Treatment for ADHD with Less Addictive Medications

Psychiatric Times
By Peggy Peck Feb 27, 2007

ROCKVILLE, Md., Feb. 27 -- The FDA has approved lisdexamfetamine dimesylate (Vyvanse), formerly known as NRP104, for attention deficit hyperactivity disorder.

The amphetamine, to be marketed by Shire, is said to have limited abuse potential, but it was designated Schedule II by the DEA. Shire plc said in a statement that the drug has a lower potential for abuse than other amphetamines used to treat ADHD.

"The label we received with the approval letter includes information about the extended duration of effect and abuse-related drug liking characteristics of Vyvanse, which illustrate benefits that differentiate this compound from other ADHD medicines," said Matthew Emmens, Shire's CEO.

Data from phase II and phase III clinical trials demonstrated statistically significant improvements in ADHD symptoms for patients ages six to 12 years treated with lisdexamfetamine compared to patients treated with placebo. These studies demonstrated significant efficacy at all time points tested (including 6 p.m.) for doses of 30 mg, 50 mg, and 70 mg.

In the phase II, analog classroom study, patients showed significantly improved behavior when receiving either lisdexamfetamine or Adderall XR (another Shire drug) as measured by the Swanson, Kotkin, Agler, M. Flynn and Pelham (SKAMP) deportment rating scale, a standardized, validated classroom assessment tool used for evaluating ADHD behavioral symptoms.

See Psychiatric Times for more information.......

The Secret

On the The Oprah Show last week she had a panel of people talking about "The Secret". This movie, The Secret, and book was created by Australian Rhonda Byrne, and she says that if you follow its philosophy, you can create the life you want—whether that means getting out of debt, finding a more fulfilling job or even falling in love.

Rhonda defines The Secret as the law of attraction, which is the principle that "like attracts like." Rhonda calls it "the most powerful law in the universe," and says it is working all the time. "What we do is we attract into our lives the things we want, and that is based on what we're thinking and feeling," Rhonda says. The principle explains that we create our own circumstances by the choices we make in life. And the choices we make are fueled by our thoughts—which means our thoughts are the most powerful things we have here on earth.

See more about the show at the link above... Sound a little like Cogntive Behavioral Therapy, Hmmmm?

Binge Drinking Among High Schoolers

By Crystal Phend
Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine. Jan 02, 2007

ATLANTA, Jan. 2 -- Binge drinking is the most common way that high schoolers consume alcohol and is tied to other risky behaviors, according to a national survey by the Centers for Disease Control and Prevention.

Among the more than 15,000 teens surveyed, nearly half reported drinking alcohol in the prior month, and more than 60% of those who drank had binged on five or more drinks, said Jacqueline W. Miller, M.D., of the CDC here, and colleagues.

These "alarming" findings call for stronger interventions to reduce both youth drinking and excessive drinking in the general population, they said in the January issue of Pediatrics.

"Pediatricians and family practice physicians should be aware that most of their high school-aged patients drink alcohol and usually do so to the point of intoxication," they wrote. "Some studies have shown that screening and brief intervention in medical settings may be helpful for youth who screen positive for alcohol problems."

The school-based National Youth Risk Behavior Survey included a nationally representative sample of students in grades nine through 12 at public and private schools. The survey was anonymous, self-administered and voluntary (overall response rate 67%).

The researchers found:

• 44.9% of the students (representing 7.4 million high schoolers) reported drinking alcohol during the prior 30 days,
• 28.8% binge drank (representing 2.6 million students),
• 16.1% drank alcohol but did not binge drink (representing 4.7 million teens), and
• 67.4% of male- and 61.1% of female-current drinkers reported binge drinking.
  

Among binge drinkers across all grade levels, the findings were:

• 68.7% (representing 3.2 million teens) reported doing so at least once in the prior month.
• 73.3% (or 1.8 million) of boys and 63.7% (or 1.4 million) of girls binged on at least two days.
• 28.2% (representing 700,000) and 18.3% (representing 400,000) binged on at least six days.
• 13.6% (or 340,000) and 6.8% (or 150,000), respectively, binge drank on at least 10 days.

While any alcohol consumption was associated with increased health risk behaviors, the association was especially strong for binge drinking.

