Saturday, July 14, 2007

WSJ Says Backlash Against Antidepressants

http://online.wsj.com/article/SB118428285736265304.html?mod=googlenews_wsj

The Wall Street Journal Home Page

The Unmedicated Mind

Backlash against antidepressants is fueling new interest in alternative treatments.
By NANCY KEATES
July 13, 2007

From lobotomies with ice picks to early antidepressants that caused brain hemorrhaging, Americans have a complicated and ever-changing approach to treating mental illness. Now, spurred by the growing disenchantment with antidepressants, an increasing number of people are seeking treatment for depression, anxiety and eating disorders from naturopaths, acupuncturists and even chiropractors. At the same time, more traditional psychiatrists are incorporating massage and meditation in their practices.

The treatments go beyond needles and spinal manipulation. They include Emotional Freedom Techniques -- tapping on the body's "energy meridians" as the patient thinks about upsetting incidents -- and craniosacral therapy, which involves a gentle rocking of the head, neck, spine and pelvis. In cranial electrotherapy stimulation, a AA-battery-powered device sends mild electrical currents to the brain. (The procedure has its roots in ancient Greek medicine, when electric eels were used.) Clinicians are also prescribing supplements like omega-3 fatty acids, found in fish oil, or amino acids like L-theanine, found in green tea.

Sarah Spring had been in therapy with a psychiatrist and on the antidepressant Wellbutrin for four years to work through a childhood trauma, but felt she wasn't making any progress. So she went to a naturopath -- a practitioner trained in holistic therapy and alternative treatments like herbal medicine and nutrition. (They attend a four-year naturopathic school -- a bachelor's degree is a prerequisite -- but only 15 states license naturopaths.) After two sessions of Emotional Freedom Techniques, the tapping treatment that is meant to clear emotions and restore balance, Ms. Spring says she doesn't get the same shortness of breath and accelerated heart rate she used to. "It's remarkable," says the Portland, Ore., marketing manager, who just started to decrease her dose of Wellbutrin.

To address the growing interest from professionals, Harvard Medical School's Department of Continuing Education will have three classes on complementary and alternative medicine in psychiatry over the next year, up from one a year since the class was introduced in 2003. David Mischoulon, an assistant professor of psychiatry at Harvard, says doctors who have attended the class report that more patients are asking for alternative treatments -- due to the side effects of antidepressants, as well as a lack of response to the medication. Only about half of patients who take antidepressants respond, he says. "It is time to broaden the horizons," he says.

But there is no proof that many of these methods work for treating mental illness. One large study found Emotional Freedom Techniques were no more effective than a placebo, while evidence is limited for acupuncture and fish oil (thought to reduce some types of depression) in the treatment of mental health problems. Using herbal supplements with conventional medicine can be dangerous, psychiatrists say. "There are always snake oil salesmen," says Carolyn Rabinowitz, president of the American Psychiatric Association.

[Ronald Parks]
Psychiatrist Ronald Parks combines conventional and alternative medicine.

Traditional therapists worry that alternative treatments might sway patients to give up conventional treatments too quickly. "People with very little data often say, 'This works,' " says Philip Muskin, Chief of Consultation-Liaison Psychiatry at Columbia-Presbyterian Medical Center in New York. A psychiatrist and trained hypnotist, Dr. Muskin believes that wellness techniques like yoga, herbs and acupuncture can make people feel better psychologically. But he says alternative providers don't have adequate training to diagnose or treat severe mental-health disorders. "Many think if you get your liver and spleen into the right balance that will help," he says.

Safety Concerns

In any one-year period, 9.5% of the population, or about 20.9 million American adults, suffer from a mood disorder, according to the National Institute of Mental Health. A study by the World Health Organization, Harvard University School of Public Health and the World Bank found that by the year 2030, depression will be second only to HIV/AIDS in terms of disability caused world-wide.

A backlash against antidepressants sparked by concerns about their safety, efficacy and side effects is helping drive patients to alternative methods. Some 80% of antidepressants are currently prescribed by primary doctors who often diagnose depression in a 20-minute visit and don't provide accompanying therapy or help manage side effects.

