, as with niacin and vitamin C, the effectiveness depends on a dosing amount many times in excess of what is considered daily recommended intake.

Read more on the McGorry controversy here.

Inuit eating frozen fish

Occupy the opposition's blogs

Here's an idea which springs from my own discouragement that there is no civil debate anymore. We bloggers tend to cluster around our own, patting like-minded bloggers on the back and roundly condemning the opinions of others who, of course, rarely venture onto our blogs. It's like all debate these days has been reduced to people bellowing at each other sideways. It won't be heard.

I think it all started with e-mail. Whoever thought it was really cool to just launch into the message without the nicety of starting with Dear So and So, and ending with Your Most Humble Servant? Some twenty year old tech geek, no doubt. I had to take my own sister to task. She works for a major hardware manufacturer and I guess this is how she deals with her supply chain, but really, I thought I was always in her dog house by the way she launched right into her e-mails. I reminded her to say Dear Rossa and to sign off with.... at least her name. That worked for about a week. I myself slip up on many occasions.

So, occupy this! Here's the plan. What do you think? We begin to occupy other bloggers' pavement stones (the Followers or Members box on their blogs). In Parliamentary terms we become the loyal opposition Members, not just loyal to the opinions of the bloggers we agree with, but loyal to the founding principles of Parliamentary democracy. We occasionally comment on their posts. Now, the trick is to be polite and not feel that we always have to have the last word. We make our point and we leave it for other's to read. We don't use profanity or accuse the other person of a being an idiot nor do we make snide remarks about others. We simply provide a different way of looking at mental health that we would like to share with others. Who can argue with that?

Most people are thrilled to have more followers, and will be perplexed that we are there, but they can't prevent us from being there, can they? And remember: It's a two way street.