Fwd: Psychiatry--APA & AACAP--Calls Children's Insurance Parity-- A Wonderful Victory

[Guest guest]

ALLIANCE FOR HUMAN RESEARCH PROTECTION Promoting Openness, Full Disclosure, and Accountability http://www.ahrp.org and  http://ahrp.blogspot.com FYISometimes the best of intentions usher in disastrous consequences.The State Children's Health Insurance Program (SCHIP) signed into law byPresident Obama, received accolades from The American PsychiatricAssociation: "We are especially pleased that this legislation includesstrong language that will strengthen and improve access to mental-healthservices..."And the American Academy of Child and Adolescent Psychiatry (AACAP) callsSCHIP "a wonderful victory."The question is whether the U.S. mental health paradigm of care--stronglypromoted by both the APA and the AACAP-- will improve or harm children'smental and physical health.Here is the problem:  American psychiatry is entirely centered on the use ofpsychotropic drugs--and the evidence shows that children are increasinglyprescribed highly toxic drugs without evidence to justify the considerablerisks of harm. An unprecedented number of American children--unlike any others in theworld--are exposed to psychotropic drugs to change their behavior. The fourclasses of drugs are: psychostimulants, antidepressants, neuroleptics /antipsychotics, and anticonvulsants. ALL carry an FDA "black box" warningbecause they can be dangerous, even fatal, at routine doses. [1]These drugs have not been proven effective in children over the long run.What improvements are sometimes visible are seen only in highly artificialclinical trials of short duration whose validity and relevance to real-worldconditions have been repeatedly called into question. PSYCHOSTIMULANTS are controlled, amphetamine-like drugs that are currentlyapproved only for the treatment of ADHD and narcolepsy. These include theamphetamines Dexedrine and Adderall, and methylphenidate (Ritalin).The major side effects of psychostimulants are loss of appetite, insomnia,changes in arousal (either overstimulation/anxiety orlistlessness/lethargy), mood changes, elevated blood pressure and increasedheart rate, and stunted growth.  An FDA safety review revealed thatpsychostimulants induce paranoid psychotic reactions, includinghallucinations, in children.ANTIDEPRESSANTS (SSRIs) include:  citalopram (Celexa),  escitalopram(Lexapro), fluoxetine (Prozac,  Sarafem),  fluvoxamine (Luvox),  paroxetine(Paxil, Seroxat), and sertraline (Zoloft, Lustral).In clinical trials, antidepressant drugs doubled the risk for suicidalideation and behavior (i.e., suicide attempts) compared to placebo. Thedrugs' black box warning label states:  "Patients who are started on therapyshould be observed closely for clinical worsening, suicidality, or unusualchanges in behavior". The drugs have not demonstrated efficacy in children.On February 5, 2009, the FDA added new label warnings to the SSRIs and theserotonin-norepinephrine reuptake inhibitors (SNRIs) about a potentiallyfatal risk: neuroleptic malignant syndrome (NMS). Previously, NMS wasprimarily linked to a single class of drugs, theneuroleptics/antipsychotics. NMS develops explosively over hours or days,and an estimated 10% to 20% of cases the result is death.The SSRIs, the wonder drugs of the 1990s, are now almost completelydiscredited. And efforts to withdraw from SSRIs and SNRIs often lead to adiscontinuation or withdrawal syndrome -- a sign of these drugs' addictivenature.SNRIs include: venlafaxine (Effexor), desvenlafaxine (Pristiq), andduloxetine (Cymbalta).NEUROLEPTICS / ANTIPSYCHOTICS include aripiprazole (Abilify), clozapine(Clozaril), olanzapine (Zyprexa), olanzapine/fluoxetine (Symbyax),risperidone ( Risperdal) and paliperidone (Invega), quetiapine (Seroquel),and ziprasidone (Geodon).The scope and magnitude of the serious debilitating adverse effects ofantipsychotics--including lethargy and extrapyramidal reactions (acute andtardive dystonias, akathisia, parkinsonism, [rigidity and tremor],dyskinesia) and tachycardia, hypotension, impotence, seizures,hyperprolactinaemia, diabetes melitus, not to mention supersensitivitypsychosis and structural brain damage--should disqualify them for use inchildren. See: Wikipedia http://en.wikipedia.org/wiki/AntipsychoticANTICONVULSANTS: drug companies promoted the use of anticonvulsants, i.e.,anti-epileptics or anti-seizure drugs--which they renamed "mood stabilizers"for people diagnosed with bipolar disorder.The most widely used anticonvulsants are carbamazepine (Tegretol, Equetro),(gabapentin) Neurontin, lamotrigine (Lamictal), valproate and valproic acid(Depakene, Depakote), topiramate (Topamax), oxcarbazepine (Trileptal), andtiagabine (Gabitril).None of these drugs have been approved by the FDA for psychiatricindications in children.In 2008, the FDA issued a warning that, in clinical trials, allanticonvulsants were shown to double the risk of suicidal ideation orbehavior compared to placebo (the risk was highest in non-psychiatricconditions).In addition, the following FDA "black box" warnings apply to