Sales of all classes of antidepressants were $13.5 billion in 2006, down from a peak of $13.8 billion in 2004, according to IMS Health, a health-care information company. Usage of selective serotonin-reuptake inhibitors (SSRIs) dropped in 2005 after warnings about side effects -- particularly the risk of suicidal behavior in people aged 25 and under, which prompted the Food and Drug Administration to order drug makers to add warnings to their packaging in 2004. The introduction of generics onto the market (most recently, for Zoloft) also contributed to lower sales.

A spokesman for the Pharmaceutical Research and Manufacturers of America says pharmaceuticals like antidepressants undergo a rigorous assessment of benefits and risks by the FDA. Other methods have been used to treat depression historically, he says, but pharmaceuticals do and will continue to play a large role in therapy.

At the same time, the rise of managed care and changes in Medicaid and Medicare have resulted in companies paying far less for mental health coverage. Employer spending on mental health care dropped to 1.3% of an employee's medical care costs in 2006, from 10.9% in 1988, according to employee-benefits firm Towers Perrin. While most employees with health insurance have some mental-health coverage, only 13% have coverage for an unlimited number of outpatient visits to providers such as psychiatrists, psychologists and social workers, says a 2006 survey of employers by the Kaiser Family Foundation. That's down from 19% in 2004. Most insurance policies pay for a limited number of visits, often 20 or 30 per year, and some put a cap on the dollars they'll pay.

[Acupuncture]

Over the past decade, insurers have started covering more alternative procedures. Plans vary, from unlimited visits to 12 or 20 visits per year, according to Doug Metz, Chief Health Services Officer at American Specialty Health, which runs complementary medicine benefits plans for insurance companies. Co-payments typically run $10 to $20, and plans limit the reasons for visits to scientifically proven techniques -- which generally does not include treatments for mental health. While coverage for visits to naturopaths is mandated by law in Connecticut, Vermont and Washington, employers can still limit the number of visits and restrict it to a network.

Aetna, for one, will cover acupuncture used to treat migraine headaches or chronic lower back pain, but not for depression; it will cover biofeedback for migraines, but not stress. The options are growing: Starting this month, members can get at least 25% off standard fees for visits to an approved list of 19,000 credentialed "natural therapy professionals," including massage therapists and dietetic counselors, for any condition. (Standard fees for a first-time acupuncturist visit can be $90 to $120.)

The shift comes as scientific research sheds new light on the causes of depression. The use of SSRIs, introduced in the 1980s, aim to increase levels of serotonin in the brain. More recent research suggests that a range of factors -- including genetic predisposition and hormones linked to stress -- can play a role.

Proponents of alternative medicine say the wide range of treatments used address broader causes like hormonal imbalances and stress. Treatment can mean spending time talking to patients about their physical and emotional problems, examining their diet and exercise habits, and doing blood tests to look for medical or environmental causes for depression, such as Lyme disease, toxic chemicals or mold.

In Los Angeles, naturopath Holly Lucille has seen 30% more patients in the past two years whose chief complaint is mental-health-related, while Sara Thyr, a naturopath in Manchester and Concord, N.H., has seen a 20% rise. Margot Longenecker's naturopathy practice in Branford and Wallingford, Conn., now has half of its patients come for anxiety and depression, compared with 25% three years ago.

"Half the time you feel like you have a psychiatric degree more than a chiropractic degree," says Basking Ridge, N.J., chiropractor Jerry Szych, who's seen a 25% rise in patients seeking counseling services over the same period. Columbus, Ohio, chiropractor Ronald Farabaugh says he has seen an increase of 20% over the past three years in those cases.

Melissa Mannon, a 36-year-old photographer in Bedford, N.H., saw psychologists for years about her depression and anxiety. Then she visited a naturopath for help with infertility, and was diagnosed with an intolerance to 90 different foods, including gluten. She changed her diet and within seven months, she got pregnant and most of her anxiety and depression went away, she says. She still sees her naturopath if she's feeling down and to discuss what's happening in her life. "She understands me," says Ms. Mannon.

