Speakers burear formed to oppose electroshock treatments in Ontario

Rabble.ca

By John Bonnar

August 18, 2011

Over the decades, many health-care professionals have spoken out against electroshock.

But for the first time an organization of professionals has been formed to expose what they call a harmful treatment, stating that "mainstream psychiatry has flagrantly and persistently misrepresented both this procedure and the vast body of research surrounding it."

The Healthcare Professionals against Electroshock Speakers Bureau is a diverse group of informed health-care professionals that includes psychotherapists, nurses, doctors, psychologists, counsellors and social workers, situated in different regions across Canada.

The group hopes that educating people about electroshock will eventually lead to its abolition.

Electroconvulsive therapy (ECT), also known as electroshock, is a psychiatric treatment in which seizures are electrically induced in anesthetized patients with severe depression who have not responded well to other forms of treatment.

"As professionals, we know that this is an essentially brain damaging procedure that wipes out huge aspects of memory," said Dr. Bonnie Burstow, a faculty member at the University of Toronto, psychotherapist, trauma specialist and researcher, who has written extensively on ECT.

Yet psychiatrists still believe modified electroshock is a safe an effective treatment.

"Modified shock has been going on since approximately 1959 and almost all the brain damaging studies we're talking about are on modified shock. We also know that it's not effective."

At Monday's press conference in the Queen's Park media studio, Burstow said she and her colleagues can't work with clients on their therapeutic issues because they can't remember what's bothering them.

"Not speaking out is a violation of our obligation of care as professionals," said Burstow, adding, "The administering of ECT is in direct violation of the doctors Hippocratic oath."

Burstow expressed concern that many professionals, including doctors and nurses, are afraid to join the Speakers Bureau because they could lose their jobs if they speak out against electroshock.

"Can you imagine getting fired for telling the truth about damage?" asked Burstow.

In spite of the risks, Simon Adam decided to join the group out of what he called "a moral commitment to his patients and their loved ones."

After a long period of moral distress, the nurse and doctoral student decided to break his silence and stand up against electroshock. "I have reviewed the pro-ECT literature and it paints a flawed picture of the intervention," said Adam.

"It depicts it as a safe treatment when it is not even remotely so."

Adam knows people who have undergone ECT treatments and tell a very different story, one of pain and tragic loss, chronic seizure problems and memory loss, and irreversible brain damage.

When working with ECT survivors, therapist and PhD psychology student Terra Dafoe said many are left with a deep distrust and fear of health-care professionals.

"Most survivors I know were never informed of the seriousness of the brain damaging effects that would follow, the years of their lives that may be erased or the impact ECT might have on their family members," said Dafoe.

"Nor were they informed about how their ability to function and live in the world might be compromised."

Even though NDP MPP Cheri DiNovo's private members bill to defund ECT in Ontario died on the order table, Dafoe said the issue is far from being decided.

"It's our responsibility to speak out at every opportunity, again and again, until the horror of ECT is no more," she said.

Confusing Medical Ailments with Mental Illness

WALL STREET JOURNAL online
August 9, 2011

An elderly woman's sudden depression turns out to be a side effect of her high blood-pressure medication.
A new mother's exhaustion and disinterest in her baby seem like postpartum depression—but actually signal a postpartum thyroid imbalance that medication can correct.
A middle-aged manager has angry outbursts at work and frequently feels "ready to explode." A brain scan reveals temporal-lobe seizures, a type of epilepsy that can be treated with surgery or medication.
More than 100 medical disorders can masquerade as psychological conditions, according to Harvard psychiatrist Barbara Schildkrout, who cited these examples among others in "Unmasking Psychological Symptoms," a book aimed at helping therapists broaden their diagnostic skills.

Different Diagnoses

More than 100 medical disorders can masquerade as psychological conditions or contribute to them, complicating treatment decisions.

