February 24, 2007

Weekend Links

As usual, there's been a ton of good stuff in my little universe of reading this past week, which I haven't gotten around to linking to. I hereby rectify this situation:

The Last Psychiatrist tackles the question of how many drinks are in a bottle of wine. He says four, in general. I say three, all the time. In addition, since wine is one of my great obsessions in life, I want to point out for everyone's benefit that California ain't the only state vinting fine wine in this country. The Pacific Northwest is rapidly overtaking California when it comes to pumping out excellent Bordeaux-style blends, Syrahs and white wines, especially Vioginiers. But wait, you ask, doesn't it rain in the PAC NW? How can you grow anything there aside from moss? Just drive across the Cascades and it's like you are in Napa. OK, I'll shut up now.

The AHRP Blog goes ripshit on the FDA's new warnings for ADD/ADHD drugs and the "Gilberg affair." Fascinating.

Spanglemonkey considers some "bad ideas."

The excellent Shrink Rap gets into why some docs don't like Xanax. I agree with the reasoning, but I've always found it odd that docs bash on benzos while being perfectly willing to hand out atypicals for long-term use for the same basic complaints. I find that troubling in light of the huge side effects of these drugs, their feeble long-term performance and emerging accounts of the addictive potential of at least one of the atypicals (Seroquel).

A commenter on the Paxil Progress forum says that the chemical imbalance theory is officially bye-bye. Nonsense. I think it will stick around as long as people believe in, oh I don't know, virgin births and supply-side economics.

Have a nice weekend.

Posted by Philip Dawdy at February 24, 2007 12:10 PM
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Comments

Being the good hypomanic that I am; I just had to do my own scientific data experiment to find out indeed how much wine is in that bottle.

Got an empty bottle(saved for it's artwork label)and my standard mood day wine glass; and my bad day/ mood wine glass.

Hands down the standard glass holds 4 glasses.

The bad day one holds 2.5 glasses.

Posted by: Stephany at February 24, 2007 11:32 PM

Have you ever heard of the Dental Amalgam theory of chronic depression.

Posted by: lurker at February 25, 2007 01:56 AM

I hadn't thought that linking to your post on the Zyprexa info might be illegal. First of all, I figure if it was illegal for you to post the documents, you'd take them down or be injucted (real word?). Secondly, does that mean that giving the phone number of a guy who committed a crime to someone else is illegal? Guilt by association, or by referral? Orwellian.

Okay, now for a taste of your own medicine (but just messing witcha, really). How can you be so enamored of wine, and encourage its consumption, while knowing that it is responsible for 75,000 deaths per year in the US and 2.3 million years of potential life lost per year (CDC MMWR 9/24/04), from liver disease, cancer, violence, and accidents? It is also responsible for permanent brain damage, major depression, psychosis, and is physically and psychologically addicting, and causes acute withdrawal symptoms that can result in seizures and death if not treated promptly.

How do you square your stance on antipsychotics with that on alcohol? Just curious.

Posted by: Roy from Shrink Rap at February 25, 2007 08:36 AM

my comment on linking wasn't directed at shrink rap but at others who've told me they are scared to link to my zyprexa posts. sad but true.

i could offer a load of answers to your question about wine. suffice to say, if you are connecting all alcohol-related deaths to wine, then you must be working from an interesting set of stats. i don't get worked up about potential years of life lost due to booze or other behaviors doctors have deemed 'bad.' for the most part, alcohol is a personal choice--i'm all for moderate consumption which last time i checked doesn't cause liver damage or psychosis--and like other allegedly bad behaviors is something a great many people enjoy. are we to be allowed to enjoy our lives by our own lights or are docs now the 'deciders' of what everyone should be allowed to put into their bodies? and so on.

as for atypicals, i don't think there are many patients who enjoy them and a fair percentage of patients who take them have little choice in the matter. or docs will deem them non-compliant. and so on.

since docs are so attentive to filtering out risks of any kind from our world, why did so many psychiatrists get on the bandwagon for long-term use of atypical in bipolar disorder right about 2000 when there was virtually no evidence of their long-term efficacy in bpd but while there was pretty good evidence in the literature at that point that long term use of atypicals caused diabetes and a host of metabolic issues? why in 02/03-ish did so many pcps fall for all the marketing hype around atypicals and start giving them to patients for mood complaints great and small when there was very little data to support such rx'ing? just curious.

