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OfflineSneezingPenis
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Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: LiquidSmoke]
    #7551443 - 10/23/07 05:41 PM (13 years, 9 months ago)

Quote:

LiquidSmoke said:
Quote:


6) off-label usage.
Off-label use is the practice of prescribing drugs for a purpose outside the scope of the drug's approved label, most often concerning the drug's indication. In the United States, the Food and Drug Administration (FDA) requires numerous clinical trials to prove a drug's safety and efficacy in treating a given disease or condition. If satisfied that the drug is safe and effective, the drug's manufacturer and the FDA agree on specific language describing dosage, route and other information to be included on the drug's label. More detail is included in the drug's package insert. However, once the FDA approves a drug for prescription use, they do not attempt to regulate the practice of medicine, and so the physician makes decisions based on her or his best judgment. It is entirely legal in the United States and in many other countries to use drugs off-label. Exceptions to this are certain controlled substances, such as opiates, which cannot be legally prescribed except for approved purposes (at least in the U.S.). In Australia, amphetamines are included in these drugs which cannot be prescribed off-label.

whats wrong with that? its legal.... right?

well, it is illegal for drug companies to promote and advertise their drugs for off label usage. But what seriously irks me is that doctors are not forced to tell patients that the drug they are prescribed is not reccommended for the intended use.





this is also a pretty big misinterpretation on your part

off-label use drugs are designed, in fact that entire policy was made, for purposes of medical research, seeing if certain drugs have other interactional benefits.

You're also forgetting that in many drugs, which have multiple beneficial mechanisms, are used as off-label prescriptions simply because the given medical indication doesn't point to the drug's original purpose....And in many cases, work BETTER than the intended use of the drug.

Go look up the following drugs:

Verapamil, disopyramide, phenylephrine, fludrocortisone, amiodarone, ipratropium...




I dont see how I am misinterpreting this. Maybe you mean that I am not using your optimism on the subject.
Drugs are regulated and approved based on the findings of the drug studies. If I have a drug that was designed for regulating blood pressure, and find that it also help hemophiliacs clot..... which is easier to get it passed by the FDA?
Here we have millions of dollars riding on this drug being passed.... do we take the route that is easier, or harder to prove efficacy and safety?
Then , with no disclosed findings upon the intended purpose of the drug, we tell doctors that it works really well for regulating blood pressure.
It is kind of like designing a gun, it is designed to shoot a bullet up to a mile with a .01% margin of error, but it might be considered too dangerous, or malicious, or whatever to be allowed to be sold on the market..... so then, we decide to sell it as a paperweight. Yeah, we can get it passed as a paperweight!
so then, when people start buying these very expensive paperweights, and people start getting shot and killed with these paperweights.... my gun company says "hey, you know, we never intended for these things to shoot bullets, they were just supposed to keep the paper from being blown away".

doctors arent forced to tell you that the drug they are prescribing you is in fact off-label usage. You arent told that you are a guinea pig.


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OfflineSneezingPenis
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Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: SneezingPenis]
    #7551570 - 10/23/07 06:14 PM (13 years, 9 months ago)

Maybe in an hour or so I will have more time to address both of your posts more in-depth... especially, the off-label use.

Quote:

A recent USA Today sponsored review of the FDA database from 2000 to 2004 found at least 45 deaths in children under 18 with atypical antipsychotics listed as the "primary suspect," and 1,328 reports of other serious side effects, some life-threatening.

Atypical antipsychotics are a relatively new class of drugs approved by the FDA for the treatment of adult schizophrenia and bipolar disorder. None of the drugs, including Clozaril, Risperdal, Zyprexa, Seroquel, Abilify and Geodon, are approved for children, but doctors continue to prescribe the drugs off-label for unapproved uses.

The FDA's adverse event reporting system is known to capture only between 1% to 10% of side effects and deaths, which means the true numbers are actually much higher.

Among the 45 deaths, discussed in the May 2, 2006, USA article, at least six were related to diabetes, and other causes ranged from heart and pulmonary problems to choking, liver failure and suicide.

An 8-year-old boy died of cardiac arrest. A 15-year-old boy died of an overdose and a 13-year-old girl experienced diabetic ketoacidosis, a deficiency of insulin. The youngest child was 4, with symptoms that indicated diabetes complications.

The most common adverse reactions reported were:


A condition known as dystonia, which produces involuntary, and often painful muscle spasms, was the most common side effect with 103 cases.


Tremors, weight gain, sedation, and other neurological effects with symptoms that varied from slight twitching to full-blown body jerking.


The neuroleptic malignant syndrome showed up in 41 children, and was the most troubling side effect, according to child psychiatrist Joseph Penn, of Bradley Hospital and Brown University School of Medicine, because it can kill within 24 hours.
Even thought the package inserts for atypicals say their safety and effectiveness with children have not been established, a skyrocketing number of prescriptions are being written for children diagnosed with attention deficit disorder or other behavioral problems, according to a study in the March-April 2006, edition of the journal Ambulatory Pediatrics.

This study found that the number of children prescribed antipsychotic drugs had increased five-fold between 1995 and 2002, to an estimated 2.5 million, which represents an increase from 8.6 for every 1,000 children in the mid-1990s, to nearly 40 in every of 1,000 in 2002.

The researchers analyzed data on children with an average age of 13, who were involved in annual national health surveys involving prescriptions issued during 119,752 doctor visits, and determined that over half of the prescriptions were written for attention deficit or other non-psychotic conditions.

The findings are troublesome "because it looks like these medications are being used for large numbers of children in a setting where we don't know if they work,"said the study's lead author, Dr William Cooper, a pediatrician at Vanderbilt Children's Hospital in Nashville, TN.

Dr Cooper and his colleagues were among the first to investigate the increase in antipsychotic use with children and teens, in a study published in the summer of 2004, that reported that prescriptions for atypicals had doubled among Tennessee children on Medicaid between 1996 and 2001.

Back then they found that 43% of prescriptions were written for ADHD, or a related disorder as the primary diagnosis, and 14% were written for bipolar disorder, and 9% for schizophrenia or other psychotic conditions.


In a later nationwide study, researchers concluded that 6 million prescriptions for atypicals were written for children between 1995 and 2002, and again found that a large percentage of the prescriptions were written with ADHD as the primary diagnosis.

"The bottom line is that we are seeing a huge increase in the use of these medications among children, and we are not sure if they work or if they are safe," Cooper told WebMD. [b"These drugs have not been tested for many of the indications that they are being used for."

Even more disturbing finding was recently reported in a study led by Oregon Health & Science University professor, David Pollack, that revealed that 246 preschool children under the age of 5, who were enrolled in the state-sponsored Medicaid program, were receiving antipsychotic or antidepressant medications. (on a personal edited side note, I would love to hear how someone of you justify this type of behaviour.... 5 year olds.)

The review of Medicaid records, reported in the April 2006, Oregon Health News, found that 41% of the preschoolers were prescribed psychiatric drugs for ADD.

Experts say the prospect of children under 5, receiving psychiatric drugs intended for adults is alarming. Also alarming was the finding that about 50% of the prescriptions were written by primary care providers and not psychiatrists.

The study was a collaboration by Oregon's department of human services, Medicaid program, and the Oregon State University College of Pharmacy.

An equally disturbing report was published in the April 25, 2005, Columbus Dispatch on an investigation of state Medicaid records that found 18 babies ranging from newborn to 3 years-old in Ohio had been prescribed antipsychotic drugs in July 2004.

In another analysis of privately insured children, by the pharmacy benefit manager, Medco Health Solutions, conducted for USA Today, the rate of children, 19 and under, with at least one atypical prescription had increased 80% in the four years from 2001 to 2005. This analysis did not include any children covered by government programs like Medicaid.

The study noted that atypical use among girls was much greater than with boys. The number of girls taking the drugs grew 103% from 2001 to 2005, compared to a 61% increase with boys.

The rate of children treated with atypicals "is growing dramatically faster than the rate for adults," said Robert Epstein, chief medical officer for Medco, in a press release.

"Doctors need to be judicious when prescribing antipsychotic drugs to children," Epstein warned. "There is evidence that the risk of diabetes and metabolic disorders from using atypical antipsychotics could be much more severe for pediatric patients than adults," he said.

"The use of these drugs," Dr Epstein warned, "can have the pediatric patient trading a behavioral condition for a lifelong metabolic condition that can lead to significant health complications."

Critics say the increased use of atypicals with children is most troubling because the dangers associated with the drugs, in adults and children, has been evident in the scientific literature since before they came on the market.

In the book, Mad In America, award winning author, Robert Whitaker, reports that one out of every 145 subjects who entered clinical trials for Zyprexa, Risperdal, Seroquel, and Serdolect died. By using the Freedom of Information Act to gain access to FDA data on the drug trials for the atypicals he determined:
One in every 145 patients died but the deaths were not mentioned in the scientific literature.