specificanticonvulsants:1) Depakote: Liver toxicity, birth defects, pancreatitis2) Tegretol: Aplastic anemia and agranulycytosis  (severe reduction in whiteblood cells)3) Lamictal: Serious rash requiring hospitalization; Stevens-JohnsonSyndrome for children under 16 yrs of age (fatal sores on mucuous membranesof mouth, nose, eyes and genitals).Some antidepressants and anticonvulsants also carry a high risk of birthdefects.Evidence shows that following the promotion of antipsychotic andanticonvulsant drugs for children and youth, there was a 40-fold increase inthe diagnosis of pediatric bipolar disorder over a ten year period in theU.S. [2] Yet, no studies confirm the efficacy and safety of eitherantipsychotics or anticonvulsants for children and adolescents diagnosedwith bipolar disorder. [3]Despite the lack of evidence for efficacy, despite the substantial body ofevidence documenting drug-induced harm, more than 90% of children and youthdiagnosed with bipolar disorder receive more than one psychoactive drug incombinations never tested for safety. Less than 40% of children receive anypsychotherapy.Evidence shows that Medicaid expenditure for drugs is a huge part of thepharmaceutical industry business: it's very attractive market - feeding atthe taxpayer trough measurable in cost but also in drug utilization.Unsupportable increased use of antipsychotics is documented by the US by theCenters for Medicare & Medicaid: Expenditures rose from $2.14 billion in2000, to $5.40 billion in 2005.Indeed, evidence shows that children covered by Medicaid insurance are farmore likely to be prescribed the most expensive, most toxic psychotropicdrugs, namely; ANTIPSYCHOTICS and the anticonvulsant, Depakote. For example, New York State Medicaid records show that in 2006, Medicaid wasbilled $82 million for psychoactive drugs for children, with fiveantipsychotics and an anticonvulsant topping the list: Risperdal ($23million); Abilify ($17 million); Seroquel ($12.2 million); Depakote ($5.7million); Zyprexa ($5.1 million)The State Children's Health Insurance Program (SCHIP) was applauded by theAmerican Psychiatric Association and the American Academy of Child andAdolescent Psychiatry as "a wonderful victory" because it will serve toincrease the roster of American children "diagnosed" with mental disordersfor which they will be prescribed psychoactive drugs that are likely toundermine their mental and physical health.SCHIP should, therefore, be amended to protect children from unjustifiableexposure to highly toxic drugs whose adverse effects are severe andlong-lasting.  The following minimal safety standards should be met before achild is exposed psychoactive drugs:(1) Proven psychosocial interventions have been exhausted.(2) The benefits of the drug outweigh the risks.(3) Those authorizing the prescriptions are fully informed about the risksand benefits, and the alternatives.(4) The children will be thoroughly monitored for adverse effects.Reference:1. See: Critical Think Rx affidavit included in the lawsuit,  Law Projectfor Psychiatric Rights v. State of Alaska (3AN 08-10115 CI)http://psychrights.org/States/Alaska/PsychRightsvAlaska/PsychRightsvAlaskaKidDruggingComplaint.pdf2. Moreno C, Laje G, Blanco C, Jiang H, Schmidt AB, Olfson M. Nationaltrends in the outpatient diagnosis and treatment of bipolar disorder inyouth. Arch Gen Psychiatry. 2007 Sep;64(93. The myth about the "safety and effectiveness" of antipsychotics has beenshown to be patently false: First, the government-funded CATIE schizophreniastudy (New England Journal of Medicine, 2005); second, the STEP-BD bipolarstudy (American Journal of Psychiatry, 2006); third, a study in the Feb. 2,2006, NEJM, reported: " Six of 34 chronic schizophrenia patients taking theantipsychotic drug clozapine improved when Johnson & Johnson's Risperdal wasadded to their treatment regimen." However, "nine improved when a placebowas added." Contact: Vera Hassner Sharavveracare212-595-8974http://www.medscape.com/viewarticle/587911Leading Psychiatric Organizations Laud Obama's Signing of SCHIP Bill New LawIncludes Strong Mental-Health Coverage Marlene BuskoFebruary 5, 2009 (UPDATED February 6, 2009)  President Barack Obama'sFebruary 4 signing of the State Children's Health Insurance Program (SCHIP)bill, making it law, has been lauded by 3 of the country's leadingpsychiatric organizations.The new law extends health insurance to 4 million uninsured children inaddition to the existing 7 million children already covered and notablyprovides strong mental-health coverage."We are especially pleased that this legislation includes strong languagethat will strengthen and improve access to mental-health services, includingsubstance-abuse-treatment services for children," Nada Stotland, MD,president of the American Psychiatric Association (APA), said in astatement.The American Academy of Pediatrics (AAP) also praised President Obama andCongress for reauthorizing the program."Today's reauthorization of the Children's Health Insurance Program is avictory for the children of this country. With the stroke of PresidentObama's pen, states