I appreciate the contributions that have come in so far, especially since it's boosted my mood a bit during a very tough couple of days with my cat, Katie. I managed to get an entire, huge (6 ounces) can of prescription cat food down her via syringe, 20 mls. at a time. I lost track of how times I fed her and how many times she scratched me. She's better than she was on Wednesday, so we'll see how things go over the next few days. I'm utterly exhausted. So is Katie.

Thanks to all of you for your support.

Some of the language in the brochures is interesting. I'll focus on the Zyprexa brochure.

"Your Medicine is called Olanzapine. Pronounced 'o-lan-za-peen.'

"Many children, teenagers and young people need to take medicines prescribed by doctors to help them stay well and healthy."

Here's a question for NHS: On what basis do you argue that Zyprexa--oops, Olanzapine--keeps children healthy? What randomized clinical trial proves this in children? Is it even approved for use in children and teens in the UK? If so, for what? Even Lilly's UK website doesn't say. Or are you in essence helping off-label market to kids and teens?

Then:

"When you first start taking olanzapine it may make you feel a bit sleepy, but this should wear off after a few days. It may make you feel like eating more food. If this happens, try not to eat more than usual, and talk to an adult or your doctor about this.

"How long do I need to take olanzapine for? You will need to keep taking olanzapine until your doctor tells you to stop. It helps to keep you well, so you should keep taking it even if you feel better."

That kind of rot speaks for itself. The other brochures strike a similar tone. Now check out what the NHS's deputy chief pharmacist told Hansen:

"Could I please request that you amend the site so that it is no longer possible to access the whole leaflet -- the front page and our contact details would be appropriate. I'm sure you appreciate that the only way that we will be able to produce more materials for patient benefit is by recouping the cost from other organisations which want to use them -- our objective is provide written materials to support the verbal counselling given by healthcare professionals -- they are not meant to stand alone as sources of information. We charge a reasonable fee for full access to all the children's leaflets and so it not in our interest, or necessarily, patients and parents to have access to them on your website without the professional support intended."

Wow, the British government charges for these brochures? I wonder what groups use them and under what circumstances. And don't you just love the irony of the British government trying to censor an American website? Good luck with that!

Hansen replied:

"We posted the NHS leaflets to stimulate public scrutiny of your agency. We call upon the NHS to stop promoting harmful psychotropic drugs for children. In a spirit of full disclosure and transparency, we have now posted your letter as well."

You can read the emails at the bottom of each link above. (Via opednews.com.)

I call upon Hansen to continue to make such advertisements and brochures available. If any of you have "interesting" brochures and whatnot from the US, UK, Canada, Australia or wherever, feel free to pass them along to me or Dr. Bonkers.

Now, here's news of a tragic and ugly case in the UK where a husband allegedly strangled his wife after coming off a Parkinson's med (given to him to control vivid nightmares) and two unnamed anti-depressants.

"Dr Paul Skett, an expert in prescription drugs, said Mr Thomas would have experienced nightmares after coming off the drugs, two antidepressants, and one to control both Parkinson's Disease related hand tremors and nightmares.

"One of the effects of the hand tremor drug was to inhibit rapid eye movement sleep, he explained.

"'With withdrawal you get a rebound effect where the individual suffers more rapid eye movement and more dreaming,' he said.

"'These can be very vivid and take the form of nightmares.'

"Mr Thomas denies murder, but prosecutors are not seeking a guilty verdict.

"Paul Thomas, QC, said he was seeking a 'special verdict' of not guilty to murder due to "insane automatism" caused by an internal condition.

The defence is arguing the defendant strangled his wife of 39 years due to 'non-insane automatism' - acting invoulntarily while sleeping - brought on by external stress."

While I'm not arguing that the meds made him do it, I am arguing that they are deeply entangled in the tragic outcome, which argues that patients and doctors have got to take the withdrawal process much more cautiously.

Take a swing through ssristories.com and do a find in your browser under "withdrawal."

"Few universities make required reports to the government about the financial conflicts of their researchers, and even when such conflicts are reported, university administrators rarely require those researchers to eliminate or reduce these conflicts, government investigators found.

"In a report expected to be made public on Thursday, Daniel R. Levinson, the inspector general of the Department of Health and Human Services, said 90 percent of universities relied solely on the researchers themselves to decide whether the money they made in consulting and other relationships with drug and device makers was relevant to their government-financed research.