The trials were structured to favor the atypicals and most of the reports were discounted by the FDA as being biased.


One in every thirty-five patients in Risperdal trials experienced a serious adverse event, defined by the FDA as a life threatening or one that required hospitalization.


The atypicals did not demonstrate superior effectiveness or safety over the older antipsychotics.
In addition, persons on atypicals have been found to commit suicide 2 to five times more often than schizophrenics in general. According to Whitaker, "researchers in Ireland reported in 2003 that since the introduction of the atypical antipsychotics, the death rate among people with schizophrenia has doubled."

For instance, in October 2004, researchers from the Johns Hopkins Children's Center reported that atypicals were found to trigger insulin resistance in children, a condition that increases the risk of developing type-2 diabetes and heart disease later in life.

Results of the study were presented at October 20, 2004, annual meeting of the American Academy of Child and Adolescent Psychiatry in Washington, DC.

In this study, the research team evaluated 11 children, some overweight and others obese, who gained significant amounts of weight while taking the drugs. Weight gain is a common side effect of the drugs, and is one of the factors that can contribute to insulin resistance.

Insulin resistance is said to occur when muscle, fat, and liver cells do not properly use insulin, which is produced by the pancreas to help cells absorb glucose and provide energy.

When resistance occurs, the pancreas tries to keep up with the demand for insulin by producing more until it eventually cannot keep up with the body's need for insulin, and then excess glucose builds up in the bloodstream which can lead to an increased risk of developing type-2 diabetes, heart disease, and stroke.

All six children in the study who were on moderate or high doses of one of the atypicals, and three out of 5 children who were on low doses, developed symptoms of insulin resistance.

The evidence in the trial indicating the condition included hypertension, high levels of triglycerides, increased levels of protein in the urine, and low levels of high density lipoprotein cholesterol.

"The insulin resistance seen in these children was greater than what would be expected from weight gain alone, suggesting there is a factor distinct from excess weight that directly induces insulin resistance," according to the study's lead author, Mark Riddle, MD, director of the division of child and adolescent psychiatry at the Children's Center.

Basically to find out how the new atypicals worked in comparison to each other and to determine whether the drugs were worth the cost, the National Institute of Mental Health (NIMH) decided to fund an 18 month study titled, Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE).

(SERIOUS HIGHLIGHT HERE!)The results of the study were published in the September 22, 2005, New England Journal of Medicine and revealed that the drugs were barely more effective than no drugs at all.

The study enrolled 1,500 schizophrenic patients from 27 medical centers across the US. Neither the patients nor the doctors knew whether a patient was getting Zyprexa, Seroquel, Risperdal, Geodon, or Trilafon.

The scientists included Trilafon to represent the older generation of antipsychotic drugs.

$44 million later, the CATIE report concluded that the new atypicals "have no substantial advantage" over the old ones.

While Zyprexa turned out to be the most effective, it also had the greatest number of side effects.

The second most effective drug was Trilafon which stunned researchers. "The biggest surprise was that the oldest medication was comparable to at least three of the new medications and not much worse than Zyprexa," said Dr Jeffrey Lieberman, MD, who led the study.

Scientists involved in designing the study debated on whether to even include Trilafon, according to researcher, Robert Rosenheck, MD. "Many of us thought the question was decided and the old drugs were of no value," he said in a news conference.

Researcher, Robert Freedman, MD from the University of Colorado, published an editorial to accompany the report in the NEJM.

"No drug provided the majority of patients a treatment that lasted the full 18 months of the study," he wrote. "Only 36% of the patients receiving the most effective drug completed the trial," Dr Freedman said.

In the end, 74% of patients elected to seek some other treatment rather than stay on their assigned medication. "The results could be viewed as discouraging," Dr Freedman wrote.

In what outraged critics are calling a blatant tax dollar funded marketing scheme, on May 1, 2006, the New York Times, revealed that "psychiatric researchers have been experimenting with a bold and controversial treatment strategy: they are prescribing drugs to young people at risk for schizophrenia who have not yet developed the full-blown disorder."

The findings from the trial, published in the May 2006 American Journal of Psychiatry, "suggest that this preventive approach is more difficult to put into effect - and more treacherous - than scientists had hoped," the NYTs says.

The study was co-funded by Eli Lilly and the National Institute of Mental Health and involved 60 patients, mostly adolescents, who supposedly scored high on a scale that assesses the risk for psychosis. The scale rates the severity of over a dozen symptoms, that include categories such as grandiosity, suspiciousness, and bizarre thoughts.

From 20 to 45% of people who score high will go on to develop full-blown psychosis, in which the symptoms become extreme, researchers claim.

The trail subjects were divided into 2 groups, with one group receiving drugs and the other placebos.

In the first year of what was slated to be a 2-year trial, five of the 31 patients on medication developed full-blown psychosis, compared to 11 of the 29 subject on placebos.

However, by the end of the first year, more than two-thirds of the patients had quit, making it impossible to interpret any differences between the 2 groups.

The report said that some subjects dropped out without explaining why; others moved; and 10 quit because they either felt the drug was not helping, could not make the appointments or did not like the side effects.

The only undisputable result was that patients taking medication gained an average of 20 pounds, once again verifying a side effect that has been documented for 15 years.

The prices charged for these drugs are over the top and their increased use, along with a few other types of psychiatric drugs, is in large part responsible for the escalating prescription drug costs.

The Medco Health Solution study determined that since 2001, antipsychotic costs for children have increased 196%, or nearly tripled, due to the increase in prescriptions written and the use of the new atypicals with children 97% of the time, rather than the older drugs that sell for only a fraction of prices charged for atypicals

Overall, in 2002, the total sales of antypicals to patients of all ages reached $6.4 billion, making them the fourth-highest-selling class of drugs in the US, according to IMS Health, a company that tracks drug sales.

Two years later in 2004, total sales had jumped more than $2 billion to $8.8 billion, with $2.4 billion of that amount paid by state Medicaid funds, according to the May/June 2005 issue of Mother Jones Magazine.

Schizophrenia drugs account for the biggest share of the $39 billion that states spend each year on prescription drugs.

On October 23, 2005, the San Francisco Chronicle reported that nationwide, "Medicaid programs purchase an estimated 60 to 75 percent of antipsychotic drugs."

The highest expenditure for California's Medicaid, was Zyprexa at close to $250 million for the year that ended June 2005. Risperdal and Seroquel, ranked 2nd and 4th in the list of high cost drugs funded by Medicaid.

The costliest per month is Zyprexa, at an average cost of $399.26, according to the California Department of Health Services.

In 2002, the Kentucky Medicaid program ended up with a $230 million deficit and the $36 million bill for Zyprexa was the state's largest per drug expense.

Judging by third quarter earning reports for 2005, fifteen years of negative studies have had no effect on sales that show:


Seroquel, $706 million, up 32%

Abilify, $206 million, up 58%

Geodon, $148 million, up 18%

Zyprexa, $1.035 billion, up 1%
In a disgusting twist of fate, Zyprexa's maker, Eli Lilly's diabetes drugs earned $653 million, up 13% when Zyprexa has consistently been found to be most likely drug to cause weight gain and high blood sugar leading to diabetes.

Risperdal is still Johnson & Johnson's top-selling drug, and had sales of $916 million in the 3rd quarter, up 23% from the same period a year earlier.

This great news for J&J but translates into 916 fatalities for Risperdal patients, according to estimates by Allen Jones, a former investigator in the Pennsylvania Office of the Inspector General, who says, "my best effort at correlating dollars spent with deaths from drug side effects suggests that people may be dying from side effects from the schizophrenia drugs alone at the rate of at least one death for each one million dollars spent on these drugs."

"The actual numbers may reflect a much higher death rate," he warns.





http://www.lawyersandsettlements.com/articles/antipsychotics


Edited by YawningAnus (10/23/07 07:45 PM)


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OfflineCrystal G
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Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: LiquidSmoke]
    #7551945 - 10/23/07 07:40 PM (13 years, 9 months ago)

Quote:

LiquidSmoke said:
Quote:

Crystal G said:
lol, i still dont understand where the lie is, you continue accusing (repetitiously i might add) but in reality youre pulling strings and gathering nothing. If you're so sure it's a bold-faced lie, then fucking call me out on it already. Come on, quit repeating yourself. Just because you say something over and over again doesn't make it credible or true, lol.





you've been trying so hard to get at it, why would you be unless you knew you WERE lying?


uhhh...because you're LYING?


What's funny is that someone who had actually experienced such similar things would be able to point out what came out of that creative imagination of yours.




Okay, I somehow missed this completely illogical statement and couldn't resist from responding.

This argument is a fallacy. If somebody vehemently accuses me of being something that puts my reputation and credibility at stake, of course I am going to defend myself to put such rumors to a stop.

