NY Times Reports on Antipsychotic Drugs Having Side Effects

http://www.nytimes.com/2009/01/15/health/research/15psych.html?_r=1&ref=health
By BENEDICT CAREY and RONI CARYN RABIN
Published: January 14, 2009
The popular drugs known as atypical antipsychotics, prescribed for an array of conditions, including schizophrenia, autism and dementia, double patients’ risk of dying from sudden heart failure, a study has found.
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Atypical Antipsychotic Drugs and the Risk of Sudden Cardiac Death (NEJM)
The finding is the latest in a succession of recent reports contradicting the long-held assumption that the new drugs, which include Risperdal, Zyprexa and Seroquel, are safer than the older and much less expensive medications that they replaced.
The risk of death from the drugs is not high, on average about 3 percent in a person being treated at least 10 years, according to the study, published Thursday in The New England Journal of Medicine. Nor was the risk different from that of the older antipsychotic drugs.
But it was significant enough that an accompanying editorial urged doctors to limit their prescribing of antipsychotic drugs, especially to children and elderly patients, who can be highly susceptible to the drugs’ side effects, including rapid weight gain.
In recent years, the newer drugs, which account for about 90 percent of the market, have become increasingly controversial, as prescription rates to children and elderly people have soared. Doctors use the drugs to settle outbursts related to a host of psychiatric disorders, including attention deficit disorder and Alzheimer’s disease. Most are not approved for such use. After an analysis of study data, the Food and Drug Administration required that all antipsychotics’ labels contain a warning that the drugs were associated with a heightened risk of heart failure in elderly patients.
The new study, an analysis of more than 250,000 Medicaid records, is the first to rigorously document that risk for the newer drugs in adults over 30 without previous heart problems.
In the study, researchers at Vanderbilt University and the Nashville Veterans Affairs Medical Center analyzed Tennessee Medicaid records for 276,907 people ages 30 to 74. About a third of them began taking an antipsychotic medication in the period studied, from 1990 to 2005, either a newer atypical or an older drug. Two-thirds made up a control group. The researchers excluded patients with heart disease or other problems that might put them at higher risk of cardiac failure. Antipsychotic drugs can affect heart rhythm in some vulnerable people.
They found 478 sudden cardiac deaths among those taking the drugs, about twice the rate of the control group. The risk — equivalent to 3 deaths for every 1,000 patients taking the drugs for a year — was about the same whether people took the newer or older medications. The higher the dose of the drug, the study found, the higher the risk of sudden death.
“The implication of this study is that physicians need to do a very careful cardiovascular evaluation prior to prescribing these drugs,” especially if there are alternative treatments, said the lead author, Wayne A. Ray, a professor of preventive medicine at Vanderbilt and the Nashville veterans’ hospital. “Then, if they’re used, to pay careful attention to using the lowest possible dose.”
Dr. Ray’s co-authors were Dr. Cecilia P. Chung, Dr. Katherine T. Murray, Kathi Hall, and C. Michael Stein, all of Vanderbilt.
In 2005, government-sponsored researchers reported that three of four new antipsychotic drugs tested were no more effective than an older, far less expensive drug in treating schizophrenia — the disorder for which they were originally approved.
In 2006, doctors working on the same large study reported that the drugs were no more effective than placebos for most elderly patients being treated for dementia-related psychosis. Since then, several review articles have come to similar conclusions, and raised concern about a far more common side effect: weight gain.
“When it comes to treating kids, these cardiac events are going to be rare,” said Dr. Jon McClellan, a psychiatrist at the University of Washington. “But heart problems due to obesity are not rare, and the public-health implications of kids on these drugs gaining 10 to 15 pounds are much greater.”

