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rao p 2010 a study of the effects of ly2216684 a selective norepinephrine reuptake inhibitor in the treatment of major depression journal of psychiatric research 44 6 356 363 doi 10 1016 j jpsychires 2009 09 013 posted by cl psych at 5 14 2010 08 18 00 am 13 comments labels antidepressants journals lilly science friday april 02 2010 charles nemeroff consultant extraordinaire the key opinion leader of key opinion leaders or boss of bosses if you prefer in any case take a peek at the following from charles nemeroff s page on the university of miami s website seems like something must have happened in 2006 to slow down chuck s momentum what this is old news yeah i know but i just hadn t written much about our friends in the world of drug sales academics lately so i just had to do this pharmaceutical and clinical research company scientific advisory boards abbott laboratories consultant abbott laboratories diagnostics division 1986 1992 research and education advisory board for psychiatry member 1990 2006 executive board 1991 1993 2003 2006 antidepressant advisory board 1991 1992 acadia pharmaceuticals clinical advisory board member 2000 2006 astrazeneca pharmaceuticals psychiatry advisory board 1997 2001 chairman 1999 2002 neuroscience scientific advisory board 1999 present bristol myers squibb antipsychotic advisory board 2003 2006 antidepressant advisory board 2003 2006 emsam advisory board chairman 2005 2006 cephalon pharmaceuticals scientific advisory board 2002 comprehensive neuroscience inc scientific advisory board 1999 2004 corcept scientific advisory board 2001 2006 cyberonics scientific advisory board 2002 2006 chair mechanism of action board 2003 2006 cypress biosciences inc board of directors 2001 2004 consultant 2004 2006 eli lilly and company psychiatry advisory board 1990 2000 bipolar advisory board 1998 1999 consultant 2002 2003 global neuroscience advisory board 2005 2006 forest laboratories citalopram clinical advisory board 1997 2002 psychiatry scientific advisory board chairman 1999 2008 glaxosmithkline advisory board of psychiatrists chairman 1991 2004 janssen pharmaceuticals mood disorders advisory board member and chairman 1998 2004 topiramate advisory board member and chairman 1999 2001 antipsychotic advisory board member 1999 present johnson johnson scientific advisory board 2007 present lundbeck consultant 2006 merck sharp dohme research laboratories consultant neuroscience research center 1994 mood disorders advisory board 1999 2003 merck medco mental health advisory board member 1996 1998 mt cook pharma board of directors 2007 present neurocrine biosciences scientific advisory board 1994 2004 neuronetics scientific advisory board 2006 novadel pharma board of directors 2003 present chair scientific advisory committee member compensation committee member nominating committee novartis pharmaceutical company bipolar advisory board chairman 2001 2003 pediatric bipolar advisory board 2002 2003 antidepressant advisory board 2006 organon pharmaceuticals psychiatry advisory board member 1997 2004 otsuka psychiatry advisory board chairman 2003 2006 pharmaneuroboost scientific advisory board 2006 present pfizer pharmaceuticals clinical neuroscience advisory board 2004 2006 chair antipsychotic advisory board 2004 2006 quintiles scientific advisory board 2004 present revaax stockholder roche laboratories a division of hoffman laroche inc mania advisory board 1993 pharmocogenomics advisory board 2006 sanofi synthelabo psychiatry advisory board 2002 2005 scirex scientific advisory board 1999 2003 solvay pharmaceuticals psychiatry advisory board member 1991 1999 chairman 1991 1999 antipsychotic advisory board 2005 2006 somerset pharmaceuticals psychiatry advisory board chair 2000 2004 vela pharmaceuticals scientific advisory board 2001 2002 wyeth ayerst psychiatric advisory board chairman and member 1995 2002 posted by cl psych at 4 02 2010 12 16 00 pm 10 comments tuesday march 16 2010 research blogging awards 2010 holy cow i ve been nominated for an award under the category of best health blog with eight other nominees voting is already closed and i can pretty much guarantee i didn t win but it s an honor to have been nominated posted by cl psych at 3 16 2010 06 52 00 am 6 comments editorial support cme and the primary care companion by now everyone who has been paying attention should know that a journal article which lists editorial support is an article that was ghostwritten yet the average reader of these articles is apparently uninformed enough to not care why else would so many articles get published which feature editorial support provided by insert name of ghostwriter here one my my favorite journals under the so bad it s good category is the primary care companion to the journal of clinical psychiatry good articles certainly make their way into the journal perhaps by accident but the journal can always be counted on to provide a steady supply of utter garbage here s the