October 18, 2006Prevention Of Psychosis Study, Ethical or Not?Earlier this year, some researchers published an article in AJP in which they reported on an attempt to prevent teens identified by the docs as being at risk of experiencing psychosis by giving them Zyprexa. Another group of patients at similar risk were given a placebo. (Set aside for a moment how the docs think they know who is "at-risk.") I wrote about the study earlier here. The basic story is that Zyprexa didn't do jack to prevent psychosis and also that many of the patients the docs identified as being at-risk never experienced psychosis after the study ended and they came off Zyprexa or the placebo. Now, a psychiatrist in Portland, Oregon is challenging the ethics of the study in a letter to AJP: "To the Editor: I am concerned that the article entitled "Randomized, Double-Blind Trial of Olanzapine Versus Placebo in Patients Prodromally Symptomatic for Psychosis" (1) lacked discussion regarding the ethics of treating young (average age=18.2 years) and nonpsychotic patients with the neuroleptic olanzapine for 1 year. Here, one of the original study's authors defends their work (full letter here): "Prevention is a new concept to psychiatry. We are used to functioning as post hoc diagnosticians and interventionists. Prevention interventions are common in other medical specialties and, by definition, they involve prescribing active treatments to a mixture of true positive and false positive persons. The clearest example is cholesterol lowering pharmacotherapy. As prevention, the strategy treats risk (high cholesterol) not disorder (coronary heart disease), and the vast majority of those treated are false positives. Are these docs behind the original study on drugs themselves? Or are they just arrogant? How many times do they plan to test their hypothesis? I cannot even begin to get into how much it angers me to hear these clowns compare slamming teens with 15 mgs. of Zyprexa with given cholesterol-lowing drugs to prevent heart disease. Perhaps these docs ought to take Zyprexa themselves and see how they feel about this ethical swamp before lining up people to take it who aren't even symptomatic. More research isn't needed. These types of studies are unethical and must stop. Posted by Philip Dawdy at October 18, 2006 12:01 AM
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Of course I cannot be silent when I read anything w regards to Zyprexa. "First Do No Harm". I have said that to doctor's faces, I skipped the letter writing at various points. I used that phrase a lot.
It just makes me cry when I read this. This just makes me sick. This med as well as Depakote has ruined my daughter's life. She has lost 40 lbs since being away from home and off of ZYprexa. She has been given the dx Polycystic ovarian syndrome from 6 yr depakote use, and no monitoring by pdoc re: her growing body and lack of menses. Until I read the box warning to the doc, re: monitoring this med in women under age 20. She is still only 18. No meds she ever took were approved for use in children. NONE. I know, let's make it simple. Let's ban all psych meds from being dispensed to anyone under 18. That way they can just be symtomatic and suffer off meds, then make an informed decision as a legal adult to use em. Now the pdocs just tell me "something else was going to emerge anyway". That, is a cop-out. My daughter's life can never be given back to her. She is now what they warned me could happen. A person I won't recognize compared to who I lost. I hope I can make a change using what I have learned. I sure intend on attempting to create a better way. Posted by: Stephany at October 18, 2006 08:44 AMOne more comment re: Mothers/Parents/Caregivers and the dispensing of psych meds to children. Once you become pro-active, you are labeled as a person who interferes with the docs. A small tip for any parent in this boat now and wanting to jump ship, but the docs won't back down...fire the doc, get several opinions, use the word "observed" a lot, and then, after all of that, watch out, because once you fire a doc, and get several opinions, you could end up being labeled after 7 years "a parent who stops treatment.". Yeah. What a parent has to realize is once you enter the docs world, you are a threat to their ego. Especially if you are a woman. I feel this is why so many parents end up worn out and beaten down, and give up. Do not give up. Another lure the docs did to me as a parent in 1999: "You are so lucky your daughter got sick when she did, the medications are superior to those in the old days." She trialed every single "new" atypical. She is now on Clozaril. The "old gold standard". If the psychiatric community was a watch-dog for all antipsychotics based on the side effects alone, then we could get somewhere. The Clozaril is so strictly monitored, due to death as a side effect, that it cannot be dispensed without bloodwork results of CBC to the pharmacy that fills the order. If the lab results come back questionable, the doc cannot give the CLozaril. Shouldnt it be this way with ALL psychiatric meds? that careful monitoring of the patient and their body on these meds? I would like to say that after 7 years doing this, I have gotten somewhere. I was told, that "just wait, in 10 years there will be a cure." "Just wait, in your daughter's lifetime there will be a cure, a simple bloodtest that can tell us exactly what's wrong with her (psych wise)." Well docs, we are closing in on the 10 year mark a look what's happened. I heard a lot of bullshit from pdocs and false promises, and their rates increased. I am sorry to report after a 7 year quest, this Mother has nothing positive to report. I am trying to blaze a trail, and I hope I live to see an outcome that is a positive one. A Decade is a long time to see no changes in docs attitudes toward medicating children. Sorry for the long post, but this is the top of the list topic here. Children and psychiatric medications. ZyPrexa and I have a long history. http://alwaysonemorethingagain.blogspot.com/2006/09/zyprexa-agitation.html Posted by: Stephany at October 19, 2006 07:52 PMI was wondering if any of you could help me with this: I can't hear. Anyone have that problem? Like when people talk to me all of a sudden I'm in my own little bubble, and I could see the person, and even absorb some of the words, but I can't make any sense of what they are saying. Nothing makes sense. That sometimes happens when I read too. I remember once when I was at the Weekly, Philip asked me to read a one page press release on the city counsel, to give him my opinion -- but I couldn't read it. It didn't make sense. And I wanted SO hard to read it! I wanted so badley to be able to give him my opinion! But the more I read it the more it didn't make sense. It was like I was watching myself read it, totally as an observer -- and therefore I coudln't understand. It was horrible! When he then asked me about it, I had to give a total generic statment... I COULDN'T let him know I even wasn't able to read the damn thing. Here I was supposed to be the brilliant and motivated intern -- and yet the simplest task I coudlnt do. So embarrsing! Does anyone have a clue as to what I'm exprieincing??? It's really like a disability. I even dropped my Honors debate class... cuase, mainly, I was SO afraid people would be debating and I wouldn't be able to hear them. For years I thought my IQ was too low to hear and read -- but that dones't sound right either. Do any of you have any idea what's wrong with me? And how I could fix it? I really need help with this. Posted by: Gwen at October 21, 2006 10:30 AMGwen, Thanks, Stephany. It's good to know that I'm not the only one this is happening to. It has just gotten so bad. Like, this past summer I had to take a high school correspondence history class, which invloved a lot of reading... and my mom ended up taking taking the whole class for me, becuase I just coudln't comprehend the simple, eight-grade level reading. Really bad. Anyway, thanks for your support. By the way, how is your daughter doing? Gwen Posted by: Gwen at October 23, 2006 10:31 AMGwen, |
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