Paul Corona, 'Guru' doctor of mood-stabilizing drugs on probation for second time

From the Orange County Register

A doctor who described himself in an Orange County Register investigation as the “guru” of mood-stabilizing drugs has been put on probation for the second time by state medical regulators.

The Medical Board of California put Laguna Niguel physician Paul Corona on a five-year probation Friday for gross negligence in treating five patients and failing to maintain adequate medical records. He was also put on probation in 2009 after suffering a psychotic breakdown.

Corona, who described himself to the Register as the most prolific prescriber of mood-stabilizing drugs anywhere, is prohibited from supervising physician assistants during his probation.

Jodi Barber, whose son, Jarrod, overdosed in 2010 on a mixture of drugs, some prescribed by Corona, said the state was too lenient. “This is ridiculous. Remove his license permanently. How many slaps on the hand is he going to be given?” said Barber of Laguna Niguel. Her son did not appear to be one of the victims in the state complaint.

Corona was the subject of a 2011 investigation by the Register into how doctors overprescribed to teens, fueling a rise in Orange County overdoses. Coroner records show accidental fatal overdoses have risen steadily from 130 in 2003 to 291 in 2013. Corona preached the use of psychotropic drugs to remove the mental traumas that feed drug addiction.

“I am the top prescriber of psychotropic medications around,” Corona said. “Ninety-five percent of my patients are very happy.”

But drug addiction experts questioned Corona’s tactics, saying it didn’t make sense to use drugs to fight drugs. Dr. Harry Haroutunian, physician director at the famed Betty Ford Center in Rancho Mirage, told the Register in 2011 it is especially dangerous to prescribe drugs with sedative qualities when treating addicts in an outpatient setting, where they might score more drugs on the street.

“If he is telling you he is the highest prescriber,” Haroutunian said, “that would be a dubious distinction by my measuring stick.”

Corona first came under the state’s attention after Orange County sheriff’s deputies were sent to his Laguna Niguel home in 2007 to investigate reports of a man having a psychotic breakdown and threatening suicide, according to a medical board accusation.

“Respondent was acting bizarre and was very aggressive, yelling and screaming incoherently. The officers had to taser respondent several times in order to subdue him,” said the report by the medical board. Corona was hospitalized for nearly a month for psychological observation.

It was the same year that he published a book about treating mood disorders, entitled “Healing the Mind and Body.” In a 2008 interview with the medical board, Corona said he suffered an episode of hypomania three years prior. State documents say that he was prescribed Seroquel by his psychiatrist, but he admitted to self-medicating from his sample drugs after his psychiatrist moved away.

“His disorder has impacted his ability to practice safely and led to his hospitalization for a psychotic breakdown,” the state complaint said. He was put under suspension for five years in June 2009.

Under the latest probation, Corona must take courses in prescribing practices, medical record keeping, medical ethics and clinical education. He must also find another physician to monitor him, according to medical board documents.

Psychotropics Lead List for Youth-Related Drug Poisoning Calls

As Reported by the Psychiatric News section of the American Psychiatric Association Website

The Referenced Report is available here in PDF Format

A new report shows that almost half of the calls made to United States poison control centers on behalf of those aged 19 and under are related to medication—with psychotropic drugs representing 50 percent of the top 10 medications contributing to unintentional poisoning.

Safe Kids Worldwide, in partnership with the American Association of Poison Control Centers (AAPCC), conducted a study to identify the types of medications that contribute to the volume of calls made to poison control centers for drug poisoning in children and teens.

Safe Kids said in statement that the study was designed to “take a deeper look at two specific groups of calls related to medicine: unintentional-general exposures, when kids get into medicine without intending to take it (such as when a young child takes medicine on a nightstand); and unintentional-therapeutic errors (such as when a child is given too much medicine or the wrong medicine).” The study did not include cases in which medications were taken intentionally.

After evaluating data generated from the National Poison Data System of calls made to poison control centers in 2013, analysts from Safe Kids found that 1.34 million calls were associated with poisoning of a child or teen, with 547,042 of those calls related to unintentional-general exposures or unintentional-therapeutic errors. Though 75 percent of the calls made for unintentional drug poisoning involved young children aged 1 to 4 compared with 3 percent for teens, serious health outcomes resulting from unintentional poisoning were six times greater in those aged 15 to 19. The most common mistakes made by teens were forgetting to take a medicine and then doubling up or taking two medicines with the same ingredients, the study found. Atypical antipsychotics and amphetamines intended for the treatment of attention-deficit/hyperactivity disorder were the top two medication classes for serious health outcomes in teens.

Other psychotropic medicines commonly reported for unintentional poisoning throughout all studied age groups included benzodiazepines, clonidine, and methylphenidate. Nonpsychotropic drug classes included antihypertensives such as beta blockers and analgesics such as ibuprofen and acetaminophen.

AAPCC Executive Director Stephen Kaminski, J.D., said the current report points to an urgent need to continue to educate families on using medicines responsibly.

“Our nation’s 55 poison centers play a crucial role in keeping Americans safe by providing poison prevention and free, expert information and advice,” said Kaminski. “In addition to the public, emergency clinicians and pediatricians rely on poison-center professionals to help treat their patients. In fact, about 20 percent of all poison-center exposure calls come from health care providers. It’s good to know that expert help is just a phone call away when the unthinkable happens.”