FDA: Smoking Cessation Drug Does Not Cause More Psychiatric Hospitalizations Than Nicotine Patches

By Join Together Staff | October 25, 2011 |

The Food and Drug Administration (FDA) has determined the smoking cessation drug Chantix (varenicline) is no more likely than nicotine patches to cause psychiatric events that require hospitalization.

The FDA drew its conclusions after reviewing two studies comparing Chantix to nicotine replacement therapy, including nicotine patches. The agency acknowledged the studies had limitations and will keep the “black box” warning labels on Chantix to advise about possible psychiatric side effects, including changes in behavior, hostility, agitation, depressed mood and suicidal thoughts or actions, Reuters reports.

“Overall, FDA has determined that the current warnings in the Chantix drug label, based on postmarketing surveillance reports, remain appropriate,” the FDA said in a statement.

One study conducted by the Department of Veterans Affairs compared 14,131 veterans using Chantix with an equal number of veterans who used nicotine patches. A second study conducted by the Department of Defense compared almost 20,000 people using Chantix with about 16,000 people who used nicotine patches for a month after they began treatment to quit smoking.

The manufacturer of Chantix, Pfizer, is conducting a large safety clinical trial of the drug to assess psychiatric side effects. Results are expected in 2017.

In June, the FDA said Chantix may be associated with a small, increased risk of certain heart problems in patients with heart disease.

http://www.drugfree.org/join-together/research/fda-smoking-cessation-drug-does-not-cause-more-psychiatric-hospitalizations-than-nicotine-patches?utm_source=Join+Together+Daily&utm_campaign=42a2475b68-JT+Daily+News%3A+Take-Back+Programs...&utm_medium=email

Reposted at darkestcloset@blogspot.com

Behind Bars Without Help: The Mental Health Controversy in Michigan

Posted at NAMI blog Thursday, August 25, 2011 Reposted at darkestcloset.bloggerspot.com

By Ron Honberg, NAMI Director of Policy and Legal AffairsThe new head of Michigan's Department of Corrections recently made national news when he expressed concerns about the extent to which his department's resources are used to provide mental health to inmates.
On August 21, it was reported in the Detroit News that Dan Heyns, director of Michigan's Department of Corrections wanted to work with sheriffs, prosecutors and local officials to ensure that fewer people living with mental illnesses come to prison.

"I've got institutions that are just packed with people who are very, very seriously mentally ill", Heyns said. "These aren't stress cases. I can't exactly provide a therapeutic environment."

Jails and prisons are the worst possible environments for people struggling with the symptoms of severe mental illnesses. Prisons are ill-equipped to provide effective psychiatric treatment. Inmates with the most severe mental illnesses are too often isolated in administrative segregation, special housing units, super-max prisons and other forms of solitary confinement. The long term isolation of individuals experiencing delusions, hallucinations or other severe psychiatric symptoms has been characterized as being akin to torture.

Sadly, the problems highlighted by Director Heyns are not unique to Michigan. A recent study revealed that about 17.1 of male inmates and 34.3 percent of female inmates in local jails throughout the country live with a serious mental illness such as schizophrenia, bipolar disorder or PTSD. When compared to figures for the general population this is roughly a 470 percent increase in prevalence for both men and women.

So what can be done to achieve Director Heyns vision that fewer individuals living with mental illnesses come to prison to begin with?

Some would respond that we need to take a close look at our nation's treatment laws. Until the 1960s, people living with serious mental illnesses were virtually devoid of civil rights protections and were frequently institutionalized for long periods of time with no due process or right to appeal. Fortunately, these egregious civil rights abuses are a thing of the past.

There are many who believe that the laws have gone too far in the other direction, asserting that requiring proof of immediate or imminent danger to self or others means that certain people will not get help when they need it the most. Not everyone agrees. Many argue equally strenuously that the laws should remain as they are, citing continuing abuses and civil rights violations in hospitals, adult care homes, and other settings as evidence that we need to maintain strict, narrow civil commitment standards.

Irrespective of how you feel about these complex issues, the overall lack of mental health services and supports across the country is beyond dispute. Even during the best of economic times, the availability of good mental health services has been limited in the US, particularly for those who rely on the public mental health system for their care. In 2006 and 2009, before the full impact of the economic crisis, NAMI gave the nation's mental health system a grade of "D" in its Grading the States 2006 and 2009 reports.