Get a clue: If somebody accuses you of stealing--when you clearly didn’t--wouldn’t you attempt to defend yourself? If somebody labels you a homo when you obviously are not, wouldn’t you at the very least, deny it?

So please, cut the crap unless you have a valid point to make.


Anyways, back to mental health:
Quote:

Most of the abuse that occurs in mental institutions involve seclusion and restraints, or restraining a patient who is deemed "violent". Why does such abuse occur? Well, studies show that most mental health care workers, sometimes called orderlies, are over-worked and underpaid. In almost every state across the nation, most mental health caretakers are paid minimum wage and receive no benefits. The also receive little or no training, outside of required courses on how to properly restrain a person.

One would think that mental health workers would receive higher pay and more training, given the fact that they are taking people's lives into their hands each time they go to work. Unfortunately, the burnout rate for mental health workers is high, so a lot of hospitals do not want to invest a lot of time or money in the workers they hire. This results in more patients being locked up instead of treated as they should be. The hospitals are ill-equip to deal with what is considered a "special population". With some hospitals, it seems like no one cares about the fact that they have peoples' lives placed in their hands.

Concerns of administrative duties and funding drown out necessary concerns for the patients themselves.
At press time, no national standards exist for the use of restraints, nor is there a comprehensive reporting system in place for incidents that occur from the misuse of seclusion and restraints. Due to this, it is difficult to determine the nature or the number of abusive incidents within hospitals, without going to each and every facility and researching their individual records. Organizations like the National Alliance For The Mentally Ill have special task forces in place to research abuse in hospitals, and have report cards on the most widely known institutions. You can find NAMI's report card at , as well as more resources for making sure you or your loved ones receive the best care from reputable facilities with good track records. A recent investigation conducted by the Hartford Courand exposed the deaths of 142 patients in just one hospital alone; this is the kind of hospital one would want to avoid at all costs. If it is at all possible, research the records of a psychiatric or mental health facility prior to admittance. During an emergency or crisis situation, county hospitals are usually good for the initial intake and assessment process; it is the long-term care facilities one must concern themselves with.




More to be read here: http://www.suite101.com/article.cfm/mental_health_advocacy/35970

http://www.mental-health-abuse.org/realCrisis14.html

If you experience any psychiatric abuse, you can file a complaint to the Citizens' Commission on Human Rights (CCHR).


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OfflineSneezingPenis
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Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: Crystal G]
    #7552017 - 10/23/07 07:56 PM (13 years, 9 months ago)

regarding ECT....

Quote:

Can ECT Permanently Harm the Brain?
Donald I. Templer and David M. Veleber
Clinical Neuropsychology (1982) 4(2): 62-66

Literature relevant to the question of whether ECT permanently injures the brain was reviewed. Similar histological findings of epileptics and patients who had received ECT were discussed. Experimental research with animals seems to have demonstrated both reversible and nonreversible pathology. Psychological test findings, even when attempting to control for possible pre-ECT differences, seem to suggest some permanent cognitive deficit. Reports of spontaneous seizures long after ECT would appear to point to permanent brain changes. Human brain autopsies sometimes indicate and sometimes do not indicate lasting effects. It was concluded that vast individual differences are salient, that massive damage in the typical ECT patient is unlikely, and that irreversible changes probably do occur in some patients.

This review centers around five areas germane to the question of whether electroconvulsive therapy (ECT) causes permanent brain pathology. Relatively indirect evidence is provided by two of these areas, the brain condition of epileptics and the examination of animal brains after experimental ECT. The other three areas are psychological testing findings with history of many ECTs, spontaneous seizures, and autopsy findings. The review does not concern the extensive literature that shows that ECT temporarily impairs cognitive functioning. Such literature eventually shows impairment beginning with the first ECT and becoming progressively worse with succeeding treatments. Improvement occurs following the course of ECT, sometimes with the tested functioning actually being higher than the pretreatment level ­ which is presumed to have been impaired by psychopathology such as thought disorder and depression. Reviews of this literature can be found elsewhere (American Psychiatric Association, 1978; Campbell, 1961; Dornbush, 1972; Dornbush and Williams, 1974; Harper and Wiens, 1975), as can reviews indicating that the unilateral ECT (applied to the right side) in increasing usage in recent years causes less impairment than bilateral ECT (American Psychiatric Association, 1978; d'Elia, 1974; Hurwitz, 1974; Zamora and Kaelbing, 1965). This literature is really not very relevant to the central issue of our review. It has never been disputed that cognitive impairment occurs after ECT. Even the most fervent and excathedra defenders acknowledge that "temporary" impairment occurs. It is the issue of permanency that has been controversial.

THE BRAINS OF EPILEPTICS

It would seem that if an epileptic grand mal seizure produces permanent brain changes, then an electrically induced convulsion should also do so. In fact, inspecting the evidence with respect to epileptics may provide us with a conservative perspective in regard to ECT since the latter could produce damage from the externally applied electrical current as well as from the seizure. Experimental research with animals has shown that the electric shocks (not to the head) produce more deleterious effects in the central nervous system than any other locality or system of the body. More pertinent are the studies of Small (1974) and of Laurell (1970) that found less memory impairment after inhalant induced convulsions than ECT. And, Levy, Serota and Grinker (1942) reported less EEG abnormality and intellectual impairment with pharmacologically induced convulsions. Further argument provided by Friedberg (1977) is the case (Larsen and Vraa-Jensen, l953) of a man who had been given four ECTs, but did not convulse. When he died three days later, a subarachnoid hemorrhage was found in the upper part of the left motor region at the site where an electrode had been applied.

A number of post-mortem reports on epileptics, as reviewed by Meldrum, Horton, and Brierley (1974) have indicated neuronal loss and gliosis, especially in the hippocampus and temporal lobe. However, as Meldrum et al. pointed out, on the basis of these post-mortem reports, one does not know whether the damage was caused by the seizures or whether both were caused by a third factor intrinsic to the epilepsy. To clarify this issue, Meldrum et al. pharmacologically induced seizures in baboons and found cell changes that corresponded to those in human epileptics.

Gastaut and Gastaut (1976) demonstrated through brain scans that in seven of 20 cases status epilepticus produced brain atrophy. They reasoned that "Since the edema and the atrophy were unilateral or bilateral and related to the localization of the convulsions (unilateral or bilateral chronic seizures), the conclusion can be drawn that the atrophic process depends upon the epileptic process and not on the cause of the status."

A common finding in epileptics and ECT patients is noteworthy. Norman (1964) stated that it is not uncommon to find at autopsy both old and recent lesions in the brains of epileptics. Alpers and Hughes (1942) reported old and recent brain lesions associated with different series of ECT.

ANIMAL BRAINS

There are a number of articles concerning the application of ECT and subsequent brain examination in animals. In the 15 study review of Hartelius (1952), 13 of the 15 reported pathological findings that were vascular, glial or neurocytological, or (as was generally the case) in two or three of these domains. However, as Hartelius pointed out, inferences of these studies tended to be conflicting because of different methods used and because of deficient controls. The research that Hartelius himself carried out was unquestionably the outstanding study in the area with respect to methodological sophistication and rigor. Hartelius employed 47 cats; 31 receiving ECT, and 16 being control animals. To prevent artifacts associated with the sacrificing of the animals, the cerebrums were removed under anesthesia while the animals were still alive. Brain examinations were conducted blindly with respect to ECT vs. control of subject. On a number of different vascular, glial, and neuronal variables, the ECT animals were significantly differentiated from the controls. The animals that had 11-16 ECTs had significantly greater pathology than the animals that had received four ECTs. Most of the significant differences with respect to reversible type changes. However, some of the significant differences pertained to clearly irreversible changes such as shadow cells and neuronophagia.

PSYCHOLOGICAL TEST FINDINGS WITH HISTORY OF MANY ECTS

There have been several studies regarding the administration of psychological tests to patients with a history of many ECTs. Unfortunately, all were not well controlled. Rabin (1948) administered the Rorschach to six chronic schizophrenics with a history of from 110 to 234 ECTs. Three patients had 6, two had 4, and one had 2 Piotrowski signs. (Piotrowski regards five or more as indicating organicity.) However, control subjects were not employed. Perlson (1945) reported the case of a 27-year-old schizophrenic with a history of 152 ECTs and 94 Metrozol convulsions. At age 12 he received an IQ of 130 on the Stanford Achievement Test; at age 14 an IQ of 110 on an unspecified general intelligence test. At the time of the case study, he scored at the 71st percentile on the Otis, at the 65th percentile on the American Council on Educational Psychological Examination, at the 77th percentile on the Ohio State Psychological Examination, at the 95th percentile for engineering freshman on the Bennett Test of Mechanical Comprehension, at the 20th percentile on engineering senior norms and at the 55th percentile on liberal arts students' norm on a special perception test. These facts led Perlson to conclude that convulsive therapy does not lead to intellectual deterioration. A more appropriate inference would be that, because of the different tests of different types and levels and norms given at different ages in one patient, no inference whatsoever is justified.