now have the funds to provide insurance coverage to morethan 11 million children nationwide. During uncertain economic times, theWhite House and Congress have come together to wisely prioritize children'shealth," David T. Tayloe, Jr., MD, AAP president, said in a statement.Wonderful VictoryThe American Academy of Child and Adolescent Psychiatry (AACAP) had asimilar positive response. "Passage of this bill addresses an urgent need tocover children who fell 'between the cracks' and were not receiving anyhealth insurance coverage," Kristin Kroeger Ptakowski, AACAP's senior deputyexecutive director, told Medscape Psychiatry.Early identification and treatment of mental illness in children oradolescents is vital, she added."The devastating reality is that youth with untreated mental disorders havea greatly diminished future to live independently. The adverse effect [ofmental illness] on youth and their families cannot be overstated."This is a wonderful victory for the millions of children who did not haveinsurance and who will now be able to seek mental-health treatment, ifneeded," Kroeger Ptakowski said.The bill (HR 2) requires private SCHIP plans to cover mental illnesses atthe same rate and on the same terms as other disorders and eliminatesdiscriminatory coverage of mental illness under the existing law.In 1997, Congress enacted SCHIP to provide states with federal matchingfunds to cover uninsured children in families with incomes too high toqualify for Medicaid but too low to afford private insurance coverage.Federal money for the program was set to expire March 31, barring action byCongress.The newly signed children's health bill entails an over-$30-billion increasein spending, which will be covered by boosting the federal excise tax oncigarettes.According to the Congressional Budget Office, the legislation will providecoverage for an additional 4 million children by 2013, while continuingcoverage for children already in the program.~~~~~~~~~~~~~~~~~~http://latimesblogs.latimes.com/booster_shots/2009/02/antidepressant.htmlTHE LOS ANGELES TIMESAntidepressant labels to carry new warning of life-threatening side effect1:12 PM, February 5, 2009The FDA has ordered a wide range of antidepressants to carry new warnings ofan unusual but potentially deadly side effect seen most often in the firstfew weeks of treatment or when a patient increases dosages. The labels oftwo classes of new-generation medications for depression -- selectiveserotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptakeinhibitors (SNRIs) must now notify patients that malignant neurolepticsyndrome has been linked to the use of these drugs.Among the drug companies ordered to revise their labels to alert patients ofthe danger were those making Celexa, Cymbalta, Effexor, Lexapro, Paxil,Pexeva, Pristiq, Prozac, Venlafaxine and Zoloft. The orders were dated Feb.4, but disseminated this morning in a public notice of FDA actions.In malignant neuroleptic syndrome, patients experience muscle rigidity,extreme variations in body temperature and wild fluctuations of heart rateand blood pressure -- all signs of malfunction in the body's autonomicnervous system, which regulates involuntary body functions. Malignantneuroleptic syndrome has been associated with older antipsychotic medicationsuch as haloperidol, lithium salts and risperidone. But the widespread useof SSRI and SNRI antidepressants has made this syndrome a more common andvisible affliction.With one in 10 Americans taking prescription antidepressants, medicines suchas Zoloft, Prozac and Effexor are currently the most commonly prescribedclass of drugs in the United States, just ahead of high-blood pressuremedicine, according to the Centers for Disease Control. And SSRIs and SNRIshave become by far the most common types of antidepressant dispensed bypharmacies, driving a tripling of prescriptions since 1988.Malignant neuroleptic syndrome is a rare but extremely dangerous conditionthat results in death in, by some estimates, 10% to 20% of cases. Untilrecently, it was so uncommon it was unlikely to be recognized in manyemergency departments. But the widespread use of SSRIs and SNRIantidepressants had made this bizarre syndrome a more common affliction seenin emergency departments.A Food and Drug Administration spokeswoman said this afternoon that she hadnot been notified of the labeling change and was unaware of what led to it.Watch this space.-- Melissa HealyFAIR USE NOTICE: This may contain copyrighted (C ) material the use of whichhas not always been specifically authorized by the copyright owner. Suchmaterial is made available for educational purposes, to advanceunderstanding of human rights, democracy, scientific, moral, ethical, andsocial justice issues, etc. It is believed that this constitutes a 'fairuse' of any such copyrighted material as provided for in Title 17 U.S.C.section 107 of the US Copyright Law. This material is distributed withoutprofit.=====In accordance with Title 17 U.S.C. Section 107, this material is distributed without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes.