BBC Reports on Injectable Ginseng Fatalities

http://news.bbc.co.uk/2/hi/asia-pacific/7660489.stm

Ginseng jabs kill three in Yunnan

In East Asia ginseng is believed to have multiple health benefits
Three people have died in south-western China after receiving an injection of Siberian ginseng extract.
The deaths, announced on China's health ministry web site, occurred in Yunnan province after six hospital patients received the injections.
It said sales and use of the ginseng extract had been suspended.
The ministry is also trying to dampen fears about melamine poisoning of milk, which has killed four babies and made thousands ill in a months-long scandal.
It said that 10,666 babies remained in hospital receiving treatment for renal problems caused by the melamine contamination of baby milk formula.
Some parents are taking legal action against the manufacturer at the centre of the scandal, the Sanlu Group, and the state quality supervision body.
Ginseng treatment
The ginseng injection was manufactured by Wandashan Pharmaceutical, based in the north-eastern Chinese province of Heilongjiang.
Siberian ginseng is often used in China to treat heart disease and thrombosis.
The six patients suffered "serious ill effects" including chills, vomiting and sudden drops in blood pressure after receiving the injections at the Number Four People's Hospital in Honghe prefecture on Sunday.
Some went into a coma. Three of the six died on Monday, official media reported two days later.
The State Food and Drug Administration (SFDA) says it has isolated two problematic batches of the extract, made from a herb called "ciwujia", and has urged immediate nationwide reporting of any adverse effects.
The Associated Press reports that a man who answered the telephone at Wandashan's marketing department in Heilongjiang, in China's north-east, said the company had stopped selling the herbal injection and had sent the two batches to the SFDA for testing.
The man was reported as saying the company had used ciwujia in its products for more than 30 years without any problem.
Poor regulation
He added that the injectable form of the herb was relatively new, saying: "I haven't heard of any bad reaction [to] this injection before."
China's pharmaceutical industry is highly lucrative but poorly regulated.
Last year, the country's former top drug regulator was executed for taking millions of dollars in bribes to approve substandard medicines, including an antibiotic that killed at least 10 people.

One Third Of Cancer Patients Use Natural Medicine

More great news from BBC
http://news.bbc.co.uk/2/hi/health/4228903.stm

Cancer alternative therapy trend

Herbs were the most popular among those surveyedA third of European cancer patients are using complementary and alternative therapies, a survey of 1,000 suggests.
Herbs are used the most, followed by homeopathy and vitamin and mineral supplements, according to European Oncology Nursing Society members.
Given their popularity, governments should rethink the way these treatments are regulated, they said.
Therapists should also be checked more rigorously, the report in the Annals of Oncology journal suggested.
We have a responsibility as professionals to look at this
Lead researcher Dr Alex Molassiotis
'Holistic therapy helped me'
Dr Alex Molassiotis, from the UK's Manchester University, along with European colleagues, surveyed nearly 1,000 cancer patients from 14 European countries.
About 58 different complementary and alternative medicines (CAM) were mentioned in the survey.
Usage rates varied from less than 15% of patients in Greece to nearly 75% in Italy, and averaged at about a third overall.
Patients typically used more than one CAM therapy together, such as a herbal medicine plus homeopathy or relaxation techniques.
Dr Molassiotis said considering the growing popularity of CAM, better regulation was needed.
Therapies used by cancer patients
Herbs
Homeopathy
Medicinal teas
Vitamins and minerals
Relaxation techniques
"Anybody can call himself or herself a therapist and practice.
"There is not a body to assess the quality of therapists.
"There are societies that therapists can register with, but it is not compulsory.
"There is a need for regulation of what is accepted and appropriate training."
Regulation
He said there was also a need for clear guidelines on which treatments work for which conditions.
"We have a responsibility as professionals to look at this and be open-minded."
We have got to make sure people feel as safe as they can through regulation and research
A spokeswoman from the Foundation for Integrated Health
In the UK, osteopathy and chiropractic are already statutorily regulated.
The Prince of Wales Foundation for Integrated Health was given a government grant last year to look into the regulation of other CAM therapies, including homeopathy, aromatherapy and reflexology.
The Foundation estimates that about one in five people are using CAMs for different ailments.
A spokeswoman from the foundation said: "We have got to make sure people feel as safe as they can through regulation and research."
Further research
Dr George Lewith, from the of the University of Southampton's Complementary Medicine Research Unit, cautioned that the study was too small to be able to make generalisations about rates of CAM use, but said there was no doubt that regulation was needed.
Dr Bob Leckridge president of the Faculty of Homeopathy, said many therapists were doctors, which meant they were regulated as an individual.
He thought all CAM practice should be subject to statutory regulation.
Dr Sosie Kassab from the Royal London Homeopathic Hospital said: "Therapies such as homeopathy can be useful as an adjunct to conventional care.
"Patients do say they benefit. We need further research into this."
Professor John Toy of Cancer Research UK said: "The National Cancer Research Institute has recently established a complementary therapies development group, showing the medical profession does not have a dismissive view of this topic."
He advised cancer patients to inform their doctors of all medications and therapies they were taking.

