I just thought I'd share a bunch of links with you, no specific theme.
The New York Times has a piece by a mom about Ritalin as a treatment for a disorder versus a academic enhancer -- I enjoyed this, and while some children really need the medication to make life work in any reasonable way, we should be questioning the use of medicine as treatment versus making someone the best they can be, at a cost. Raising the Ritalin Generation.
So psychoanalysis is big in Argentina. Who knew? I'll go have me a steak and get myself analyzed. Do Argentines need therapy? Pull up a couch.
The media tells us that Jared Loughner is now competent to stand trial. He has pleaded guilty to the charges against him for the Tuscon shootings, a life sentence, no death penalty. So it's over, no trial, no insanity defense. He still remains in a forensic hospital, but I assume he will be transferred to a prison at some point. Here is a video on World News with Diane Sawyer.
Oh, and there was an article I wanted to comment on about a violent patient in a state forensic facility who was deemed incompetent to stand trial and one of the attorney's was quoted as saying they would keep the patient there for now, treating him with "aspirins" or whatever. But I can't access the article without paying a fee, much less the quote, and I really just wanted to say that I think those involved in the prosecution or defense of people with major mental illnesses might like to know that we have new treatments now that sometimes work better than aspirins. And even if they don't, the attorneys might sound a little more sophisticated if they referred to treatments with psychotherapy and psychiatric medications, rather than aspirins. I hear it does help headaches. No link, I'm not sure I have my facts straight so I'm just rambling here.
Happy Presidents' Day. I probably have 50 blog posts floating around in my head, but I thought I'd share with you some of the stuff I've been reading on line lately.
The New York Times Op Ed editor doesn't seem to like stimulants these days. A few weeks back there was an article talking about a study showing that long-term stimulants aren't helpful, and today there is a piece by a writer who finds distraction helpful...told with some contempt towards his friend's son whom he calls Ritalin Boy. Steve over on Thought Broadcast has his own take on ADD meds.
What do you think: are stimulants helpful or not? I'll stand aside for this one.
Then there was the article about the business/computer whiz who put hundreds of thousands of dollars of his own money (and all his time) into a kidney transplant matchmaking service. If you need an uplifting story, this is an interesting one.
Over on KevinMD, Dr. George Lundberg is a bit skeptical of SAMHSA's new defining features for the Recovery Movement. I more or less agree, it feels like it's more about semantics (what does it mean to say recovery is "person-driven"? as opposed to?) than substance, and a lot of it seems to boil down to the idea that patients should be treated with respect and people with mental illnesses should work towards achieving their full potential. Those things I agree with, for everyone.
And finally, for the writers among us, Pete Earley has a Before You Quit Your Day Job post up on his blog. I'm still pondering the $80,000 advance. The Shrink Rappers need an agent, oh, but we do love our friends over at Johns Hopkins University Press.
And finally, for my friend ClinkShrink the Introvert, who wrote a review of a Quiet: The Power of Introverts in a World that Can't stop Talking (---huh, stop looking at me), here is an article called The Brainstorming Myth by Jonah Lehrer in The New Yorker.
Okay, lots of links. This is what I've been thinking about. Aside from that, I made a quick trip to NYC and had my photo taken with Cookie Monster in Times Square, and I loved Jersey Boys.
Ooooh, let me tell you: I love vacation. I really love vacation. I'm back. It's cold here, and I spent the day unpacking and doing laundry, and getting ready to start my week. I returned calls, went in to the office and checked my mail, emailed, postal mailed, and watched the Ducks win the Rose Bowl. Sad, because even though we Shrink Rappers like ducks, I have my own personal Badger out in Pasadena cheering for Wisconsin, and it's a sad football day for him, I'm sure.
Roy did a great job of holding down the blog. Please give him a hand. Clink was off on another one of her adventures. For some reason, vacation is not fun for her if there isn't the possibility that she'll fall thousands of feet, get eaten by some form of wildlife, or have her life depend on properly functioning equipment while she gurgles beneath the sea. She's the only person I know where "I had a fantastic time" is followed by an injury report.
Roy's Happy New Year duck was taken from the Havre de Grace annual New Year's Duck Drop. From the Aegis:
It was a glorious night for ringing in a new year. Temperatures, unusually inviting for a New Year's Eve in Harford County, hovered around 43. Wind was non-existent. And many people had gathered around the Havre de Grace Middle School grounds for the annual Duck Drop and fireworks to welcome another new year.
In other stories around the web, if you're a distracted duck, you might have notice that it's hard to find Ritalin or Adderall-- perhaps another example of DEA limits allowing Big Pharma to be being overly ducky about reducing supply of the cheaper, generic medications. From the The New York Times, do check out "A.D.H.D. Drug Shortage Has Patients Scrambling."
And if you're a duck contemplating filing for Social Security Disability, do read Dr. Steve's post on Thought Broadcast about The Curious Psychology of "Disability." With 41 comments on that post, I'm going to swim away from the temptation to comment myself.
And finally, for those ducks who want to know the latest on Electronic Medical Records, check out Shrink Rap News over on CPN for "Notes from SAMHSA's EHR Summit." If that doesn't make you want to be served up with orange sauce, then nothing will.
So I love vacation, but I did miss all the Shrink Rappin.' Happy New Year to everyone!
From Clink: I don't have a duck in this race, so I thought folks might enjoy a seahorse instead. He's black with white stripes and seems to be perched on top of the green moray eel's head. Yes, the eel was that close.
No significant injuries this time. A slight jellyfish sting and lots of no-see-'ums, that's it.
- Ritalin patch: I expect to see this a lot in nursing homes. I've seen methylphenidate make a huge positive impact on older depressed folks, and a patch form of administration makes it easier. But, it's another one of those dang off-label issues that's flaring up lately.
- 4.6% Medicare cuts next year: Will this ever get fixed? Locally, I hear of folks having a hard time finding psychiatrists who will even take Medicare. It used to be one of the easiest to participate with... no multipage treatment plans, etc. But practice costs increase every year, and we cannot make up the difference by seeing more pts (although I hear there have been some "creative" docs who have learned how to squeeze 50 90807s in a 24-hour day... no, thanks).
- Top 10 Psychiatrist Diagnoses: Something is wrong with this picture. The #1 dx is 296.2 (single episode major depr). I would expect recurrent episode major dep to be #1. And all of "Anxiety states" is only #3? I don't think so. The data come from Verispan's survey of 162 psychiatrists. GIGO.
- Don't flush your fluoxetine: Says to advise your pts on how to dispose of old pills, but does not say what to tell them. I used to tell them to flush them, but now I say to either return to pharmacy. It seems that flushing has led to high drug levels in the water supply.
- Prazosin reduces PTSD nightmares: This is new to me. Alpha-1 antagonists apparently reduce sleep problems and nightmares in PTSD. [PubMed]
- Vivitrol: I saw an ad for this recently approved i.m. form of naltrexone (it was going to be named Vivitrex, but I guess this was too close to some other name). Even if there is some efficacy data, this drug will go nowhere. Why? $695 per injection! Are folks gonna pay $22/day to be sober? It's cheaper to stay drunk! Cephalon blew it. I can only imagine that the market they are going after is the court-ordered treatment market. If they hit that one, they will have a blockbuster on their hands, because it is worth $22/day to stay out of jail. (The number of ad-blogs for this drug are incredible.)