Unfortunately, the economic recession has only made these problems worse. In March, 2011, NAMI released a report entitled State Mental Health Cuts: A National Crisis. This report revealed cuts to non-Medicaid state mental health spending of nearly $1.6 billion dollars between 2009 and 2011, with even deeper cuts projected for 2012. These cuts have led to the erosion of vital inpatient and community services for tens of thousands of youth and adults living with the most serious mental illnesses. Hospital beds have been eliminated and in many parts of the country, there are virtually no community services available either.
Not surprisingly, these cuts have added to already considerable burdens faced by law enforcement and correction centers. In Nevada, Judge Jackie Glass, who runs the Clark County (Las Vegas) Mental Health Court implored legislators not to impose further cuts on mental health services. She testified that "you will see … people [who lose mental health services] ending up in prisons, jails, emergency rooms, homeless…"
In Sacramento County, California, U.S. District Court Judge John A. Mendez went further, blocking the county from cutting mental health services as a way to balance the budget. He stated that the county's budget cutting plan would cause "catastrophic harm" and violate the Americans with Disabilities Act (ADA).
The U.S. is clearly at a pivotal moment in its history. Solutions to the budget crisis are not easy. However, one thing is clear: Indiscriminate cuts to mental health budgets will not save money, but cost more in the long run. Cuts of the magnitude that have occurred will continue to perpetuate the national disgrace of incarcerating people for the "crime" of having a serious mental illness. We should pay heed to Director Heyns, Judge Glass, Judge Mendez and others on the front lines responding to people in crisis. A civilized, advanced nation must do better for its most vulnerable citizens.

Suicide more likely after brushes with the law

By Frederik Joelving

NEW YORK | Tue Feb 8, 2011 5:19pm EST

NEW YORK (Reuters Health) - People who come into contact with the criminal justice system are at increased risk of suicide, a Danish study shows, even if they're found not guilty.

The findings expand on US research showing that in the 1980s, jail inmates were nine times as likely to kill themselves as the general population.

In 2007, the US suicide rate was about 11 deaths per 100,000 people, according to the National Institute of Mental Health. That rate is only slightly higher than the rate in Denmark.
"This study is a new contribution in that it puts the criminal justice system on the agenda in terms of suicide risk factors," said Roger Webb, who studies suicide prevention at the University of Manchester in the UK and worked on the new results.

"What we have shown is a high risk of suicide across the spectrum of people who have been in contact with the criminal justice system," he told Reuters Health. "This includes people who have never been held in custody, and even people who were never found guilty."

Other risk factors include physical or sexual abuse as well as depression and other mental illnesses.

The new findings are based on data on more than 27,000 Danish men and women who committed suicide between 1981 and 2006. For comparison, the research team also studied more than half a million people of the same age and gender who were still alive.

About a third of the men who'd killed themselves had been charged with a criminal offense of some sort -- from speeding to homicide. In the comparison group, only a quarter had ever been charged.

For women, nearly one of every eight who committed suicide had been in contact with the criminal justice system, compared to one in 20 of the women who were still alive.

Of course, Webb said, people who brush up against the law tend to have a troubled history.
"It's a group of people who have quite complex needs, people who come from deprived communities or dysfunctional families, which puts them at higher risk of suicide to begin with," he said.

But even taking into account any admission to a psychiatric hospital, and factors such as poverty and education, the suicide risk was increased by more than half for men and nearly doubled among women with criminal charges.

That doesn't necessarily mean the encounter with the law caused any suicides. But Webb, whose results appear in the Archives of General Psychiatry, said the experience might in principle have pushed some people over the edge.

"You've got people who are already quite vulnerable -- they have alcohol problems or mental illness that might never have been properly treated," he said. "And then on top of this there is the stress and uncertainty of passing through the criminal justice system."

He said the authorities should be aware of the increased suicide risk, which peaks just after people land in prison and immediately after their release, according to earlier research.
However, before changing policies, more research is needed, Webb added.

SOURCE: bit.ly/e5bqSD Archives of General Psychiatry, online February 7, 2011.