Comedy TV: Beverly Hillbillies Season 1 Episode 34 - The Psychiatrist Gets Clampetted

Classic American TV Comedy Show

The show was ranked #1 and attracted as many as 60 million viewers per week. The Clampett Clan included Buddy Ebsen (Jed), Irene Ryan ("Granny"), Max Baer Jr. (Jethro), Donna Douglas (Elly May). Also starred Raymond Bailey (Milburn Drysdale), and Nancy Kulp (Jane Hathaway)

In this episode, Jethro finally gets his bill of health from Dr. Twombly so he can graduate the fifth grade, but Twombly really wants to talk to Grannie again. Drysdale brings him to the Clampetts' just as Grannie showed Pearl how to use a love potion, so everyone thinks Twombly's interest in Grannie is love.

Waking up from sadness: Many find trouble getting off antidepressants

Part of a much longer story at Al Jazeera America:

Long-term use of antidepressants has become increasingly common over the past decade, according to a recent National Health and Nutrition Examination Survey study. Some 70 percent of the estimated 16 million long-term users in the United States — defined as having used the drugs more than 24 months — are women.

Data from IMS Health, as reported in a study published in the December Journal of Clinical Psychiatry by lead author Dr. Ramin Mojtabai, shows antidepressants are the most commonly prescribed medication class in the U.S. It links national trends in increased long-term use of antidepressants with treatment in primary-care settings, where most antidepressants are prescribed.

Scott, who did not see a mental-health specialist until 2010, believes her general practitioners repeatedly misdiagnosed her.

“Nobody’s listening,” Scott said. “They just prescribe.”

With the help of a nonprofit withdrawal program, Scott has been working to become antidepressant-free after finding out last year that she has thyroid disease as well as a hormonal imbalance. Working to address these underlying physical conditions, Scott said she feels better than she has in years.

[...]

. . . findings in the April issue of the journal Psychotherapy and Psychosomatics that found almost two-thirds of a sample of 5,000 patients diagnosed with depression within the previous year did not meet the Diagnostic and Statistical Manual of Mental Disorders criteria for a major depressive episode.

Instead, the patients were given false positive diagnoses, according to Mojtabai’s study.

[...]

“Almost anything emotionally and behaviorally destructive can happen during withdrawal because serotonin is the most widespread neurotransmitter in the brain,” said (Peter) Breggin, the psychiatric withdrawal expert.

Coming off SSRIs can cause “all kinds of behavioral and neurological disturbances,” he said, listing some common side effects, such as “shocklike feelings in the head, imbalance, odd feelings in different parts of your body, depression, hopelessness, suicidal feelings and actions, disabling anxiety and persisting sexual dysfunction.”

But Breggin warned not to be discouraged by these side effects, since it is not yet known whether any damage is irreversible.

“There’s a reason to come off,” he said. “You want to try as best as you can to withdraw, because it’s only going to get worse in time.”

Former Veterans Affairs Psychiatrist Pleads Guilty to Medicare Fraud

As seen in this press Release from the US Department of Justice

Department of Justice
Office of Public Affairs
FOR IMMEDIATE RELEASE
Wednesday, October 30, 2013

Former Veterans Affairs Psychiatrist Pleads Guilty to Medicare Fraud

Dr. Mikhail L. Presman, a licensed psychiatrist employed by the Department of Veterans Affairs (VA), pleaded guilty today to health care fraud for falsely billing Medicare for home medical treatment to Medicare beneficiaries and agreed to forfeit more than $1.2 million in illegal profits.

Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney Loretta Lynch of the Eastern District of New York, and Special Agent in Charge Thomas O’Donnell of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) made the announcement.

According to court documents, from Jan. 1, 2006, through May 10, 2013, Presman submitted approximately $4 million in Medicare claims for home treatment of Medicare beneficiaries notwithstanding his full-time, salaried position as a psychiatrist at the VA hospital in Brooklyn. Contrary to his representations, Presman did not provide any treatment to a substantial number of the beneficiaries he claimed to have treated. For example, Presman submitted claims to Medicare for home medical visits at locations within New York City even though he was physically located in China at the time of these purported home visits. Additionally, Presman submitted claims to Medicare for 55 home medical visits to beneficiaries who were hospitalized on the date of the purported visits.

Presman is scheduled to be sentenced by U.S. District Judge I. Leo Glasser of the Eastern District of New York on Feb. 13, 2014, and faces a maximum sentence of 10 years in prison.

The case was investigated by the HHS-OIG, with assistance from the Department of Veterans Affairs Office of Inspector General, and brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of New York. The case is being prosecuted by Trial Attorney Bryan D. Fields of the Fraud Section and Assistant U.S. Attorney Patricia E. Notopoulos of the Eastern District of New York.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,500 defendants who have collectively billed the Medicare program for more than $5 billion. In addition, HHS’s Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to:

http://www.stopmedicarefraud.gov

Did Antidepressant Play a Role in Navy Yard Massacre?

Did Antidepressant Play a Role in Navy Yard Massacre? By John Horgan in Scientific American

Once again, antidepressants have been linked to an episode of horrific violence. The New York Times reports that Aaron Alexis, who allegedly shot 12 people to death at a Navy facility in Washington, D.C., earlier this week, received a prescription for the antidepressant trazodone in August.