[Guest guest]

Thanks

from Dr. JN Sharma

 

On 2/10/09, Viviane Lerner <vivlerner wrote:

>

>

>

>

> ALLIANCE FOR HUMAN RESEARCH PROTECTION

> Promoting Openness, Full Disclosure, and Accountability

> http://www.ahrp.org and http://ahrp.blogspot.com

>

> FYI

>

> Sometimes the best of intentions usher in disastrous consequences.

>

> The State Children's Health Insurance Program (SCHIP) signed into law by

> President Obama, received accolades from The American Psychiatric

> Association: " We are especially pleased that this legislation includes

> strong language that will strengthen and improve access to mental-health

> services... "

>

> And the American Academy of Child and Adolescent Psychiatry (AACAP)

> calls

> SCHIP " a wonderful victory. "

>

> The question is whether the U.S. mental health paradigm of care--

> strongly

> promoted by both the APA and the AACAP-- will improve or harm children's

> mental and physical health.

>

> Here is the problem: American psychiatry is entirely centered on the

> use of

> psychotropic drugs--and the evidence shows that children are

> increasingly

> prescribed highly toxic drugs without evidence to justify the

> considerable

> risks of harm.

>

> An unprecedented number of American children--unlike any others in the

> world--are exposed to psychotropic drugs to change their behavior.

> The four

> classes of drugs are: psychostimulants, antidepressants, neuroleptics /

> antipsychotics, and anticonvulsants. ALL carry an FDA " black box "

> warning

> because they can be dangerous, even fatal, at routine doses. [1]

>

> These drugs have not been proven effective in children over the long

> run.

> What improvements are sometimes visible are seen only in highly

> artificial

> clinical trials of short duration whose validity and relevance to

> real-world

> conditions have been repeatedly called into question.

>

> PSYCHOSTIMULANTS are controlled, amphetamine-like drugs that are

> currently

> approved only for the treatment of ADHD and narcolepsy. These include

> the

> amphetamines Dexedrine and Adderall, and methylphenidate (Ritalin).

>

> The major side effects of psychostimulants are loss of appetite,

> insomnia,

> changes in arousal (either overstimulation/anxiety or

> listlessness/lethargy), mood changes, elevated blood pressure and

> increased

> heart rate, and stunted growth. An FDA safety review revealed that

> psychostimulants induce paranoid psychotic reactions, including

> hallucinations, in children.

>

> ANTIDEPRESSANTS (SSRIs) include: citalopram (Celexa), escitalopram

> (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox),

> paroxetine

> (Paxil, Seroxat), and sertraline (Zoloft, Lustral).

>

> In clinical trials, antidepressant drugs doubled the risk for suicidal

> ideation and behavior (i.e., suicide attempts) compared to placebo. The

> drugs' black box warning label states: " Patients who are started on

> therapy

> should be observed closely for clinical worsening, suicidality, or

> unusual

> changes in behavior " . The drugs have not demonstrated efficacy in

> children.