BBC News Reports on Red Clover Helping With Hot Flushes

Here is the link to the story:
http://news.bbc.co.uk/2/hi/health/4738277.stm

Red clover contains hormone-mimicking chemicalsScientists are testing an extract of red clover as an alternative to hormone replacement therapy for symptoms of the menopause, such as hot flushes.
The extract contains chemicals called isoflavones, which mimic the effects of the female sex hormone oestrogen.
A study will be carried out by Queen Charlotte's and Chelsea Hospital's menopause and PMS centre.
Use of HRT has declined in recent years following suggestions of an increased risk of stroke and breast cancer.
Since the scares about HRT some patients are just not taking anything at all
Dr Chun Ng
Guidance issued last year by the Royal College of Obstetricians and Gynaecologists concluded that HRT should only be used for short term relief of menopausal symptoms.
The Queen Charlotte team hope their work will provide women with an effective alternative.
Lead researcher Dr Chun Ng said: "We hope the product may help women with menopausal symptoms such as hot flushes, and also those with premenstrual syndrome.
"Problems such as hot flushes have a negative impact on quality of life, although many women simply suffer in silence.
"Since the scares about HRT, some patients are just not taking anything at all."
Respiratory remedy
Red clover is used as a herbal remedy for respiratory problems, particularly whooping cough.
It is also marketed as a treatment for chronic skin conditions such as eczema and psoriasis.
The Queen Charlotte team will also test a second treatment, using low doses of a compound known as desvenlafaxine succinate, which is thought to stabilise the body's heat control mechanism.
Professor David Purdie, of the Centre for Metabolic Disease at Hull University, told the BBC News website, an alternative therapy would be useful for women who either could not or would not take oestrogen-based HRT.
However, he stressed that taking oestrogen was currently by far the best way to tackle menopausal symptoms.
"There is evidence that long-term use of combined oestrogen and progesterone therapy does carry a slight increased risk of breast cancer, although the risk is probably much less for oestrogen-only therapy," he said.
"This has to be put into context. We are talking about just a few cases per 1,000 women over five years.
"Women have to decide whether the better quality of life HRT can offer them outweighs the small increased risks."
Professor Purdie also said the effects of oestrogen-like substances taken from plants had been hyped up somewhat.
He said trials of their effect had to be tightly controlled as previous studies had shown that women with menopausal symptoms often responded positively to dummy treatments.
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Getting Fit Without Breaking the Budget

I know that gym memberships are up in January due to many of our resolutions. After a few weeks, attendance drops because it is not what people thought, they lose motivation or they don't find the hours that work for them. Sometimes just changing the types of classes you attend, swimming or changing your exercise routine, can be enough to keep you interested.

Using equipment can be boring for some. You may love exercise and if you do, that is awesome.
A few ways that you can exercise and not notice the time passing are as follows:

• take a walk or your cross country skis through a scenic trail or in the country
• go tobaggoning, I recently did and was pooped after an hour, plus it was fun
• go dancing one or two nights a week
• learn to square dance, latin dance or even belly dance
• volunteer to walk dogs from the animal shelter
• help your elderly neighbour shovel or mow their lawn in the summer

If you want to buy exercise equipment you can often find used equipment online. I wasn't sure if I would use a home gym with weights. I just didn't find my hours worked with my gym. I loved the look and hype of a machine called the "bowflex", I decided to buy a used universal gym from www.craigslist.com or www.kijiji.com It only cost me $40.00, the man said he had it for years, used it only 4 times and it had become a place he hung his laudry. He was grateful to move it out of his place. Now my son and I use it a few times a week.

I also found an eliptical trainer at a liquidation store and saved $400.00 from the regular price. That was a real deal. There were also many used eliptical trainers, treadmills and other equipment I found online. If you are like me, you may find aerobic equipment feels like running on a hamster wheel. I used to try all kinds of good music to inspire me. Now I read a book (something I rarely have time for anymore) and I am suprised where the time went.

