Philip Dawdy is a journalist who writes about mental health news on his blog called Furious Seasons. Since the journalism industry is tanking (yes, I know, there were no newspapers around for you to read about it in) he has been unemployed for the past two years, but using his time well to do independent reporting, including breaking a story on sex scandals and Seroquel just yesterday. He is now conducting a pledge drive. I would ask you to consider him like NPR, to check out his site and pay online with paypal. Twenty bucks is fine.

I have pledged fifty bucks, and then promised to pay ten dollars for every psychiatrist who donated. As one of the readers of this blog pointed out, this pledge is not likely to break my bank, but is was a nice gesture. So I am willing to extend my generosity to the following classes of people, to match any pledge they make with the following amounts. Please don’t take this as a pecking order. I naturally put my own discipline at the top. Psychologists, but our group below the cockroaches if you want.

Psychologists, nurses, social workers: $2.00

journalists: $1.00

cafeteria workers: $0.50

Drug company employees: $0.25

Drug company CEOs: $0.10

VP for HR at Pfizer: $0.08

Chipmunks: $0.05

Squirrels: $0.04

Dead squirrels: $0.03

Cockroaches: $0.02

Pieces of wood: $0.01

My kids who take money from my wallet: $0.00

[March 1, 2009, Update: Philip posted my challenge for his pledge drive here. I added unemployed journalists ($1), ex everything of the above, and catnip mousie heads to the pledge].

Kudos to Philip Dawdy at the Furious Seasons blog for his original reporting on the litigation behind the antipsychotic drug Seroquel (quetiapine). Thousands of people have brought lawsuits against the maker of Seroquel, Astrazenica, because the drug was pushed off label for the treament of conditions other than schizophrenia and bipolar disorder, the conditions it was approved for, without adequate warning that the drug could cause weight gain, which leads to heart disease and diabetes. Not too good for a drug that is associated with only a 10% improvement in depression, while it increases the risk of life threatening diabetes, and is associated with a 25% increase in sedation, based on studies in the American Journal of Psychiatry and Journal of Clinical Psychopharmacology.

Now it comes out that Dr. Wayne MacFadden, who was heading up the group that was performing clinical trials of Seroquel for bipolar, was banging: 1) one of the study investigators; 2) a ghost writer writing manuscripts and preparing posters and presentations about the drug; 3) two other research assistants and/or employees. He also offered sexual favors in return for getting inside scoops from the investigator about other competing drug companies, and tried to intimidate her about reading the literature related to other drug trials. I wonder if he was one of the early members of the ACNP who according to (ill founded, I’m sure) rumour opted to have their annual meeting in Puerto Rico cuz they had cheaper whores? And in the end, it looks like after all that aggravation, the investigator in question who was identified as a doctor at the Institute of Psychiatry in London, apparently didn’t even get her name on the friggin paper!

I’ve been through THAT aggravation!

WE SEL DRUGZ LEZ HAVE SOME WINE!

The funniest part is that Philip emailed the Editors of the American Journal of Psychiatry where one of the studies, with the cheesy name of “Bolder” was published, asking for a comment about whether this affected their opinion of the integrity of the trial results, and one of them responsed “Let’s not respond to this guy anymore.” But then copied Philip on the email! HA HA!

Sometimes these older generation guys are a little clueless on basic use of the computer. So let us digress now for a little lesson. When you get an email and want to respond to it, there are two choices: reply and reply all.

Don't hit the button on the right, unless you are absolutely sure.

More on this story here and here. And original post here.

This week’s JAMA has an article that evaluates guidelines written for the appropriate treatment of a variety of cardiac conditions. These are guidelines written by experts in the field about appropriate treatments for a variety of conditions, from heart attacks to atrial fibrillation. The guidelines were ranked according to level of evidence, with guidelines ranked as A being based on multiple clinical trials, B based on a single study, and C based on expert opinion, “standard of care”, or case studies. The study showed that in 54% of cases, the guidelines were based on evidence ranked as C, in other words the personal opinions of whoever was writing the guidelines. The other finding was that the number of guidelines were increasing all the time, in spite of the fact that the evidence to support these opinions wasn’t.

In other words, about half the time someone is writing something and everyone else is supposed to go along. This is actually how medical education works; you see the professor prescribe in a certain way, and you do the same. Given the fact that the pharmaceutical industry has moved in and gotten control of leaders in their fields, through payments for consulting and lecturing, whom they derisively refer to as “KOLs” (Key Opinion Leaders), and whom pay consulting groups to “manage their KOLs”, you shouldn’t have much confidence in these guidelines, as I wrote about recently in “How Much You Gonna Pay Me for Those Guidelines.”