Some say the extra time and intimacy of the treatments can encourage patients to open up. Naturopath Mark Sanders, who has seen the number of patients coming for mental health rise threefold to about 60% since he started his practice five years ago, says patients tend to open up when he performs craniosacral therapy. (It is meant to ease stress and improve physical movement.) "I've had people tell me stuff they don't tell their therapist," he says.

[Samantha Brody]
'I don't dig into childhood stuff,' says naturopath Samantha Brody.

Stanford University Medical School clinical professor of medicine Kenneth Pelletier says chiropractors and naturopaths aren't adequately trained to recognize true psychopathology. But Dr. Pelletier believes most of these practitioners are ethical about remaining within the scope of their practice and refer patients to licensed mental-health-care practitioners when they think the diagnoses are severe.

That's what Portland, Ore., naturopath Samantha Brody has been doing as she increasingly sees patients with eating disorders, anxiety and depression. While the stigma of seeing a shrink may have declined in cities like New York and Los Angeles, it is alive and well in Portland, and some patients won't follow up on her referrals. Still, Ms. Brody steers away from serious counseling. "I don't dig into childhood stuff," she says.

Cheryl Higgins started seeing Ms. Brody three years ago for acupuncture because her back hurt. She was also driving her friends crazy by trying to use them as therapists and needed an outlet for her anxiety and depression. "I spilled my guts to her at the first session," says the 26-year-old office manager. Her treatment: chemical and amino-acid supplements, plus acupuncture three times a week.

Ms. Higgins hesitated to follow Ms. Brody's referral to a psychologist, but eventually she did see one who recommended that her primary care doctor put her on an antidepressant. She went on Lexapro for nine months, then went back to the naturopath to help her get off of it. "It made me yawn all the time," she says.

While the research is limited, some studies have shown promise in using alternative methods to treat mental illness. A recent study at Boston University School of Medicine and McLean Hospital in Belmont, Mass., showed a neurochemical response to the practice of yoga that's similar to neurochemical responses seen when people are treated with antidepressants.

Even pharmaceutical companies are starting to look at ingredients that have traditionally been part of natural medicine. Last year, Novartis bought the U.S. rights to a drug called agomelatine -- a melatonin-related agonist that is thought to influence mood in part through the sleep-wake cycle.

Of course, alternative medicine has been used for mental health issues for years. A 2001 study by Ron Kessler and David Eisenberg at Harvard Medical School found that among those with anxiety and or depression, more than half used alternative medicine therapies; among those who sought the treatment of a licensed conventional provider, two-thirds also used alternative medicine during the prior year. The perceived helpfulness of the alternative therapies was similar to the perceived helpfulness of conventional therapies.

Some critics say the growing interest is, in a sense, a step backwards. As people become frustrated with the shortcomings of new treatments, they become more inclined to try age-old therapies, regardless of whether they've been rigorously tested. The treatment of depression is "a constant succession of hyped theories and overall pathetically little progress," says John Horgan, director of the Center for Science Writings at the Stevens Institute of Technology in Hoboken, N.J.

Serious Applications

Now, community clinics are using the approach. The Mental Health Center of Greater Manchester, N.H. -- which combines traditional psychiatry with naturopathic treatments for seriously mentally ill patients -- received a two-year grant last summer from the New York-based Ittleson Foundation to promote the intermingling of naturopathy and psychiatry. "It's just a better way to approach the problem," says Ronald Parks, an internist and psychiatrist in Asheville, N.C., who uses alternative methods and was just approached to create a community-based model near his practice.

Aliza Sherman Risdahl agrees. She began experiencing uncontrollable rage, irritation and anxiety after the birth of her daughter. Though the 42-year-old Anchorage, Alaska, consultant was already seeing a therapist, she didn't want to go on antidepressants. She turned to a naturopath, who diagnosed her with overactive adrenal glands and suggested an amino acid to spray under her tongue.

Now she's no longer throwing dirty plates from the dinner table up in the air, screaming at her husband to "give me the baby, you can't keep her from me!" and running through the house slamming doors and cursing at him. "I am so grateful," she says.

