medications in the media

drumwhacker · Apr 21, 2006

Well.... you touched on two of the current hot button drug classes. The use of stimulants such as Adderall and Ritalin for treating ADHD in children will likely be an ongoing controversy for many years. Additionally, the use of SSRI's in children and their potential for actually increasing depressive/suicidal thoughts has been widely discussed in the media; both in the news and entertainment programming.

RANT ALERT***As the research on the origins of childhood behavioral/emotional disorders grows, perhaps some of the misinformation will be clarified. I recently saw a documentary that suggested many behavioral deficits in chidren are established by the age of 2. More specifically, violent behaviors either become engrained or are resolved at a very young age. Imagine the sociocultural implications this would have if it became mainstream! While we attempt to "fix" our kids with the latest wonder drug, the focus on prevention/early intervention gets pushed to the side.

Sorry for the rant, but what ever happened to parental responsibility in teaching children appropriate social behavior??? I consider myself an open-minded, free-thinking person and I'm still awestruck by our culture of thinking there's a "quick fix" and "there's a pill for everything" (I worked as an adolescent counselor for several years after my master's degree and intend to work as a psychiatric RN). ***END OF RANT.

OK... whew..... :selfbonk: : Another drug class that continues to receive considerable attention, albeit outside of the psychiatric community, is the Cox-2 inhibitor NSAID's. Vioxx has been pulled off the market and the others are very seldom used. Merck, the manufacturer of Vioxx, has been forced to pay several settlements to people who died of cardiac problems while taking the drug (example: http://news.bbc.co.uk/2/hi/business/4932722.stm).

Finally, if I were to venture a guess on another potential drug class of controversy, it would be the "Statins". While these drugs seem to be an excellent adjunct to other conventional anti-platelet therapies, their touted (by the drug companies) benefits as anti-cholesterol agents are beginning to draw some ire from physicians. I've spoken to some who have noted that the whole "good cholesterol vs. bad cholesterol" argument seems to have been started by drug companies in order to benefit sales. Some current research shows little if any correlation between using statins to alter cholesterol levels and a decreased risk of cardiac events.

Some of the second-generation antipsychotics, such as Abilify, have apparently increased the risk of hyperglycemia in the elderly population. While no definite correlation has been specified due to the tendency of the population to be at high risk for diabetes anyway, a plausible relationship has been noted (www.fda.gov/medwatch/safety/2004/safety04.htm).

The last two drug classes have seen little controversy in the media at this point, but they seemed worthy of discussion since drugs that are over-hyped or that have catastrophic side-effects are the ones on which the media will eventually focus.

Good Luck!

dw

work4choc · Apr 21, 2006

While we attempt to "fix" our kids with the latest wonder drug, the focus on prevention/early intervention gets pushed to the side.
Sorry for the rant, but what ever happened to parental responsibility in teaching children appropriate social behavior???

OK I have to rant here for a minute *warning* Just had to let you know there are still SOME of us out here that have been working our tails off on this since our children were babies and first exhibited typical inappropriate social behavior. Then, as other kids grew out of it and ours did not, enlisted the help of professionals, books by professionals, teachers, doctors, nurses, etc....Just because a kid has behavior problems does not mean that the parents have been shirking responsiblity or started too late. Sometimes there is a neurologic basis to the behavior and it is a two steps forward, one step back process to help them learn to control their behavior. I'm freaking exhausted by it and could probably teach classes on behavior management techniques. We don't medicate because our child has tics and I don't want the stimulants to make them worse than they already are. *end of my rant*

Back to the original topic, I think your suggestions are good!

The only other thing I could add would be off-label prescribing - giving a med for a diagnosis it is not approved for. I think Depakote is used in childhood bipolar disorder but it is approved in kids only as an anticonvulsant. Clonidine is used for impulsive behavior in kids, but is not labeled for that. That kind of thing....not sure how controversial it is though.

Good luck with your presentation brittney!

drumwhacker · Apr 21, 2006

OK I have to rant here for a minute *warning* Just had to let you know there are still SOME of us out here that have been working our tails off on this since our children were babies and first exhibited typical inappropriate social behavior. Then, as other kids grew out of it and ours did not, enlisted the help of professionals, books by professionals, teachers, doctors, nurses, etc....Just because a kid has behavior problems does not mean that the parents have been shirking responsiblity or started too late. Sometimes there is a neurologic basis to the behavior and it is a two steps forward, one step back process to help them learn to control their behavior. I'm freaking exhausted by it and could probably teach classes on behavior management techniques. We don't medicate because our child has tics and I don't want the stimulants to make them worse than they already are. *end of my rant*

Great to hear! And I hope you realize that my rant wasn't an indictment of the folks like you who are out there doing everything within their power to rear a healthy/happy child. My frustration is with the ones who do nothing and expect perfection. Also, I was talking more about simple violence and impulse control than issues that have a definable origin in psychiatric/neurological/physical disorders. I apologize for not clarifying myself better. People like you are the ones who actually restore a bit of my hope for our society. Thanks for your comments :)

And...sorry for deviating from the original thread.. I hope we haven't thrown you for too much of a loop, Brittney :flowersfo Let me know if I can help you further.

dw

pattyjo, MSN, RN · Apr 22, 2006

>>Finally, if I were to venture a guess on another potential drug class of

Some of the second-generation antipsychotics, such as Abilify, have apparently increased the risk of hyperglycemia in the elderly population. While no definite correlation has been specified due to the tendency of the population to be at high risk for diabetes anyway, a plausible relationship has been noted (www.fda.gov/medwatch/safety/2004/safety04.htm).

True, plus further studies have prompted a black box warning on these meds due to unexpected cardiac-related deaths and deaths from infection. Also addresses the "off label" issue since none of these are approved for use in agitation with dementia. (Someone correct me if that has been updated)

http://www.fda.gov/cder/drug/advisory/antipsychotics.htm

Patty