Californians voted to legalize recreational pot in 2016. Three years later, emergency room visits for cannabis-induced psychosis went up 54% across the state, from 682 to 1,053, according to state hospital data. For people who already have a psychotic disorder, cannabis makes things worse — leading to more ER visits, more hospitalizations, and more legal troubles, said Dr. Deepak Cyril D’Souza, a psychiatry professor at Yale University School of Medicine who also serves on the physicians’ advisory board for Connecticut’s medical marijuana program.
“I took the medication only as prescribed,” Bobbi said. After her benzodiazepine was stopped abruptly, she suffered multiple disabling neurological symptoms, including seizures, cognitive and visual impairment, difficulty walking, and hand contractures, leaving her unable to work. Bobbi is one of many patients my advocacy organization helped report their harm to the FDA. Our goal was to raise awareness of the adverse effects of benzodiazepines and advocate for stronger warning labels.
Thus, I was pleasantly surprised last September to see the FDA’s drug safety communication announcing an update to the boxed warning for benzodiazepines “to address the serious risks of abuse, addiction, physical dependence, and withdrawal reactions.” Curious, I filed a FOIA request for the FDA’s 175-page report on benzodiazepines. Many of the document’s conclusions raise the same concerns benzodiazepine safety advocates have had for decades.
Subsequent research discovered that this age-related U-shape in job satisfaction is part of a much broader phenomenon. A similar midlife nadir is detectable in measures of people’s overall life satisfaction and has been found in more than 50 countries. On average, life satisfaction is high when people are young, then starts to decline in the early 30s, bottoming out between the mid-40s and mid-50s before increasing again to levels as high as during young adulthood. And this U-curve occurs across the entire socio-economic spectrum, hitting senior-level executives as well as blue-collar workers and stay-at-home parents. It affects childless couples as well as single people or parents of four. In short, a mid-career crisis does not discriminate.
The pandemic and the parallel economic crisis have fueled new concern about access to mental health care. An estimated 40% of American adults are have a condition involving mental illness or substance abuse. In June, federal health officials reported nearly 11% percent of adults surveyed seriously considered suicide during the past 30 days.
The current investigators analyzed national healthcare claims from the US Medicaid program from 2001 to 2010 for 39,582 Medicaid beneficiaries (mean age, 44.5 years; 78.5% women) diagnosed with depression. Patients with alternative indications for anti-psychotic therapy, such as schizophrenia, psychotic depression or bipolar disorder, were excluded.
After a period of at least 3 months of treatment with a single antidepressant, more than half of the patients (56.6%) augmented their treatment with one of these atypical anti-psychotics: quetiapine, risperidone, aripiprazole or olanzapine. The remaining patients (43.4%) added a second antidepressant. The average chlorpromazine-equivalent starting dose for all atypical anti-psychotics was 68 mg/day, which increased to 100 mg/day during follow-up.
A total of 153 patients died during 13,328 person-years of follow-up, including 105 who augmented with an atypical anti-psychotic and 48 who augmented with a second antidepressant.
Compared with those who added a second antidepressant, those who added an anti-psychotic had a 45% increased risk of dying during follow up (adjusted hazard ratio,1.45; 95% CI, 1.02 – 2.06).
I have been struggling with diabulimia on and off since my diagnosis of type 1 diabetes in 2011, at age 30. I had just started a PhD and spent the first semester walking around campus with all the classic symptoms of type 1 diabetes: famished, dehydrated, constantly needing to urinate, and experiencing rapid weight loss. After my diabetes diagnosis, when I started injecting insulin, I gained the weight back—and then some. It didn’t take long to figure out that omitting insulin was not only an effective weight loss tool, compared with vomiting, it was a much less violent way to purge. Having a history of bulimia nervosa, I thought I had found the holy grail. I could eat what I wanted, not use insulin, and not gain weight.
Nutritional deficiencies, especially deficiencies in folate and vitamin D, are associated with first-episode psychosis (FEP), new research suggests.
Australian researchers found significantly lower levels of folate and vitamin D in patients with FEP, compared to healthy control persons. Limited evidence also suggested that serum levels of vitamin C were reduced in people with FEP.
“In this study of children ages 8 to 13, epilepsy was a risk factor for developing psychiatric symptoms and was a much stronger risk factor in girls than in boys. A number of other independent risk factors were also identified.”