Saving Normal
By SAURABH JHA, MD
The iconoclastic psychiatrist Thomas Szasz said that mental illness was metaphorical, not real, because mental diseases lacked biological substrates. The absence of a substrate predisposes psychiatry to overdiagnosis and avoiding overdiagnosis is psychiatry’s biggest challenge. This challenge has been taken up by Allen Frances in Saving Normal. Like Szasz, Frances writes in cultured, erudite prose. Unlike Szasz, Frances believes that psychiatric illnesses are real. To save the mentally ill, to save psychiatry from itself, Frances says we must save normal.
Six years ago, Frances was enjoying retireme...
Source: The Health Care Blog - December 16, 2015 Category: Consumer Health News Authors: Simon Nath Tags: THCB Saurabh Jha Source Type: blogs
Prescription Drugs And The Slowdown In Health Care Spending
Several studies have examined the underlying sources for the recent slowdown in health care spending. These analyses have focused largely on the role of the 2007-2009 recession, the increasing prevalence of high deductible health insurance plans, and other structural changes in the payment and delivery of care. However, the studies examining these factors do not account for the full decline in spending, or raise questions about the pattern and timing of the slowdown.
Role Of Prescription Drugs In The Health Spending Slowdown
Certainly the recession accounted for a component of the post 2007 slowdown in spending. However, t...
Source: Health Affairs Blog - November 18, 2015 Category: Health Management Authors: Kenneth Thorpe and Jason Hockenberry Tags: Costs and Spending Drugs and Medical Technology Featured Quality generic drugs medication adherence Prescription Drugs Source Type: blogs
The Good, the Bad, and the Ugly
The urine drug screen commonly utilized in the emergency department is an immunoassay that uses antibodies to detect specific drugs or their metabolites. This allows for rapid screening for drugs of abuse, but it has many limitations.
Gas chromatography-mass spectrometry (GC-MS) is the confirmatory test, but it is more costly, time-consuming, and generally can only be performed by outside laboratories. This confirmatory test is generally not useful in the emergency department, but has a role in cases of pediatric exposures, research, or occupational drug testing.
One of the limitations of a urine drug screen a...
Source: The Tox Cave - June 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
The Good, the Bad, and the Ugly
The urine drug screen commonly utilized in the emergency department is an immunoassay that uses antibodies to detect specific drugs or their metabolites. This allows for rapid screening for drugs of abuse, but it has many limitations.
Gas chromatography-mass spectrometry (GC-MS) is the confirmatory test, but it is more costly, time-consuming, and generally can only be performed by outside laboratories. This confirmatory test is generally not useful in the emergency department, but has a role in cases of pediatric exposures, research, or occupational drug testing.
One of the limitations of a urine drug s...
Source: The Tox Cave - June 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Patch Down the Hatch
A 42-year-old man presented with somnolence. His initial vital signs were heart rate 54 bpm, blood pressure 92/68 mm Hg, temperature 37°C, respiratory rate 6, and pulse oximetry 90% on room air. His physical examination was remarkable for depressed level of consciousness, miosis, and bradypnea. His mental status and respiratory rate temporarily improved with the administration of 0.04 mg naloxone. He reports swallowing several “patches” in a suicide attempt.
Popular transdermal patches are listed in the table. Others include diclofenac, buprenorphine, hormone patches (estrogen, contraceptive, testosterone), methy...
Source: The Tox Cave - March 31, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Patch Down the Hatch
A 42-year-old man presented with somnolence. Initial vital signs include: heart rate 54 bpm, blood pressure 92/68 mm/Hg, temperature 37°C, respiratory rate 6, pulse oximetry 90% on room air. Physical examination is remarkable for depressed level of consciousness, miosis, and bradypnea. His mental status and respiratory rate temporarily improved with the administration of 0.04 mg naloxone. He reports swallowing several “patches” in a suicide attempt.
What are examples of medications available as a transdermal patch? Compare the dose of drug delivered and the patch content.
Popular transdermal patches are listed bel...
Source: The Tox Cave - March 31, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Medicating Our Kids: The Agony of Making a Decision
In his June 6 Director’s Blog, Thomas Insel, head of the NIMH, reports that:
According to a CDC study cited at a recent Carter Center symposium, 10,000 toddlers may be receiving psychostimulant medication, such as Ritalin.
According to the National Center for Health Statistics, 7.5 percent of US children ages 6-17 took meds for “emotional or behavioral difficulties in 2011-2012.
The CDC reports a five-fold increase of kids on... (Source: John McManamy's SharePosts)
Source: John McManamy's SharePosts - September 1, 2014 Category: Mental Illness Authors: John McManamy Source Type: blogs
Once an Addict, Always an Addict?
This is a saying I’ve always grappled with. One part of me is against any type of labeling, let alone a heavy label to be carried for the rest of your life. We are all so interchangeably dynamic, that to categorize someone into a box forever doesn’t sit well.
Another part of me completely agrees with this statement and perceives it to be utterly valid. Instead of denying who you are, true acceptance perhaps is the only way to not only recover, but to continue to maintain your recovery. However much I am against “branding” someone for life, it is human nature to create categorizes in order to piece things togethe...
Source: World of Psychology - August 30, 2014 Category: Psychiatrists and Psychologists Authors: Kristin Bach Tags: Addiction Celebrities Habits Health-related Mindfulness Personal Recovery Born Again Designer Drugs Party Drugs Peer Pressure Self Acceptance smoking Substance Abuse Source Type: blogs
Update: Why brain training needs to be better targeted, and more widely available
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Time for SharpBrains’ August 2014 e-newsletter, featuring a wealth of insights, science and technology reports…and this brain teaser to exercise your mental rotation abilities. Enjoy!