There are two studies that provide more methodological sophistication than the above described articles. Goldman, Gomer, and Templer (1972) administered the Bender-Gestalt and the Benton Visual Retention Test to schizophrenics in a VA hospital. Twenty had a past history of from 50 to 219 ECTs and 20 had no history of ECT. The ECT patients did significantly worse on both instruments. Furthermore, within the ECT groups there were significant inverse correlations between performance on these tests and number of ECTs received. However, the authors acknowledged that ECT-caused brain damage could not be conclusively inferred because of the possibility that the ECT patients were more psychiatrically disturbed and for this reason received the treatment. (Schizophrenics tend to do poorly on tests of organicity.) In a subsequent study aimed at ruling out this possibility, Templer, Ruff, and Armstrong (1973) administered the Bender-Gestalt, the Benton, and the Wechsler Adult Intelligence Scale to 22 state hospital schizophrenics who had a past history of from 40 to 263 ECTs and to 22 control schizophrenics. The ECT patients were significantly inferior on all three tests. However, the ECT patients were found to be more psychotic. Nevertheless, with degree of psychosis controlled for, the performance of the ECT patients was still significantly inferior on the Bender-Gestalt, although not significantly so on the other two tests.

SPONTANEOUS SEIZURES

It would appear that if seizures that were not previously evidenced appeared after ECT and persisted, permanent brain pathology must be inferred. There have been numerous cases of post-ECT spontaneous seizures reported in the literature and briefly reviewed by Blumenthal (1955, Pacella and Barrera (1945), and Karliner (1956). It appears that in the majority of cases the seizures do not persist indefinitely, although an exact perspective is difficult to obtain because of anticonvulsant medication employed and the limited follow-up information. another difficulty is, in all cases, definitively tracing the etiology to the ECT, since spontaneous seizures develop in only a very small proportion of patients given this treatment. Nevertheless, the composite of relevant literature does indicate that, at least in some patients, no evidence of seizure potential existed before treatment and post-ECT seizures persist for years.

An article that is one of the most systematic and representative in terms of findings is that of Blumenthal (1955) who reported on 12 schizophrenic patients in one hospital who developed post-ECT convulsions. Six of the patients had previous EEGs with four of them being normal, one clearly abnormal, and one mildly abnormal. The patients averaged 72 ECTs and 12 spontaneous seizures. The time from last treatment to first spontaneous seizure ranged from 12 hours to 11 months with an average of 2 and 1/2 months. The total duration of spontaneous seizures in the study period ranged from 1 day to 3 and 1/2 years with an average of 1 year. Following the onset of seizures, 8 of the 12 patients were found to have a clearly abnormal, and 1 a mildly abnormal EEG.

Mosovich and Katzenelbogen (1948) reported that 20 of their 82 patients had convulsive pattern cerebral dysrhythmia 10 months post ECT. None had such in their pre-treatment EEG. Nine (15%) of the 60 patients who had 3 to 15 treatments, and 11(50%) of the 22 patients who had from 16 to 42 treatments had this 10 month posttreatment dysrhythmia.

HUMAN BRAIN AUTOPSY REPORTS

In the 1940s and 1950s there were a large number of reports concerning the examination of brains of persons who had died following ECT. Madow (1956) reviewed 38 such cases. In 31 of the 38 cases there was vascular pathology. However, much of this could have been of a potentially reversible nature. Such reversibility was much less with the 12 patients who had neuronal and/or glial pathology. The following are the comments pertaining to the neuronal and glial pathology and the amount of time between last treatment and death: "Gliosis and fibrosis" (5 months); "Small areas of cortical devastation, diffuse degeneration of nerve cells", "Astrocytic proliferation" (1 hour, 35 minutes); "Small areas of recent necrosis in cortex, hippocampus and medulla", "Astrocytic proliferation" (immediate); "Central chromatolysis, pyknosis, shadow cells (15 to 20 minutes); "Shrinking and swelling. ghost cells", "Satellitosis and neuronophagia" (7 days); "Chromatolysis, cell shrinkage''. "Diffuse gliosis, glial nodules beneath the ependyma of the third ventricle" (15 days); "Increased Astrocytes" (13 days); "Schemic and pyknotic ganglion cells" (48 hours); "Pigmentation and fatty degeneration, sclerotic and ghost cells", "Perivascular and pericellular gliosis" (10 minutes); "Decrease in ganglion cells in frontal lobes, lipoid pigment in globus pallidus and medical nucleus of thalamus", "Moderate glial proliferation" (36 hours); "Glial fibrosis in marginal layer of cortex, gliosis around ventricles and in marginal areas of brain stem, perivascular gliosis in white matter" (immediate); "Marginal proliferation of astrocytes, glial fibrosis around blood vessels of white matter, gliosis of thalamus, brain stem and medulla" (immediate). In one case the author (Riese, 1948), in addition to giving the neuronal and glial changes, reported numerous slits and rents similar to that seen after execution. Needless to say, patients who died following ECT are not representative of patients receiving ECT. They tended to be in inferior physical health. Madow concluded, on the basis of these 38 cases and 5 of his own, "If the individual being treated is well physically, most of the neuropathological changes are reversible. If, on the other hand, the patient has cardiac, vascular, or renal disease, the cerebral changes, chiefly vascular, may be permanent."

CONCLUSION

A wide array of research and clinical based facts that provide suggestive to impressive evidence in isolation, provide compelling evidence when viewed in a composite fashion. Some human and animal autopsies reveal permanent brain pathology. Some patients have persisting spontaneous seizures after having received ECT. Patients having received many ECTs score lower than control patients on psychological tests of organicity, even when degree of psychosis is controlled for.

A convergence of evidence indicates the importance of number of ECTs. We have previously referred to the significant inverse correlations between number of ECTs and scores on psychological tests. It is conceivable that this could be a function of the more disturbed patients receiving more ECTs and doing more poorly on tests. However, it would be much more difficult to explain away the relationship between number of ECTs received and EEG convulsive pattern dysrhythmia (Mosovich and Katzenelbogen, 1948). No patients had dysrhythmia prior to ECTs. Also difficult to explain away is that in Table I of Meldrum, Horton and Brierley (1974), the nine baboons who suffered brain damage from experimentally administrated convulsions tended to have received more convulsions than the five that did not incur damage. (According to our calculations, U=9, p < .05 ) And, as already stated, Hartelius found greater damage, both reversible and irreversible, in cats that were given 11 to l6 than in those given 4 ECTs.

Throughout this review the vast individual differences are striking. In the animal and human autopsy studies there is typically a range of findings from no lasting effect to considerable lasting damage with the latter being more of the exception. Most ECT patients don't have spontaneous seizures but some do. The subjective reports of patients likewise differ from those of no lasting effect to appreciable, although usually not devastating impairment. The fact that many patients and subjects suffer no demonstrable permanent effects has provided rationale for some authorities to commit the non-sequitur that ECT causes no permanent harm.

There is evidence to suggest that pre-ECT physical condition accounts in part for the vast individual differences. Jacobs (1944) determined the cerebrospinal fluid protein and cell content before, during, and after a course of ECT with 21 patients. The one person who developed abnormal protein and cell elevations was a 57-year-old diabetic, hypertensive, arteriosclerotic woman. Jacobs recommended that CSF protein and cell counts be ascertained before and after ECT in patients with significant degree of arteriosclerotic or hypertensive disease. Alpers (1946) reported, "Autopsied cases suggest that brain damage is likely to occur in conditions with pre-existing brain damage, as in cerebral arteriosclerosis." Wilcox (1944) offered the clinical impression that, in older patients, ECT memory changes continue for a longer time than for younger patients. Hartelius (1952) found significantly more reversible and irreversible brain changes following ECT in older cats than younger cats. Mosovich and Katzenelbogen (1948) found that patients with pretreatment EEG abnormalities are more likely to show marked post-ECT cerebral dysrhythmia and to generally show EEGs more adversely affected by treatment.

In spite of the abundance of evidence that ECT sometimes causes brain damage, the Report of The Task Force on Electroconvulsive Therapy of the American Psychiatric Association (1978) makes a legitimate point in stating that the preponderance of human and animal autopsy studies were carried out prior to the modern era of ECT administration that included anesthesia, muscle relaxants, and hyperoxygenation. In fact, animals which were paralyzed and artificially ventilated on oxygen had brain damage of somewhat lesser magnitude than, although similar patterns as, animals not convulsed without special measures. (Meldrum and Brierley, 1973; Meldrum, Vigourocex, Brierley, 1973). And it could further be maintained that the vast individual differences stressed above argue for the possibility of making ECT very safe for the brain through refinement of procedures and selection of patients. Regardless of such optimistic possibilities, our position remains that ECT has caused and can cause permanent pathology.