Posted by: Dawdy at February 25, 2007 09:58 AM

Glasses in a bottle of wine? I drink it right from the bottle. Glasses are for Victorian age righteous sycophants.

Funny chemical balance theory joke. People WILL believe almost anything, sadly.

Posted by: zipzip at February 25, 2007 09:58 AM

@Roy
I can do it for you.
Drink(ing) is a voluntary action. Alcohol like a gun does not kill people, people kill people, and themselves.

Psych meds/drugs are prescribed by doctors, issued by a pharmacist, and then taken in one of two ways 1)forced 1a)in hospital/AKA jail 1b)by exploiting fear, anxiety and 2)voluntarily .
Two things have to be true here, the patient has to be ill and the medication has to work.
Who defines the illness , and who defines work(ing) medication in most cases is the psychiatrist as there is no blood, urine, brain scan available to get an unbiased scientific measurement.

Posted by: Mark at February 25, 2007 09:59 AM

better reason to drink here , about 6 minutes into the video.
http://www.youtube.com/watch?v=7bbaRyDLMvA

Posted by: Mark at February 25, 2007 10:48 AM

Zip,
I had to look up the word sycophant. I love statements like those. Though, I am not out to impress anyone with wine glass use, I find your comment somehow correct.

Posted by: Stephany at February 25, 2007 01:54 PM

Hi Stephany!

How are you?

Love,
Gwen

Posted by: Gwen at February 25, 2007 05:25 PM

Hi Gwen,

I am fine, it is so good to see you here!

Love,
Stephany
:)

Posted by: Stephany at February 25, 2007 08:34 PM

I guess my point was that just like alcohol can have risks and benefits, so can other psychoactive drugs. Folks need to know the R/B of these drugs and make their own decision about whether they help more than they harm; same as Lipitor, Norvasc, aspirin, whatever. All the studies in the world won't inform one about how a particular drug will help/harm in your particular body.

Do the drug companies have too much influence on docs and patients? No doubt. Just as much as Anheiser-Busch does on what beers are sold and which people buy them. (Wine, interestingly, does not seem to suffer from the over-hyped marketing that you see with beer and liquor. Not sure why.)

To Mark, I wish we had such a test, but we don't. I think, for the most part, patients and families define what is "ill" and what "works". Noone's gonna take a pill if they see no potential benefit (excepting the forced situations you mention... that's a societal decision about where the forced medication line is drawn).

I think that with the rise of the internet and consumer-directed health care, patients will increasingly take control of their health care decisions, with health care professionals increasingly becoming simply consultants who provide advice. The quality of that advice will be subject to review and scrutiny on the web, both by payors and by consumers. I'll drink to that.

Posted by: Roy from Shrink Rap at February 26, 2007 12:04 AM

Roy, it's fairly obvious why beer is heavily marketed and wine isn't.

1) The beer market is pretty much controlled by a few huge companies, just as pharma is. Huge companies that need to sell 500 million dollars worth of product, be it beer or zyprexa, can afford to saturate the airwaves. For small companies, it may not be worth the effort to set up a serious PR division.

2) Beer, much more so than wine, is seen as a drug that can be abused. Politicians are much more critical of beer than of wine, and not infrequently talk of either taxing (the sin tax) or banning it. Consequently, beer moguls are more likely to push a lot of money into politics, as the Coors family has been known to do, and into the media. The more advertisements and politicians you buy, the fewer investigative reporters and "crusaders against vice" bother you. Pharma, of course is exactly the same, if not worse. The more advertisements it buys, the less bad press it gets. Pharma's input into the political proce$$ is pretty much legendary.

At this point, I am not sure whether politicians tell pharma companies what they want to see happen, or whether pharma companies tell politicians what they want to see happen. Why did governor Perry of Texas issue an executive order - with little explanation - requiring the State of Texas to buy HPV vaccination$ for all of Texas' young women? And why didn't he also include young men, who can also carry the virus? In my opinion, Eli Lilly's escapades in the justice system make Harry Houdini's escapades look terribly pedestrian.