"And half of universities do not ask their faculty members to disclose the amount of money or stock they make from drug and device makers, so the potential for extensive conflicts with their government-financed research is often known only to the researchers themselves, the report concluded."

That should shake everyone up because these universities, collectively, take in billions a year in federal research funding yet apparently refuse or are too lazy to monitor whether the researchers getting federal funds are also getting unreported pharma monies. The whole thing is downright Nemeroffian. I'm not sure what needs to happen to clean this system up but I think it's outrageous that these same researchers are the types of "experts" the media quotes in health stories that instruct the public in how to behave and these are the same folks who would likely claim to be "highly ethical" (and probably teach medical students in medical ethics) yet they're violating research ethics all over the place.

It's stories and reports such as the above that make me deeply distrustful of our health care system and the pronouncements of experts. It's simply not that hard to do the right thing and play by the rules and it's very telling that loads of researchers in various disciplines don't seem to care.

And if you want take a look at yesterday's post where I outline some of what I've covered on this site since September 1st. Let's just say there's a good amount of news there that the mainstream media either doesn't know about or won't touch.

As for my dear 14-year-old cat Katie, she took ill again late last week with an upper respiratory infection, which made it difficult for her to eat, so the problem with her liver re-appeared. I spent much of yesterday at the vet and then feeding her prescription food via syringe. And giving her anti-biotics and closing her in the bathroom with me while I showered so the steam would help clear her nose. I've got to get as much food down her as I can and get weight back on her promptly or things won't work out too well. Getting a can of cat food down a cat by syringe takes multiple feedings and results in multiple scratches. Katie is tolerating the process as best she can, but there's not a cat alive who enjoys being fed that way. Hopefully, she'll be back to eating on her own in a few days when her nose clears up. She bounced back well enough after the problems in early October for me to trust that she's a fighter and that we can make this work.

I sure hope so.

Overall, AZ faces 14,000 Seroquel-related lawsuits.

I won't have much more to say until I see the bill itself or at least see some thorough reporting on it.

Like I said, discouraging. That this is likely mostly going on amongst non-commissioned personnel who are probably fairly young is doubly upsetting.

I think we all know that the active duty military--especially the Army and Marines--are under epic amounts of stress and that many of our fighting men and women have been through multiple deployments in Afghanistan and Iraq. The Army did claim, however, that one-third of the suicides were among personnel who'd not seen action overseas. If we have so many suicides among Army personnel who've not been exposed to the stresses of war, then that does make me wonder what the hell is going on here. Because something is and it'd be good to know what that something is.

John Grohol at PsychCentral.com had some sharp things to say:

"When you’re threatening court martial to moms who can’t find child care for their 10-month old before deployment and have psychiatrists shooting up your training bases because you don’t acknowledge the inherent conflicts in service amongst your ranks (or your officers don’t have the stomach to discharge someone they clearly saw as problematic), then yes, you have some serious problems. And yes, they are related to the two wars you are currently fighting.

"As the article notes, the military’s suicide rate among active-duty soldiers was about 20 per 100,000, nearly double the national U.S. rate of 11.1 suicides per 100,000 people.

"There is something significantly wrong there if twice as many people in your service are taking their own lives. This hasn’t always been the case. And rather than trying to whitewash the issue, you should be pulling out all the stops — and all significantly increasing the funding — to figure out how to stop the blood letting."

I agree that this issue merits a lot of attention. The answers are bound to be ugly because we have very high rates of medication with psychotropics among our troops now and that clearly does not seem to be helping things. We have a military that pays more attention to mental health problems that it probably ever has in its history and yet things keep getting worse. We also have the problem caused by the military not keeping official suicide statistics before 1980 and, as a result, we've got no way to compare what's going on now with experiences in the Vietnam War and World War II.

I don't pretend to know what any of the answers are here. I just know that I am tired of writing about this topic.

Anyway, the overall goal for this fundraiser is $4,000 from 100 contributors over the next month, although the earlier contributions come in then the earlier I can end the fundraiser. As usual, the PayPal button is on the right. If you prefer using snail mail, shoot me an email and I'll send you my mailing address.

Of course, I know intimately just how rotten the economy is right now. So what have I been doing around here since September 1?