New trends:
How to incorporate mindfulness into psychotherapy
Challenging the outdated “fixed brain” dogma, the cognitive training market keeps growing
Increased awareness and use of cognitive assessments seen as dementia-related priorities by RAND policy brief
Playing table tennis to enhance mental health
Beauty in and out: Brain training workshop @ Estée Lauder
New research:
Use of methylphenidate-based ADHD medic...
Source: SharpBrains - August 29, 2014 Category: Neurologists Authors: SharpBrains Tags: Cognitive Neuroscience Education & Lifelong Learning Health & Wellness Technology Accenture Brain-Fitness Brain-Training Cognitive-Training Emotiv Gaiam Interaxon market Mental-Health mindfulness neuroplasticity Philips Psy Source Type: blogs
Study: Use of methylphenidate-based ADHD medication increases the risk of heart problems
ADHD medication enhances the risk of heart problems in children (Science Nordic):
“The risk of developing heart problems is twice as big for children taking medicine for Attention Deficit-Hyperactivity Disorder (ADHD) when compared to children not receiving the medicine…The study builds on data from 714,000 children born in 1990–1999…The study covered nearly all types of ADHD medicine. Methylphenidate-based medications account for 98 per cent of treatments. This group of medication is sold under the brands Concerta, Methylin, Ritalin, Equasym XL, Motiron and Medikinet…
To make sure that the measured difference wa...
Source: SharpBrains - August 20, 2014 Category: Neurologists Authors: SharpBrains Tags: Attention and ADD/ADHD Health & Wellness ADHD-diagnosis ADHD-medication cardiovascular Concerta Equasym XL heart problems Medikinet Methylin methylphenidate Motiron Ritalin Source Type: blogs
Hunting For the Marijuana-Dopamine Connection
Why do heavy pot smokers show a blunted reaction to stimulants?Most drugs of abuse increase dopamine transmission in the brain, and indeed, this is thought to be the basic neural mechanism underlying the rewarding effects of addictive drugs. But in the case of marijuana, the dopamine connection is not so clear-cut. Evidence has been found both for and against the notion of increases in dopamine signaling during marijuana intoxication. Marijuana has always been the odd duck in the pond, research-wise. Partly this is due to longstanding federal intransigence toward cannabis research, and partly it is because cannabis, chemic...
Source: Addiction Inbox - July 21, 2014 Category: Addiction Authors: Dirk Hanson Source Type: blogs
Battling Cancer – and Losing My Mind
I have been trying to complete a blog for the past few weeks. My mind won’t focus, I am easily distracted and I have difficulty finding the words I want to use.
The only thing I can attribute this to is chemo brain. In addition to the surreal aspect of being diagnosed and treated for advanced cancer, the impact of the treatment on my cognitive process makes me feel like I am dealing with a disability.
The American Cancer Society quotes doctors as saying chemo brain is “mild cognitive impairment.” But the thought of returning to work as a registered nurse with this debilitating brain condition concerns me more than th...
Source: Life with Breast Cancer - April 16, 2014 Category: Cancer Authors: Kathy-Ellen Kups, RN Tags: Breast Cancer chemo brain chemo therapy metastatic breast cancer Source Type: blogs
Losing to Ritalin but Accepting that it was the Right Choice
After more than a year of alternative methods, Ritalin provided the cognitive relief that was needed to re-establish a good learning routine, a healthy personal outlook, and an overall more successful day.Contributor: Jo BrodeckiPublished: Mar 08, 2014 (Source: Most Recent Health Wellness - Associated Content)
Source: Most Recent Health Wellness - Associated Content - March 9, 2014 Category: Other Conditions Source Type: blogs
ADHD Study: Reducing the Need for High Medication Doses with Behavior Therapy
Medication treatment and behavior therapy are both considered effective treatments for ADHD; the combination of these treatments is generally regarded as an ideal approach for many children. However, in the Multimodal Treatment Study of ADHD (MTA Study), the largest ADHD treatment study ever conducted, the benefit of combined treatment relative to medication treatment alone — while significant for some outcome measures — was not especially robust. This has led some professionals to question whether behavior therapy is necessary when a child is being effectively treated with medication, i.e., will behavior therapy make ...
Source: SharpBrains - February 21, 2014 Category: Neurologists Authors: Dr. David Rabiner Tags: Attention and ADD/ADHD Cognitive Neuroscience behavior-therapy medication Source Type: blogs
Study: Neurofeedback brain training can complement ADHD stimulant medications
CONCLUSION: Neurofeedback made greater improvements in ADHD symptoms compared to both the control and CT conditions. Thus, NF is a promising attention training treatment intervention for children with ADHD.
Related articles:
Biofeedback is a “Level 1 — Best Support” Intervention for Attention and Hyperactivity Behaviors
FDA clears use of EEG-based ADHD test
Sensible and perplexing changes in ADHD diagnostic criteria (DSM-V) (Source: SharpBrains)
Source: SharpBrains - February 17, 2014 Category: Neurologists Authors: SharpBrains Tags: Attention and ADD/ADHD Cognitive Neuroscience Education & Lifelong Learning Health & Wellness Adderall attention deficit hyperactivity disorder attention-training Brain-Training cognitive-therapy medication Neurofeedback pediatrics Source Type: blogs
