Psychosis risk syndrome DSM5, medicated military, drug makers’ profits outweigh penalties, dark side of birth control pill: Monday news and blogs


  • DSM5 ‘Psychosis Risk Syndrome’–Far Too Risky — Psychology Today — Among all the problematic suggestions for DSM5, the proposal for a ” Psychosis Risk Syndrome” stands out as the most ill conceived and potentially harmful. It aims to solve a pressing problem in psychiatry–the need for early identification and preventive treatment. Psychotic episodes create tremendous short term impairment and may impact negatively on long term prognosis and treatment efficacy. It would save great suffering if we could get there early and do something useful to reduce the lifetime burden of illness before too much damage is done. — But good intentions are not enough. The whole concept of early intervention rests on three fundamental pillars- being able to diagnose the right people and then providing them with a treatment that is effective and safe. “Psychosis Risk Syndrome” fails badly on all three counts: 1) it would misidentify many teenagers who are not really at risk for psychosis; 2) the treatment they would most often receive (atypical antipsychotic medication) has no proven efficacy; but, 3) it does have definite dangerous complications. — First, let’s deal with the misidentification problem. Even in the most expert of hands (ie in very highly selected research clinics), at least two of three people who get the diagnosis do not go on to become psychotic. Of great counterintuitive interest, the longer the research clinic operates the lower becomes its rate of correct identification. With time and spreading reputation, the clinic attracts increasingly heterogeneous referrals- so that it is more difficult to discriminate from among them those who are truly at risk for psychosis.
  • Medicating the military — Army Times — Use of psychiatric drugs has spiked; concerns surface about suicide, other dangers
  • When drug makers’ profits outweigh penalties — Washington Post  —  For this new felony, Pfizer paid the largest criminal fine in U.S. history: $1.19 billion. On the same day, it paid $1 billion to settle civil cases involving the off-label promotion of Bextra and three other drugs with the United States and 49 states. — “At the very same time Pfizer was in our office negotiating and resolving the allegations of criminal conduct in 2004, Pfizer was itself in its other operations violating those very same laws,” Loucks, 54, says. “They’ve repeatedly marketed drugs for things they knew they couldn’t demonstrate efficacy for. That’s clearly criminal.” — The penalties Pfizer paid for promoting Bextra off-label were the latest chapter in the drug’s benighted history. The FDA found Bextra to be so dangerous that Pfizer took it off the market for all uses in 2005. — Across the United States, pharmaceutical companies have pleaded guilty to criminal charges or paid penalties in civil cases when the Justice Department finds that they deceptively marketed drugs for unapproved uses, putting millions of people at risk of chest infections, heart attacks, suicidal impulses or death.

About Monica Cassani

Author/Editor Beyond Meds: Everything Matters