>

> On February 5, 2009, the FDA added new label warnings to the SSRIs

> and the

> serotonin-norepinephrine reuptake inhibitors (SNRIs) about a potentially

> fatal risk: neuroleptic malignant syndrome (NMS). Previously, NMS was

> primarily linked to a single class of drugs, the

> neuroleptics/antipsychotics. NMS develops explosively over hours or

> days,

> and an estimated 10% to 20% of cases the result is death.

>

> The SSRIs, the wonder drugs of the 1990s, are now almost completely

> discredited. And efforts to withdraw from SSRIs and SNRIs often lead

> to a

> discontinuation or withdrawal syndrome -- a sign of these drugs'

> addictive

> nature.

>

> SNRIs include: venlafaxine (Effexor), desvenlafaxine (Pristiq), and

> duloxetine (Cymbalta).

>

> NEUROLEPTICS / ANTIPSYCHOTICS include aripiprazole (Abilify), clozapine

> (Clozaril), olanzapine (Zyprexa), olanzapine/fluoxetine (Symbyax),

> risperidone ( Risperdal) and paliperidone (Invega), quetiapine

> (Seroquel),

> and ziprasidone (Geodon).

>

> The scope and magnitude of the serious debilitating adverse effects of

> antipsychotics--including lethargy and extrapyramidal reactions

> (acute and

> tardive dystonias, akathisia, parkinsonism, [rigidity and tremor],

> dyskinesia) and tachycardia, hypotension, impotence, seizures,

> hyperprolactinaemia, diabetes melitus, not to mention supersensitivity

> psychosis and structural brain damage--should disqualify them for use in

> children. See: Wikipedia http://en.wikipedia.org/wiki/Antipsychotic

>

> ANTICONVULSANTS: drug companies promoted the use of anticonvulsants,

> i.e.,

> anti-epileptics or anti-seizure drugs--which they renamed " mood

> stabilizers "

> for people diagnosed with bipolar disorder.

>

> The most widely used anticonvulsants are carbamazepine (Tegretol,

> Equetro),

> (gabapentin) Neurontin, lamotrigine (Lamictal), valproate and

> valproic acid

> (Depakene, Depakote), topiramate (Topamax), oxcarbazepine

> (Trileptal), and

> tiagabine (Gabitril).

>

> None of these drugs have been approved by the FDA for psychiatric

> indications in children.

>

> In 2008, the FDA issued a warning that, in clinical trials, all

> anticonvulsants were shown to double the risk of suicidal ideation or

> behavior compared to placebo (the risk was highest in non-psychiatric

> conditions).

>

> In addition, the following FDA " black box " warnings apply to specific

> anticonvulsants:

> 1) Depakote: Liver toxicity, birth defects, pancreatitis

> 2) Tegretol: Aplastic anemia and agranulycytosis (severe reduction

> in white

> blood cells)

> 3) Lamictal: Serious rash requiring hospitalization; Stevens-Johnson

> Syndrome for children under 16 yrs of age (fatal sores on mucuous

> membranes

> of mouth, nose, eyes and genitals).

>

> Some antidepressants and anticonvulsants also carry a high risk of birth

> defects.

>

> Evidence shows that following the promotion of antipsychotic and

> anticonvulsant drugs for children and youth, there was a 40-fold

> increase in

> the diagnosis of pediatric bipolar disorder over a ten year period in

> the

> U.S. [2] Yet, no studies confirm the efficacy and safety of either

> antipsychotics or anticonvulsants for children and adolescents diagnosed

> with bipolar disorder. [3]

>

> Despite the lack of evidence for efficacy, despite the substantial

> body of

> evidence documenting drug-induced harm, more than 90% of children and

> youth

> diagnosed with bipolar disorder receive more than one psychoactive

> drug in

> combinations never tested for safety. Less than 40% of children

> receive any

> psychotherapy.

>

> Evidence shows that Medicaid expenditure for drugs is a huge part of the

> pharmaceutical industry business: it's very attractive market -

> feeding at

> the taxpayer trough measurable in cost but also in drug utilization.

> Unsupportable increased use of antipsychotics is documented by the US

> by the

> Centers for Medicare & Medicaid: Expenditures rose from $2.14 billion in

> 2000, to $5.40 billion in 2005.