 

When I first researched antidepressants almost 20 years ago, I encountered claims that they sometimes triggered violent episodes—for example, a 1989 incident in which a Kentucky man taking fluoxetine (brand name Prozac) shot to death eight co-workers and then himself. I dismissed the claims, reasoning that, because people prescribed psychiatric drugs are disturbed to begin with, it is not surprising that a tiny fraction hurt themselves and/or others.

By 2004, however, in part because of lawsuits that forced pharmaceutical companies to disclose data on adverse effects, the FDA ordered antidepressant manufacturers to include a warning that antidepressants “increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders.”

Alexis, who was 34, was reportedly seeking treatment for insomnia when he received his prescription for trazodone. Originally marketed as an antidepressant after its approval by the FDA in 1981, trazodone is also prescribed for anxiety and insomnia. Trazodone was a precursor of the extremely popular selective serotonin reuptake inhibitors (SSRIs); like the SSRIs, trazodone boosts levels of the neurotransmitter serotonin.
A website maintained by the National Institutes of Health states that trazodone and other antidepressants have been associated with “new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement.”

Could trazodone have played some role in the Navy Yard rampage? I put this question to David Healy, a professor of psychiatry at Cardiff University in England and an authority on side effects of psychiatric medications.* He has testified in numerous court cases involving suicides and homicides whose perpetrators were ingesting antidepressants. Healy is not opposed to psychiatric medications–he prescribes them to his own patients—but he has long been active in pointing out medications’ risks. *[Healy and other health-care experts have founded an organization called RxISK to gather data on side effects of drugs. See Postscript.]

Healy responded by email that he “would need to know much more details” to judge whether trazodone might have contributed to this week’s massacre. Indeed, as the Times reported, Alexis had displayed signs of mental illness and acted violently well before being prescribed trazodone. In 2004 he fired bullets into a car in Seattle, during what he described later as a “black out” episode. So far, moreover, there are no reports that he had trazodone in his system during his Navy Yard rampage.

But Healy said that, although data on antidepressants and violence are much more scarce than data on suicide, there is evidence that “you can put healthy volunteers on these drugs and some will become violent.” A study by the Drug Safety Research Unit in Southampton of paroxetine (Paxil) and fluoxetine (Prozac) involving more than 25,000 subjects showed that one out of every 250 subjects were involved in “a violent episode,” including 31 assaults and one homicide, Healy said.

Another study involving more than 9,000 subjects taking the antidepressant paroxetine (Paxil) for depression and other disorders showed that subjects experienced more than twice as many “hostility events” as subjects taking a placebo. Healy added: “I have had clinical experience of at least one older man, with no prior history of violence, who became homicidal after a week on citalopram where the problem cleared up once treatment had stopped.”

Healy suspects that the main causal factor behind suicide and violence toward others is increased mental and/or physical agitation, which leads about 5 percent of subjects taking antidepressants to drop out of clinical trials, compared to only 0.5 percent of people on placebos.
In their excellent overview “Antidepressants and Violence: Problems at the Interface of Medicine and Law,” published in PLoS Medicine in 2006, Healy and two co-authors note that “serious violence on antidepressants is likely to be very rare.” But they call for “more clinical trial and epidemiological data to be made available and for good clinical descriptions of the adverse outcomes of treatment.”
They add: “Legal systems are likely to continue to be faced with cases of violence associated with the use of psychotropic drugs, and it may fall to the courts to demand access to currently unavailable data. The problem is international and calls for an international response.”

Antidepressants and other psychiatric drugs clearly help alleviate mental illness in some patients. But as I have written previously, such medications may on balance harm patients more than they help. We need better data on the risks that these medications pose not only to patients but also to others.

*Postscript: David Healy and other health-care experts from around the world have formed an organization called RxISK to gather data on adverse effects of pharmaceutical drugs, including violence. The RxISK website calls it “the first free, independent website where patients, doctors, and pharmacists can research prescription drugs and easily report a drug side effect–identifying problems and possible solutions earlier than is currently happening.” I hope RxISK succeeds, because we badly need it.

Post-Postscript: For more on links between psychiatric medications and violence, see this 2010 paper in PLOS One, “Prescription Drugs Associated with Reports of Violence Towards Others,” and a followup blog post by journalist Robert Whitaker, author of Anatomy of an Epidemic.

Ex-psychiatrist in Cresco sex case has long history of lewd behavior

As reported in the Pocono Record

Charged in Monroe County with soliciting sex from what he believed to be a 13-year-old boy, a former psychiatrist has had his license revoked in three states including Pennsylvania, and served jail time in New Jersey for lewdness, according to the Pennsylvania Board of Medicine.

[...]

Monroe County District Attorney's Office detectives arrested Kessler at his home Friday.

This resulted from an investigation detectives began in May, after a woman told state police a suspicious adult had been contacting her 13-year-old son on Facebook.

Authorities said this adult, identified as Kessler and using a fake name online, contacted a detective posing as the boy and began a sexual conversation.