There are many ways to get active. If we could all move at least a half an hour each day, we will live a longer and healthier life.

Get Active this Year!

In the spirit of exercise, here is a cute funny to brighten your day:
http://www.youtube.com/watch?v=-I7WWYzEHEg

Happiness Can Be Contagious!

Life Extension puts out another good newsworthy piece again:
http://www.lef.org/news/LefDailyNews.htm?NewsID=7660&Section=AGING&source=DHB_090101&key=Body+ContinueReading

Happiness Just Might Be Contagious
International Herald Tribune
12-08-08
How happy you are may depend on how happy your friends' friends' friends are, even if you don't know them at all.
And a cheery next-door neighbor has more effect on your happiness than your spouse's mood.
So says a new study that followed a large group of people for 20 years - happiness is more contagious than previously thought.
"Your happiness depends not just on your choices and actions, but also on the choices and actions of people you don't even know who are one, two and three degrees removed from you," said Nicholas Christakis, a physician and social scientist at Harvard Medical School and an author of the study, published Friday in BMJ, a British journal. "There's kind of an emotional quiet riot that occurs and takes on a life of its own, that people themselves may be unaware of. Emotions have a collective existence - they are not just an individual phenomenon."
In fact, said his co-author, James Fowler, an associate professor of political science at the University of California at San Diego, their research found that "if your friend's friend's friend becomes happy, that has a bigger impact on you being happy than putting an extra $5,000 in your pocket."
The researchers analyzed information on the happiness of 4,739 people and their connections with several thousand others - spouses, relatives, close friends, neighbors and coworkers - from 1983 to 2003.
"It's extremely important and interesting work," said Daniel Kahneman, an emeritus professor of psychology and Nobel laureate at Princeton, who was not involved in the study.
Several social scientists and economists praised the data and analysis, but raised possible limitations.
Steven Durlauf, an economist at the University of Wisconsin- Madison, questioned whether the study proved that people became happy because of their social contacts or some unrelated reason.
Kahneman said that unless the findings were replicated, he could not accept that a spouse's happiness had less impact than a next- door neighbor's.
A study also published Friday in BMJ, by Ethan Cohen-Cole, an economist at the Federal Reserve Bank of Boston, and Jason Fletcher, an assistant professor at the Yale School of Public Health, criticizes the methodology of the Christakis-Fowler team, saying that it was possible to find what look like social-contagion effects with conditions like acne, headaches and height but that contagion effects go away when researchers include environmental factors that friends or neighbors have in common.
"Researchers should be cautious in attributing correlations in health outcomes of close friends to social network effects," the dissenting authors say.
In an interview, Christakis said that criticism and the acne- headache study's methods were flawed.
An accompanying BMJ editorial about the two studies called the Christakis-Fowler study "groundbreaking," but said "future work is needed to verify the presence and strength of these associations."
The team previously published studies concluding that obesity and quitting smoking were socially contagious.
But the happiness study, financed by the National Institute on Aging, is unusual in several ways. Happiness would seem to be "the epitome of an individualistic state," said John Cacioppo, director of the University of Chicago's Center for Cognitive and Social Neuroscience, who was not involved in the study.
And what about schadenfreude or its opposite, good old-fashioned envy when a friend lands a promotion or wins the marathon?
"There may be some people who become unhappy when their friends become happy, but we found that more people become happy over all," Christakis said.
Cacioppo said that suggests that unconscious signals of well- being pack more zing than conscious feelings of resentment.
"I might be jealous of the fact that they won the lottery," he said, "but they're in such a good mood that I walk away feeling happier without even being aware that they were the site for my happiness."
The subtle transmission of emotion may explain other findings, too. In the obesity and smoking cessation studies, friends were influential even if they lived far away. But the effect on happiness was much greater from friends, siblings or neighbors who lived nearby.
The BMJ study used data from the federal Framingham Heart Study, which began following people in Framingham, Massachusetts, after World War II and ultimately followed their children and grandchildren. Beginning in 1983, participants periodically completed questionnaires on their emotional well-being.