Prescribing Antipsychotic Drugs to Kids

Consumer Reports looks at current practices and finds them alarming:

The number of children taking powerful antipsychotic drugs has nearly tripled over the last 10 to 15 years, according to recent research. The increase comes not because of an epidemic of schizophrenia or other forms of serious mental illness in children, but because doctors are increasingly prescribing the drugs to treat behavior problems, a use not approved by the Food and Drug Administration (FDA). And a disproportionate number of those prescriptions are written for poor and minority children, some as young as age 2.

Doctors are prescribing antipsychotics even though there’s minimal evidence that the drugs help kids for approved uses, much less the unapproved ones, such as behavioral problems. And to make matters worse, the little research there is suggests the drugs can cause troubling side effects, including weight gain, high cholesterol, and an increased risk of type-2 diabetes.

This pattern repeats itself throughout the medical system. A drug that may be helpful for certain severe cases is prescribed for vastly greater numbers of people. As we move down the severity scale, the risk-benefit ratio gets worse and worse. Milder cases (even assuming the diagnosis is correct) are those least likely to benefit from drug treatment and most likely to have a cost-benefit ratio that’s underwater.

New Cholesterol Calculator Tells Healthy People They Need Statins

The cholesterol guidelines released last week are already poised to drastically increase the number of people prescribed statin drugs, and this calculator that the American College of Cardiology just unveiled will help people miscalculate their risk (substantially upwards, of course) even more.

This is beyond the beyond. Worth reading this whole article if you or a loved one are considering taking statins.

“[It] overpredicted risk by 75-150%, depending on the population. A man whose risk was 4 percent, for example, might show up as having an 8 percent risk. With a 4 percent risk, he would not warrant treatment…..  Miscalibration to this extent should be reconciled and addressed before these new prediction models are widely implemented. If real, such systematic overestimation of risk will lead to considerable overprescription.”

“Something is terribly wrong,” Dr. Nissen said. Using the calculator’s results, he said, “your average healthy Joe gets treated, virtually every African-American man over 65 gets treated.”…

FDA Moves Against Trans Fats

This move should complete the elimination of artificial trans fats from the American diet. Previous advice from the government had already lowered the amount of trans fats in packaged foods substantially.

On the basis of a review of scientific evidence and findings from expert panels, the agency made a preliminary determination that the oils “are not generally recognized as safe for use in food” and should be eliminated, FDA Commissioner Margaret Hamburg, MD, said on a conference call with reporters.

The decision “is very welcome and strongly supported by massive scientific evidence that trans fat has many adverse effects on health,” Walter Willett, MD, DrPH, of the Harvard School of Public Health, said in an email to MedPage Today. “Trans fat has no place on the table, and this step will help make the diets of Americans safer.”

Harvard School of Public Health’s Walter Willett, PhD, puts the change into context:

Willett added, “Further removal of trans fats will also likely nudge down rates of diabetes, obesity, and other conditions as well.”

“Importantly, by getting trans fat off the table entirely, we will be able to focus attention on other aspects of diet that also need to be improved,” he said. “This will likely have a ripple effect worldwide because other countries are considering similar actions.”