Authorities said Kessler, thinking he was still talking to a minor, sent links to pornographic videos, along with a photo of a nude male he identified as himself, and told the detective he wanted to perform oral and other sex. Kessler's license to practice psychiatry in Pennsylvania had been revoked in July 2012 by the Pennsylvania Board of Medicine, said Pennsylvania Department of State spokesman Ronald Ruman. Kessler's license revocation was the latest development in a troubled history that began in 2001. The Board of Medicine's license revocation ruling reveals the following details:

• A graduate of the University of Connecticut School of Medicine and Central Connecticut State University, Kessler was first licensed in 1999 in New York, where in June 2001 he completed a four-year internship/residency at what was then Long Island Jewish Medical Center and Hillside Hospital.
• Kessler later was licensed in Massachusetts.
• On July 1, 2001, he began a residency in a child/adolescent psychiatry program at Cambridge Health Alliance in Massachusetts.
• On July 8, Kessler was charged with "open and gross lewdness" and disorderly conduct, after two men told police he had exposed himself to them and masturbated in his car in a doughnut shop parking lot in Walpole, Mass.
• This prompted Cambridge Health Alliance to fire him from its child/adolescent psychiatry program Aug. 1.
• In November 2001, with the earlier criminal case still pending, Kessler again was charged with open and gross lewdness and indecent exposure.
• Two boys, ages 10 and 12, told police they saw him nude and masturbating in the front window of his mother's Falmouth, Mass., home.
• With two criminal cases now pending against him, and unable to find work since his termination from Cambridge Health Alliance, Kessler returned to New York.
• Because he did not renew his Massachusetts license when it came due in December 2001, the license was labeled "revoked," though not due to any disciplinary action at that time.
• Kessler applied at Brunswick Hospital Center in Amityville, N.Y., and Holliswood Hospital in Queens, N.Y.
• He omitted his Massachusetts employment on both applications, and put "no" when asked on Brunswick Hospital Center's group malpractice insurance policy application if he'd ever been charged with a felony.
• On Dec. 1, 2001, Kessler started working full time at Brunswick.
• On June 2, 2002, Kessler was convicted of open and gross lewdness in the second criminal case in Massachusetts.
• He began the long process of appealing the verdict, but there is no mention of whether he served any jail time, according to state papers.
• On June 3, he pleaded not guilty to open and gross lewdness in the first criminal case, while the disorderly conduct charge in that case had been dismissed, but the matter would be continued for another year.
• In October 2002, Kessler admitted on his New York license renewal application to having been charged with a crime and disciplined by a hospital.

Based on this, the New York Board for Professional Medical Conduct charged him in December 2002 with lying on his hospital job applications about never having faced any criminal charges.

Psychiatrist Frederick Berlin, founder of the Johns Hopkins Sexual Disorders Clinic in Baltimore, testified at the January 2003 board hearing on the charges.

Berlin said Kessler has "a sexual disorder characterized by exhibitionism and an urge to be seen masturbating by young males," but that Kessler at the time was being adequately treated for the disorder.

Psychiatrist Marc Reubins testified Kessler has "a systemic disorder characterized by anxiety and depression," while psychiatrist Seymour Block agreed with the anxiety assessment.

Deeming Berlin's testimony the most convincing, the board in February 2003 found Kessler's actions constituted "fraudulent practice" and "moral unfitness to practice medicine," and revoked his New York license.

Kessler then became a licensed life, accident and health insurance broker in New York, New Jersey, Connecticut and Pennsylvania. He went to work for a New Jersey firm specializing in minimizing health insurance cost increases related to disease management.

He also gave monthly free seminars in New York for high school students and parents on maximizing college financial aid, and prepared state and federal income tax returns for people and businesses.

Meanwhile, the first criminal case against him was finally dismissed in June 2003.

In September of that year, the Massachusetts Board of Registration in Medicine moved to take disciplinary action against Kessler's Massachusetts license based on the conviction in the remaining criminal case and his New York license revocation.

In November 2004, the Massachusetts Supreme Judicial Court overturned the criminal conviction.

Despite this, the Board of Registration in Medicine in July 2006 revoked Kessler's right to renew his Massachusetts license.

The board found he had "undermined public confidence in the integrity of the medical profession, lacked good moral character and had been disciplined by another state for the capacity to deceive and defraud."

After moving to Pennsylvania, Kessler in November 2006 applied to practice medicine in this state.

The Board of Medicine in January 2007 denied his application based on the New York and Massachusetts license revocations.

Kessler and Reubins, the psychiatrist who had testified on his behalf before the New York board, appeared at an October 2007 appeal hearing.

Reubins told the Board of Medicine that Kessler had been in no further trouble since 2001, was getting treatment for his anxiety and wanted to get back into medical practice.

Agreeing with Reubins that Kessler should have another chance to practice medicine, the board in December 2007 granted Kessler a five-year probationary license with terms and conditions, including the successful completion of a board-approved clinical skills evaluation/remediation program.

From October 2008 to June 2009, Kessler worked at ISL Psychiatric Services in Stroudsburg, and then as associate medical director for a school-based partial hospitalization program in Monroe and Northampton counties from July 2009 to May 2011.

He traveled among area schools, treating children with various mental illnesses.

From 2010 until March 2011, Kessler covered for the staff psychiatrist at Shawnee Academy in Shawnee-on-Delaware, a residential treatment facility for children with severe mental illnesses.