>

> Indeed, evidence shows that children covered by Medicaid insurance

> are far

> more likely to be prescribed the most expensive, most toxic psychotropic

> drugs, namely; ANTIPSYCHOTICS and the anticonvulsant, Depakote.

>

> For example, New York State Medicaid records show that in 2006,

> Medicaid was

> billed $82 million for psychoactive drugs for children, with five

> antipsychotics and an anticonvulsant topping the list: Risperdal ($23

> million); Abilify ($17 million); Seroquel ($12.2 million); Depakote

> ($5.7

> million); Zyprexa ($5.1 million)

>

> The State Children's Health Insurance Program (SCHIP) was applauded

> by the

> American Psychiatric Association and the American Academy of Child and

> Adolescent Psychiatry as " a wonderful victory " because it will serve to

> increase the roster of American children " diagnosed " with mental

> disorders

> for which they will be prescribed psychoactive drugs that are likely to

> undermine their mental and physical health.

>

> SCHIP should, therefore, be amended to protect children from

> unjustifiable

> exposure to highly toxic drugs whose adverse effects are severe and

> long-lasting. The following minimal safety standards should be met

> before a

> child is exposed psychoactive drugs:

>

> (1) Proven psychosocial interventions have been exhausted.

>

> (2) The benefits of the drug outweigh the risks.

>

> (3) Those authorizing the prescriptions are fully informed about the

> risks

> and benefits, and the alternatives.

>

> (4) The children will be thoroughly monitored for adverse effects.

>

>

> Reference:

> 1. See: Critical Think Rx affidavit included in the lawsuit, Law

> Project

> for Psychiatric Rights v. State of Alaska (3AN 08-10115 CI)

> http://psychrights.org/States/Alaska/PsychRightsvAlaska/

> PsychRightsvAlaskaKi

> dDruggingComplaint.pdf

>

> 2. Moreno C, Laje G, Blanco C, Jiang H, Schmidt AB, Olfson M. National

> trends in the outpatient diagnosis and treatment of bipolar disorder in

> youth. Arch Gen Psychiatry. 2007 Sep;64(9

>

> 3. The myth about the " safety and effectiveness " of antipsychotics

> has been

> shown to be patently false: First, the government-funded CATIE

> schizophrenia

> study (New England Journal of Medicine, 2005); second, the STEP-BD

> bipolar

> study (American Journal of Psychiatry, 2006); third, a study in the

> Feb. 2,

> 2006, NEJM, reported: " Six of 34 chronic schizophrenia patients

> taking the

> antipsychotic drug clozapine improved when Johnson & Johnson's

> Risperdal was

> added to their treatment regimen. " However, " nine improved when a

> placebo

> was added. "

>

>

>

> Contact: Vera Hassner Sharav

> veracare

> 212-595-8974

>

> http://www.medscape.com/viewarticle/587911

> Leading Psychiatric Organizations Laud Obama's Signing of SCHIP Bill

> New Law

> Includes Strong Mental-Health Coverage Marlene Busko

>

> February 5, 2009 (UPDATED February 6, 2009) President Barack Obama's

> February 4 signing of the State Children's Health Insurance Program

> (SCHIP)

> bill, making it law, has been lauded by 3 of the country's leading

> psychiatric organizations.

>

> The new law extends health insurance to 4 million uninsured children in

> addition to the existing 7 million children already covered and notably

> provides strong mental-health coverage.

>

> " We are especially pleased that this legislation includes strong

> language

> that will strengthen and improve access to mental-health services,

> including

> substance-abuse-treatment services for children, " Nada Stotland, MD,

> president of the American Psychiatric Association (APA), said in a

> statement.

>

> The American Academy of Pediatrics (AAP) also praised President Obama

> and

> Congress for reauthorizing the program.

>

> " Today's reauthorization of the Children's Health Insurance Program is a

> victory for the children of this country. With the stroke of President

> Obama's pen, states now have the funds to provide insurance coverage

> to more

> than 11 million children nationwide. During uncertain economic times,

> the

> White House and Congress have come together to wisely prioritize

> children's

> health, " David T. Tayloe, Jr., MD, AAP president, said in a statement.