I would like you to read through the entire thing, because it almost seems as if the person writing it, really didnt want some of it to be true. But I would still say that the article is unbiased, and if it is biased in any direction, it is so in favor of psychiatry and ECT, if not only to give it the benefit of the doubt.

but if you really dont feel like reading it, just read the very last line and we can be done with this ridiculous conversation of whether or not ECT is harmful or not.

let me give it to you again...

Quote:

Regardless of such optimistic possibilities, our position remains that ECT has caused and can cause permanent pathology.





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OfflineSneezingPenis
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Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: SneezingPenis]
    #7552026 - 10/23/07 07:58 PM (13 years, 9 months ago)

http://www.ect.org/effects/templer.html

that is the link.... I think the shroomery is acting up, it wouldnt let me edit the last post.

Oh also, that was a response to badchad, not you crystal G.


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Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: SneezingPenis]
    #7552036 - 10/23/07 08:02 PM (13 years, 9 months ago)

Quote:

YawningAnus said:



Quote:

this is also a pretty big misinterpretation on your part

off-label use drugs are designed, in fact that entire policy was made, for purposes of medical research, seeing if certain drugs have other interactional benefits.

You're also forgetting that in many drugs, which have multiple beneficial mechanisms, are used as off-label prescriptions simply because the given medical indication doesn't point to the drug's original purpose....And in many cases, work BETTER than the intended use of the drug.

Go look up the following drugs:

Verapamil, disopyramide, phenylephrine, fludrocortisone, amiodarone, ipratropium...




I dont see how I am misinterpreting this. Maybe you mean that I am not using your optimism on the subject. If I have a drug that was designed for regulating blood pressure, and find that it also help hemophiliacs clot..... which is easier to get it passed by the FDA?
Here we have millions of dollars riding on this drug being passed.... do we take the route that is easier, or harder to prove efficacy and safety?




Let me ask you a question, did you even read the point of my reply? because it sounds like you didn't even understand what i was rebutting to but instead you were too eager to run on anecdotes.

You were complaining that drugs are being used for "off label" purposes without the intent if telling the patient the drugs "original means of legalization"

I was saying how it's because alot of a drug's initial mechanisms end up not even being the more significant role of the drug.

This has nothing to do with the push of legalizing a drug with one explanation over the other.


Quote:

Drugs are regulated and approved based on the findings of the drug studies.




Do you realize that the research on alot of classes of drugs are always going on? Many times, new discoveries or scientific breakthroughs on human physiology will alter the perspective and potential of a drug which had already been released for use.

Look at the research they're doing on N.O., or beta-blocker's benefits on heart failure. Seriously, go look.

Quote:

Then , with no disclosed findings upon the intended purpose of the drug, we tell doctors that it works really well for regulating blood pressure.




So when a patient is dying of a rapid spreading infarct, and already entering comatous, it should be the doctor's duty to say

"uhm so here's the drug i'm going to give to you, it wasn't originally used to do this, but it works well on this as seen from more recent research. Here let me list you all the 95 drug interactions and possible side effects you might experience"

Quote:


doctors arent forced to tell you that the drug they are prescribing you is in fact off-label usage. You arent told that you are a guinea pig.




Research, is really an ongoing process. New benefits and mechanisms which are found continuously shape the use and promotion of drugs. There's a huge commercial pressure on the industry for sure.


You should atleast consider looking at some of the drugs I listed. Their research and molding roles as drugs have heavily changed due to modern research.


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Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: SneezingPenis]
    #7552056 - 10/23/07 08:07 PM (13 years, 9 months ago)

Quote:

YawningAnus said:
Oh also, that was a response to badchad, not you crystal G.




hehehe, i know that :wink: i've been following the thread like a good pip.


I recall one VERY depresssed patient in the psych ward who was receiving ECT, because he did not like the concept of taking prescription drugs. How they cornered him into signing the papers for this treatment, I don't even want to know. I'm sure they manipulated him somehow, he was in there longer than everybody else.

Nowadays when ECT is conducted, the patient is SUPPOSED to be passed out. However, what do they do for those who refuse to accept drug medications? I'd really like to know myself.

Also, to add to your statement, I'm pretty sure doctors have determined that if the brain is kept in a state of constant seizure for more than a few minutes, it causes demyelination.


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Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: SneezingPenis]
    #7552087 - 10/23/07 08:16 PM (13 years, 9 months ago)

Quote:

YawningAnus said:
Maybe in an hour or so I will have more time to address both of your posts more in-depth... especially, the off-label use.







thanks for posting a big link that had nothing to do about what we were debating.

I've already heard your stance on anti-psychotics, you've repeated it several times per debate.


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Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: LiquidSmoke]
    #7552268 - 10/23/07 08:59 PM (13 years, 9 months ago)

that link I posted, atleast in the beginning, was relevant to our discussion of off label use.
Atypical anti-psychotics being given to 5 year olds is rather off label wouldnt you say?
or am I wrong on that? where are all these studies that have come out in favor of showing atypical anti-psychotics are effective in treating ADD/ADHD in 5 year olds?
oh wait, there isnt any.

how does that hold up to your "doctors are prescribing off label because of new studies coming to light" theory?
frankly, i am not that against off label use for medical procedures and whatnot. I understand that each medical case is different and where one drug would work off label for someone, it wouldnt work for 1000 others with the same condition.
I get that.... granted, i am apalled at the unregulated, almost turning a blind eye, of pharm corps buying doctors to push their pills.... but I have slightly more respect for medical doctors than the lowly scum that are psychiatrists.

I think if you go back and read the entire quote that you will understand the difference between giving patient A a different medication than intended use for Problem B.... and putting children on zyprexa for being hyperactive.
There is no definitive diagnostic criteria for ADD/ADHD... in fact, nothing about the psychiatric field has been confirmed by science to be true... it is all based on theories that are loosely supported by correlation.
it isnt scientific by any means. the entire industry is working on the premise of cause and effect. Give out drugs, say it cures this disease we made up, then when people realize that it is causing health problems, and in general not working, give them the new and improved drug....


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Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: LiquidSmoke]
    #7552486 - 10/23/07 09:44 PM (13 years, 9 months ago)

Quote:

LiquidSmoke said:

You were complaining that drugs are being used for "off label" purposes without the intent if telling the patient the drugs "original means of legalization"




I dont think you understood my post. that is only a slight reason I am against off label use. Is it really hard to tell a patient "hey, this drug I am prescribing was initially designed for X, but it has shown significant promise in dealing with Y, and it has been known to cause side effects of A,B and C, have a nice day".?

there is no real definition, or diagnosis of insanity. It is purely subjective, so we cant say that "You have X, this drug was intended for Y, but has shown promise in people with X" because you can never definitively say that this person has X.
Am I wrong in asserting that the "diagnosis" and symptoms of bi-polar, anxiety, depression and a myriad of other "diseases" have huge areas of overlapping?
take a stroll through this forum and see how many people have made claims of their doctors misdiagnosing their mental disorder.


Quote:

I was saying how it's because alot of a drug's initial mechanisms end up not even being the more significant role of the drug.



yeah, but when you approve your drug for one thing, you are targeting a certain group of people, with similar conditions.... when you start Rxing off label, you are treating a different condition than was previously tested.... and this group of different conditions might have different side effects that went previously unnoticed due to the conditions of the initial test group.

Quote:

This has nothing to do with the push of legalizing a drug with one explanation over the other.



really? so doctors dont get financial incentives to push certain drugs? maybe you want to look into that before you taste your shoe.


Quote:

Quote:

Then , with no disclosed findings upon the intended purpose of the drug, we tell doctors that it works really well for regulating blood pressure.




So when a patient is dying of a rapid spreading infarct, and already entering comatous, it should be the doctor's duty to say

"uhm so here's the drug i'm going to give to you, it wasn't originally used to do this, but it works well on this as seen from more recent research. Here let me list you all the 95 drug interactions and possible side effects you might experience"







now who is being anecdotal?

I doubt in a life or death situation a doctor will risk his career because some pharm rep gave him a trip to vegas for a week to use Drug X.... but when you go to visit a doctor for a problem, and you are sitting there talking to him while he is writing out the prescription... bam, there is a great time to tell them a little about the drug.
People put too much trust in doctors, and the pharmaceutical industry has preyed upon that.


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Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: SneezingPenis]
    #7553309 - 10/24/07 01:37 AM (13 years, 9 months ago)

Quote:

YawningAnus said:


I dont think you understood my post. that is only a slight reason I am against off label use. Is it really hard to tell a patient "hey, this drug I am prescribing was initially designed for X, but it has shown significant promise in dealing with Y, and it has been known to cause side effects of A,B and C, have a nice day".?




So you're against using a drug if it's not for it's initial intended use? You just said you're against off label use.

Consent is a completely different issue. No shit it's better off the doc telling you the possible side effects of a certain drug.

