Marketing Off-Label Uses: Shady Practices Within a Gray Market
For pharmaceutical companies, off-label use of a drug represents a substantial “gray market,” to which the company is unable to sell their product directly, yet may be a significant revenue stream. Some drugs have been used more for off-label purposes than for originally approved indications.1
DisFigured: The Making of a Movie
July 14th 2009I wrote, directed, coedited, and financed DisFigured because it’s a movie I wanted to see. I’m not a woman and I don’t have an eating disorder, but the issues of appearance, control, isolation, and our complicated relationships with our bodies seem universal to me. They are also sadly underexplored or horribly twisted in almost every form of media. I am particularly aware of this because my wife Jenn is beautiful, graceful, stylish and-according to popular culture-fat.
Inflammation, Psychosis, and the Brain
July 11th 2009When the solution to a clinical or scientific puzzle eludes us for more than a century, as with schizophrenia, we need new methods to examine the pathology. If we want to make an impact on the disease we must shift research paradigms and focus on the early detection, early intervention, and new avenues of treatment that address different symptoms of schizophrenia.
Delirium With Catatonic Features: A New Subtype?
July 10th 2009Delirium has been recognized and described since antiquity. It is a brain disturbance manifested by a syndrome of diverse neuropsychiatric symptoms. Various terms have been used for delirium, such as acute brain disorder, metabolic encephalopathy, organic brain syndrome, and ICU psychosis.
PTSD Is a Valid Diagnosis: Who Benefits From Challenging Its Existence?
July 10th 2009PTSD filled a nosological gap by providing a way to characterize the long-lasting effects of trauma exposure.1 This led to a plethora of previously lacking scientific observations. Now the existence of PTSD is being called into question because some of the original assumptions that helped make the case for it have proved to be incorrect.2-4 However, it is possible to update some of the flawed assumptions of PTSD without rescinding the diagnosis. There is no reason to throw the baby out with the bathwater.
PTSD Has Unreliable Diagnostic Criteria
July 10th 2009Currently the Veterans Administration (VA) is the world’s largest recipient of per patient funding for PTSD. The VA treats 200,000 veterans with this diagnosis annually at a cost of $4 billion. But research calls into question the very existence of the “PTSD” syndrome, and its diagnostic formulation remains invalid. We do not minimize the suffering of those who experience trauma or the need for comfort and restitution. We seek only to reexamine research evidence, to clarify the impact of culture on diagnosis, to reevaluate the consequences of trauma, and to ensure optimal allocation of resources.
Dr Frances Responds to Dr Carpenter: A Sharp Difference of Opinion
July 9th 2009I have the highest respect and affection for Will Carpenter, MD, who wrote a recent response ("Criticism vs Fact: A Response To A Warning Sign on the Road to DSM-V by Allen Frances, MD," Psychiatric Times, July 7, 2009) to my earlier commentary, but we do differ sharply on the following points.
Complementary, Alternative, and Integrative Rx: Safety Issues
July 7th 2009Findings of a recent large population survey suggest that 1 in 3 adults in this country (approximately 72 million people) uses 1 or more complementary and alternative medicine (CAM) modalities during any given year.1 Many CAMs are widely regarded as safe on the basis of their established uses in traditional systems of medicine over centuries or longer and their current widespread use in the United States and other Western countries. Unfortunately, there is limited reliable information on potential risks associated with the majority of these approaches.