Category: Health Policy

No more shocks? Study shows drug treatment for major depression just as effective as electroconvulsive therapy

By Gretchen Cuda Kroen: Complete Post through this link…

The anesthetic drug ketamine is at least as effective as electroconvulsive therapy for treating major depression and has fewer side effects, a study published Wednesday in the New England Journal of Medicine reported.

More than 21 million adults in the US are estimated to suffer from Major Depressive Disorder. For those whose depression fails to respond to anti-depressive drugs, ECT, which involves inducing a seizure via electrical stimulation of the brain, is one of the few treatments that can provide life-changing relief.

The clinical trial of 403 patientsis the largest study ever done comparing ketamine and ECT treatments for depression that has ever been done, and the only one that also measured impacts to memory, Anand said.

The trial, conducted overfiveyears across multiple institutions including the Cleveland Clinic, compared the outcomes of patients selected at random to either receive ECT three times per week or ketamine twice per week for three weeks. Following treatment, patients answered questions about their depressive symptoms and quality of life, along with a battery of memory tests for the next six months.

Investigators found that 55% of patients who received ketamine and 41% who received ECT reported at least a 50% improvement in their self-reported depressive symptoms and quality of life that lasted at least six-months and concluded that treatments with ketamine were as effective as ECT.

Polypharmacy Killed My Son. He’s Not Alone

BY ANDREA SONNENBERG: Complete Post through this link…

Five years ago, my 21-year-old son Bradley died of psychiatric drug interactions, after years of battling anxiety, depression, and an eating disorder. In most respects, Bradley was very much like many kids you know. He was funny, smart, and talented, constantly making people laugh with goofy impersonations, and starring in school plays and musicals. We—me, my husband, and Bradley’s siblings—deeply supported him in his challenges with mental health. He had access to the best healthcare available. But despite his privilege, we couldn’t save him.

At the time of his death, Bradley was taking a cocktail of medications prescribed by respected doctors. Bradley died unexpectedly in his sleep because of a practice called polypharmacy—the layering of multiple medications on top of one another, often without regard to what other doctors have already prescribed or the potential interactions between the drugs.

It is not uncommon for patients to receive psychiatric medication without being evaluated by a mental-health professional. Often, a primary-care physician will prescribe an antidepressant without considering various other evidence-based treatments that may be more effective and without possible side effects. There are also the financial incentives, whereby insurance companies are more inclined to pay for medications than therapy, and at a higher reimbursement rate. That’s not to say that medications can’t be helpful; often they are critical to treatment and produce miraculous results. But many medications come with serious side effects. When many medications are taken together, they can cause harmful drug interactions. Plus, there is the risk of taking the wrong dosage, either too high or too low, which can lead to potential withdrawal symptoms or accidental overdose.

Advocacy Pays Off Now That Full Senate Will Consider Safe Step Act

From PHA: Complete Post through this link…

Thanks to advocacy efforts by the Pulmonary Hypertension Association (PHA) and others, the Safe Step Act moves to the full Senate floor for the first time.

“This is a huge step in the legislative process,” says PHA President and CEO Matt Granato. “While there is more work ahead before this bill becomes law, PHA celebrates this milestone achievement, which wouldn’t have been possible without the tireless efforts of PHA advocates and the amazing PHA advocacy staff.”

Those who advocated for the legislation include people with pulmonary hypertension, caregivers and health care professionals, as well as other patient organizations.

The Safe Step Act aims to limit step-therapy requirements for people with pulmonary hypertension (PH) and other life-threatening conditions. Step therapy refers to insurance company policies that require people to try less expensive treatments than those their doctors prescribe. The insurance companies  authorize prescribed treatment only after the less expensive treatment fails.

Congress introduced the Safe Step in 2017, but this is the first time legislation has moved beyond committee. That means all members of the Senate will be able to review and eventually vote on the bill. The next step is for advocates to convince the House of Representatives Committee on Education and the Workforce to send its version of the bill to full House floor. Both the House and Senate must approve a bill before it can become law.

Chronic Pain Incidence Is High in the U.S.

by Judy George: Complete Post through this link…

New cases occur more frequently than other conditions, and often persist.

New cases of chronic pain — defined as pain experienced on most days or every day over 3 months — occurred more frequently than new cases of other common chronic conditions, U.S. survey data showed.

Chronic pain incidence was 52.4 cases per 1,000 person-years, reported Richard Nahin, MPH, PhD, of the NIH in Bethesda, Maryland, and co-authors.

This was higher than the incidence of diabetes (7.1 cases/1,000 person-years), depression (15.9 cases), and hypertension (45.3 cases), the researchers said in JAMA Network Openopens in a new tab or window.

Moreover, chronic pain was persistent: nearly two-thirds (61.4%) of adults with chronic pain in 2019 continued to have it in 2020.

The findings come from National Health Interview Survey (NHISopens in a new tab or window) data and are the first nationwide estimates of chronic pain incidence.

Recent NHIS data showed the prevalence of chronic painopens in a new tab or window in the U.S. was about 21%, affecting an estimated 51.6 million adults. High-impact chronic pain — pain severe enough to restrict daily activities — affected 17.1 million people.

“Understanding incidence, beyond overall prevalence, is critical to understanding how chronic pain manifests and evolves over time,” Nahin said in a statement. “These data on pain progression stress the need for increased use of multimodal, multidisciplinary interventions able to change the course of pain and improve outcomes for people.”

Risk of Parkinson Disease Among Service Members at Marine Corps Base Camp Lejeune

By Samuel M. Goldman. et al.: Complete Post through this link…

Key Points

Question  Is Parkinson disease risk increased in military service members who were stationed at Marine Corps Base Camp Lejeune, North Carolina, during 1975-1985 when the water supply was contaminated with trichloroethylene and other volatile organic compounds?