acknowledgements section from one recent piece in the journal editorial support was provided by george rogan msc phase five communications inc new york new york mr rogan reports no other financial affiliations relevant to the subject of this article and in case you re wondering funding for editorial support was provided by bristol myers squibb if you ve somehow guessed that this is an advertorial for abilify you win other ghostwritten pieces of fluff paid for by bms include an article discussing the safety profile of abilify in depression it states that in conclusion this post hoc analysis extends previous findings demonstrating that aripiprazole is safe and generally well tolerated as an augmentation strategy to standard adt in patients with mdd with a history of an inadequate response to antidepressant medication but abilify caused akathisia in a quarter of patients i think that s a problem but wait there s more an article based on data from two trials which showed allegedly that seroquel improves anxiety in patients with bipolar disorder this piece also acknowledges that it was ghostwritten and we know that astrazeneca manufacturer of seroquel has cooked the books on seroquel in the past feel free to look through the journal every month and have a giggle at some of the ridiculous pieces that make their way into print cme you can get your continuing medical education cme from the primary care companion as well one particularly awesome piece of medical wisdom pimped abilify educated physicians about the best ways to manage resistant depression this one is a beauty it was supported by cash from bms which features prominently in the treat aggressively message of the piece the article features none other than michael thase as the leading discussant the same guy who was the leading author on a paper which allegedly showed the wonders of abilify for depression despite the pesky fact that patients said it didn t work back to the cme thase starts off by stating that only a third of patients achieve remission of depressive symptoms during treatment given that abilify is being marketed for treatment resistant depression this is a perfect way to start off this infomercial educational piece he adds that failure to achieve remission increases the risk of suicide and puts people at risk for more depression worse psychiatric outcomes and all sorts of other bad things so we better get rid of all symptoms of depression thase suggests that clinicians should closely monitor patients to see if their symptoms are remitting in particular relying on the global statement i m definitely better from the patient overlooks persistent minor or residual symptoms dr thase recommended using a standardized symptom assessment measure and keeping track of the patient s levels of symptom burden so even if the patient says he or she is much better don t believe it have the patient fill out rating scales and if any symptoms at any level are present keep treating in thase s words if the current treatment is well tolerated and the individual has made significant symptom improvement but is still experiencing residual symptoms then it may be necessary to adjust the treatment dose add another medication or combine pharmacotherapy and psychotherapy note that adding psychotherapy comes after adding another medication then a series of other objective expert psychiatrists chime in dr gaynes offers his wisdom which includes dr gaynes concluded that incomplete remission requires aggressive identification and management don t be afraid be aggressive the unspoken message hey using an antipsychotic like abilify for depression may seem freakin crazy but don t worry you need to be aggressive dr trivedi then comments about using rating scales to measure side effects i don t have much to say about his section but things get worse momentarily dr papakostas then checks in a meta analysis of randomized double blind placebo controlled studies found that augmentation of various antidepressants with the atypical antipsychotic agents olanzapine risperidone and quetiapine was more efficacious than adjunctive placebo therapy in addition dr papakostas noted that the atypical antipsychotic aripiprazole was recently approved by the us food and drug administration fda for use as an adjunctive therapy to antidepressants in mdd augmenting with atypical antipsychotics has so far been the best studied strategy for managing treatment resistant depression said dr papakostas dr p was the coauthor of a meta analysis that provided considerable evidence regarding the wonders of antipsychotic therapy for depression the only problem was that the analysis actually did not find convincing evidence that the drugs were particularly effective which i discussed in december 2009 next comes dr shelton time to be aggressive again thus said dr shelton the long term management of depression should be viewed in the context of acute treatment and the need for early aggressive management to get the patient as well as possible be aggressive