He was then at Pocono Psychiatric Associates in Smithfield Township.

But trouble again surfaced in November 2010, when Kessler for the third time was charged with lewdness.

Three juvenile males allegedly saw him masturbating in a vehicle at the Sutton Park Mall in Flanders, N.J.

Kessler in March 2011 pleaded guilty and was sentenced to 90 days in county jail and fined $1,000. This led to his Pennsylvania license eventually being revoked in July 2012.

It's unknown how or if Kessler was employed when charged Friday in the current criminal case.

He was placed in Monroe County Correctional Facility in lieu of $50,000 bail and will appear in district court at a future date.

Disciplinary Hearing of Florida Psychiatrist Ronald Kurlander

As seen in the description on YouTube

On April 5, 2013 in Deerfield Beach, Florida psychiatrist Ronald Kurlander was disciplined by the Florida Department of Health. He was accused of prescribing drugs to people he had never examined or even met. The father of one of Kurlander's patients gave testimony as to the extensive damage caused by these drugs to his son. Kurlander is the one with the moustache and goatee with wire frame glasses seated to he left. He was fined over $30,000.00, given a reprimand, ordered to take a law and rules course, a drug course and a medical records course. Additionally, he has to undergo a risk management assessment.

Why the University of Minnesota psychiatric research scandal must be investigated

As writen by Carl Elliot, and Published on the MinnPost Website

Carl Elliott is a professor in the Center for Bioethics at the University of Minnesota.

Three former editors of the New England Journal of Medicine have called for an investigation. So has the scholar who uncovered the Guatemala syphilis studies. The former Health and Disability Commissioner of New Zealand has called the conduct of the researchers “unethical,” pointing out the need to “put in safeguards in place to prevent a similar tragedy from happening again.” A recent Medical Journal of Australia editorial compared it to the exploitation of poor black men with syphilis in Tuskegee, Ala. Yet the University of Minnesota, where the research scandal occurred, simply keeps repeating, “Nothing to see here, folks. Just move along.”

The research abuse in this case is so stunning that when I first learned about it I could scarcely imagine it happening anywhere, much less at the university where I work. In late 2003, psychiatric researchers at the University of Minnesota recruited a mentally ill young man named Dan Markingson into a profitable, industry-funded research study of antipsychotic drugs. The researchers signed him up over the objections of his mother, Mary Weiss, who did not want him in the study, and despite the fact that he could not give proper informed consent. Dan was acutely psychotic, plagued by delusions about demons, and he had repeatedly been judged incapable of making his own medical decisions. Even worse, he had been placed under an involuntary commitment order that legally compelled him to obey the recommendations of the psychiatrist who recruited him into the study.

For months, Mary tried desperately to get Dan out of the study, warning that he was getting worse and that he was in danger of committing suicide. But her warnings were ignored. On April 23, 2004, she left a voice message with the study coordinator, asking, “Do we have to wait for him to kill himself or someone else before anyone does anything?” Three weeks later, Dan committed suicide in the most violent way imaginable. His body was discovered in the shower of a halfway house, his throat slit so severely that he was nearly decapitated, along with a note that said, “I went through this experience smiling.”

Conflicts of interest, other issues

As outrageous as that sounds, there is more. The psychiatrists had financial conflicts of interest from their work with the pharmaceutical industry. The study sponsor also provided financial incentives for the researchers to keep subjects in the study as long as possible. Last fall, the state Board of Social Work found that the study coordinator had falsified the initials of doctors on study records, failed to warn Dan of new dangers of the study drugs, had been given medical responsibilities far beyond her training as a social worker, and had failed to respond to Mary’s warnings that Dan was in danger of killing himself.

After Dan’s suicide, it got even worse. When Mary’s lawsuit against the university was dismissed on technical grounds of “sovereign immunity,” the university lawyers filed a legal action against her called a “notice to assess costs,” demanding that she pay them $57,000 in legal fees. Yes, you read that correctly: The U tried to force the mother of a suicide victim to pay it $57,000.

None of this is a secret. The case has generated international outrage. Yet for three years the University of Minnesota has managed to bluster and stonewall its way through all the criticism, insisting that it has already been exonerated. Even when the state Legislature passed “Dan’s Law” in 2009, banning psychiatrists from recruiting mentally ill patients under an involuntary commitment order into drug studies, the university continued to insist it had done nothing wrong.

A petition to Gov. Dayton

Two weeks ago, as a last resort, Mary Weiss, the mother of Dan Markingson, and her friend Mike Howard started a petition to Gov. Mark Dayton. Their request is simple: Please appoint an external, impartial panel to investigate the scandal. More than 1,200 people have signed, including well over 150 academic experts. Many University of Minnesota alumni have joined as well. A typical but telling comment: “I am ashamed of my alma mater right now.”

This is not an issue from the distant past. We do not know if other research subjects have died, or if they have been injured or mistreated. We do not even know if mistreatment is still continuing today. That may well be the most compelling reason for Minnesotans to sign the petition. If a case of research abuse this brazen can be sanctioned and defended by the university, there is no way to feel confident that other research subjects are being protected. In 2004 it was Dan Markingson. But it could have been any of us.