Findings  This cohort study of 340 489 service members found that the risk of Parkinson disease was 70% higher in Camp Lejeune veterans compared with veterans stationed at a Marine Corps base where water was not contaminated. In veterans without Parkinson disease, risk was also significantly higher for several prodromal features of Parkinson disease.

Meaning  The study’s findings suggest that exposure to trichloroethylene in water may increase the risk of Parkinson disease; millions worldwide have been and continue to be exposed to this ubiquitous environmental contaminant.

Why Lyme disease symptoms go away quickly for some and last years for others

By Caroline Hopkins: Complete Post through this link…

Why some people recover from Lyme disease, while others experience months, years or even decades of chronic symptoms has long puzzled doctors. New research offers some clues to an immune system marker in the blood that is elevated among people with lingering Lyme disease symptoms, even after they’d received antibiotics. 

In the new study, published on May 9 in the Center for Disease Control and Prevention’s Emerging Infectious Diseases journal, researchers found an immune system marker in the blood called interferon-alpha was elevated among people who had been treated for Lyme disease but had lingering symptoms.

Interferon-alpha is one of a handful of key signaling proteins the body makes to tell immune cells to fight off bacteria or viruses. If the blood levels are too high, the immune system can overact, causing pain, swelling and fatigue — symptoms often seen with Lyme disease.

In patients with high levels of interferon-alpha, the immune response to the Lyme bacteria may cause chronic inflammation, even once the infection is gone, said Klemen Strle, an assistant research professor of molecular biology and microbiology at Tufts University and an author of the new study. 

Non-Invasive Brain Imaging Deciphers Hand Gestures

From Neuroscience News: Complete Post through this link…

Summary: Researchers have developed a non-invasive method to identify hand gestures through brain imaging.

The technique utilizes magnetoencephalography (MEG) and could contribute to the evolution of brain-computer interfaces. Such interfaces could help individuals with physical challenges, like paralysis or amputated limbs, to control supportive devices using their minds.

This work represents the most successful non-invasive single-hand gesture differentiation achieved to date.

Key Facts:

  1. The researchers successfully used non-invasive MEG to distinguish different hand gestures with over 85% accuracy.
  2. The technique, which is as safe as taking a patient’s temperature, has potential applications for those with physical challenges.
  3. MEG measurements from only half of the brain regions sampled yielded nearly comparable results, suggesting future MEG helmets might require fewer sensors.

The FDA just approved rub-on gene therapy that helps “butterfly” children

By Antonio Regalado: Complete Post through this link…

Biotech companies are getting creative with how they deliver DNA fixes into people’s bodies.

Antonio Vento is 13 years old. He’s a tiny figure in bandages who doesn’t walk and, until recently, couldn’t see more than shadows. He has dystrophic epidermolysis bullosa, an inherited disease that makes his skin so fragile that kids with the illness are called “butterfly children.”

But now, thanks to a novel gene therapy squirted onto his skin and dripped into his eyes, things are better. His wounds have gotten smaller, and a visit to the eye doctor this week confirmed that his vision had dramatically improved.

“They said my right eye is 20/25,” he chirped in Spanish during a phone call. “Now I can see small things.” That includes the blocks and items in the video game Minecraft, which he has started to play.

And call him Anthony, he said. He prefers it.

Press Release: Not Dead Yet Joins Anti-Discrimination Lawsuit To Oppose Assisted Suicide Law

From Not Dead Yet: Complete Post through this link…

Los Angeles, CA — April 26, 2023 – Yesterday, the United Spinal Association (“United Spinal”), Not Dead Yet (“NDY”), Institute for Patients’ Rights (“IPR”), Communities Actively Living Independent & Free “CALIF”, and individual plaintiffs, Lonnie VanHook and Ingrid Tischer, filed a lawsuit in the U.S. District Court for the Central District of California, asking that California’s End of Life Option Act (EOLOA) be declared unlawful and unconstitutional.

“This lawsuit is a long-held dream come true for Not Dead Yet,” said Diane Coleman, president and CEO of NDY, a national disability organization. “We’re honored to join our fellow plaintiffs and attorneys to bring this fundamental disability rights challenge to the discrimination inherent in assisted suicide laws.”

NDY’s assistant director/policy analyst Jules Good says, “At a time where our rights are being stripped away, hateful laws are being enacted against LGBTQ+ members of our community, and disabled people of color are facing continued systemic violence, policies that make it easier for disabled people to die with help from their doctors are especially dangerous. Assisted suicide policies are inherently discriminatory, full stop.” 

NDY’s director of minority outreach, Anita Cameron, says, “As a Black disabled woman, I have experienced both racial and disability discrimination in healthcare. Although few Blacks and people of color request assisted suicide, as it becomes normalized across the country, racial disparities and the devaluing of the lives of disabled people will lead to people being forced, or ‘convinced’ to ask for assisted suicide.”

Doctors More Neurotic, Less Open Than Patients, Surveys Find

by Michael DePeau-Wilson: Complete Post through this link…

ngd-Maybe this has something to do with the appalling work processes that doctors have to operate under in order to work at all…

Personality data may have clinical implications for doctor-patient relationships.

Doctors may be more neurotic than both patients and the general population, according to two nationally representative Australian surveys.

When it comes to the “Big Five” personality traits, doctors were also significantly more agreeable, conscientious, and extroverted than both the general population and patients, according to Mehdi Ammi, PhD, health economist of Carleton University, in Ottawa, Canada, and the University of Queensland, in Australia, and coauthors.