by adding abilify to the antidepressant regimen if not your patient won t achieve full remission and will suffer needlessly dr shelton advised clinicians to be aggressive in treatment and stay active over time asking themselves if everything has honestly been done to help the patient psychotherapy is given a brief mention in this section but let s face it most physicians think of be aggressive as upping the dosage and or adding medications not as let s be aggressive by adding psychotherapy then there s the exam at the end write up your answers mail them in and get your medical education credit here s one of the questions 3 scores on both patient and clinician rated scales found that ms b is still experiencing residual depressive symptoms you optimize her current ssri dose which produces some improvement she has not reported any problems with side effects what course of action to improve her outcome has the most comprehensive efficacy data a increase the dose of her current ssri again b augment her current ssri with another ssri c switch her to a serotonin norepinephrine reuptake inhibitor d augment her current ssri with an atypical antipsychotic if you guessed that d is the correct answer you re one step closer to cme credit and one step closer to writing a prescription for abilify despite the fact that it is as likely to induce akathisia as to induce remission of depressive symptoms or that its advantage over placebo is small on several measures and nonexistent on a patient rated measure of depression but d is still the correct answer the offending educational piece is cited below thase m gaynes b papakostas g shelton r trivedi m 2009 tackling partial response to depression treatment the primary care companion to the journal of clinical psychiatry 11 4 155 162 doi 10 4088 pcc 8133ah3c posted by cl psych at 3 16 2010 06 42 00 am 6 comments labels abilify ghostwriting journals medical education wednesday march 03 2010 if you don t learn your lesson the first time i m short on time so i apologize for the lack of details the short of it a researcher at the university of sheffield guirong jang submitted research findings regarding procter gamble s osteoporosis medication actonel however sheffield had a contract with p g to only release actonel data with the permission of p g so dr jang is in big trouble as sheffield wouldn t want to offend its corporate sponsor by releasing any potentially unflattering data more can be found here p g actonel and trying to effectively manage data to best suit the needs of actonel s marketing hey wait this sounds familiar you may recall the case of aubrey blumsohn a researcher at the same university investigating the same drug followed by all sorts of strange happenings read more on the blumsohn story here posted by cl psych at 3 03 2010 09 52 00 am 0 comments labels procter and gamble wednesday february 10 2010 say hello to temper dysregulation disorder with dysphoria the buzz around the new version of the dsm is already starting the draft version is now online and it features a new condition with the ungainly moniker of temper dysregulation disorder with dysphoria that s a friggin mouthful so let s try t triple d for short wtf is this disorder well according to my first look it closely resembles the bad behavin kids who have been labeled as bipolar for the last few years the symptoms are below and can also be found on the official dsm v website a the disorder is characterized by severe recurrent temper outbursts in response to common stressors 1 the temper outbursts are manifest verbally and or behaviorally such as in the form of verbal rages or physical aggression towards people or property 2 the reaction is grossly out of proportion in intensity or duration to the situation or provocation 3 the responses are inconsistent with developmental level b frequency the temper outbursts occur on average three or more times per week c mood between temper outbursts 1 nearly every day the mood between temper outbursts is persistently negative irritable angry and or sad 2 the negative mood is observable by others e g parents teachers peers d duration criteria a c have been present for at least 12 months throughout that time the person has never been without the symptoms of criteria a c for more than 3 months at a time e the temper outbursts and or negative mood are present in at least two settings at home at school or with peers and must be severe in at least in one setting f chronological age is at least 6 years or equivalent developmental level g the onset is before age 10 years h in the past year there has never been a distinct period lasting more than one day during which abnormally elevated or expansive mood was present most of the day for most days and the abnormally elevated or expansive mood was accompanied by the onset or worsening of three of the b criteria of mania i e grandiosity or inflated self esteem decreased need for sleep pressured speech flight...
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