WHAT SEEMS LIKE ...	MAY ACTUALLY BE ...
Depression	Underactive thyroid; low vitamin D or B-12 or folate; diabetes; hormonal changes; heart disease; Lyme disease; lupus; head trauma, sleep disorders; some cancers and cancer drugs
Anxiety	Overactive thyroid; respiratory problems; very low blood pressure; concussion; anaphylactic shock
Irritability	Brain injury; temporal lobe epilepsy;  disease and early stage dementia; parasitic infection; hormonal changes
Hallucinations	Epilepsy; brain tumor; fever; narcolepsy; substance abuse
Cognitive changes	Brain injury or infection; Alzheimer's; Parkinson's; liver failure; mercury or lead poisoning
Psychosis	Venereal disease; brain tumors and cysts; stroke; epilepsy; steroids; substance abuse

Source: WSJ reporting

Studies have suggested that medical conditions may cause mental-health issues in as many as 25% of psychiatric patients and contribute to them in more than 75%.
Untangling cause and effect can challenge even seasoned clinicians, and the potential for missed diagnoses is growing these days, said Dr. Schildkrout, who has more than 25 years of clinical practice in the Boston area. Most mental-health counselors rely on primary-care doctors to spot medical issues, but those physicians are increasingly time-pressed and may not know their patients well. Neither do the psychiatrists who mainly write prescriptions and see patients only briefly, she said in an interview.
Common culprits include under- or over-active thyroid glands, which can cause depression and anxiety, respectively. Deficiencies of vitamins D, B-12 and folate, as well as hormonal changes and sleep disorders have also been linked to depression.
Diabetes, lupus and Lyme disease can have a variety of psychiatric symptoms, as can mercury and lead poisoning and sexually transmitted diseases. Many medications also list mood changes among their side effects, and substance abuse is notorious for causing psychiatric problems.
Some underlying conditions are readily treatable. Others, such as Alzheimer's and Parkinson's disease and some brain tumors, are not. But a correct diagnosis can save months or years of frustration and ineffective treatment.
In some cases, a psychological problem is just the first sign of a serious medical issue. "Depression predicts heart disease and heart disease predicts depression," said Gary Kennedy, director of the geriatric psychiatry at Montefiore Medical Center in Bronx, N.Y.
About one-third of people who have their first episode of depression after age 55 have changes in brain circuits that are associated with hypertension, diabetes and heart attacks. Such patients are usually apathetic, have difficulty with executive planning and don't respond well to antidepressants. Making sure their blood pressure and blood-sugar levels are on target is crucial, though medical and psychotherapy may be needed as well, Dr. Kennedy said.
Recognizing an underlying medical condition can be particularly difficult when there is also a psychological explanation for a patient's dark moods. For example, victims of domestic violence are often anxious, depressed and withdrawn—but mild brain injury could be causing such symptoms, too.

Warning Signs

When to suspect a mental problem may be medical:
• Sudden change in mood or personality
• History of head trauma
• Depression that occurs for the first time after age 55
• Recent travel or exposure to infections
• Any rash, swelling, drooping eyelid; facial tic
• Standard medication or therapy isn't effective