Quote:

there is no real definition, or diagnosis of insanity. It is purely subjective, so we cant say that "You have X, this drug was intended for Y, but has shown promise in people with X" because you can never definitively say that this person has X.
Am I wrong in asserting that the "diagnosis" and symptoms of bi-polar, anxiety, depression and a myriad of other "diseases" have huge areas of overlapping?
take a stroll through this forum and see how many people have made claims of their doctors misdiagnosing their mental disorder.




You just went from talking about the intended drug use of a prescription to talking about why it's so hard to diagnose certain psychotic diseases. That had NOTHING to do with what we were talking about. You specifically said you're against off-label drug use, i gave you some benefits and examples, and you haven't even looked them up.



Quote:


yeah, but when you approve your drug for one thing, you are targeting a certain group of people, with similar conditions.... when you start Rxing off label, you are treating a different condition than was previously tested.... and this group of different conditions might have different side effects that went previously unnoticed due to the conditions of the initial test group.




So you're basically assuming that when a drug is being researched for it's supplementary beneficial use, that they don't also discover various side effects WITHIN those groups?

It should also be noted that many drugs have been shown to be beneficial in instances where they are counterindicated. What does that tell you?

Quote:


really? so doctors dont get financial incentives to push certain drugs? maybe you want to look into that before you taste your shoe.




do you even realize what the initial discussion was about? have you forgotten what we were talking about?

YOU SAID, and i repeat, that you oppose the use of off-label drugs, period. This had nothing to do with pushing drugs on patients, nothing to do with anti psychotics, and nothing to do with that paper you posted.

Off label drugs, that is what we're talking about. Stay on topic.


Quote:


I doubt in a life or death situation a doctor will risk his career because some pharm rep gave him a trip to vegas for a week to use Drug X.... but when you go to visit a doctor for a problem, and you are sitting there talking to him while he is writing out the prescription... bam, there is a great time to tell them a little about the drug.
People put too much trust in doctors, and the pharmaceutical industry has preyed upon that.




you were talking specifically about the use of blood pressure medication, do you realize the majority of blood pressure medication is used during emergency situations?

antiarrythmics anyone? can you stay on topic instead of using this oppurtunity to go off on a soap box that really has nothing to do with what we're talking about?


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Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: SneezingPenis]
    #7553311 - 10/24/07 01:39 AM (13 years, 9 months ago)

Quote:

YawningAnus said:

frankly, i am not that against off label use for medical procedures and whatnot.





Quote:

YawningAnus said:
that is only a slight reason I am against off label use.





Uhhhhh ok. We'll end it there.


Wieeerrrrdoooo. I just think getting into extensive shroomery debates gives you some sort of emotional pleasure.


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Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: LiquidSmoke]
    #7553390 - 10/24/07 02:21 AM (13 years, 9 months ago)

ok, you say I am going off topic, and I say that my last 4 posts excluding the ECT one, is dealing with some of the reasons why I am against off label use.


you are just skirting around the issue.

I cant tell if you are really this oblivious, or if this is some debating tactic.... but here is an example of why I am the one who is being on topic, and you are wasting time on semantics and non-sequitir positioning.

you said
Quote:

This has nothing to do with the push of legalizing a drug with one explanation over the other.




then I replied
Quote:

really? so doctors dont get financial incentives to push certain drugs? maybe you want to look into that before you taste your shoe.




then you said
Quote:

do you even realize what the initial discussion was about? have you forgotten what we were talking about?





Dont you understand that off label use is basically a way to bypass the FDA? It is kind of like lobbying. let me break this down for you like I am talking to a 4 year old.
like a politician, corporations need people. Politicians need people to vote them into office, and corporations need people to buy their product or service.
But once a politician is voted into office, he really doesnt need the people anymore... that is where the lobbyist comes in. He buys his vote so that they can get their financial and future intrests cemented into law.
Much liek the politician, some corporations have products that have been considered a neccesity.... so, once you have a product that is a neccessity, you really dont have to pander to the consumers (the people).... and these people place an unwavering trust in their doctor, who is in turn bribed, much like the politician in our other story, to push designer and name brand drugs for intended as well as off-label use.

Do you seriously not see how this is relevant to our discussion? maybe you need a flow chart...
people trust doctors ----> doctors get financial incentives to make decisions that arent always in the best intrest of the health of thir patient ----> they prescribe them the drugs they were paid to prescribe by the pharmaceutical company ----> pharmaceutical company sits on a big pile of money that it got from bankrupting state funded medicare.


yes, I am against off label use.... as it is right now. why? because it isnt regulated.... at all. In fact, the only thing that is a retarding force in the free-for-all prescription fest is the threat of malpractice lawsuits.... which the pharmaceutical industry doesnt have to worry about, but rather the doctors, even though they are insured for such things.

you are acting as if off label use as it stands right now is some do-or-die problem, that cannot have a compromise. I agree that in certain situations a doctor needs to use off label use at his discretion.... but there needs to be more rules.

and I wasnt discussing blood pressure medications really, I was just using that as an example. One you obviously seemed to have missed.

Quote:

So you're basically assuming that when a drug is being researched for it's supplementary beneficial use, that they don't also discover various side effects WITHIN those groups?

It should also be noted that many drugs have been shown to be beneficial in instances where they are counterindicated. What does that tell you?




1) who is carrying out these studies? I will find it if you want, but I remember reading an article about something the FDA said regarding how they are unable to supervise even a fraction of these studies and are forced to take these companies words for their findings.
2) I dont doubt that some drugs have benefits beyond their intended use, just as much as they find more side effects beyond their initial studies.


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Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: SneezingPenis]
    #7553411 - 10/24/07 02:28 AM (13 years, 9 months ago)

lol, he thinks youre going off-topic because he doesn't realize that all the issues you discussed are actually INTERCONNECTED. LMFAO!!!


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Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: SneezingPenis]
    #7553438 - 10/24/07 02:42 AM (13 years, 9 months ago)

I think if a drug is going to be used for off-label purposes, the patient needs to be aware that the drug isn't being prescribed for its typical treatment.  If a doctor told me "this drug is prescribed for ____ but has shown promise in treating ____.  Using it for this purpose is still relatively new, would you like to give it a try" I would most likely be cool with it.  On the other hand, if I was prescribed something off-label, which ended up causing more harm than good, I'd be very pissed.

A lot of you are being too general with your judgments.  Some doctors do care about pushing a drug, while others care more about helping the patient.  In the past, I was prescribed Paxil.  The doctor warned me of all the possible side-effects, told me I can expect it to take 2 or more weeks to begin feeling the effects, and that it could make me drowsy.  This doctor also went on to help me get set up with a counselor.

Recently, I was prescribed alprazolam (Xanax) by a doctor.  Depression isn't really a problem anymore (thanks to psylocybin adventures), but anxiety continues to be an issue.  I was worried about being prescribed another (ineffective) SSRI, and chose to pump my leg to increase heartrate and think of things that usually upset my anxiety just to make sure I would get something different.  In less than 5 minutes, the doctor had a prescription for Xanax made and was out the door.  Honestly, I was somewhat upset that he would be so quick to prescribe a benzodiazepam without telling me ANY side effects, dangers, withdrawals, etc.  Originally he was going to write a 3 month prescription for 2mg a day, but changed his mind and decided to prescribe it for a month, advising me that if it works to try taking half a dose (.5mg) at a time and see how it does.  This is the only "responsible" thing I feel that he did.  He asked if I smoke or drink, and I told him not much smoking but I do drink, and he didn't even advise me of the possible amnesia when mixing alcohol and xanax:mad:

Alprazolam isn't the most dangerous prescription by far, but it has a great potential for being problematic.  It just kind of bugged me that he was so quick to prescribe a benzo without telling anything about them.  If the prescriptions didn't come with an information sheet, I'd be even more upset, even though I'm sure 90% of patients don't even read/comprehend it.

My point is, every doctor is different.  Generalizing that ALL doctors are bad or good is not a great idea.  Some (maybe most?) are out there to help people.


--------------------
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OfflineLiquidSmoke
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Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: SneezingPenis]
    #7553443 - 10/24/07 02:43 AM (13 years, 9 months ago)

Quote:

YawningAnus said:
ok, you say I am going off topic, and I say that my last 4 posts excluding the ECT one, is dealing with some of the reasons why I am against off label use.

you are just skirting around the issue.

I cant tell if you are really this oblivious, or if this is some debating tactic.... but here is an example of why I am the one who is being on topic, and you are wasting time on semantics and non-sequitir positioning.





the post above you, shows you're pretty much wasting your own time contradicting yourself.

Quote:


Dont you understand that off label use is basically a way to bypass the FDA?




Don't you understand that has nothing to do with the initial purpose of off label use? Something that you haven't even acknowledged yet? Do you even read my rebuttals?

