freakoutcrazy

Blog des AK Psychiatriekritik der NFJ Berlin

Monat: März, 2012

Massenhafter Einsatz von Psychopharmaka bei Demenz

by Focus

In Deutschland bekommt fast eine Viertelmillion pflegebedürftiger Menschen Psychopharmaka, ohne dass sie damit wirksam behandelt würden. Die Medikamente sollen sie ruhig stellen, um Pflegekosten zu sparen.

In Deutschland werden knapp 240 000 Demenzkranke in Heimen oder in ambulanter Pflege mit den verschreibungspflichtigen Medikamenten behandelt, um sie ruhigzustellen. Zu diesem Ergebnis kommt eine Berechnung des Zentrums für Sozialpolitik an der Universität Bremen für die „Welt am Sonntag“. „In diesen Fällen werden die Medikamente nicht verschrieben, um die Leiden der Patienten zu lindern, sondern um Personal einzusparen und somit den Heimbetreibern höhere Gewinne zu bescheren“, sagt der renommierte Bremer Sozialforscher Professor Gerd Glaeske, der die Berechnung angestellt hat.

Die SPD-Bundestagsfraktion hält für das Phänomen der massenhaften Verschreibung die Bundesregierung für mitverantwortlich, die für die finanzielle Absicherung Demenzkranker bisher zu wenig getan habe. „Weder Herr Rösler noch Herr Bahr haben auch nur einen Handschlag für die Dementen getan“, kritisierte der gesundheitspolitische Sprecher der SPD-Bundestagsfraktion, Karl Lauterbach.

Pflege ist nicht zum Nulltarif zu bekommen

Auch in seinem neuen Gesetzesentwurf für eine Reform der Pflegeversicherung sehe Bundesgesundheitsminister Daniel Bahr „allenfalls ein kleines Almosen für die Dementen vor“, sagt Lauterbach. Anstatt einen neuen Pflegebedürftigkeitsbegriff einzuführen und so den Demenzkranken spürbar mehr Ansprüche aus der Pflegeversicherung zuzusprechen, wie dies bereits unter der SPD-Bundesgesundheitsministerin Ulla Schmidt während der rot-grünen Legislaturperiode geplant war, habe Bahr bisher lediglich eine neue Kommission eingesetzt.

Der Sozialverband VdK forderte, mehr Geld in die Pflege zu stecken. „Demenzkranke haben einen hohen Betreuungsbedarf, weil sie oft einen starken Bewegungsdrang und sogenannte Weglauftendenzen haben“, sagte VdK-Präsidentin Ulrike Mascher. Auch müssten in den kommenden Jahren viele Pflegeheime umgebaut werden, um der steigenden Zahl an Demenzkranken gerecht zu werden. „All das ist aber nicht zum Nulltarif zu haben“, sagt Mascher. Sie fordert einen Solidarausgleich zwischen privater und gesetzlicher Pflegeversicherung. Die jährlichen Milliardenüberschüsse in der privaten Pflegeversicherung könnten zur Finanzierung von Leistungen für Demenzkranke verwendet werden.

The Dr. Peter Breggin Hour 19/03/12

Maybe the best discussion ever about overcoming  without resort to drugs.  My guest Dr.  is a therapist and author with a marvelous approach to depression.

download

Did You Used to be R.D. Laing?

In this documentary R.D. Laing recites stories from his own life and from his patients’ experiences to present insight into his radical brand of psychotherapy. 1989.

Trial set for Ark. suit over anti-psychotic drugs

by NECN.COM

A jury trial is scheduled to begin Monday over accusations that a pharmaceutical company illegally marketed an anti-psychotic medication in Arkansas.

Arkansas Attorney General Dustin McDaniel filed a lawsuit against Johnson & Johnson, claiming that its Janssen Pharmaceuticals subsidiary concealed the potential health risks of the drug Risperdal. The suit also alleges that the company promoted it for unauthorized uses in violation of Arkansas‘ Deceptive Trade Practices Act and the Medicaid Fraud False Claims Act.

Risperdal is used to treat schizophrenia and bipolar disorder.

If the company is found to be in violation of the law, the state could possibly see an award of about $1 billion, the Arkansas Democrat-Gazette (http://bit.ly/GNDDkA) reported on Saturday.

It’s the fourth time Johnson & Johnson has gone to trial over a state’s complaints about Risperdal since they first arose in 2004. The most recent trial, in Texas, ended with a $158 million settlement.