Friday, July 13, 2007

Suicide Victims Are Soaked With Psych Drugs

New Study Adds to Heated Debate over
Suicide Risks of Antidepressants


May 28, 2007


Analysis Reveals Suicide Victims Have Psych Drugs in Blood Stream

The findings of a study presented at the annual American Psychiatric Association (APA) conference in San Diego and published in Psychiatric Times may incite another firestorm in the heated debate over the correlation between antidepressants and suicide.

The psychiatric watchdog group, Citizens Commission on Human Rights (CCHR), says that in spite of psychiatric vested interests downplaying the suicidal side effects of antidepressants, which they have known about for more than a decade and a half (see video), new evidence has forced psychiatrists to acknowledge a link between antidepressants and suicide.

The study, "Antidepressants and Suicide in Children and Adolescents in Virginia: Toxicology Findings," analyzed toxicology reports in "unnatural" deaths from the Virginia Medical Examiner's Office, and was presented to the APA last week.

Researcher Dr. Antony Fernandez and colleagues found that youth suicide victims were significantly more likely to have SSRI (Selective Serotonin Reuptake Inhibitor) antidepressants in their bloodstream than were victims of other unnatural deaths. SSRIs were found in the bloodstream of at least 56 of the Virginia youth suicide victims whose toxicology results were available-the suicides ranged from poisoning to hanging and gunshots.

These findings follow a 2004 warning by the Food and Drug Administration (FDA) that children and teens are twice as likely to experience "suicidal thoughts and behaviors" than they are on placebo. The APA has yet to acknowledge that eight recent adolescents committing homicide in school shootings were in fact under the influence of antidepressants-documented to cause mania, psychosis, depersonalization, and in some cases, "homicidal ideation."

Despite mounting evidence of a link between antidepressants and suicide/violence, psychiatrists indiscriminately prescribe the drugs to millions, based on subjective diagnoses made without any physical tests-such as blood tests, brain scans or X-rays-and try to obscure the dangerous side effects of the drugs in order to protect billions in profit from drug sales.

Psychiatrist David Brent, one of the researchers in a recent study published in the Journal of the American Medical Association that pushed that the "benefits" of antidepressants for kids trumped suicidal side effects, urged the FDA to moderate the black box suicide warning on antidepressants - - although many parents' rights activists say this warning is imperative in upholding their right to informed consent. Another leading psychiatrist, John Mann of Columbia University, further attempted to diminish the negative publicity on such profitable drugs by claiming, "The idea that antidepressants are responsible for suicides isn't supported by the data."

CCHR says human rights activists, parents, experts and others who have been insisting that the public be warned about the suicidal side effects of antidepressants are once again vindicated by this new study on SSRIs in suicide victims. Because these findings are so alarming, the Psychiatric Times published "action points"-in effect, suggestions on how psychiatrists can assuage parents' fears that may prevent them from purchasing the drugs for their children-including telling consumers that the study "represents an association rather than causation..." and that "These data and conclusions should be considered preliminary...."

The Citizens Commission on Human Rights is an international psychiatric watchdog group co-founded in 1969 by the Church of Scientology and Dr. Thomas Szasz, Professor of Psychiatry Emeritus, to investigate and expose psychiatric violations of human rights.

For more information, contact CCHR at 800-782-2878 or
email: laurie@cchrflorida.org.

Citizens Commission On Human Rights of Florida
1217 N. Ft. Harrison
Dunedin, FL 33755

Thursday, July 12, 2007

Nevada TeenScreen Pusher Up On Ethics Charges

The entire article is reproduced below. To see it in its original setting, click here.

July 11, 2007
by Joe Enge

As reported by Samantha Stone with KOH Radio this morning, 2 of the 4 charges Joe Enge with EdWatch Nevada filed against state board member Gary Waters in June of 2006 in trying to implement TeenScreen have been upheld to warrant a formal hearing with the Nevada Commission on Ethics in September. Waters is no longer a board member, his final term ended in December of 2006. Waters set up The Center for Health & Learning as a non-profit to implement TeenScreen. I questioned whether it is legal for a state board member to set up a non-profit and use Nevada Department of Education equipment and office.

