Evidence That Altered Amygdala Activity in Schizophrenia Is Related to Clinical State [ie the drugs someone is taking] and Not Genetic Risk
Roberta Rasetti, M.D., Venkata S. Mattay, M.D., Lisa M. Wiedholz, B.A., Bhaskar S. Kolachana, Ph.D., Ahmad R. Hariri, Ph.D., Joseph H. Callicott, M.D., Andreas Meyer-Lindenberg, M.D., Ph.D., and Daniel R. Weinberger, M.D.
http://ajp.psychiatryonline.org/cgi/content/abstract/166/2/216
OBJECTIVE: Although amygdala dysfunction is reported in schizophrenia, it is unknown whether this deficit represents a heritable phenotype that is related to risk for schizophrenia or whether it is related to disease state. The purpose of the present study was to examine amygdala response to threatening faces among healthy siblings of schizophrenia patients in whom a subtler heritable deficit might be observed. METHOD: Participants were 34 schizophrenia patients, 29 unaffected siblings, and 20 healthy comparison subjects. Blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) was conducted during an implicit facial information processing task.
The N-back working memory task, which has been shown to elicit prefrontal cortex abnormalities in unaffected siblings of schizophrenia patients, was employed as a positive experimental control. RESULTS:
Schizophrenia patients demonstrated a deficit in amygdala reactivity to negative face stimuli and an alteration, correlated with neuroleptic drug dosage, in the functional coupling between the amygdala and subgenual cingulate. In contrast, unaffected siblings showed a pattern that was not statistically different from that of healthy comparison subjects. ...
...
CONCLUSIONS: These data suggest that the pathophysiological mechanism underlying the inability of individuals with schizophrenia to normally engage the amygdala in processing fearful and angry facial representations is more likely a phenomenon related to the disease state, specifically to treatment. - snip [inline bolding is mine, the words are from the experimenters -padraic]
Showing posts with label meds. Show all posts
Showing posts with label meds. Show all posts
Thursday, October 01, 2009
Thursday, May 07, 2009
academics in psychiatry call for better research standards- letter to NEJM
link to article-
http://content.nejm.org/cgi/content/full/360/19/2035
Today, the field of psychiatry is perceived to have suffered a unique "crisis of credibility" with respect to the growing influence of pharmaceutical companies on organized psychiatry.1
The reaction of the organization that is increasingly in question, the American Psychiatric Association (APA), has ranged from calling for greater transparency — mandating that all members of task forces that produce its diagnostic guidelines (i.e., the Diagnostic and Statistical Manual of Mental Disorders [DSM]) complete financial-disclosure statements — to labeling critics' concerns about conflicts of interest as a "well documented antimedication bias."2 However, it is clear that transparency alone is not enough of a safeguard: approximately 68% of the members of the DSM-V task force reported having industry ties, which represents a relative increase of 20% over the proportion of DSM-IV task-force members with such ties. Also, of the 137 DSM-V panel members who have posted disclosure statements, 77 (56%) have reported having industry ties, such as holding stock in pharmaceutical companies, serving as consultants to industry, or serving on company boards3 — no improvement over the 56% of DSM-IV members who were found to have such industry relationships.4 If financial conflicts of interest are not reduced, private-sponsor bias in research will be exacerbated.
Moreover, both disclosure requirements and specific policies about the management of existing conflicts of interest are missing in the APA's clinical practice guidelines. This is an especially important omission because these guidelines are seen by many as the standard for evidence-based medicine in clinical psychiatry. The APA is in the process of revising both its diagnostic guidelines and some of its most influential clinical practice guidelines (e.g., for bipolar disorder and major depressive disorder). Thus, it would be both timely and prudent for the APA to take this opportunity to address the gaps in existing policies regarding transparency and the management of conflicts of interest. For example, unrestricted research grants were excluded from disclosure requirements, and currently, there are no policies for managing indirect financial ties, such as industry funds that are pooled and given to academic departments, hospitals, and medical schools. To strengthen its current conflict-of-interest policy and monitor the process for the development of unbiased diagnostic and treatment guidelines, the APA will need to substantially free itself from its extensive financial ties to pharmaceutical companies.
.. as of today I have 3 NEW heros - padraic
http://content.nejm.org/cgi/content/full/360/19/2035
Today, the field of psychiatry is perceived to have suffered a unique "crisis of credibility" with respect to the growing influence of pharmaceutical companies on organized psychiatry.1
The reaction of the organization that is increasingly in question, the American Psychiatric Association (APA), has ranged from calling for greater transparency — mandating that all members of task forces that produce its diagnostic guidelines (i.e., the Diagnostic and Statistical Manual of Mental Disorders [DSM]) complete financial-disclosure statements — to labeling critics' concerns about conflicts of interest as a "well documented antimedication bias."2 However, it is clear that transparency alone is not enough of a safeguard: approximately 68% of the members of the DSM-V task force reported having industry ties, which represents a relative increase of 20% over the proportion of DSM-IV task-force members with such ties. Also, of the 137 DSM-V panel members who have posted disclosure statements, 77 (56%) have reported having industry ties, such as holding stock in pharmaceutical companies, serving as consultants to industry, or serving on company boards3 — no improvement over the 56% of DSM-IV members who were found to have such industry relationships.4 If financial conflicts of interest are not reduced, private-sponsor bias in research will be exacerbated.