In a final appearance before Circuit Judge Tim Fox on Friday, both sides said settlement talks are over. Fletch Trammell, one of the attorneys representing Arkansas, described negotiations between both sides as „unfruitful.“

Asked by the judge whether talks had concluded, Johnson & Johnson attorney Jim Simpson nodded in agreement.

Arkansas is accusing the drugmaker of risking the lives and health of thousands of residents by deliberately hiding the drug’s potential to cause serious weight gain and inflict diabetes and related ailments, as well as cause circulatory problems that increase the risk of strokes.

State attorneys, in describing Risperdal as the most widely prescribed antipsychotic medication of its kind, allege that its „blockbuster success“ was due in large part to the company hiding or downplaying its risks, even to the point of concealing negative results of studies.

The lawsuit also alleges that Risperdal was prescribed for purposes other than its labeled, federally approved purpose. The drugmaker promoted it for the treatment of dementia and Alzheimer’s disease, according to the suit, despite testing that showed the drug increased the risk of death in elderly users.

State attorneys want the drugmaker to be fined the $10,000 maximum allowed under Arkansas law for every improper Risperdal prescription paid for using state Medicaid money.

In the original lawsuit suit filed more than four years ago, the attorney general cited 597,906 eligible prescriptions, but that number has been scaled back to 250,000 prescriptions. At the $5,000 minimum penalty required by the statute, that amounts to a potential fine of $1.25 billion.

The state originally cited 23,827 cases of questionable marketing practices under the deceptive claims act, but that was reduced last month under the limitations statute to around 20,000 instances.

Jurors will be asked to assess whether the drugmaker has any liability. The decision on fines and penalties will be up to Fox.

At least eight other states have pending Risperdal lawsuits against Johnson & Johnson, while a consortium of attorneys general is representing as many as 30 other states investigating the company for possible litigation, according to company financial disclosures released earlier this month.

Playing Hide-and-Seek With Psychiatric Drug Studies

by Carl Elliott

If I were in charge of distributing NIH grant money, I’d be sending a lot of it to researchers like Erick Turner, a psychiatrist at Oregon Health and Sciences University and a former FDA reviewer.  You might remember Turner’s name from a terrific study of antidepressants he led a few years ago that wound up in the New England Journal of Medicine. The question he asked was simple. Does the published medical literature accurately reflect the available data on antidepressants? The methodology Turner and his colleagues used was equally simple (although exhaustively detailed and time-consuming to execute). They compared published studies of antidepressants with the studies listed in FDA drug approval packages. What did they find? Well, if a study was positive for the antidepressant, it was almost certainly published. But it the study came out poorly for the antidepressant, the study was probably never published — and when it was, the published version was given a positive spin.

This week, Turner and his colleague performed the same trick with second-generation antipsychotic drugs, this time for PloS Medicine. Although their results for the antipsychotics were not as pronounced as their results for the antidepressants, the pattern was similar. Of the 24 FDA-registered trials, 4 were never published, and, of course, those unpublished trials had all turned out poorly for the sponsor. (Three of them failed to show that the study drug was better than a placebo, and the other showed that the drug was statistically inferior to the control drug.) Fifteen of the 20 published trials were positive, however, and those that were negative showed evidence of bias in favor of the sponsor’s drug. “Some of what we found could constitute spin, some would fall into the category of shenanigans,” Turner told ABC News. “The take-home message is there are loopholes in the publication process by which doctors may be relying on information that’s incomplete or somehow skewed. The drug’s effects may be exaggerated or its safety concerns may be downplayed.”

Turner’s article adds to a growing body of evidence showing just how biased the medical literature on antipsychotic drugs has come to be.  An especially striking paper, published in 2006 in the American Journal of Psychiatry, was called “Why olanzapine beats risperidone, risperidone beats quetiapine, and quetiapine beats olanzapine.” (Or, to translate that title into brand names, “Why Zyprexa beats Risperdal, Risperdal beats Seroquel, and Seroquel beats Zyprexa.”) The researchers looked at head-to-head comparative trials of antipsychotic drugs and found that 90 percent of the time, the sponsor’s drug beat its competitors. If Lilly sponsored the trial, Zyprexa won. If Janssen sponsored the trial, Risperdal won. And if AstraZeneca sponsored the trial, Seroquel won.

Critics of the drug industry often point to studies like this as evidence that we can’t trust what we read in medical journals anymore. That’s probably true, but there is also a deeper ethical problem. All of these psychiatric drug studies involve human subjects, who are taking real risks when they sign up for clinical trials. How many of them would consent to a trial if they understood that the sponsor was going to bury or spin the results in order to market its drug?