Abbott and Costello at the Psychiatrist's Office

A small amount of Satire

California Psychiatrist Suspended for Missing his Own Mental Exam

As seen in this report from The Marin Independent Journal

The state medical board suspended the license of a Mill Valley psychiatrist Thursday for failing to show up for a mandatory psychiatric examination. The board ordered Dr. Brent Taylor Cox to get the test last year after a complaint that he "may be suffering from a substance addiction disorder and/or other mental impairment that may affect his ability to practice medicine safely," according to board documents. The board said Cox did not arrive for his scheduled exam, even though it sent him notices by certified and first-class mail to three addresses and emailed the notice to his Gmail account. The board also sent an investigator to his addresses to serve the letter, but "no one answered the door," board documents said. Regulators moved to discipline Cox, and he appeared for a hearing in November with his attorney, Mitchell Green of San Francisco. Cox agreed to a settlement in which the board suspends his license and gives him 30 days to get the psychiatric testing. Green said the whole dispute exists because Cox never received the initial order to get the psychiatric exam. Cox was in the middle of changing his office location at the time and was no longer using the same Gmail address, but he neglected to update his email address with the board, Green said.

Hat tip to PsychSearch.net for the story

High-Prescribing Chicago Psychiatrist Faces Federal Fraud Suit

As Reported by ProPublica

The U.S. Attorney for the Northern District of Illinois filed a federal fraud lawsuit today against a Chicago psychiatrist profiled by ProPublica and the Chicago Tribune in 2009 for his voluminous prescribing of antipsychotic drugs to nursing home patients.

In a news release, the government says that Dr. Michael Reinstein “received illegal kickbacks from pharmaceutical companies and submitted at least 140,000 false claims to Medicare and Medicaid for antipsychotic medications he prescribed for thousands of mentally ill patients in area nursing homes.”

ProPublica and the Tribune reported in 2009 that Reinstein prescribed more of the risky antipsychotic clozapine to patients in Illinois’ Medicaid program in 2007 than all of the doctors in the Medicaid programs of Texas, Florida and North Carolina.

The government accuses Reinstein of billing Medicare and Medicaid for managing his patients’ medications, “knowing that he did not engage in substantive evaluations of his patients’ medical and psychiatric conditions to properly manage their medications,” the U.S. attorney’s office said in its release. “Instead, he allegedly prescribed medications to his patients based on his receipt of kickbacks from pharmaceutical companies.

Prosecutors allege that Reinstein’s prescribing decisions were motivated by money and perks from pharmaceutical companies. He allegedly switched patients from one brand of clozapine to another based on money and other enticements he received from a pharmaceutical maker.

Before August 2003, thegovernment alleged, Reinstein prescribed Clozaril, brand name for clozapine made by Novartis, which paid him to promote the drug.

When the drug went off patent in 1998, the lawsuit says, Reinstein resisted attempts to switch his patients to cheaper, generic versions. But when Novartis stopped paying Reinstein in 2003, the lawsuit says, he switched his patients to a generic version made by IVAX Pharamceuticals.

That company had agreed to pay him a consulting fee, pay his nurse to speak on the drug’s behalf and fund a research study at an affiliated institute, according to the lawsuit.

“While generally only four percent of schizophrenia patients who were prescribed antipsychotics received clozapine, during the time Reinstein was allegedly accepting kickbacks from IVAX, more than 50 percent of his patients were prescribed IVAX’s clozapine,” the U.S. Attorney’s office said in its news release. “At one nursing home, Reinstein had 75 percent of the 400 residents on IVAX’s clozapine.”

Ivax paid other perks to Reinstein and his associates, including airfare, entertainment expenses, a fishing trip, a boat cruise and a golf outing, the lawsuit says.

In 2006, Reinstein began switching to clozapine made by a different company but moved some patients back when he received additional perks and funds, the lawsuit says.

In an interview, federal prosecutor Eric Pruitt would not comment on whether his office would pursue criminal charges against Reinstein or whether any legal action would be taken against the pharmaceutical companies that allegedly paid the physician kickbacks.

A call left at the office of Reinstein’s attorney was not immediately returned.

The 2009 investigation by ProPublica and the Tribune showed that Reinstein’s high prescribing had serious consequences for his patients. Autopsy and court records showed that by 2009 at least three patients under Reinstein’s care had died of clozapine intoxication. One of them, a 50-year-old man, had five times the toxic level of clozapine in his blood when he died, according to his medical records.

Reporters determined that, based on his Medicaid prescribing alone, Reinstein he would have to work 21 hours a day, seven days a week to see each of his patients for 10 minutes. Research has found that the typical U.S. psychiatrist sees about 35 patients per week; Reinstein was seeing 60 each day, he wrote in an audit report in 2007.

In the 2009 investigation, Reinstein strongly defended his reliance on clozapine, saying the medication is underprescribed and is the most effective in its class for schizophrenic patients.

Big Pharma's Newest Money-Making Scheme: Adult ADHD

Evelyn Pringle has brought us another expose of disease mongering by the psych drug industry. Here's a snippet. Please visit the original post for all of the details

By Evelyn Pringle and Martha Rosenberg

Who belongs to this “untapped” market? Just about anybody.