3) Wine, much more than beer, is something enjoyed by the middle and upper classes. Politicians will think twice and three times about upsetting the middle and upper class; they are much less likely to object to beer being sold in slums, or ritalin and other psychotropics being heavily sold to lower income humans. If poor people die, of legal or illegal drug overdoses, every knows that there will be plenty of other poor people left, so it's really not too big a deal.

In fact, if the patients in question are either on disability or social security, as many zyprexa consumers are / were, the sooner they die, even if it's because of toxic side-effects of medications they are obliged to take, the easier it is for politicians to lower taxes and get reelected. If Eli Lilly was marketing Zyprexa off label for dementia, and zyprexa does indeed cause strokes, as the black box warning on zyprexa indicates, this may actually have been good for the economy, insofar as it reduces the bloat in the welfare system. www.adrugrecall.com mentions that "New studies have also found that elderly patients taking Zyprexa for Alzheimer's and dementia are twice as likely to die or suffer a serious stroke compared to patients in a control group." Can you imagine how much money the government saves when those with no savings and Alzheimer's rapidly depart for their heavenly abode? Perhaps it is Christian to cheer when those with Alzheimer's quickly make it to heaven.

4) A good wine doesn't need much marketing; those with taste and style don't need to be told what a Mouton Rothschild is; in fact, were good wines to be marketed in a big way, their savvy buyers would (correctly) smell a rat. Urine beers, on the other hand, are all about getting suckers down on their luck to buy it, hence the plethora of tacky advertising. The same applies to big pharma. Look at what drugs are heavily advertised: anti-depressants and the like, which are aimed at people down on their luck. I've yet to see an advertisement on tv for a drug for cardiac complaints; maybe having heart problems doesn't mean you're a loser.

You rarely see heavy advertising for treatments that are generally reserved for the upper class, such as retreats at ritzy health spas, simply because they would smell a rat, and not buy them.

5) Beer, much more than wine, is sold in accounts. If a brewery can persuade a big chain like TGIF to carry one its brews, this means big money. Similarly, if a pharma company can get a big hospital, or even a doctor to carry and prescribe its warez, the sums involved can add up. This could explain why some pharma reps will pump gas, and pay for the gas they are pumping into a doctor's car while "educating" him about the "product" they are "promoting." If a restaurant only carries fetid wines, customers won't come; in other words, wine sells itself.

Please forgive me for this dispassionate and Christian economic analysis, but these do seem to be the facts of life (and death.)

Posted by: lurker at February 26, 2007 08:12 AM

lurker,

In the midst of your good comment you bring up strokes and Zyprexa use.

After 6 years of Zyprexa use, my family member has now been described by several professionals; as a person "resembling a stroke victim".

As a result of my lengthy research over the years, I have also come to believe that Zyprexa causes a drug-induced dementia, as well as drug-induced schizophrenic reaction.

I am pretty sure I have it correct.(though this is just my opinion.)

Posted by: Stephany at February 26, 2007 10:56 AM

Some of the so-called neuroleptics are known to bind to manganese and leach it out of the body. There is an MD by the name of Kunin who believes that many if not most tardive dyskinesias are actually severe cases of manganese deficiency. The crazy thing is that he has reversed the majority of the cases of tardive dyskinesia he treated, a permanent neurological disorder in the lore of "academic" "medicine." Play with google!

Posted by: lurker at February 26, 2007 12:51 PM

lurker,

You might be interested in reading my latest post on my blog:

"Stroke Victim, or Zyprexa Victim?"

Posted by: Stephany at February 26, 2007 04:22 PM

Stephany,

As Monty Python advised us, always look at the bright side of life! Your relative's life expectancy has almost certainly plunged greatly, and this, in Christian theology, means that he / she, (or is it appropriate for a vegetable?) is so much closer to entering heaven, where there will only be joy and rejoicing.

Maybe you could even call Eli Lilly, or buttonhole one of their sales reps, and thank them for doing so. If you want to be funny, you may ask them why your relative will not also get to enjoy the company of 72 virgins.

Posted by: lurker at February 26, 2007 11:14 PM

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