Podcast #57: A Matter of National Security

We kept this podcast a little shorter and strangely enough, we didn't ramble or argue or rant. Maybe it was a little boring?

Clink wanted to talk about a report she found online about Dr. Bruce Ivins, a researcher who was a suspect in the 2001 deadly anthrax attacks via the postal mail. Dr. Ivins died of suicide in 2008, and a group was commissioned to look at the process for obtaining security clearances, and where that process may have weaknesses. This gave Clink the opportunity to talk a little about issues that arise when psychiatrists get requests from the government for information about whether their patients pose a threat to national security.

Our links for this portion of our podcast are: A Wikipedia article about Dr. Bruce Ivins and the APA's official document called Psychiatrists’ Responses to Requests for Psychiatric Information in Federal Personnel Investigations.

Our last topic was about the management of pregnant women with opiate addictions and we discussed the use of methadone versus buprenorphine and the effects on the baby. Roy discussed an article from the New England Journal of Medicine, "Neonatal Abstinence Syndrome after Methadone or Buprenorphine Exposure."

At the end of the podcast, we mentioned that we're coming up on our 5th anniversary of Shrink Rap in late April. Roy had a surprise gift for us! Mugs with the cover of book on them! This was a fun gift. And I had brought chocolate ducks. But of course we took a picture.
Thank you for listening. Please do write a review on iTunes!

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This podcast is available on iTunes or as an RSS feed or Feedburner feed. You can also listen to or download the mp3 or the MPEG-4 file from mythreeshrinks.com. Thank you for listening. Send your questions and comments to: mythreeshrinks@gmail.com.

FDA Drugs: December 2006

2007: Mar | Feb | Jan . . . 2006: Dec | Nov | Oct | Sep

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I'm a bit behind on listing relevant FDA update info, so I'll get you all up to date.

• Zyprexa (olanzapine) labeling change: Label was revised to state that "Rare postmarketing reports of hepatitis have been received. Very rare cases of cholestatic or mixed liver injury have also been reported in the postmarketing period." [.pdf]
• Bifeprunox for Schizophrenia: Phase III results were released showing that patients did better on this than on placebo over 6 months (not hard to beat placebo). They also reported weight and lipid profile reductions. Their New Drug Application was submitted to the FDA in October.
• Invega (iloperidone) results: These results are interesting in that they looked at efficacy and side effects data stratified by whether or not one had a particular pharmacogenetic genotype. They do not identify the genotype, but I suspect it is something like DRD4 or DAT-1. So far, however, we have yet to see the promise of a pharmacogenetic test which one would perform prior to prescribing a drug. For this to really work, the test will have to be free and the results available promptly.
• Melt-in-your-mouth Methadone: Roxane got a dissolvable 40mg methadone approved.
• Invega (iloperidone) approved: This is an active metabolite of Risperdal/risperidone, very similar to this atypical antipsychotic. [label] [detailed review]