Quote:

Do you seriously not see how this is relevant to our discussion? maybe you need a flow chart...
people trust doctors ----> doctors get financial incentives to make decisions that arent always in the best intrest of the health of thir patient ----> they prescribe them the drugs they were paid to prescribe by the pharmaceutical company ----> pharmaceutical company sits on a big pile of money that it got from bankrupting state funded medicare.




Once again i'll ask you since you love being on such a soap box of an entire debate that still has very little relevance to what we're talking about.

You said, you were, against off label drug use. If one of your primary reasons is because of the pill pushing on doctors, you're using a pretty weak example, considering:

#1 the issue of pill pushing is mainly for the use of specialized renditions of generic drugs, while very few off-label drugs are even the primary concern of pharmaceutical reps' influence on doctors.

SO again i ask you, what the hell was the point of that big paper?

#2 you're going way off topic, diverting the issue to something that is only one small facet about the pros and cons of allowing off-label drug use.

You're failing to realize, that I never said pill pushing wasn't a factor in the problem of off-label drug use, NO SHIT it is. You spent too little time actually trying to address what i initially posted, which was the original purpose of off-label drug use. And you spent too much time posting things and creating a side-debate talking about pill-pushing when you weren't even considering that i've already, along long time ago in this thread, acknowledged that pill pushing is a problem.

Reading comprehension failure? Go look up, it's there.


Quote:

yes, I am against off label use.... as it is right now. why? because it isnt regulated.... at all. In fact, the only thing that is a retarding force in the free-for-all prescription fest is the threat of malpractice lawsuits.... which the pharmaceutical industry doesnt have to worry about, but rather the doctors, even though they are insured for such things.




So every single drug that's out there, that's being used for multiple purposes, should only be used for their intended purpose.

That's basically what you're getting at. If you're against off label use, that means you're against the use of drugs outside of their originally intended purpose, right? Since that's the definition of "off label use".

Quote:

you are acting as if off label use as it stands right now is some do-or-die problem, that cannot have a compromise.




Do you even know about all the different drugs used in emergency situations...which are considered "off label"? Do you?

Quote:


1) who is carrying out these studies? I will find it if you want, but I remember reading an article about something the FDA said regarding how they are unable to supervise even a fraction of these studies and are forced to take these companies words for their findings.




Uhhh it's been a pretty familiar breakthrough recently in pharmaceuticals that the effects of beta-blockers are actually beneficial in heart failure situations, something previously considered a counter indication.

Why?

Because the advent of more recent research has shed new light on the drug's regulation of hormonal synthesis.

But i guess the drug shouldn't be used for heart failure, since it would be considered an "off label" use of the drug, right?



Quote:

2) I dont doubt that some drugs have benefits beyond their intended use, just as much as they find more side effects beyond their initial studies.





Really, so you just assume this, without even following the research being done on various drugs already placed in the market?

You truely believe that a drug's additional discovered benefits wouldn't be able to override it's side effects? Are you making a general statement about every single drug being researched out there?


--------------------
"Shmokin' weed, Shmokin' wizz, doin' coke, drinkin' beers.  Drinkin' beers beers beers, rollin' fatties, smokin' blunts.  Who smokes tha blunts?  We smoke the blunts" - Jay and Silent Bob strike Back


Edited by LiquidSmoke (10/24/07 03:09 AM)


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OfflineLiquidSmoke
My title's cooler than yours DBK


Registered: 09/04/01
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Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: SneezingPenis]
    #7553518 - 10/24/07 03:18 AM (13 years, 9 months ago)

Quote:

YawningAnus said:

Quote:

This has nothing to do with the push of legalizing a drug with one explanation over the other.



really? so doctors dont get financial incentives to push certain drugs? maybe you want to look into that before you taste your shoe.







this is the PERFECT EXAMPLE of you shifting topics in some sort of mental confusion.

How did you go from talking about the off-label use definition being used as an FDA approval mechanism, something that had nothing to do with my initial mentioning of the benefits of off-label use,

to talking about me all of a sudden not believing doctor's recieve incentives for pushing drugs onto their patients?

What does pushing pills on doctors as off-label use have ANYTHING TO DO WITH the pharmaceutical company's alteration of the drug's intended use in order to get FDA approval?

Did you even understand the context of my rebuttal that you quoted? It seems like you REALLY didn't.


--------------------
"Shmokin' weed, Shmokin' wizz, doin' coke, drinkin' beers.  Drinkin' beers beers beers, rollin' fatties, smokin' blunts.  Who smokes tha blunts?  We smoke the blunts" - Jay and Silent Bob strike Back


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OfflineSneezingPenis
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Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: LiquidSmoke]
    #7553639 - 10/24/07 05:23 AM (13 years, 9 months ago)

Quote:

LiquidSmoke said:
Quote:

YawningAnus said:

Quote:

This has nothing to do with the push of legalizing a drug with one explanation over the other.



really? so doctors dont get financial incentives to push certain drugs? maybe you want to look into that before you taste your shoe.







this is the PERFECT EXAMPLE of you shifting topics in some sort of mental confusion.

How did you go from talking about the off-label use definition being used as an FDA approval mechanism, something that had nothing to do with my initial mentioning of the benefits of off-label use,

to talking about me all of a sudden not believing doctor's recieve incentives for pushing drugs onto their patients?

What does pushing pills on doctors as off-label use have ANYTHING TO DO WITH the pharmaceutical company's alteration of the drug's intended use in order to get FDA approval?

Did you even understand the context of my rebuttal that you quoted? It seems like you REALLY didn't.




I am trying to convey my astonishment at your lack of cognition upon this without flaming you.... but nothing comes to mind that truly relates how much contempt I have for your myopic dawdling.

I dont know how to get you to understand this. I have tried analogy, I have tried a flow chart.
maybe we need to find some common ground and work from there.

1) do you agree that it is very difficult to get FDA approval for a drug?
2) Do you agree that some drugs, if not all, have more than one effect when consumed? be that effect good or bad.
3) do you agree that for a drug to get FDA approval it has to show efficacy in it proposed use or uses?
4) do you agree that it doesnt financially make sense for a pharmaceutical company to try and get FDA approval for every possible use of their drug?
5) do you agree that once a drug gets FDA approval for atleast one use, it can then be prescribed for anything?
6) do you agree that pharmaceutical reps give financial/gift incentives to doctors in hopes that they will prescribe their drug off label?
7) do you agree that doctors do in fact prescribe drugs for off label use?

now, if you agree to all of these things, I dont see why it is so hard to connect the dots to come to the conclusion that off label use is in fact a loophole for the pharmaceutical companies to bypass the oversight and regulation of the FDA.
If you dont agree with all of these... then I will gladly give you multiple sources that will prove it.

Quote:

Big Pharma pays for thousands of speeches by doctors each year because companies can not legally promote off-label uses. So in other words, the law allows drug makers to hire doctors to do the dirty work that would be illegal for the company itself. In 2004, doctors spoke at 237,000 meetings sponsored by drug companies, up from 66,000 in 1999, according to the July 15, 2005, Wall Street Journal.




lets take seroquel for example. Oddly enough it is an atypical antipsychotic (where have I heard that phrase before..... atypical antipsychotic.... I know I heard that somewhere before..... oh, probably in that long paper I quoted to you that you didnt even read).
which was first approved for treating schitzophrenia. In 2006, a study found that almost half of its sales came from off label use.

from wiki..

Quote:

Onset of symptoms typically occurs in young adulthood,[1] with approximately 0.4–0.6%[2][3] of the population affected. Diagnosis is based on the patient's self-reported experiences and observed behavior. No laboratory test for schizophrenia exists.




so we can say that it is prevalent in half a percent of the population...
more wiki...
Quote:

Quetiapine is controversially marketed to parents of moody and irritable teenagers in magazines such as Parade and TV Guide.[2][3] It is sometimes used off-label, often as an augmentation agent, to treat such conditions as obsessive-compulsive disorder, post-traumatic stress disorder, restless legs syndrome, autism, alcoholism, Tourette syndrome,[4] and has been used by physicians as a sedative for those with sleep disorders or anxiety disorders.




now, why do I have a problem with this? because even when studies show that the drug is basically useless, or at best, no more effective at treating its primary condition.... it doesnt matter, because it got approval, and it is now free to be pushed by lobbied doctors to subject the population to being generally sedated in hopes that you will be drugged enough to not be bothered by your condition.

for example..
Quote:

In 2005, quetiapine and other "atypical antipsychotics" were shown by the New England Journal of Medicine to be no more effective than perphenazine (Trilifon®), a typical antipsychotic, for the treatment of schizophrenia. However, the subsequent CATIE trial, funded by AstraZeneca and other major pharmaceutical manufacturers,[5] contradicted the 2005 study in certain instances.

