Archive for category Drugs
What is Schizophrenia?
Schizophrenia is an illness, a medical condition. It affects the normal functioning of the brain, interfering with a person’s ability to think, feel and act. Some do recover completely, and, with time, most find that their symptoms improve. However, for many, it is a prolonged illness which can involve years of distressing symptoms and disability.
People affected by schizophrenia have one ‘personality,’ just like everyone else. It is a myth and totally untrue that those affected have a so-called ‘split personality’.
What are the symptoms?
If not receiving treatment, people with schizophrenia experience persistent symptoms of what is called psychosis. These include:
• Confused thinking
When acutely ill, people with psychotic symptoms experience disordered thinking. The everyday thoughts that let us live our daily lives become confused and don’t join up properly.
A delusion is a false belief held by a person which is not held by others of the same cultural background.
The person sees, hears, feels, smells or tastes something that is not actually there. The hallucination is often of disembodied voices which no one else can hear.
Other associated symptoms are low motivation and changed feelings.
What causes Schizophrenia?
The causes of schizophrenia are not fully understood. They are likely to be a combination of hereditary and other factors. It is probable that some people are born with a predisposition to develop this kind of illness, and that certain things — for example, stress or use of drugs such as marijuana, LSD or speed — can trigger their first episode.
How many people develop Schizophrenia?
About one in a hundred people will develop schizophrenia at some time in their lives. Most of these will be first affected in their late teens and early twenties.
How is Schizophrenia treated?
Treatment can do much to reduce and even eliminate the symptoms. Treatment should generally include a combination of medication and community support. Both are usually essential for the best outcome.
Certain medications assist the brain to restore its usual chemical balance. This then helps reduce or get rid of some of the symptoms.
• Community support programs
This support should include information; accommodation; help with finding suitable work; training and education; psychosocial rehabilitation and mutual support groups. Understanding and acceptance by the community is also very important.
How do I find out more?
It is important to ask your doctor about any concerns you have. SANE Australia also produces a range of easy-to-read publications and multimedia resources on mental illness. For more information about this topic see:
Find a translated version of this factsheet.
• SANE Guide to Schizophrenia and other Psychotic Illness
Explains what it means to have a psychotic illness such as schizophrenia, examining effective treatments and what family and friends can do to help.
• Schizophrenia DVD Kit (37 minutes)
People who’ve experienced illness and their carers talk about the things which have helped them cope better. The SANE Guide to Schizophrenia and other Psychotic Illness included. See above for details.
• Voices: The Auditory Hallucinations Project
An Audio CD that explains how it feels to hear voices and what can be done to help.
• Tell Me I’m Here by Anne Deveson
Writer, journalist and filmmaker tells the moving and courageous story of what happened to her family when her son Jonathan developed schizophrenia.
• Recovered, Not Cured by Richard McLean (audio CD)
A graphic journey exploring the author’s experience of schizophrenia: the first signs, reactions from friends and family, how he sought help and the challenges of recovery.
• Flying with Paper Wings by Sandy Jeffs
Flying with Paper Wings is the story of one woman’s struggle to survive against an invisible illness, and her continued fight for an identity, self-esteem and a future.
For people with mental health problems, care can be elusive
http://www.latimes.com/health/la-he-healthcare-mental-health Michelle Andrews Kaiser Health News March 21, 2011
In any given year, more than a quarter of U.S. adults have a diagnosable mental health problem — from depression to bipolar disorder — yet fewer than half get any kind of treatment for it. The figures are similar for children.
Many who do receive care get it through their primary-care physician rather than a mental health professional like a psychiatrist or psychologist. That’s partly by choice: People prefer to talk to someone they know and trust about medical problems, and for many, there’s still a stigma in seeing a “shrink.”
But part of the reason people turn to their primary-care doctors or go without care is that it can be tough to get an appointment with a mental health expert. Psychiatrists, in particular, are in short supply especially in rural areas.
A recent survey conducted for the Tennessee Psychological Association, for example, found that the average wait to see a psychiatrist for a non-emergency appointment was 54 days for patients with private health insurance and 90 days for those covered by TennCare, the state’s Medicaid program, says Lance Laurence, director of professional affairs for the TPA.
“It’s a huge access issue,” says Katherine Nordal, executive director for professional practice at the American Psychological Association, a trade group for psychologists.
Psychologists say they have a solution to help address the access problems: Give them more authority to prescribe psychotropic medications. They can already prescribe in New Mexico and Louisiana, as well as in all branches of the military and the Indian Health Service. A half-dozen other states are considering measures that would give more psychologists prescribing authority.
Some of those states have considered and rejected such legislation before, but Nordal says her group is “cautiously optimistic” that it may succeed in a few states this year.