Dr Curt Furberg testifies before Congress regarding expert consensus guidelines

Hey! I think I came up with a better use for those guidelines!

A better use for expert consensus guidelines

A paper just out in Nature Neuroscience on the effects of childhood abuse on the brain has been predictably shilled by the NY Times as being the first evidence that childhood abuse can have an effect on your brain. Now before you all get all hot and bothered consider the fact that childhood abuse may have had an effect on your brain but that it is not irreversible. This study reported a change in the gene coding for the glucocorticoid receptor in the hippocampus in abused subjects who suicided compared to controls. The gene can be changed by life experience, and by implication can be re-changed if you will. The fact that childhood abuse can affect the brain is nothing new. In fact this writer showed smaller hippocampal volume in abuse related PTSD back in 1997. So this new report is really not so much news. The blogosphere is invoking Buddhism to deal with what seems to be negative news of irrevocable damage, but I would say that there is evidence of change in the brain with treatment, and that may include meditation (we have studies ongoing on that now that look promising) so don’t give up hope. And don’t freak out every time you see the latest drug shill news release.

Oh btw my mother was a Buddhist and when I went back to our old house after 40 years I discovered that there were three sheep living in the “farm” behind our house. Since my mother was a Buddhist I decided that she may have been reincarnated as a sheep, maybe one of those sheep since she liked that house with its Japanese theme (Buddhism) and all. Anyhoo the current owner is also a Shephardess and spinner of yarn and she gave us some so Mrs. Bremner has been knitting me a scarf from the wool. Kinda like Penelope. LOL!

I just wrote a post (which I think will be my last) on The Huffington Post called “Good bye to You, Yaz” about the birth control pill which doctors don’t tell women can make them depressed if it doesn’t kill their libido or make them have heart failure. I haven’t posted there since last November for a number of reasons. Many people don’t know it but just a few weeks after I started this blog (before it was a fully functional bloggy blog) last year I got contacted by the lovely Willow Bay who asked me to write about drug news for the huffpost:

The lovely Willow Bay, reporter-model for The Huffington Post

I mean, who could say no?

She was certainly better looking than Geoff Ruttledge MD of Wellsphere

Geoff Ruttledge, MD, of Wellsphere

He sent out thousands of cheesy emails to medical bloggers to get them to put their content on his Wellsphere medical website for free, and then they turned around and sold it. I didn’t fall for it that time around, and many other medical bloggers did not as well, but at least Willow had a more believable personal message.

I have written many posts for them, But nevertheless
I am not happy with writing for them, cuz although I usually put a version of what I wrote for them on my site, they always have a higher impact rating, and they were often late or didn’t fully feature the posts, and I think it is still just giving stuff away for free, and even though writing on my own site is free, at least it comes from me. A lot of abused people may have liked the attention, but later it makes them feel kind of creepy and used. Also, as pointed out by other blogs like Respectful Insolence by David Gorski, it is kind of demeaning to by pretending to write about “science” when you are competing for attention with the likes of whores like Jenny Block.

And in the end I like my own Arianna better than the other one. My own Arianna is of course my cat, who lines up on the kitchen counter every night waiting for her cup of milk. Here she is relaxing on the couch in corporate headquarters of the Drug Safety and Health News Blog.

Arianna Vaccarino Bremner, in her youth, relaxing with her brother Orestes

And looking up this sentimental picture reminds me of her brother, Orestes. Both of them came from the Humane Society of Dekalb County, GA, but Orestes died young. Alas. Here he is.

Orestes Bremner, you are not forgotten

I really loved that cat. He was up there with Sappho, also an all black cat, who was my main squeeze when I met Mrs. Bremner. I never had her fixed, and I think that was her undoing, as the neighborhood males were all over her and probably gave her some disease. But I never had the heart to take that pleasure away from her.

Looks like they spelled Orestes name wrong. And my address and phone number are now published on the internet. LOL!

And I just revealed our family habit of naming boys after me and girls with two last names. LOL!

When my grandfather was alive my cousins and I always got our cats from the “barn cats” in Lynden WA. Grandpa would pull a board off the side of the barn to find the nest where the kittens had been born in the hay. Since living on the East Coast all of our cats have been named with the names of Greek gods and other figures with Italian spellings. Most of them were descended from an original Siamese tabby cat mixed cat. When Mrs. Bremner first moved to the US the current cat was so upset she jumped out of a third floor window!

I guess it is not good bye to Arianna, but good bye to Orestes. So long, old pal.

Since I wrote my post on “A Brief History of Bastards” the letters have been pouring in with readers telling me about their own bastard stories. Well we haven’t been sitting idle here at the Drug News and Health Safety Blog either. In fact, one of us has been asking the question, has anyone seen this soldier?