In September, I reported on a child psych researcher who claimed 3-year-olds can have chronic depression had apparent unreported conflicts of interest in recent journal articles; I challenged the relevant journals to address the situation; the Archives of General Psychiatry later decided to investigate the matter while the American Journal of Psychiatry didn't respond; I wrote of an ignored study linking ADHD stimulants to risk of sudden death in kids and another study of the emotional blunting caused by SSRIs; that 60 percent of antipsychotic use in the VA system is off-label; that 2006's suicide rate remained unchanged from 2005's; that anti-depressants were again linked to some birth defects. In October, it was onto a study showing that the Mediterranean diet looked to be somewhat protective against depression (another study the media ignored); that a large percentage of cases of bipolar disorder "resolve spontaneously" by the mid-30s (another one the media went nowhere near); that Lilly is trialing its anti-depressant Cymbalta is kids as young as 7; AstraZeneca itself wrote me to defend its handling of Seroquel weight gain warnings; that Shire was trialing an ADHD stimulant as a depression treatment; I tackled NPR's recent biased reporting on mental health; revealed that Lexapro sales were boosted by the company selling anti-depressants to teens; wrote of an animal study showing that psych med use among young animals created psychiatric disorders in later life; wrote of a study (one the media picked up on) showing that atypicals are causing explosive weight gain in youths; revealed that the House health care reform bill had slipped the controversial MOTHERS Act into its language; called out NAMI National for lying in a letter to the New York Times. So far this month I've detailed yet another ignored study laying out depresson's link to processed food; wrote of a study where researchers shot down the existence of pre-adolescent mania; noted that Technorati ranked this blog way up in its Top 100 Health blogs; wrote of child psychiatrists allegedly behaving badly with children; wrote of a scary Yale study attempting to link ADHD in childhood to criminal behavior as an adult; wrote about absurd claims by the Juvenile Bipolar Research Foundation that bedwetting and nightmares among young children constitute pediatric bipolar disorder symptoms; and there's more to come.

I don't think you'll find much of the above anywhere in the mainstream media, print or broadcast. If you'd like to support such work, I'd appreciate your support. Thanks.

Anyhow one study of the drug got a ton of press attention yesterday. It involved 1,378 women in stable relationship who were diagnosed with HSDD. The drug was trialed against placebo over 24 weeks and study subjects reported more "satisfying sexual events"--a careful term if there ever was one--on the drug than on placebo.

Before I get to the skepticism of my headline, let me address the two or three of you who might wonder why I'm writing about a purported treatment for HSDD on a mental health website. First, sex and relationships are obviously entwined with mood and, in many respects, overall mental health. Second, I'm endlessly fascinated by how anti-depressants have been repurposed over the years and this story is a big repurposing.

Now for some skepticism:

2. If the response rate is as high as claimed--60 percent to 75 percent--then that means the placebo response in this study was very high. In one press account of the study, the effect size is put at 22 percent. That means that the placebo response rate would be 38 percent to 53 percent. Very high.

3. It's an anti-depressant playing with serotonin receptors and that likely means that there were patients in the study who could have had some level of side effects associated with taking the drug. None of the press accounts I've seen so far get into that question. But you know there's bound to be reports of suicidality and withdrawal problems and the like once this drug gets to a large population, if it ever does.

4. With such a high placebo response, you know something else has to be going on to explain these women's lack of libido.

"Problems with sexual desire are 'a big deal,' for women, according to Dr. Marie Savard, a medical consultant to ABC News.

"'We know the role of sex is so important to relationships,' she said. 'But for women it's unrealistic to think a pill is going to fix the impact of so many issues that women face.'

"Savard said women have many reasons for a lack of libido, including stress, caregiving roles and lack of self-esteem, and added it's difficult to label women with a simple diagnosis like HSSD. But she said since the brain is a woman's 'biggest sex organ,' it might make sense that they would benefit from a drug like flibanserin."

5. Said one of the study researchers:

"'Viagra increases blood flow. This doesn't do that. It affects the brain. (Flibanserin) affects the neurotransmitters in the brain that affects sex,' Guay said."

Points 4 and 5 come from the same article and in the same article you have two doctors in fundamental disagreement about what causes lack of desire.

6. Reportedly 20 percent of adult women in America experience HSDD. With roughly 115 million adult American women that would work out to about 23 million American women with HSDD, a potentially gigantic market for drug treatments as far as Big Pharma is concerned. By comparison, about 10 million to about 12 million American women take anti-depressants to treat depression. With a potential market so large, any drug that gets approved to treat HSDD--the causes of which remain unclear--will be marketed very aggressively, perhaps as aggressively as ED treatments. My point is that any claims for these drugs should be greeted with extreme skepticism because when Big Pharma is chasing a big market drug companies--and doctors --will make outlandish claims.

