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Increased Number Of Antidepressants Prescribed To Patients Without A Psychiatric Diagnosis

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Prescriptions for antidepressants given by nonpsychiatrists to patients without a specific psychiatric disorder increased more than 12% in 12 years, leading to the drug class becoming the third most commonly prescribed, a study found.

A study in the August issue of Health Affairs reported that antidepressant prescriptions by doctors who didn’t record a specific psychiatric disorder increased from 59.5% of all prescriptions by nonpsychiatrists in 1996 to 72.7% in 2007.

Researchers reviewed data on patients age eighteen or older from the 1996-2007 Centers for Disease Control and Prevention’s National Ambulatory Medical Care Surveys, a national sample of more than 233,000 office-based visits. The proportion of antidepressants prescribed for patients without a psychiatric diagnosis increased from 2.5% of all visits to nonpsychiatrist providers to 6.4% between 1996 and 2007. For visits to primary care providers, antidepressant prescribing grew from 3.1% to 7.1%. For other nonpsychiatric providers, visits without a psychiatric diagnosis grew from 1.9% to 5.8%. In contrast, antidepressants prescribed with a psychiatric diagnosis increased from 1.7% to 2.4%.

Patients who received antidepressants without a psychiatric diagnosis by nonpsychiatrist providers were more likely to be Read more »

*This blog post was originally published at ACP Internist*

Individualizing “The Fight Against Cancer”

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You have heard it countless times, “The War on Cancer.” President Nixon announced it. The National Cancer Institute has spearheaded what TV and radio commercials always talk about as “the fight against cancer.” Singular. But we really need to start thinking about it as a plural.  Wars on cancer. Fights against cancer. Taking it one step further, we need to see each person’s fight as an individual battle.  Not just individualized to the patient’s spirit or age or sense of hope, but individualized to his or her particular biology, matched up with the specific cancer and available treatments. That is the nature of “personalized medicine” applied to cancer. We’ve been talking about it for a few years around here, but what’s exciting now is that even more super smart people in the cancer scientific community are devoting themselves to it.

I met two people like that today near the research labs at the University of Washington in Seattle. Without giving too much away (they’ve got big plans), these two hematologist-oncologists, with many advanced degrees between them and decades of experience, are trying to build something really big that could lengthen lives and save many too.

What they’re trying to do is Read more »

*This blog post was originally published at Andrew's Blog*

Painful Bladder Condition Often Goes Undiagnosed In Women

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Woman-stomach-painMillions of Americans—most of them women—suffer from a bladder condition known as interstitial cystitis. According to a new study of this disorder, fewer than 10% of women with symptoms of interstitial cystitis are actually diagnosed with the disorder, even though it severely affects their lives. Without a proper diagnosis, women with interstitial cystitis are missing out on treatments that might bring them some relief.

As I describe in an article in the August 2011 issue of the Harvard Women’s Health Watch, interstitial cystitis is a chronic bladder condition that causes recurring bouts of pain and pressure in the bladder and pelvic area. Individuals with the condition usually have an urgent and frequent need to urinate—sometimes as often as 60 times a day. The pain and discomfort can be so excruciating that only about half of people with interstitial cystitis work full-time.

Researchers with the federally funded RAND Interstitial Cystitis Epidemiology (RICE) study surveyed nearly 150,000 households in the United States between 2007 and 2009. Based on data gathered during follow-up interviews, the RICE researchers estimated Read more »

*This blog post was originally published at Harvard Health Blog*

Antibiotic-Resistant Glue Ear And A Potential New Treatment

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Glue ear is the layman’s term for thick mucoid effusion of the middle ear, usually due to chronic ear infections.

The fluid itself is like maple syrup and usually treated with ear tube placement followed by suctioning as much of the fluid out as possible. However, given there is always some residual present, antibiotic ear drops with steroids is often prescribed.

Unfortunately, these patients are at higher risk of requiring repeated sets of tubes after the body spits them out.

Why? Read more »

*This blog post was originally published at Fauquier ENT Blog*

Article Reviews The Effectiveness Of NSAIDs For Arthritis Pain

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Recently I gave in and went to see a rheumatologist after more than 3 months of intense morning stiffness and swelling of my hands (especially around the PIPs and MCPs) and wrists which improved during the day but never went away.  It had gotten to the point where I could no longer open small lid jars (decreased strength), do my push-ups or pull ups (pain and limited wrist motion), and OTC products (Tylenol, Advil, etc) weren’t working.  I can’t take Aleve due to the severe esophagitis it induces.  I didn’t want to write a prescription for my self-diagnosed (without) lab arthritis.

BTW, all the lab work came back negative with the exception of a slightly elevated sed rate and very weakly positive ANA.  The rheumatologist was impressed with the swelling, pain, and stiffness and was as surprised as I by the normal lab work.  He thinks (and I agree) that I am in the early presentation of rheumatoid arthritis.  He wrote a prescription for Celebrex and told me to continue with the Zantac I was already taking (thanks to the Aleve).  The Celebrex is helping.

So I was happy to see this article (full reference below) come across by twitter feed.  H/T to @marcuspainmd: Useful review of NSAIDs effects & side effects for arthritis pain: Read more »

*This blog post was originally published at Suture for a Living*

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