>

> Wonderful Victory

> The American Academy of Child and Adolescent Psychiatry (AACAP) had a

> similar positive response. " Passage of this bill addresses an urgent

> need to

> cover children who fell 'between the cracks' and were not receiving any

> health insurance coverage, " Kristin Kroeger Ptakowski, AACAP's senior

> deputy

> executive director, told Medscape Psychiatry.

>

> Early identification and treatment of mental illness in children or

> adolescents is vital, she added.

>

> " The devastating reality is that youth with untreated mental

> disorders have

> a greatly diminished future to live independently. The adverse effect

> [of

> mental illness] on youth and their families cannot be overstated.

>

> " This is a wonderful victory for the millions of children who did not

> have

> insurance and who will now be able to seek mental-health treatment, if

> needed, " Kroeger Ptakowski said.

>

> The bill (HR 2) requires private SCHIP plans to cover mental

> illnesses at

> the same rate and on the same terms as other disorders and eliminates

> discriminatory coverage of mental illness under the existing law.

>

> In 1997, Congress enacted SCHIP to provide states with federal matching

> funds to cover uninsured children in families with incomes too high to

> qualify for Medicaid but too low to afford private insurance coverage.

>

> Federal money for the program was set to expire March 31, barring

> action by

> Congress.

>

> The newly signed children's health bill entails an over-$30-billion

> increase

> in spending, which will be covered by boosting the federal excise tax on

> cigarettes.

>

> According to the Congressional Budget Office, the legislation will

> provide

> coverage for an additional 4 million children by 2013, while continuing

> coverage for children already in the program.

> ~~~~~~~~~~~~~~~~~~

>

> http://latimesblogs.latimes.com/booster_shots/2009/02/

> antidepressant.html

> THE LOS ANGELES TIMES

> Antidepressant labels to carry new warning of life-threatening side

> effect

> 1:12 PM, February 5, 2009

>

> The FDA has ordered a wide range of antidepressants to carry new

> warnings of

> an unusual but potentially deadly side effect seen most often in the

> first

> few weeks of treatment or when a patient increases dosages. The

> labels of

> two classes of new-generation medications for depression -- selective

> serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine

> reuptake

> inhibitors (SNRIs) must now notify patients that malignant neuroleptic

> syndrome has been linked to the use of these drugs.

>

> Among the drug companies ordered to revise their labels to alert

> patients of

> the danger were those making Celexa, Cymbalta, Effexor, Lexapro, Paxil,

> Pexeva, Pristiq, Prozac, Venlafaxine and Zoloft. The orders were

> dated Feb.

> 4, but disseminated this morning in a public notice of FDA actions.

>

> In malignant neuroleptic syndrome, patients experience muscle rigidity,

> extreme variations in body temperature and wild fluctuations of heart

> rate

> and blood pressure -- all signs of malfunction in the body's autonomic

> nervous system, which regulates involuntary body functions. Malignant

> neuroleptic syndrome has been associated with older antipsychotic

> medication

> such as haloperidol, lithium salts and risperidone. But the

> widespread use

> of SSRI and SNRI antidepressants has made this syndrome a more common

> and

> visible affliction.

>

> With one in 10 Americans taking prescription antidepressants,

> medicines such

> as Zoloft, Prozac and Effexor are currently the most commonly prescribed

> class of drugs in the United States, just ahead of high-blood pressure

> medicine, according to the Centers for Disease Control. And SSRIs and

> SNRIs

> have become by far the most common types of antidepressant dispensed by

> pharmacies, driving a tripling of prescriptions since 1988.

>

> Malignant neuroleptic syndrome is a rare but extremely dangerous

> condition

> that results in death in, by some estimates, 10% to 20% of cases. Until

> recently, it was so uncommon it was unlikely to be recognized in many

> emergency departments. But the widespread use of SSRIs and SNRI

> antidepressants had made this bizarre syndrome a more common

> affliction seen

> in emergency departments.

>

> A Food and Drug Administration spokeswoman said this afternoon that

> she had

> not been notified of the labeling change and was unaware of what led

> to it.

> Watch this space.

>

> -- Melissa Healy

>

>

> FAIR USE NOTICE: This may contain copyrighted (C ) material the use

> of which

> has not always been specifically authorized by the copyright owner. Such

> material is made available for educational purposes, to advance

> understanding of human rights, democracy, scientific, moral, ethical,

> and

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