7. The results of four different studies of Flibanserin were presented at the same conference that resulted in the press coverage of but one of the studies. I don't know what the results of the other three were, but it's likely that the press was being spoonfed the results of one study. It'll be interesting to see the results of the other studies, once they become public.

8. I sure hope the FDA takes a long, hard look at the results of the main study because the placebo response is so high that it makes me a bit suspicious. Was there something odd with the study design? Why were so many people getting such a response to placebo? Is it really a good idea for the US for millions of Americans to take Flibanserin when it's clear that HSDD drug trials had such a high placebo response? The FDA isn't the most skeptical organization on Earth, but on occasion it does surprise me. I hope this is one of those times.

9. If Flibanserin is approved by the FDA, I simple cannot wait to see the television commercials that will roll out for this drug and what imagery the ad agencies will use to capture women's imaginations. One of the classic Viagra commercials, for example, features a bunch of country pickers cranking out "Viva Viagra" before blazing down the road on loud motorcycles and in fast cars. What would the women's version of that be? Who would be the feminine equivalent of NASCAR god Mark Martin tearing 'round Talledega in the Viagra car a few years ago? Would there be female sports stars endorsing the drug a la Rafael Palmeiro? The mind boggles.

"Respected LA-area pediatrician Chris Tolcher says we don't know enough about cannabis for kids.

"'I think for all the parents out there whose children may have autism,' Tolcher says, 'I think the message here is that this is intriguing information that needs more research before we can confidently say that marijuana is a safe and effective treatment for autism complications.'"

If the DEA wouldn't make such research impossible, then perhaps we might have some answers.

"Since first approved in 1997 for the treatment of schizophrenia, the U.S. Food and Drug Administration has approved Seroquel as safe and effective for three indications in bipolar disorder, as well as in a new formulation for additional treatments in schizophrenia and bipolar disorder. Today Seroquel and Seroquel XR are the only medicines approved as monotherapy by the FDA to treat both the acute depressive and manic episodes associated with bipolar disorder.

"The safety and efficacy of Seroquel has been evaluated in clinical trials with thousands of patients and AstraZeneca has shared all required data with the FDA, both before and after the agency approved it as safe and effective.

"AstraZeneca believes the totality of the science around Seroquel -- including company-sponsored studies, research sponsored by the federal government and physician experience -- confirms it is an effective and appropriate treatment choice for many patients who suffer from schizophrenia and bipolar disorder."

OK, fine. But since Jewell is relying so much upon the FDA's blessing of the drug to make his case to the public that Seroquel is safe and effective and that AZ plays by the rules, then I need to point out that last December the FDA busted AZ for off-label marketing of Seroquel for depression. To date, the agency has refused to answer any questions about its finding or to reveal what sanctions it might impose on the company. It's almost one year later and high time the FDA did something.

You just had to know that with Big Pharma openly supporting health care reform and alleged cost-cutting that something funny had to be going on. Now, we know what it was.

"A large new study confirms that people with severe mental disorders - such as schizophrenia or other psychotic disorders - are 25 percent to 40 percent more prone to die from heart disease than people without mental illness are.

"Moreover, smoking and physical inactivity - behaviors that individuals potentially can change - significantly contribute to this increased risk of death, found researchers led by Amy Kilbourne, Ph.D."

The study was among people in the VA system.

Interestingly, inactivity was a greater risk factor (66 percent higher risk) of a heart disease death than was smoking (32 percent higher risk). The study calls for smoking cessation programs and promotion of physical activity among veterans with psychotic disorders. How they plan on getting veterans zonked on Zyprexa to exercise is beyond me.

There is no mention in the study of the role antipsychotics may be playing in all of this even though antipsychotics are well-known to boost blood lipids and cholesterol as well as to cause diabetes and weight gain--all risk factors for heart disease. What's odder about the omission is that atypical antipsychotics carry warnings of diabetes and cardiac problems, so why would researchers ignore the hazards presented by these medications?

Oh, we know why. These are doctors in denial much as with this study from earlier this year which claimed that people diagnosed with bipolar disorder died early, but barely mentioned any connection to chronic use of medications. I'm not excusing smoking or inactivity, but for this current study to ignore meds altogether is inexcusable.