There is good news and bad news about attention deficit/hyperactivity disorder (ADHD) -- that is, if you’re a drug company. The bad news is the kid market has peaked out with 4.5 million U.S. children now carrying the label. The good news is adult ADHD is an emerging market. In fact, adult ADHD, with symptoms similar to pediatric ADHD such as impulsivity, distractibility and difficulty paying attention, following instructions and meeting deadlines, is the next big thing.

"Immature adult market continues to offer greatest commercial potential," read a 2008 press release to the pharmaceutical industry from the market research agency Datamonitor: "Estimated to be twice the size of the pediatric ADHD population, the highly prevalent, yet largely untapped, adult ADHD population continues to represent an attractive niche to target."

Also seen on Alternet here

10 Mind-Boggling Psychiatric Treatments

As posted on Mental Floss

Nobody ever claimed a visit to the doctor was a pleasant way to pass the time. But if you're timid about diving onto a psychiatrist's couch or paranoid about popping pills, remember: It could be worse. Like getting-a-hole-drilled-into-your-skull worse.

Gems include Insulin-Coma Therapy, Malaria Therapy, Chemically Induced Seizures, and of course, Lobotomy Check out the link for the full article

Dr. Khristine Eroshevich, Beverly Hills Psychiatrist Who Treated Anna Nicole Smith, Has License Suspended

As Reported in the Huffington Post

LOS ANGELES -- State medical board officials say a Beverly Hills psychiatrist who treated Anna Nicole Smith has had her license suspended for a criminal conviction involving the Playboy Playmate.

The March 30 decision by the Medical Board of California did not name any patients in the case against Dr. Khristine Eroshevich, but the filing listed the court number of the Smith case.

Eroshevich's license was revoked, but the revocation was stayed.

Instead, Eroshevich's license will be suspended for 90 days and she will be placed on five years of probation by the state licensing agency for wrongly prescribing opiates and other misconduct.

As terms of her probation, the board ordered Eroshevich to take classes on prescribing practices, ethics. She must also undergo psychiatric and medical evaluations. When she returns to practicing medicine, it will be under the supervision of a monitor approved by the state's licensing agency.

Eroshevich was with Smith when the former Playboy Playmate checked into the Florida hotel, where she later died of an accidental overdose.

According to the medical examiner's office in Florida, Eroshevich authorized all 11 prescription medications in the Florida hotel room where Smith was found unresponsive shortly before her death on Feb. 8, 2007.

More than 600 pills – including about 450 muscle relaxants – were missing from prescriptions that were no more than five weeks old.

Eroshevich was initially convicted of two felonies in the drug trial involving the treatment of Smith. One was later thrown out and the other was reduced to a misdemeanor. The misdemeanor is under appeal.

According to the medical board filing, Eroshevich admitted misconduct in signing off on two workers' compensation and disability claims without actually examining the patients.

The examinations were done by Eroshevich's colleague in 2004 and 2006.

Peter Cook & Dudley Moore Psychiatry Satire (Aversion Therapy)

Thousand Oaks psychiatrist arrested twice for DUI; patient death probed

As seen in this report from Los Angels' ABC7 News

A Thousand Oaks doctor arrested twice for DUI is now under investigation in connection with the death of a patient.

Dr. Daryl Westerback, 55, was arrested on June 5 for driving under the influence of prescription drugs after he was spotted on the road by a narcotics detective.

Westerback is now being investigated for overprescribing drugs to his patients. Authorities are looking into at least one death related to his practice.

"We began looking into him and found that one of his patients last year died of a fatal overdose, so we're now opening the case and investigating that death," said Capt. Don Aguilar with the Ventura County Sheriff's Department.

Westerback, a psychiatrist, is also accused of treating patients while he was impaired by prescription drugs.

"We started watching him and found that he was also under the influence of opiates while seeing patients. We found that he was operating a psychiatry office and was treating pain-management patients without an exam room, without all the typical methods of good medicine," said Aguilar.

Officials say they are investigating at least 10 doctors for operating criminally in Ventura County. They say these doctors appear to be nothing more than drug dealers peddling prescription medications for profit.

Ventura County sheriff officials say federal law enforcement is helping with a special task force to crack down on the growing illegal use of prescription drugs like Oxycontin, Vicodin and more.

"This has been created out of a prescription drug problem we've been seeing in the county, specifically in East County," said Aguilar.

Detectives said Westerback's license to prescribe medication has been suspended and he remains free on bail.

Westerback was also arrested for driving under the influence of drugs and felony child endangerment after being involved in a car crash in Thousand Oaks on March 8, according to Ventura County Assistant Sheriff Gary Pentis.

Licensing and the Pharma Patent Cliff

As posted on the Licensing Law Blog October 22nd, 2010, by Richard R. Bergovoy

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 2.0 Generic License.

Peering over the edge of a “patent cliff” that threatens to cut deeply into its profits, Big Pharma is considering modifying its current business model of in-house development of all-or-nothing blockbuster drugs towards a business model of in-licensing from biotech startups and university researchers.

The time and cost of developing new drugs from scratch is enormous– typically $2 billion per successful drug and 10 to 15 years from initial research to final regulatory approval.