Similarly, a former college athlete who becomes angry and irritable in his 40s could be suffering a midlife crisis—or delayed reaction to head injuries sustained decades earlier. "We now know that multiple concussions can have a sleeper effect for years. Then one day, out of the blue, you start acting explosive and depressed," due to a brain swelling known as chronic trauma encephalopathy, said Jerrold Pollak, a neuropsychologist at Seacoast Mental Health Center in Portsmouth, N.H., and lead author of an article on distinguishing mental from medical disorders in the Journal of Clinical Psychology Practice this spring.
If the head-injury diagnosis is missed, Dr. Pollak added, the patient could be in psychotherapy for months, "thinking that he has trouble with his father or feels like a failure for not becoming a pro athlete."
Giving every patient who seeks psychological help a brain scan first would be prohibitively expensive and likely yield many confusing results. But experts say mental-health counselors should ask patients about their medical histories as well as emotional issues, and make sure they've had a recent physical exam.
Tell-tale signs of underlying medical problems include significant changes in energy, weight, appetite or sleep, which could be due to an endocrine disorder. Sudden changes in mood or personality, visual hallucinations and alternations in smell, taste or tactile senses could signal a brain tumor or other abnormality.
Sometimes a single physical sign can broaden a clinician's diagnostic thinking. Manhattan psychiatrist Drew Ramsey recalled that early in his career, he examined a patient with daily panic attacks and noticed a swelling on her shins, a classic sign of Graves' disease, a form of overactive thyroid that can cause severe anxiety.
Like other psychiatrists, Dr. Ramsey said he always takes a medical history and orders blood tests for patients. He found that one was anemic and improved markedly when meat was added to her diet. Another who was depressed and drinking heavily was low on vitamins D and B-12.
Similarly, Dr. Schildkrout once treated a 50-year-old woman for mood swings and noticed a slight slurring to her speech. While it could have been dismissed as ill-fitting dentures, it turned out to be the first sign of amyotrophic lateral sclerosis, which also causes severe fatigue and odd jags of laughing and crying in its early stages.
Some patients may benefit from both psychological counseling and medical help. Therapists need not turn patients away while medical issues are being explored, experts say. "Clinicians can say, 'While we work on these issues, let's also discuss any possible medical conditions that could be contributing, so we can at least rule them out,"' Dr. Pollak said.
Finally clarifying a diagnosis can be a relief to clinicians and patients—particularly when therapy hasn't been working or patients have spent years blaming themselves. "When you find the right diagnosis, not only is there appropriate treatment, but it can make a dramatic improvement in terms of healing their self esteem," Dr. Schildkrout said.
—Email HealthJournal@wsj.com

Copyright ©2011 Dow Jones & Company, Inc. All Rights Reserved

Hurting Pharma Targets Alcoholics

Out of New Diseases and Blank Checks from Insurers, Pharma Targets Alcoholics

By Martha Rosenberg
August 2011

The gravy train of the 2000's is over for Pharma reports yesterday's Wall Street Journal. New drugs made the drug industry $11.8 billion in 2005 and only $4.3 billion last year-- almost two-thirds less.

Why? There are several reasons, says the Journal. Doctors have a "growing fear of prescribing new drugs with unknown side effects," the government is continuing to crackdown on Pharma's illegal marketing, and private and government insurers are becoming less willing to "cough up money for an expensive new drug--particularly when a cheap and reliable generic is available." Could the change be retroactive, some wonder?

It's gotten so bad, AstraZeneca, whose controversial Seroquel still makes $5.3 billion a year, now conducts "payer excellence academies" to teach reps to sell insurers and state health care systems on its latest drugs (if there's any more government money to loot, that is, or if private premiums can go any higher.)

Maybe that's why Pharma is now targeting the nation's millions of alcoholics and drugs addicts as its new revenue source. Like energetic kids who are really hyperactive and people with normal life problems who are really depressed, alcoholics and drug addicts, we are now told, really have a brain disease!

"Sixty percent of people with a substance abuse disorder also suffer from another form of mental illness, says an article in this week's New York Times' Science Times. (Another? ) They are "wired differently" and may have a "developmental brain disorder," says the article, next to a photo of Amy Winehouse, lest anyone miss The Point. But luckily, scientists are cracking the code and beginning to "find answers," says Science Times.
Pharma is mongering the "dual diagnosis" of alcoholics and addicts--they have both an addiction and a psychiatric illne$$ --with so much unbranded advertising and Madison Avenue spin, nationally known major rehab centers are telling their patients they have "co-occurring disorders," in a repudiation of basic recovery theory.
Getting the millions in bars and on street corners on antidepressants and other psychoactive drugs for their putative lack of "dopamine receptors," would certainly help Pharma through its slump as it runs out of people to call sick. But Nora D. Volkow, director of the National Institute on Drug Abuse, has bigger ideas: Let's give alcoholics and drug addicts vaccines, she said at last year's American Psychiatric Association's meeting in New Orleans. Rehabilitation professionals fell out of their seats.
Not only do we know the brains of alcoholics and addicts are different from normal people, say psychopharmacology buffs and brain researchers, not only do we know their addictions are progressive, with a little help (and more federal money) we can even identify who is At Risk. Just like we identify those with pre-asthma, pre-diabetes, pre-schizophrenia and pre-osteoporosis. Treat 'em early and often.
Let's use those gigantic government primate centers! Let's concoct more unnecessary vaccines. Let's help Pharma's decade of the biologic drug. Let's cement government/industry incest. Let's pimp the nation's alcoholics and addicts!
There's only one problem with Pharma's new buzz campaign and intended demographic. Alcoholics and addicts are neither mentally ill or suffering from a vaccine deficiency. They recover perfectly with the help of each other in self-help groups for free (a painful word for Pharma) and have done so for almost eighty years. More importantly, for alcoholics and addicts, drugs are the problem not the solution!