South Vietnam, 1968

The baby actually works now for the Drug Safety and Health News Blog in the Research Department. Betcha never thought she’d get out of that cesspool, didya soldier? Here she is again.

Someday I'm gonna work for "Drug Safety" blog!

Anyhoo, being the kinda guy I am, I applied my finely honed abilities fresh from finding 42 aunts, uncles and cousins related to me through my mother who was adopted at birth, and tried tracking down the sheepish looking man in the picture. She couldn’t remember his name at first and said it was “Darryl S.” So I found a wife of a Darryl S. in Indiana last year who was working at some kind of fundamentalist church. Bad sign. Anyhoo I sent her an email.

ME: Hi, I am doing some family research for a friend of mine. Was your husband living in Ohio in 1968? (He he, a little deceptive, noo?)

WIFE OF DARRYL: No, Why do you ask?

ME: Actually, I am looking for someone for someone who was a soldier in Vietnam in 1968. My friend thinks she might be related to him.

I didn’t hear back from her for a while. When I recontacted her she basically said that he wasn’t the one, and thanks alot for screwing up their marriage by making her have doubts about him and possible babies outside of their marriage. I thought they were supposed to be good Christians?

The next time I got on the track it was with the accurate name, Dale S. I found about 12 Dale S. in the US. Baptist preacher from Arkansas? Too young. Professor from Canada? Also too young. Jewish musician from LA? I emailed him and he was not the one. 

There was one in North Dakota who was in the right age range. Again, the wife was easier to find cuz her email was on the internet, but she didn’t respond, so I gave her a call.

ME: I am looking for someone who was a soldier in Vietnam in 1968. This friend of mine thinks she might be related to him.

WIFE OF DALE S: Well he was in Vietnam but that couldn’t be him, because I was dating him and he isn’t that kind of a guy.

I didn’t hear from her, and a week later I emailed her the picture above, following which I got an immediate response of relief that that man was not HER Dale S.

Anyhoo I had one more on the list…

Book Review: Is It You, Me, or Adult ADD? by Gina Pera (Alarm Press, 2008)

I know someone with childhood attention deficit hyperactivity disorder (ADHD) whom I describe as Jack in my book in order to describe all of the possible side effects you can get with drugs like Adderall. However I didn’t know much about Adult Attention Deficit Disorder (ADD) before I started reading Gina Pera’s well written and highly informative book.

For starters, of course, Mrs. Bremner had to take that survey of Adult ADD partners to see if I qualify. Here is how it went (maybe you can take it too):

• Scatter-brained or absent minded: check
• Immature: check
• Dysfunctional family background: check
• Selfish: check
• Passive, lazy or introverted: (last one, check)
• “Free spirit” or eccentric: check
• Passive-aggressive: not really
• “That’s how men are”: (confused look, not in Italy)
• Deceptive/sneaky: No
• “Hyper” high strung or extroverted: No
• History of bad luck: check
• Thrill seeker: No (writing a blog can be thrilling, I say)
• “That’s how creative people are”: I guess
• Workaholic: No (at least not compared to Mrs. Bremner)
• Rebel: check
• Past/current substance abuse: No (didn’t inhale)

I had to take my Dad off of my email list because of #3 (sigh).

Anyhoo two thumbs up for this book!

Gina also writes an entertaining blog related to Adult ADD called ADHD Roller Coaster.

More bad news about bisphosphonate drugs for osteoporosis, which were bad enough to have readers write in about cases of erosive esophagitis and an incredible case of physician writing a case report (Jennifer Schneider MD, also a reader of this blog) about her own femoral fracture caused by getting out of her seat on a train while on alendronate. Well it looks like the medical community is starting to catch on as evidenced by a commentary in JAMA this week by Bridget Kuehn called “Long Term Risks of Bisphosphonates Probed” in which she highlights recent reports of increased risk of femoral fracture, atrial fibrillation, and esophageal cancer in women treated with bisphosphonate drugs like Fosamax and Boniva for osteoporosis, and points to the increasing awareness that treatment for longer than five years with these drugs probably worsens health outcomes. A recent study by Lane et al in 2009 showed that amongst a series of patients 37% of patients with subtrochanteric and femoral shaft fractures were on Fosamax (alendronate) compared to 11% of patients with hip or femoral neck fractures, indicating that long term treatment with this drug was associated with a specific type of fracture. As I have previously written about, these drugs turn off bone turnover and after five years make bones more brittle, not less. She also cited a letter to the New England Journal of Medicine by Diane Wysowski PhD of the FDA (old aquaintance from the Accutane wars) documenting 23 cases of esophageal cancer, with 8 deaths, in patients on bisphosphonates.
A terrible outcome of bisphosphonates of course is osteonecrosis of the jaw, which used to be called “Phossy jaw” cuz it was seen in match factory workers (the phosphorus in the matches got into the bone and turned off bone turnover), a condition so terrible it drove match factory workers to suicide. Nowadays we call it “Fossy jaw” in honor of our old friend, Fosamax (“Ladies Don’t Get Sucked Into the Bone Mineral Density Testing Rat Maze”).