But during the next five years, many top-selling blockbuster drugs will come off patent, and face severe price competition from generic versions, including: Pfizer’s Lipitor; Astra-Zeneca’s Seroquel; and Sanofi-Aventis’ and Bristol-Myers Squib’s Plavix. Between 2011 and 2014, four of Eli Lilly’s top five sellers will fall off the patent cliff: Zyprexa, Symbalta, Gemzar, and Evista. Estimates peg the total revenue loss to Big Pharma as high as $140 billion through 2016.

In response, analysts at Morgan Stanley are advocating a move away from the go-for-broke nature of the blockbuster business model, towards a Pharma 2.0 model of in-licensing from biotechs and academic researchers, who do all early-stage research and testing, and assume most of the risk. According to their analysis, the return on investment of in-licensed drugs is three times higher than drugs developed in-house.

And it appears that some of Big Pharma is listening. According to thepharmaletter.com, in 2009 the top 10 pharmaceutical companies entered into 12% more health-care focused licensing deals than the year before. Andrew Baum of Morgan Stanley estimates that large European pharmas will cut research spending by 40% in the next two years, and focus on licensing and acquisitions of promising drugs in development.

But for other pharmaceutical companies, the “Not Invented Here” syndrome still rules the day. Eli Lilly, which faces probably the most severe patent cliff among the major pharmas (above), has announced that it will meet the challenge mainly through cost cuts, job cuts, and modifications of existing product lines, rather than major new licensing or acquisition initiatives. It argues that slashing in-house research and development to boost return on investment is a short-term fix that would undermine Lilly’s long-term mission.

As we have argued in other contexts, while licensing may not always be appropriate as a complete replacement for in-house research and development, it is almost always appropriate as a complementary business model. When you are looking over the side of a cliff, Not Invented Here goeth before the fall.

Two Top Liability Risks for Psychiatrists: Patients with Suicidal Behavior and Psychopharmacology

as seen in this PRMS (Professional Risk Management Services) press release

Snippet:

Patient suicides may trigger the most lawsuits, but according to PRMS data, cases with the largest verdicts or settlements don't involve the death of a patient, but significant and permanent physical and neurological damage requiring lifelong care. Such damage can occur from things like renal failure from lithium toxicity, severe Stevens-Johnson Syndrome or brain damage from a suicide attempt.

"Defensive medicine is not the answer," said Jacqueline Melonas, RN, MS, JD, Senior Vice President of Risk Management for PRMS. "Care that has a sound clinical basis that also is well-documented is the best way to avoid or, if necessary, defend lawsuits."

more at the link

Alabama Psychiatrist Arrested for Drug Trafficking

As seen in this report

FLORENCE, AL (WAFF) - A Shoals area psychiatrist and his wife were arrested in a Huntsville hotel on trafficking charges. Dr. William Roddy and his wife Wendy Sue Roddy were both arrested at the Embassy Suites in Huntsville on Sunday. The two were accused of trafficking a controlled substance, though Huntsville Police would not comment on what the substance was. Trafficking a controlled substance is a felony in the state of Alabama and if convicted a person can serve as much as 20 years in jail for the offense.

also via Psych Search

Huntsville Police Sgt. Mark Roberts says 50-year-old Dr. William Roddy and 43-year-old Wendy Sue Roddy were charged with trafficking in a controlled substance. He says they were arrested on Sunday and were released on $250,000 bail each. Roberts says officers responded to a call about a man with a gun in a hotel parking lot and arrested Roddy. He says a search of Roddy and his hotel room turned up prescription narcotics and thousands of dollars in cash. Police say they searched the couple’s home and found more drugs.

Chinese Dissidents Committed to Mental Hospitals

As reported on the PBS NewsHour of September 11, 2009



(Video Link Updated)

From the Transcript

China's emphasis on social harmony provides an incentive for petitioners to press for justice, but it also sets the stage for their persecution. That's because petitioners know that Chinese officials in the central government take unrest in local communities seriously, but the local officials who are being complained about will often seek retribution or try to stop people from petitioning in the first place.

Teng Biao, a professor at the University of Politics and Law in Beijing, says the system itself creates these kinds of problems. He runs an NGO to provide legal aid to petitioners.

TENG BIAO, University of Politics and Law, Beijing: From the top down, the petitioning situation is an assessing index for the officials on their political achievements. If there are many petitioners coming to Beijing from a place, then it will affect the local officials on their promotions and bonuses.

SHANNON VAN SANT: For his work, Teng Biao had his lawyers license and passport taken away. After this interview, Chinese authorities shut down Teng Biao's NGO, and police detained two of his colleagues. Despite the risk, Teng said he will continue his work.

I traveled to Wuhan to talk with another Chinese activist, Liu Feiyue, but he was under house arrest. Liu heads an NGO that is currently following 100 cases of wrongful psychiatric detention. Over the last three years, he says he knows of 500 more whistleblowers and protesters who have been detained in mental hospitals.

Robin Munro, who has extensively researched psychiatric detention in China and written two books on the topic, thinks the practice is widespread.

ROBIN MUNRO, human rights activist: China's experience in this area is far more serious and extensive than any other country.