Martha Rosenberg is columnist and cartoonist based in Chicago.
Copyright � 2002-2011, OpEdNews

Mass Attorney General Files Suit Against Ortho-McNeil-Janssen for Illegally Marketing Risperdal

MARTHA COAKLEY
ATTORNEY GENERAL
Press Release
August 01, 2011

BOSTON – Drug manufacturer Ortho-McNeil-Janssen (“Janssen”) is being sued by Attorney General Martha Coakley’s office for illegally marketing Risperdal, an atypical antipsychotic medication. The lawsuit alleges that Janssen promoted the drug to treat elderly dementia and a number of uses in children and adolescents when these uses had not been shown to be safe and effective and had not been approved by the U.S. Food and Drug Administration (“FDA”).

The complaint, filed in Suffolk Superior Court, further alleges that Janssen failed to disclose serious risks associated with Risperdal’s use, including the risk of excessive weight gain, diabetes and, for elderly dementia patients, an increased risk of death.

“Manufacturers should not promote uses of their pharmaceutical products that have not been established to be safe and effective,” Attorney General Coakley said. “Janssen put profits ahead of patient safety by promoting Risperdal for uses that had not been approved and by failing to disclose serious risks associated with Risperdal’s use.”

According to the Attorney General’s lawsuit, Janssen’s unfair and deceptive practices included:

Omitting and/or concealing material facts regarding Risperdal’s efficacy and safety in its communications with Massachusetts health care providers and consumers;

• Concealing, omitting or minimizing the side effects and risks associated with Risperdal’s use;
• Promoting Risperdal to treat elderly dementia without disclosing to prescribers the serious risks associated with Risperdal’s use in dementia patients, including an increased risk of death;
• Promoting Risperdal to treat elderly dementia without disclosing to prescribers that the U.S. Food & Drug Administration had rejected the company’s request to market Risperdal for this use because of unaddressed safety concerns;
• Promoting Risperdal’s use as safe and effective to treat conduct disorder and other conditions in children for more than a decade before receiving FDA approval to market Risperdal to treat any conditions in children;
• Making misleading and deceptive statements to prescribers about Risperdal’s safety, particularly with respect to weight gain and the risk of developing diabetes;
• Paying physicians to participate in sham consulting programs that were, in fact, thinly disguised marketing programs touting unapproved uses;
• Targeting its sales and marketing efforts to prescribers who rarely, if ever, prescribe Risperdal for its FDA-approved uses, primarily the treatment of schizophrenia and bipolar mood disorder.

Janssen’s illegal marketing and sales tactics helped the company generate hundreds of millions of dollars in sales in the Commonwealth, according to the complaint. Citing company documents, the lawsuit notes that these illegal tactics helped make Risperdal a market leader in both the children and adolescent and elderly market segments.

This matter is being handled by Assistant Attorneys General Sarah Ragland, Wendoly Langlois and Emiliano Mazlen, with assistance from division chief Thomas O’Brien and paralegal Marie Defer, all of the Attorney General Coakley’s Health Care Division.