A 2005 British Medical Journal report showed that quetiapine was ineffective in reducing agitation among Alzheimer’s patients, whose consumption of the drug then constituted 29% of sales; in fact, quetiapine was found to make cognitive functioning worse in elderly patients with dementia.[6]

The National Institutes of Health recommends against the use of quetiapine and almost all other psychotropic medications (including all atypicals, most anti-depressants, and all benzodiazepines) by children or those under 18,[7] observing that teenagers taking quetiapine "may be more likely to think about harming or killing themselves or to plan or try to do so."[8]




and an even further slap in the face is that, even when a respected medical organization such as the NIH says it isnt ethical to prescribe it to people under 18, you see something like this
Quote:

Quetiapine is controversially marketed to parents of moody and irritable teenagers in magazines such as Parade and TV Guide




and then we basically have groups of "lesser" people who are subjected to unknowingly being lab rats.... like people on medicare and in prisons.
Quote:

Drugs like Seroquel are often prescribed off-label in prisons and in homes for the elderly. Mental health expert Dr. Terry Kupers, a California psychiatrist, said that drugs are often prescribed in these situations "to quiet people down. ... They're over-prescribed for people who are not psychotic but who are not sleeping or who are causing disruptions in the prisons," he said.

Vermont Department of Corrections records obtained through a freedom of information request by the AP reveal that at one prison Seroquel was prescribed for more than 20 percent of inmates, even though fewer inmates were categorized as "seriously mentally ill." At another state prison, nearly 1/3 of its inmates were taking Seroquel. $1.76 million was spent by the state on drugs for prisoners last year






have I connected enough dots for you? do you get it now?

wait, let me give you one more example.

Quote:

Gabapentin has also been used in the treatment of bipolar disorder. However, its off-label use for this purpose is increasingly controversial.[6] Some claim gabapentin acts as a mood stabilizer and has the advantage of having fewer side-effects than more conventional bipolar drugs such as lithium and valproic acid. Some small, non-controlled studies in the 1990s, most sponsored by gabapentin's manufacturer, suggested that gabapentin treatment for bipolar disorder may be promising.[6] However, more recently, several larger, controlled, and double-blind studies have found that gabapentin was no more effective than (and in one study, slightly less effective than) placebo.[7] Despite this scientific evidence that gabapentin in the treatment of bipolar disorder is not an optimal treatment, many psychiatrists continue to prescribe it for this purpose.




better known as neurontin, it was approved "...as an adjunctive medication to control partial seizures".

so get this.... it got FDA approval as an adjunctive. For those watching at home.
adjunctive:1: something joined or added to another thing but not essentially a part of it

it got past the FDA by humpacking on other drugs. one study found that 90% of Neurontins sales were from off label use... and later GET THIS!!! THEY GOT SUED AND HAD TO PAY 430 MILLION DOLLARS BECAUSE THEY WERE FOUND GUILTY OF ILLEGALLY MARKETING IT!!!

So... I was going to address your other post, but I felt it nececssary that we clear this "hu! mah! I cant shwiusuitiubfiusiuuusss ear you" you are kkkshhkshkhsk breaking up" crap up.


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OfflineSneezingPenis
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Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: LiquidSmoke]
    #7553666 - 10/24/07 06:12 AM (13 years, 9 months ago)

Quote:

LiquidSmoke said:

Quote:


Dont you understand that off label use is basically a way to bypass the FDA?




Don't you understand that has nothing to do with the initial purpose of off label use? Something that you haven't even acknowledged yet? Do you even read my rebuttals?




I understand the concept behind off label use. Doctors shouldnt have to wait for the months/years of proper testing to be done to use a drug outside of its intended purpose... but there needs to be some sort of regulation. right now, all we have are "tsk tsk" and strong reprimanding.

Quote:

Quote:

Do you seriously not see how this is relevant to our discussion? maybe you need a flow chart...
people trust doctors ----> doctors get financial incentives to make decisions that arent always in the best intrest of the health of thir patient ----> they prescribe them the drugs they were paid to prescribe by the pharmaceutical company ----> pharmaceutical company sits on a big pile of money that it got from bankrupting state funded medicare.




Once again i'll ask you since you love being on such a soap box of an entire debate that still has very little relevance to what we're talking about.

You said, you were, against off label drug use. If one of your primary reasons is because of the pill pushing on doctors, you're using a pretty weak example, considering:

#1 the issue of pill pushing is mainly for the use of specialized renditions of generic drugs, while very few off-label drugs are even the primary concern of pharmaceutical reps' influence on doctors.



#1 makes no sense to me. please reword it.

Quote:


#2 you're going way off topic, diverting the issue to something that is only one small facet about the pros and cons of allowing off-label drug use.




how is discussing off label use way off topic when discussing off label use? small facet? is it a small facet when seroquel caused 3x the prevalence of death in elderly patients than placebo? especially when it is still prescribed off label to elderly?


Quote:

You're failing to realize, that I never said pill pushing wasn't a factor in the problem of off-label drug use, NO SHIT it is. You spent too little time actually trying to address what i initially posted, which was the original purpose of off-label drug use. And you spent too much time posting things and creating a side-debate talking about pill-pushing when you weren't even considering that i've already, along long time ago in this thread, acknowledged that pill pushing is a problem.



so you acknowledge that pill pushing is a problem, yet you dont see how it has anything to do with off label use?
I think you have spent too much time trying to back yourself out of a corner by debating semantics, and too little time being on topic.

Quote:



So every single drug that's out there, that's being used for multiple purposes, should only be used for their intended purpose.

That's basically what you're getting at. If you're against off label use, that means you're against the use of drugs outside of their originally intended purpose, right? Since that's the definition of "off label use".



didnt I just get done telling you that I am against the system in which it is carried out and allowed?
You didnt say anything about the holocaust, so you obviously are a nazi supporter. I mean, that is what you are getting at right?



Quote:

Really, so you just assume this, without even following the research being done on various drugs already placed in the market?

You truely believe that a drug's additional discovered benefits wouldn't be able to override it's side effects? Are you making a general statement about every single drug being researched out there?



I am saying that when these off label benefits are discovered, how often do the pharm reps also talk about the new side effects? for example, if we have a drug that is intended for anxiety, and someone says that it helps fight dementia in the elderly, then you are working with an entirely different group of possible side effects.... during drug trials, it didnt have to show its safety with octegenarians, so it is left up to the pharm corps to be on the honor system and disclose the new problems that arise.... and yes, I am saying that about every single drug... no matter what it is, it will have side effects, and when you change the target consumers, you will find new side effects.
Im willing to bet the "good news" travels a lot faster than the "but...." news.
How do you think doctors find out about this off label use? either they make their patients guinea pigs, or they are told by another doctor who was paid to give a lecture by a pharmaceutical company.

think about this. outside of "coincidence", there is no possible avenue in which "discovering" the benefits of a psychopharmaceutical drug in off label use can come about in an ethical way.
At one point, someone took a complete shot in the dark and said "hey maybe if I gave you this drug, you would be too sedated to be depressed".


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Invisiblebadchad
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Registered: 03/02/05
Posts: 13,144
Re: "Evil docters, dangerous pharms..." Enough of this poppy cock [Re: SneezingPenis]
    #7553796 - 10/24/07 08:09 AM (13 years, 9 months ago)

Quote:

YawningAnus said:
I would like you to read through the entire thing, because it almost seems as if the person writing it, really didnt want some of it to be true. But I would still say that the article is unbiased, and if it is biased in any direction, it is so in favor of psychiatry and ECT, if not only to give it the benefit of the doubt.

but if you really dont feel like reading it, just read the very last line and we can be done with this ridiculous conversation of whether or not ECT is harmful or not.





I don't doubt the quality of your article as it is actually peer-reviewed and in a research journal. This is much different than something published in a newspaper or by www.ihatepsychiatry.com. Unfortunately it's about 25 years old.

Plenty of other studies have shown favorable outcomes with ECT, and few side effects. Thus, the argument over the clinical use of ECT is not "ridiculous" by any means. The use of ECT has a risk:benefit ratio just like any other medical procedure.

As far as off-label use is concerned, what is your general position on the FDA then?

You usually say: "The FDA doesn't protect anyone, they are a puppet of big pharma ", but then you turn around and say: "It's really hard to get a drug approved, so to get around this problem, off-label use was created".

Off-label use is under the discretion of the physician. If he/she chooses to use it for an off-label use, that patient should be the responsibility of the physician. Considering the amount of lawsuits brought forth in this country against doctors, I believe most physicians will act in the best interests of their patient.


--------------------
...the whole experience is (and is as) a profound piece of knowledge.  It is an indellible experience; it is forever known.  I have known myself in a way I doubt I would have ever occurred except as it did.

Smith, P.  Bull. Menninger Clinic (1959) 23:20-27; p. 27.

...most subjects find the experience valuable, some find it frightening, and many say that is it uniquely lovely.

Osmond, H.  Annals, NY Acad Science (1957) 66:418-434; p.436


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