SHANNON VAN SANT: Munro, who is based in Hong Kong, believes that since there are no national mental health laws protecting the rights of people who have been compulsorily hospitalized, but there are rules limiting arbitrary arrest, hospitals are becoming a convenient means of silencing protesters.

ROBIN MUNRO: Once diagnosed in this way, as dangerously mentally ill, citizens have no rights. They have no legal right to see a lawyer; they have no legal right to be brought before a judge so that a judicial determination can be made.

SHANNON VAN SANT: The Chinese press, including the Beijing News, has reported on the hospitalizations. The story was picked up by the state's official press agency, The People's Daily and Sina.com, where it drew 23,000 comments. Such coverage in Chinese newspapers could imply there is central government support for preventing wrongful psychiatric detention by local officials.

China's Ministry of Health denied requests for an interview, but sent a list of relevant regulations on treatment of the mentally ill, which said, in part, "The diagnosis of psychiatric disease is, according to the Chinese mental disorder category and diagnosis standard third edition, approved by Chinese medical association and referring to the related standards of international disease diagnosis category."

When asked at a press conference about the increasing numbers of protesters being put in mental hospitals, the spokesperson for the Ministry of Foreign Affairs said...

QIN GANG, Spokesperson, Ministry of Foreign Affairs (through translator): It's the first time for me to hear the situation you addressed. I don't know about the situation of psychiatric hospitals, but please believe the related Chinese governmental departments conduct administration according to law.

SHANNON VAN SANT: But in Wuhan, another petitioner, Hu Guohong, said he has been forcibly hospitalized in mental institutions four times and that he and his wife, Cheng Xue, have been warned repeatedly by local officials to stop petitioning.

HU GUOHONG, petitioner: They said, "We don't allow you to go petitioning to the upper levels. If you do that, we will beat you to death."

The myth of the chemical cure - It only gets you stoned

A commentary publish on the BBC website It looks like the drugs merely get you stoned or something, and cost way too much as well.

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Taking a pill to treat depression is widely believed to work by reversing a chemical imbalance.

Medication is a mainstay of mental health therapy

But in this week's Scrubbing Up health column, Dr Joanna Moncrieff, of the department of mental health sciences at University College London, says they actually put people into "drug-induced states".

If you've seen a doctor about emotional problems some time over the past 20 years, you may have been told that you had a chemical imbalance, and that you needed tablets to correct it.

It's not just doctors that think this way, either.

Magazines, newspapers, patients' organisations and internet sites have all publicised the idea that conditions like depression, anxiety, schizophrenia and bipolar disorder can be treated by drugs that help to rectify an underlying brain problem.

People with schizophrenia and other conditions are frequently told that they need to take psychiatric medication for the rest of their lives to stabilise their brain chemicals, just like a diabetic needs to take insulin.

The trouble is there is little justification for this view of psychiatric drugs.


Altered states

First, although ideas like the serotonin theory of depression have been widely publicised, scientific research has not detected any reliable abnormalities of the serotonin system in people who are depressed.

Second, it is often said the fact that drug treatment "works" proves there's an underlying biological deficiency.

Psychoactive drugs make people feel different

But there is another explanation for how psychiatric drugs affect people with emotional problems.

It is frequently overlooked that drugs used in psychiatry are psychoactive drugs, like alcohol and cannabis.

Psychoactive drugs make people feel different; they put people into an altered mental and physical state.

They affect everyone, regardless of whether they have a mental disorder or not.

Therefore, an alternative way of understanding how psychiatric drugs affect people is to look at the psychoactive effects they produce.

Drugs referred to as antipsychotics, for example, dampen down thoughts and emotions, which may be helpful in someone with psychosis.

Drugs like Valium produce a state of relaxation and a pleasant drowsiness, which may reduce anxiety and agitation.

Drugs labelled as "anti-depressants" come from many different chemical classes and produce a variety of effects.

Prior to the 1950s, the drugs that were used for mental health problems were thought of as psychoactive drugs, which produced mainly sedative effects.

'Informed choice'

Views about psychiatric drugs changed over the course of the 1950s and 1960s.

They gradually came to be seen as being specific treatments for specific diseases, or "magic bullets", and their psychoactive effects were forgotten.

However, this transformation was not based on any compelling evidence.

In my view it remains more plausible that they "work" by producing drug-induced states which suppress or mask emotional problems.

If we gave people a clearer picture drug treatment might not always be so appealing

This doesn't mean psychiatric drugs can't be useful, sometimes.

But, people need to be aware of what they do and the sorts of effects they produce.

At the moment people are being encouraged to believe that taking a pill will make them feel better by reversing some defective brain process.

That sounds good. If your brain is not functioning properly, and a drug can make it work better, then it makes sense to take the pill.

If, on the other hand, we gave people a clearer picture, drug treatment might not always be so appealing.

If you told people that we have no idea what is going on in their brain, but that they could take a drug that would make them feel different and might help to suppress their thoughts and feelings, then many people might choose to avoid taking drugs if they could.

On the other hand, people who are severely disturbed or distressed might welcome these effects, at least for a time.

People need to make up their own minds about whether taking psychoactive drugs is a useful way to manage emotional problems.

To do this responsibly, however, doctors and patients need much more information about the nature of psychiatric drugs and the effects they produce.