Moreover, both disclosure requirements and specific policies about the management of existing conflicts of interest are missing in the APA's clinical practice guidelines. This is an especially important omission because these guidelines are seen by many as the standard for evidence-based medicine in clinical psychiatry. The APA is in the process of revising both its diagnostic guidelines and some of its most influential clinical practice guidelines (e.g., for bipolar disorder and major depressive disorder). Thus, it would be both timely and prudent for the APA to take this opportunity to address the gaps in existing policies regarding transparency and the management of conflicts of interest. For example, unrestricted research grants were excluded from disclosure requirements, and currently, there are no policies for managing indirect financial ties, such as industry funds that are pooled and given to academic departments, hospitals, and medical schools. To strengthen its current conflict-of-interest policy and monitor the process for the development of unbiased diagnostic and treatment guidelines, the APA will need to substantially free itself from its extensive financial ties to pharmaceutical companies.
.. as of today I have 3 NEW heros - padraic
Wednesday, September 24, 2008
In the news recently about kids and medical research on psych meds
As the concerned father of a 'bipolar child' who is now 17- and not doing too well- some recent news disturbs me...
Harvard-
A world-renowned Harvard child psychiatrist whose work has helped fuel an explosion in the use of powerful antipsychotic medicines in children earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007 but for years did not report much of this income to university officials, according to information given Congressional investigators [what would happen to ME or you if we didn't report even 2 thousand bucks in income or consulting fees ?!? Something just doesn't seem right here. Spiro Agnew resigned the VP slot under Nixon for much less of an IRS affront- as I recall.]
By failing to report income, the psychiatrist, Dr. Joseph Biederman, and a colleague in the psychiatry department at Harvard Medical School, Dr. Timothy E. Wilens, may have violated federal and university research rules designed to police potential conflicts of interest, according to Senator Charles E. Grassley, Republican of Iowa. Some of their research is financed by government grants.
NY Times
Ohio
The University of Cincinnati will increase scrutiny on a psychiatry professor for not reporting all of the hundreds of thousands of dollars in corporate research money she received from a pharmaceutical giant during the last decade.
Melissa DelBello now has to review all of of her interactions with companies with her department chairman, UC vice president of research Sandra Degen said Friday.
DelBello's teaching and research haven't been restricted, but the fact that she didn't tell the university about some of her outside income has been detailed in her personnel file.
link to news source
Brown University in Rhode Island- [Professor] Keller has gained notoriety for authoring a controversial clinical study of the antidepressant drug paroxetine - marketed as Paxil in the United States - which concluded that the drug was safe and effective in adolescents. Keller and some of the study's co-authors have been accused by doctors, lawyers and journalists of having the 2001 study ghostwritten, earning large sums of money from Paxil's maker, GlaxoSmithKline. In addition, some say the researchers manipulated and suppressed data - including those showing increased suicidal tendencies in children taking the drug.Island
link to news source
Texas
According to [Senator] Grassley's research, Dr. Wagner, who is on the faculty at UTMB in Galveston, was paid more than $160,000 from GlaxoSmithKline between 2000 and 2005, though she reported just $600 to the university. In 2000 and 2001, she worked on a major study on the company's drug Paxil research that has been widely criticized for over-promoting positive findings while downplaying heightened suicidal thoughts and behavior in adolescents.
link to news source
Harvard-
A world-renowned Harvard child psychiatrist whose work has helped fuel an explosion in the use of powerful antipsychotic medicines in children earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007 but for years did not report much of this income to university officials, according to information given Congressional investigators [what would happen to ME or you if we didn't report even 2 thousand bucks in income or consulting fees ?!? Something just doesn't seem right here. Spiro Agnew resigned the VP slot under Nixon for much less of an IRS affront- as I recall.]
By failing to report income, the psychiatrist, Dr. Joseph Biederman, and a colleague in the psychiatry department at Harvard Medical School, Dr. Timothy E. Wilens, may have violated federal and university research rules designed to police potential conflicts of interest, according to Senator Charles E. Grassley, Republican of Iowa. Some of their research is financed by government grants.
NY Times
Ohio
The University of Cincinnati will increase scrutiny on a psychiatry professor for not reporting all of the hundreds of thousands of dollars in corporate research money she received from a pharmaceutical giant during the last decade.
Melissa DelBello now has to review all of of her interactions with companies with her department chairman, UC vice president of research Sandra Degen said Friday.
DelBello's teaching and research haven't been restricted, but the fact that she didn't tell the university about some of her outside income has been detailed in her personnel file.
link to news source
Brown University in Rhode Island- [Professor] Keller has gained notoriety for authoring a controversial clinical study of the antidepressant drug paroxetine - marketed as Paxil in the United States - which concluded that the drug was safe and effective in adolescents. Keller and some of the study's co-authors have been accused by doctors, lawyers and journalists of having the 2001 study ghostwritten, earning large sums of money from Paxil's maker, GlaxoSmithKline. In addition, some say the researchers manipulated and suppressed data - including those showing increased suicidal tendencies in children taking the drug.Island
link to news source
Texas
According to [Senator] Grassley's research, Dr. Wagner, who is on the faculty at UTMB in Galveston, was paid more than $160,000 from GlaxoSmithKline between 2000 and 2005, though she reported just $600 to the university. In 2000 and 2001, she worked on a major study on the company's drug Paxil research that has been widely criticized for over-promoting positive findings while downplaying heightened suicidal thoughts and behavior in adolescents.
link to news source
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