Wednesday, May 24, 2006

ADHD Drugs and ER visits

Study: ADHD Drugs Send Thousands to ERs
By LINDA A. JOHNSON, Associated Press Writer


Accidental overdoses and side effects from attention deficit drugs likely send thousands of children and adults to emergency rooms, according to the first national estimates of the problem.
Scientists at the U.S. Centers for Disease Control and Prevention estimated problems with the stimulant drugs drive nearly 3,100 people to ERs each year. Nearly two-thirds _ overdoses and accidental use _ could be prevented by parents locking the pills away, the researchers say.
Other patients had side effects, including potential cardiac problems such as chest pain, stroke, high blood pressure and fast heart rate.
Concerns over those effects have led some doctors to urge the Food and Drug Administration to require a "black box," its most serious warning, on package inserts for drugs such as Ritalin, Concerta and Adderall. Yet even doctors advising the FDA don't agree on whether that's warranted.
The issue was discussed in a series of letters in Thursday's New England Journal of Medicine, including some from doctors worried about the dangers of not treating attention deficit hyperactivity disorder.
"The numbers (of side effects) are puny compared to the numbers of stimulant prescriptions per year," said Dr. Tolga Taneli, a child and adolescent psychiatrist at University of Medicine and Dentistry of New Jersey in Newark. "I'm not alarmed."
An estimated 3.3 million Americans who are 19 or younger and nearly 1.5 million ages 20 and older are taking ADHD medicines. Ritalin is made by Novartis Pharmaceuticals Corp. of East Hanover, N.J.; Concerta by Johnson & Johnson of New Brunswick, N.J., and Adderall by Shire US Inc. of Newport, Ky.
Twenty-five deaths linked to ADHD drugs, 19 involving children, were reported to FDA from 1999 through 2003. Fifty-four other cases of serious heart problems, including heart attacks and strokes, were also reported. Some of the patients had prior heart problems.
Still, there hasn't been a clear estimate of the scope of side effects. The CDC report, while not a rigorous scientific study, attempts to provide that by using a new hospital surveillance network.
From August 2003 through December 2005, the researchers counted 188 ER visits for problems with the drugs at the 64 hospitals in the network, a representative sample of ERs monitored to spot drug side effects.
Doctors linked use of stimulant ADHD drugs to 73 patients with side effects or allergic reactions. Another 115 accidentally swallowed ADHD pills, including a month-old baby, or took too much.
"These are cases where a young child took someone else's medication or they took too much of their own," CDC epidemiologist Dr. Adam Cohen said of the second group.
Nearly 1 in 5 patients was admitted to the hospital, 1 in 5 needed stomach pumping or treatment with medicines, and 1 in 7 had cardiac symptoms. Sixteen percent of the side effects involved interaction with another drug.
Besides cardiac problems, common symptoms included abdominal pain, rashes and spasms, pain or weakness in muscles, according to Cohen. No patients died.
Extrapolating to all U.S. hospitals, the researchers estimated 3,075 ER visits occur each year.
In another letter in the journal, the heads of the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry wrote they are concerned a black box warning would discourage use of ADHD drugs, raising patients' risks of academic failure, substance abuse and other problems.
This past February, an FDA drug safety advisory panel voted 8-7 for a black box warning. The next month, another FDA panel instead recommended data on cardiac and other risks go in a new "highlights" section the agency plans to add to the top of drug inserts.
Dr. Marsha Rappley, pediatrics professor at Michigan State University, and two other doctors on the advisory panels believe the vote for a black box was premature.
She said studies show the drugs raise blood pressure and pulse rates a bit, but it's unknown whether that would harm children taking them for years, and that cardiac risks may be higher for adults.
Dr. Steven Nissen, cardiology chief at the Cleveland Clinic, who had pressed for a black box warning at the FDA panel meeting, said ADHD drugs are powerful stimulants and inherently risky. Nissen and other doctors say the drugs are being prescribed to some who don't need them.
This week, the FDA said it is "working diligently" on "labeling changes that we feel accurately reflect the available data and the advice of the committees." The agency declined interview requests.
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Tuesday, May 23, 2006

Kentucky passes Historic Acupuncture Law

Kentucky Passes Historic Acupuncture Law

On April 24, 2006, after unanimous passage by the Kentucky Senate and House of Representatives, Gov. Ernie Fletcher affixed his signature to House Bill 17, one of the first pieces of legislation voted on in the 2006 session. In so doing, Gov. Fletcher has made Kentucky the 43rd state in the U.S., and the second state in three months, to enact a law allowing for the practice of acupuncture by nonphysician acupuncturists.
"I've known people who have been helped tremendously with acupuncture," said state Rep. Denver Butler, chair of the House Licensing and Occupations Committee, who introduced the bill and was instrumental in its passage. "Acupuncture has been around for more than 4,000 years in China. The medical doctor may not be able to explain why, but it does help, and I felt that people deserved that opportunity to try it and be helped."


for more of the article and info go to www.acupuncturetoday.com

Friday, May 05, 2006

Folic Acid



Folic acid (or folate) is one of the few nutrients known to prevent neural tube birth defects such as spina bifida, which affects about one in 1,000 pregnancies each year in the United States. The Centers for Disease Control report that women who take the recommended daily dose of folic acid starting one month before they conceive and throughout the first trimester reduce their baby's risk of birth defects such as spina bifida by up to 70 percent.It doesn’t end at spina bifida, some studies have shown that women who don't get enough folic acid may increase their risk of miscarriage, as well as cleft lip and palate, limb defects, and certain types of heart defects in their babiesRemember that folic acid is needed for the production, repair, and functioning of DNA, our genetic map and a basic building block of cells, so getting enough is particularly important for the rapid cell growth that occurs during pregnancy. Folate is also required for a complex metabolic process that involves the conversion of the amino acid (homocysteine) into another amino acid (methionine). If you don't get enough folate, you can end up with too much homocysteine in the blood, which is thought to contribute to some birth defects. Elevated levels of homocysteine in pregnancy also have been linked to blood clots, placental abruption, recurrent miscarriages, and stillbirth. Researchers are trying to find out whether taking folic acid throughout pregnancy decreases your risk for these problems. Finally, folate helps make normal red blood cells, prevent anemia, and produce the nervous system chemicals norepinephrine and serotonin.

-dfh