Compared with students who reported no drinking, the findings were:

• Riding with a drunk driver was 3.5 times (95% confidence interval 2.8 to 4.2) times more common among current drinkers and 10.8 times more likely (95% CI 9.0 to 13.1) among binge drinkers.
• Being sexually active was 2.2 more likely (95% CI 1.9 to 2.6) among drinkers and 5.5 times (95% CI 4.5 to 6.5) more likely among binge drinkers.
• Smoking tobacco was 4.2 times (95% CI 3.3 to 5.3) more likely among drinkers and 18.9-fold (95% CI 15.3 to 23.4) more likely among binge drinkers.
• Being a victim of dating violence was 1.9-fold (95% CI 1.5 to 2.3) and 3.7 times (95% CI 3.0 to 4.5) more likely, respectively.
• Attempting suicide was 2.0-fold (95% CI 1.6 to 2.7) more likely among drinkers and 4.3 times (95% CI 3.5 to 5.4) more likely among binge drinkers.
• Using illegal drugs was 3.2 to 5.9 times more likely among drinkers for various drugs while it was 12.3 to 63.2 times more likely among binge drinkers.

There was a strong dose-response relationship....for more link to Pyschiatric Times.

Prevalence of Eating Disorders

Results from a large-scale national survey suggest that binge-eating disorder is more prevalent than both anorexia nervosa and bulimia nervosa. The study, published in the February 1, 2007, issue of Biological Psychiatry, was based on data gleaned from the NIMH-funded National Comorbidity Survey Replication (NCS-R), a nationally representative survey conducted between February 2001 and December 2003.

Anorexia nervosa is characterized by emaciation, a relentless pursuit of thinness and extremely disturbed eating behaviors, such as deliberate self-starvation. Bulimia nervosa is characterized by recurrent and frequent episodes of eating unusually large amounts of food (binging) during which a person feels a lack of control over the eating, followed by purging behavior such as vomiting, fasting, use of diuretics (water pills), or excessive exercise. Binge-eating disorder is characterized by recurrent binge-eating episodes during which a person feels a loss of control similar to bulimia. Unlike bulimia, however, binge-eating episodes are not followed by purging, excessive exercise or fasting.

Further details and findings associated with this topic are found at Eating Disorders.

Teen Suicide Rates Increase

Provided by: Associated Press
Written by: LUNDSEY TANNER Feb. 5, 2007

CHICAGO (AP) - New government figures show a surprising increase in youth suicides after a decade of decline, and some mental health experts think a drop in use of antidepressant drugs may be to blame.

The suicide rate climbed 18 per cent from 2003 to 2004 for Americans under age 20, from 1,737 deaths to 1,985. Most suicides occurred in older teens, according to the data - the most current to date from the federal Centers for Disease Control and Prevention.
By contrast, the suicide rate among 15-to 19-year-olds fell in previous years, from about 11 per 100,000 in 1990 to 7.3 per 100,000 in 2003.

Suicides were the only cause of death that increased for children through age 19 from 2003-04, according to a CDC report released Monday.

See More...........

Intermittent Explosive Disorder

By Arline Kaplan (Psychiatric Times)
January 2007, Vol. XXIV, No. 1

Intermittent explosive disorder (IED) is not yet on the radar screens of many psychiatrists, but it is more prevalent than panic disorder and warrants extensive research and attention, 2 experts on IED said recently.

In exclusive interviews, Ronald Kessler, PhD, professor of health care policy at Harvard Medical School, and Emil Coccaro, MD, Ellen C. Manning professor and chair of the University of Chicago's department of psychiatry, discussed their recently released study of the prevalence and correlates of IED1 and current as well as planned treatment research.

Depending on how it is defined, IED affects between 5.4% and 7.3% of adults (11.5 to 16 million Americans) in their lifetimes. The prevalence study, funded by the National Institute of Mental Health, was based on data from the National Comorbidity Survey Replication, a national representative, face-to-face household survey of 9282 US adults aged 18 years and older. The diagnoses used in that survey emanated from version 3.0 of the World Health Organization Composite International Diagnostic Interview, which included an assessment of DSM-IV IED.
Findings of the survey indicate that IED is a lot more common than it was previously thought to be, Kessler told Psychiatric Times. It is more common than panic disorder, and anger attacks are more common than panic attacks.

"When you look at the impairment data about the impact on people's lives, IED is very important there, too, because it not only affects the person who has it, but . . . the people around the person with the disorder—the people whom the lamp gets thrown at rather than the person who is throwing the lamp," Kessler added. "Isn't it amazing that something this important has been going on . . . under the radar screen?"

Read More from Psychiatric Times.....