TeenScreen is a highly controversial mental health screen that asserts it can identify students from the 5th to 12th grades who are suicidal. Critics nationally point out TeenScreen does more harm than good with their self-admitted 84% rate of false positives and makes end runs around the Protection of Pupil Rights Amendment without obtaining proper, positive consent from parents. You can read details about TeenScreen on my former EdWatch Nevada Web site at: www.campaignsitebuilder.com/templates/displayfiles1/Tmpl34.asp?id=19383.

Also available at http://www.edwatchnevada.com/ is one of the actual TeenScreen exams. Much to their chagrin, TeenScreen’s “super secret” exam is now public. The exam is listed under the heading of “Downloads.”

The two charges for setting up the non-profit were dropped. The Nevada Commission on Ethics came to the conclusion that it is legal for a non-profit, set up by a Nevada State Board of Education member, to use government equipment and offices. What’s legal is not always what’s right. I questioned also how this could be done without formal State Board of Education approval. They concluded the State Superintendent of Instruction, Keith Rheault, could do this on his own authority. They also concluded Waters did not make any money. $71,000 was awarded to the Center for Health & Learning, but he did not receive any of it.

My information shows Waters intended to start collecting money from a far larger federal grant of $1.2 million after he left office in December of 2006, the very reason he set up the non-profit. I suspect the publicity and scrutiny of my filing these Ethics charges in June of 2006 threw a monkey wrench into those plans. The federal $1.2 million grant has a table on page 29 showing a list of staff who will participate in the project with their role and level of effort. Waters is listed as director of the Center for Health & Learning and 100% FTE (full time equivalent). The center is also listed as a sub-grantee for funding. He can’t be convicted of his intentions once out of office since he was forced by these charges not to carry it out.

The Nevada Commission of Ethics did find just and sufficient cause exists to hold a hearing and render an opinion regarding whether Waters did not properly disclose his commitment, interests, or business relationship at the March, April, and June 2006 Nevada State Board of Education meetings at the time proposed standards for supplemental mental health and suicide were discussed, violating {NRS 281.501 (4)}. They also found just and sufficient cause exists to hear whether Waters acting on the same issues at these meetings violated {NRS 281.501 (2)}. The Nevada Commission on Ethics is scheduled to hear this matter on September 12, 2007 in Las Vegas at the Grant Sawyer State Building, room 4401.

Given it is legal in Nevada for non-profits to use government equipment and facilities, I think I will request an office in the Nevada Department of Education building in Carson City on behalf of EdWatch Nevada to better oversee their activities. I wonder what their reply will be.

+++
Joe Enge serves as an education analyst with NPRI, as chairman of EdWatch Nevada, and as a member of the Carson City School Board. Author of two world history textbooks, columnist for Liberty Watch Magazine, Joe was a high school teacher in Nevada from 1988 to 2006 and a Fulbright teacher to the former Soviet Union. He was named a Madison Fellow in 2005

Tuesday, July 10, 2007

Paxil Settlement On… You Tube;
July 10th, 2007
By Ed Silverman

In an unusual move, the Public Citizen advocacy group has posted a video on YouTube to alert parents to a $48 million settlement of a lawsuit concerning Glaxo’s Paxil antidepressant and side effects. The drugmaker was required to announce the settlement terms last October, but wasn’t to publicize that the terms were improved and simplified in April, the group notes.

Even without receipts, parents can recover up to $100, but any money that isn’t claimed prior to the August 31, 2007, deadline will revert back to Glaxo. Although it’s not clear, Public Citizen may be correct in noting this is the first time such a class-action settlement uses YouTube to publicize terms.

The video, which is just a minute and a half, resembles a public service announcment read by a news anchor, who says: “Now, $48 million is sitting in a fund waiting to pay back parents whose children were on Paxil before their 18th birthday.” You can visit www.paxilpayback.org

See here: www.paxilpayback.org


You are entitled to this money if:
• you live in the U.S. and
• you purchased Paxil or Paxil CR for someone under the age of 18.

If you qualify, you MUST fill out a claim form and mail it to the Paxil Pediatric Settlement Administrator in order to receive compensation. The claims must be received by August 31, 2007.