This week’s issue of Nature Neuroscience has an article entitled “Beyond extinction: erasing human fear responses and preventing the return of fear.” Well if the title of the article wasn’t enough to get your juices rolling I can tell you that they basically claim that they have discovered a pill that will erase traumatic memories and that could represent a miracle cure for PTSD. Needless to say the journalist hoi poloi have had a field day over this one as they always do whenever they get a sniff of something that smells like a pill that can eliminate the misery of the human condition. The pill, of course, is propranolol, a beta blocker drug that blocks the norepinephrine beta receptors in the brain and has been noted to specifically block these receptors in a brain area called the amygdala, the seat of fear responses in the brain. Giving this drug in rats has been shown to interfere with the development of fear memories.

Most of the hype about propanolol’s effects on fear and other emotions is based on research in rats, which leads me to ask the question, could it have been, perhaps, this particular rat?

This rat is pissed that his, well, humanity is not recognized.

He wouldn’t have been the best cuz he would have had a, er, whadya call it, bad attitude? Having been the giant inflatable rat that made an appearance outside of Pfizer headquarters which led us to send the lolcats We Sel Drugz to the reskew.

Fast forward to humans and whether this drug can prevent the development of PTSD. Harvard psychiatrist Roger Pitman MD did a study of propranolol in ER trauma victims and the data showed that it did not have a statistically significant effect on PTSD symptoms, although it did have an effect on heart rate and blood pressure responses. This didn’t stop the popular press from blowing their horns about this new magic pill that could be used to prevent PTSD. The next study by Vaiva et al also proposed that it demonstrated that propranolol prevented PTSD in acute trauma victims. However this study did not use a randomized, placebo controlled design. It showed that one patient out of 11 developed PTSD on propanolol versus 3/8 who “refused” propanolol in the ER. This is obviously a miniscule difference in a small group, factors that could influence who would “refuse” might affect treatment response, and obviously people who chose the active drug probably believed it would work, leading to a robust placebo response.

Enter the current study. In the background of studies that have been over hyped as preventing PTSD (when they don’t) we now have a study showing that giving propranolol (a drug which lowers heart rate and blood pressure response) to normal people in the context of being re exposed to an upsetting film will result in lower heart rate and blood pressure response the next time they see the film.

And of course their conclusion is that this has major implications for PTSD patients and other trauma survivors.

This is starting to solidify my belief that they shouldn’t allow people from The Netherlands to do research. Oops! I take that back. Don’t want to get cut out on my invitations to Amsterdam, har har har! (and it’s NOT what YOU are thinking! Stop that!)

Let me cut through the bullshit here folks. Propranolol is not the magic bullet for the slings and arrows of outrageous fortune. All they did is show that if you can give a drug that hold down your blood pressure response to a traumatic film that the next time you see the film your blood pressure response will be lower. They also fail to cite the work of Larry Cahill. Who did a pretty similar experiment, as far as I can tell, ten years ago.

You can’t take a pill after a trauma or a grievous loss and make the pain go away.

Propranolol is not the magic pill. Get over it. You need psychotherapy to heal your hurting.

Hat tip to the Beyond Meds blog.

This just in from the European Desk of the Drugs News and Health Safety Blog, an article in the Journal of Psychopharmacology by Dr. David Nutt called “Equasy: An overlooked addiction with implications for the current debate on drug harms”, has been kicking up some dust in England. Professor Nutt writes in this article that:

Drug harm can be equal to harms in other parts of life. There is not much difference between horse-riding and ecstasy.

Hmmm. Dr. Nutt came up with the term “Equasy” to describe people who like to ride around on horses and then fall off and kill themselves or get brain damage. Apparently about 1/350 who ride horses regularly will do so. According to our English sources this article has been getting quite a bit of attention in the English press, and since he is head of the Advisory Council on Drugs Misuse this provoked a comment from the British Home Secretary.

I’m sure most people would simply not accept the link that he makes up in his article between horse riding and illegal drug taking

Indeed. But what if you got high and then went horse back riding? And what about the movie Equus?

Anyhoo, I couldn’t resist the photoshop opportunity to have Dr. Nutt go riding into the Sunset with our very own Lolcat, We Sel Drugz, to fight these vicious English media people who are creating such a commotion.

We sel drugz to da reskew! Help Professor Nutt!