Psychiatrists are medical doctors with a specialty in psychiatry; psychologists have doctoral degrees, and their training includes coursework in diagnosing and managing mental illness. Any medical doctor, from dermatologist to surgeon, can prescribe psychotropic drugs; but before psychologists can prescribe drugs — in the jurisdictions that allow it — they must complete work equivalent to an additional master’s degree in clinical psychopharmacology, says Nordal. With the exception of psychiatrists, she says, no medical professional is as well versed in medication for mental disorders as prescribing psychologists.
In addition, psychologists provide other types of treatment, such as talk therapy and cognitive behavioral therapy, in contrast to psychiatrists who often only prescribe drugs. A national survey found that only 10.8 percent of psychiatrists offer talk therapy to all their patients. “We have a bigger toolkit than many others do that prescribe,” Nordal says.
Health insurance generally covers prescription drugs to treat mental illness, but coverage for therapy sessions with a mental health provider is less routine. This has resulted in an over-reliance on drug therapy in recent years, all agree. Experts say this imbalance should change under the Mental Health Parity Act which took effect last year; it requires mental health benefits, if offered, to be at least as generous as benefits for medical and surgical care. Even if the type of treatment shifts somewhat, however, many patients will still need drug therapy.
Physician groups such as the American Medical Association and some patient advocacy groups, however, are cool to the idea of letting psychologists prescribe drugs. “These are serious drugs with serious side effects,” says Mike Fitzpatrick, executive director of the National Alliance on Mental Illness a consumer advocacy organization. “We feel strongly that [prescribing] should be handled by someone with medical training.”
Unfortunately, even some doctors have difficulty prescribing medication for patients with mental disorders. Primary-care physicians, for example, prescribe 41 percent of all antidepressants, but research shows that they may misjudge the correct dose and don’t schedule necessary follow-up visits.
The problem is likely to become more acute with an estimated 32 million people expected to gain health insurance under the health-care overhaul law. The Assn. of American Medical Colleges projects a shortage of 45,000 primary-care physicians alone by 2020.
Experts agree that solutions lie in better integration between primary care and mental health care. This makes sense in part because for more than a third of patients with mental health problems, the only practitioner they see is a primary-care provider.
In addition, people with chronic illnesses such as diabetes, heart disease and asthma are significantly more likely to have mental health problems than those without chronic illness. People with serious mental illness, in fact, die 25 years sooner, on average, than the rest of the population.
The health-care overhaul, with its emphasis on medical homes and accountable care organizations that take responsibility for managing a patient’s health rather than just providing medical services, offers promising models for integration, experts agree.
In clinical psychologist Benjamin Miller’s primary care “dream world,” mental health providers work alongside primary-care physicians, in the same office. Miller is an assistant professor of family medicine at the University of Colorado’s school of medicine in Denver. Part of his job is to integrate mental health into the family medicine department’s clinical, education and research functions.
“There’s a range of mental health needs that will be seen in primary care,” he says. “You can’t tease it out from the other conditions that an individual is facing.”
-Andrews writes for Kaiser Health News, an editorially independent news service and a program of the Kaiser Family Foundation, a nonpartisan healthcare policy research organization. Neither Kaiser Health News nor the foundation is affiliated with Kaiser Permanente.
Copyright © 2011, Los Angeles Times
http://www.bbc.co.uk/news/business-12539197 22 February 2011
The NHS in England has launched legal action against Reckitt Benckiser, maker of heartburn medicine Gaviscon.
According to High Court documents, Health Secretary Andrew Lansley is leading the action on behalf of health authorities and primary care trusts.
The Department of Health refused to comment on the subject of the suit.
Reckitt Benckiser was fined £10m last year for abusing its dominant market position in the supply of heartburn remedies to the NHS.
A spokesman for Reckitt said the company could not comment as it had not been served with any papers.
Papers lodged at the High Court show Reckitt is being sued collectively by all 10 Strategic Health Authorities and 144 Primary Care Trusts in England, as well as Andrew Lansley as Secretary of State for Health.
The Office of Fair Trading (OFT) said in October last year that Reckitt had restricted competition in the supply of heartburn medicines.
The household products maker withdrew the original Gavison from the NHS in 2005 and patients were transferred to Gaviscon Advance Liquid.
This happened after Gaviscon’s patent had expired, but before a generic name had been assigned to it, the OFT said.
That meant that prescriptions were issued for Gaviscon Advance, rather than pharmacists being able to choose a cheaper generic alternative.
The OFT’s inquiry followed an investigation by the BBC’s Newsnight programme in 2008.
Gaviscon is one of the most heavily prescribed medicines within the NHS. Confidential papers leaked to the programme by a whistleblower showed it was also very profitable, with a gross margin of 77% in 2003.
The then-chief executive of the OFT, John Fingleton, said at the time: “This case underlines our determination to prevent companies with a dominant position in a market from using their strength to seek to restrict competition from rivals”.
In response to the OFT’s fine, Reckitt said that it had believed it was acting within the law at the time and respected the watchdog’s findings.